Benzodiazepines: Miracle Drugs?

Philip Hickey, PhD
91
252

The first benzodiazepine – chlordiazepoxide – became available, from Hoffman-La Roche, in 1960, under the brand name Librium.  It was soon followed by:

  • diazepam (Valium) 1963;
  • nitrazepam (Mogadon) and oxazepam (Serax) in 1965;
  • temazepam (Restoril) 1969;
  • clorazepate (Tranxene) 1972;
  • flurazepam (Dalmane) 1973;
  • clonazepam (Klonopin) 1975;
  • lorazepam (Ativan) in 1977; and
  • alprazolam (Xanax) in 1981;
  • etc.

Benzodiazepines are categorized as sedative/hypnotics, which means that they have a relaxing, generally pleasant, sleep-inducing effect, and were embraced promptly by psychiatry for the “treatment” of anxiety, tension, worry, sleeplessness, etc.

In this respect, the benzodiazepines largely replaced the earlier barbiturates, which had received a great deal of negative publicity because of their much-publicized role in lethal overdoses, both accidental and intentional.

. . .

Initially, there was a good measure of skepticism among the general public with regards to benzos, and indeed, with regards to psychotropic drugs generally.  The dominant philosophy in those days was that transient, drug-induced states of consciousness were not only ineffective in addressing human problems, but were also dangerous. There were still lingering traces in the collective memory of the laudanum travesty, and, of course, there were daily reminders of the dangers of “drowning one’s sorrows” in alcohol.

But pharma-psychiatry systematically, deliberately, and self-servingly undermined this skepticism.  Pharma’s motivation in this regard is clear:  to make money.  Psychiatry’s motivation is more difficult to understand because the history, as is often the case, is largely forgotten.  At present, psychiatrists have come to be accepted as “real doctors” by the medical profession generally, and by the general public.  But in 1960, it would not be an exaggeration to say that they were considered something of a laughing stock among medical practitioners, and were regarded with bemused tolerance by the general public.

For these reasons, psychiatrists were highly motivated to accept something that would enhance their status, and create an appearance of medical authenticity.

Meanwhile, pharma was looking for ways to market their products.  It was a match – to mangle the usual phrase – made in Hell.  Psychiatrists – desperate for status and assurance, and smarting under the negative publicity of the barbiturate debacle – succumbed readily to pharma’s unctuous flattery and cajolery, and linked themselves whole-heartedly to the industry’s efforts to undermine the healthy skepticism of the general public, and incidentally, of a great many real doctors.

And the package sold like hot cakes.

By 1977, according to Wikipedia, “…benzodiazepines were globally the most prescribed medications.”  Sales dipped briefly in the late 70’s after their classification in the US as a Schedule IV drug, but benzos remained generally popular, and today, the drugs continue to grow in popularity.  According to IMS Health, a total of 76.7 million prescriptions for benzodiazepines were written in the US in 2005.  By 2009, that figure had risen to 87.9 million – an increase of 14.6%.  During the same period, the US population had gone from 295.52 million to 306.77 million, an increase of only 3.8%.

. . . . . 

So what we have here is a success story.  Pharma sells billions of dollars worth of drugs, psychiatry takes its “rightful” place in the ranks of bona fide medical specialties, and vast numbers of people receive safe and effective “treatment” for “real” illnesses such as generalized anxiety disorder, social anxiety disorder, agoraphobia, etc…

So what’s the problem?  Well, there are lots of problems.

Firstly, the products, despite the long-insisted pharma-psychiatry hype, are addictive – a fact which is now well-known and need not be labored here.  Check the website Beyond Meds, or search Google for benzodiazepine addiction/dependence.

Secondly, it began to be clear early on, that the drugs did indeed have some serious adverse effects.  These included:  drowsiness and falls; skill impairment/traffic accidents; disinhibition/aggression; memory problems; etc.

Thirdly, more evidence of adverse effects emerges almost every year.  Most recently, it has been reported that benzodiazepine use is associated with an increased incidence of homicide and dementia.

Homicide

In June 2015, Tiihonen et al published a study from Finland on the link between homicide and various drugs.  They found that the risk ratio for current use of benzodiazepines was 1.45, with a 95% confidence interval of 1.17-1.81.  In other words, current benzo users were about 45% more likely to commit a homicide than comparable non-users.

“Benzodiazepine…use was linked with a higher risk of homicidal offending, and the findings remained highly significant even after correction for multiple comparisons.”

Dementia

In May 2015, Zhon et al published a meta-analysis from China which explored the association between long-term benzodiazepine use and the risk of developing dementia.  A meta-analysis is a study which combines the results of previous studies on the same topic.  Zhon et al combined the findings from six studies, involving a total of 45,391 participants, including 11,891 individuals with dementia, and found:

“Compared with never users, pooled adjusted risk ratios (RRs) for dementia were 1.49 (95% confidence interval (CI) 1.30–1.72) for ever users, 1.55 (95% CI 1.31–1.83) for recent users, and 1.55 (95% CI 1.17–2.03) for past users. The risk of dementia increased by 22% for every additional 20 defined daily dose per year (RR, 1.22, 95%CI 1.18–1.25). When we restricted our meta-analyses to unadjusted RRs, all initial significant associations persisted.”

And concluded:

“On the basis of either unadjusted or adjusted risk estimates, our study consistently indicates that long-term benzodiazepine use is associated with an increased risk of dementia.”

The authors point out that associations of this sort do not necessarily prove causality.  However, given the known neurotoxic effects of these products, a causative link seems likely.

Zhon et al conducted three separate investigations:  ever use vs. never use; recent use vs. never use; and past use vs. never use.  In all three cases, the association between benzo use and dementia was clear and substantial, which prompted the authors to write:

“…our findings regarding recent and past use of benzodiazepines may provide an important implication that stopping use of benzodiazepines cannot significantly reduce the risk of developing dementia.”

In other words, the damage is already done.  People who have used benzos in the past are at increased risk of developing dementia even if they haven’t used the drugs recently.

Discussion

So there it is.  Pharma invents a dangerous drug, and with the enthusiastic help of psychiatry, markets it as “safe and effective” in the “treatment” of anxiety, which psychiatry has obligingly, conveniently, (and incidentally, fraudulently) transformed into an illness.

The reality is that anxiety is not an illness, but is, rather, the normal human response to anxiety-provoking situations.  And in our brave modern world, there is no end of anxiety-provoking situations.

Personally, I have not experienced a great deal of anxiety in my life, but I will readily acknowledge that in recent years, I have experienced a fair measure of anxiety while driving or riding in fast-moving, congested traffic.  My concerns in this regard are exacerbated when I notice the very large number of other drivers who are speaking on their cell phones (and even texting!) as they careen blithely through the narrow lanes of potential carnage.

I have resolved this problem by the simple expedient – and this is not Einsteinian stuff – of avoiding fast-moving, congested traffic!  The notion that a person could or should dissipate anxiety of this sort (or any sort) by ingesting a downer drug is a special kind of inanity found only in psychiatry.

And fast-moving, congested traffic is only one of the many anxiety-provoking situations in modern life.  Here are a few others:

  • Persistent inability to make financial ends meet
  • Not having medical insurance
  • Being concerned about losing one’s job
  • Driving an unreliable car
  • Living in tornado/hurricane areas
  • Being troubled by painful/distressing memories
  • Getting into the “right” school
  • Getting one’s children into the right school
  • Competing for college placement
  • Involvement in competitive sports
  • Living in big cities
  • Choosing the “right” food
  • Socializing with members of the opposite sex
  • Decision-making generally in everyday life
  • Concern about child-rearing
  • Worry about exposure to everyday toxins
  • Dealing with new job/city/people
  • Poor health
  • Feeling overwhelmed by the demands of one’s job
  • Having a chronically sick child
  • Caring for an aging parent
  • Involvement in a stressful relationship
  • Caring for an ailing partner
  • Tension surrounding the sale/purchase of a home
  • Fluctuations in the stock market
  • Forest fires
  • Noisy neighbors
  • Street violence
  • Floods
  • Drought
  • Blocked septic systems
  • Earthquakes
  • Failure to conceive
  • Unplanned pregnancy
  • Threat of domestic violence
  • Having little or no social/family support
  • Being alienated from one’s family
  • Etc., etc., etc…

I recognize, of course, that avoiding fast-moving, congested traffic is a great deal easier than dealing with most of the anxiety-provoking situations in the above list. But the general principles are the same.

Anxieties are normal.  In fact, they are adaptive.  They encourage us to be alert and ready for action, and also to take corrective actions with regards to the anxiety-provoking situations.  Extreme anxiety is the normal and adaptive response to extreme situations.

During my career as a psychologist, every client who came to me in extreme distress or anxiety was living in circumstances that were extremely distressful or anxiety-provoking.  Helping the individual ameliorate the distressing circumstances invariably ameliorated the feelings of distress.

Psychiatrists don’t see this obvious fact, or if they do, they ignore it, because they are conditioned by their training and by the exigencies of reimbursement, to pretend that the problem is – to quote the DSM phrase – “in the individual”.  The problem is fraudulently presented as an illness, because psychiatrists need illnesses to legitimize their drug-pushing, and for their continued survival as a profession.

Benzos “work” on these anxieties essentially by switching off neuronal activity.  Benzo users don’t feel anxiety, because the pills have impaired their ability to feel anxious.  To put it plainly, people who use benzos on a regular basis to dissipate anxiety are chronically intoxicated to the point of blissful apathy, all the while incurring an array of risks which often are far more serious than the initial problem.  (Some people, of course, use benzos to avoid withdrawals, but that’s a whole other issue.)

And psychiatrists actually have promoted, and continue to promote, the notion that this constitutes treating an illness!  It is noteworthy that at a time when real doctors are developing an increased recognition and respect for the body’s natural resources, warning systems, and defense mechanisms, psychiatry is going in the opposite direction.  All psychiatric drugs – including benzos – operate, not by correcting an abnormal state, but rather by suppressing/distorting normal function and creating a pathological state.  Chronic benzo intoxication is a pathological state.

Modern life offers unprecedented comforts and conveniences, but, in exchange, exacts a huge toll in terms of tension and anxiety.  The notion of dissipating these anxieties with neurotoxic, addictive drugs isn’t just ill-conceived, dangerous, and disempowering; it’s a dehumanizing obscenity.

Support MIA

Enjoyed what you just read? Consider a donation to help us continue to produce content, provide up-to-date research news, offer continuing education courses, and continue building a community for exploring alternatives to the current paradigm of mental health. All donations are tax deductible.

$
Select Payment Method
Loading...
Personal Info

Credit Card Info
This is a secure SSL encrypted payment.

Donation Total: $20.00

91 COMMENTS

  1. “Blissful apathy” isn’t the first choice of words I would use to describe my use (as prescribed and directed by my psychiatrist) of benzodiazepines. Apathy, yes, to the point I no longer wanted to live at times. Blissful…never.

    Tolerance withdrawal which developed quickly led to a multitude of symptoms and suffering which was anything but “blissful”. I was incredibly ill, developed multiple health problems for which I saw multiple specialists- none of them identified the benzos/tolerance as the cause. My life fell apart, I became depressed and suicidal, lost my job and became so agoraphobic I could no longer function, so cognitively impaired I could no longer read and so anxious I could barely stand to exist.

    I’d also like to point out that a substance being “addictive” (having the potential for abuse- which is a behavior) and a substance carrying a risk of dependence are not the same thing. Many people become iatrogenically dependent (which is a physiological process in the body that occurs when exposed chronically to a substance) on benzodiazepines simply by taking them as directed by their doctor for any period longer than the recommended short-term use of 2-4 weeks. Most people who become iatrogenically dependent do so because they were not given informed consent by the prescribing practitioner.

    The withdrawal syndrome they can produce is unspeakable horror that can persist for months and years.

  2. More good news; after 19+ months of PAWS thanks to the prescribed Klonopin (and the other psych drugs I discontinued with varying degrees of difficulty) I still am prone to dementia…I don’t even have my cognition back and now learn that perhaps, it never will return…

    And yes, I think it’s important to differentiate between iatrogenic damage/dependence and ‘addiction’…thanks for that.

  3. Photo-sensitivity can’t leave the house during daylight hours. Teeth clenching from interdose withdrawals and gum recession from interdose withdrawals- causing dislocated jaw and lose of bite and fracutured teeth.Weight loss of 20kg in 6 months.
    Agoraphobia, terror and fear of everything, suicidal ideation’s and feelings, looping intrusive thoughts. OCD totally out of control over everything. The most brutal insidious depression. Depersonalisation and cortisol/adrenaline surges all day.
    This all started a month of taking ativan for anxiety last year 2mgs…which i am still on split in 4 doses . Was i told how it should be taken no, was i told what might happen no. Have i been given any help from any doctor to get off it safely even though i have spent all my money to try and find a doctor who will acknowledge what is going on and someone with integrity who will prescribe the liquid and listen and work with me to get off it.
    I was never depressed 20 years ago until i started to be polydrugged, often an all to familiar story for many of us. One drug too many my nervous system is now shot god knows how i am still here and i am a shell of person just existing.

    • And then they blame you for getting worse, don’t they? I am so sorry you have had to go through this awful experience! I’m glad you’ve at least identified the culprits, however. Thanks for sharing your testimony as to the incredible lack of integrity and dishonesty the so-called “mentally ill” are exposed to! Hope things get better for you over time.

      —- Steve

      • Millions of course suffer from the commonplace anxieties such as heavy traffic and money woes. But you don’t acknowledge that there are many of us with anxiety attacks that are totally debilitating, that come in the night causing sweating, pounding heart, horrible sickness and the absolute conviction that one is dying. I am one of those. Yes, I know the cause and am addressing it but don’t wish to discuss it here.

        My primary care physician prescribed Ativan, dosage of 1/2 milligram but no more than 2 doses per day. It stops that terrible anxiety. I have been using this wonder drug for 10 years with no side effects, and I mean no side effects, no dementia, no nightmares, dizziness, no adverse effects on my otherwise normal life. NO side effects. I deal successfully with life’s normal problems. No amount of preaching to me will convince me that stopping is a good idea in my case Thanks for listening.

    • Almost complete anterograde amnesia, feeling “high” followed by tolerance after 1 dose leading to aggression. Happily I have never taken that for longer than a few days at the torture chamber, oh, sorry “hospital”.

      Btw, the good professionals managed to miss the fact that the person in their “care” has no functioning long-term memory. Pretty damn impressive for people who claim they are specialists in how brain works.

    • I was taking 80 milligrams of valium for over 2 years. I tried to stop to see if i was addicted and after 2 days felt fine, I didnt realize that sometimes it take 3 days for withdrawals to start. When i stopped I went through 3 months of living hell with muscle and stomach cramps , terrible anxiety, couldn’t sleep, couldn’t think, everything seemed like an unending nightmare. Finally I couldnt take it so i signed myself into a recovery center. I lost a lot of weight and had no appetite. The good news is that it gets better, I finally got free and have over 20 years sobriety. For most of those years I went to AA and NA meetings at least once a week.

  4. I appreciate what you say about anxiety being a normal response to anxiety-provoking situations. In addition, each of us has our own unique sense of what causes us anxiety. When we are tapped into our own inner wisdom around this, then we can make informed choices for ourselves, thus reducing our propensity for anxiety.

    But I also notice that a lot of people are simply in the habit of thinking and beliefs that are anxiety-inducing–for example, that the world is doomed. Fear-mongering is a way of creating anxiety out of nothing, pure illusory thoughts. Perhaps if we were to focus on perspectives that instill hope and clarity rather than fear and confusion, then anxiety would be reduced collectively, and we, humans, could actually evolve as a species into a higher, self-healing consciousness.

      • Sadly (and frustratingly), yes, this has been my experience and conclusion, as well. If there is one thing that is in our control, it is the quality, clarity, and integrity of our interactions. Not sure we’re doing such a great job, here, as collective, but I guess we’re all learning as we go. When we own our anxiety, we can transform it and not pass it on to others. That’s takes focus, practice, and commitment, however.

    • “a lot of people are simply in the habit of thinking and beliefs that are anxiety-inducing–for example, that the world is doomed”
      Well, it is, kind of. At least when you think about the future of our species it does not looks rosy at all. So nothing illusory about that. In my mind the only thing that can save one from anxiety is activism. Even if it feels close to meaningless against the powers that run this place, it is better than doing nothing.

      • I would agree that there is an element of ‘doom’ in the air now, thanks to all the corrupt politics, chronic violence, and the lack of global cooperation, and that would create anxiety in anyone.

        However, my feeling is that what is ‘doomed’ is more a way of life than the actual world, itself, which creates the opportunity for new ways of living to come about, that would feel just, safe, and creatively rich. Being aware of how energy can shift and realities transform not only reduces anxiety around what is happening in the world, but it also adds an element of hope and even excitement at the prospect of this opportunity to bring significant change to the planet. After all, core healing is all about transformation, whether for an individual, society, or the world at large.

        And I also agree that activism is key, here. Without activism, nothing would change. Activism keeps the opportunities for change alive. There are a lot of effective ways to be an activist. How we each do this, individually, creates an activist collective. If in synch, aligned, and cooperative, that would be a powerful community of change. If disjointed and in perpetual conflict, then there is no power there. Cohesion would be a good focus, if activism is to be productive rather than self-destructive.

  5. Um, even back in the days these medications first hit the market, PCPs and other non psychiatrists wrote more than 50% of them, so, to focus your ire on psychiatry is a bit disingenuous at best. I would bet good money today that over 70% of non psychiatrists write for benzos in general as a class, and over 85% write for Xanax/alprazolam. Oh, and patients demand, not ask for them until proven otherwise.

    So, who is at fault for this misuse, providers alone? I await your column slamming the pervasive use of opiates, maybe start with the recent Time magazine article for some direction?

    Joel Hassman, MD

    • “So, who is at fault for this misuse, providers alone?”
      Yes. Providers are the ones with the prescription pad and they are the ones who are supposed to take the decision and who are (unfortunately only in theory) legally responsible.

      • Informed consent, Joel Hassman, MD. I had no idea and foolishly trusted my ‘doc’ both the shrink AND the subsequent MDs…

        If it’s so easy for patients to get the drug they *ask* for, why not pheonbarb? Why not cocaine? Why not heroin?

        I expect ‘health care providers’ to KNOW the ins and outs of the deadly medicines they prescribe.

    • Joel, it is definitely true that people come to the doctors demanding benzos and other drugs, and certainly the pharmaceutical industry has much responsibility to bear for this state of affairs, as well as our government for being foolish enough to allow DTC advertising, which most enlightened Western democracies are smart enough not to allow. And you’re also correct that non-psychiatrists write the lion’s share of scripts for benzos, stimulants, and SSRIs. Where I find psychiatry as an institution to be grossly at fault is for providing a socially accepted pretext for this kind of prescribing behavior. When there are “diagnoses” available that are so speculative and subjective as “anxiety disorder,” and when the pharma companies have free rein to “educate” both doctors and the general public about these vague “disorders” (and in the meanwhile gradually distort the diagnostic boundaries so that more and more people appear to “fit” the criteria), the current scenario is an almost inevitable result, human nature being what it is.

      This advertising and distortion could not occur without sanction of the APA’s DSM diagnostic criteria, and patients could not demand medication for an “anxiety disorder” if there were no such disorder to provide cover for their demand. Of course, it is 100% the doctor’s responsibility NOT to prescribe based on patient demand, but again, human nature says that the pressure to do so will mean more docs will give in and more patients will be prescribed drugs that are not needed or helpful.

      I believe psychiatry’s institutional responsibility is to speak out loudly and firmly against this practice. Every benzo, as you well know, has written on the product information that it is not to be prescribed for longer than a several week period of time due to its addictive nature. Yet doctors all over the country are prescribing these for regular use over many years. I think it is incumbent on psychiatrists, who define these disorders and their treatments, to demand that this behavior stop, both within their ranks (which you yourself amount to 30% of the prescriptions or more) and within general medicine. I’d also expect a fully ethical psychiatric profession to speak out against DTC advertising, as it is obvious the impact this is having on patients and their increasing self-diagnosis and increasing demands on doctors for prescriptions, compounding this problem.

      I see none of this. I see psychiatry as a profession sitting on its hands and blaming drug companies and family docs and even patients for the situation and taking no action whatsoever to remedy it. I don’t blame psychiatry for the entire problem, because psychiatry does not control the actions of patients or non-psychiatric docs or pharmaceutical companies.

      But I do blame psychiatry for failing to take the responsibility to correct the massive amount of misinformation and mythology out there about benzos and psychiatric drugs in general. There is in my view a significant degree to which psychiatry promotes these very practices, but at the least, I’ve heard little to nothing from key opinion leaders concretely working to correct misimpressions about “chemical imbalances” and deteriorating long-term outcomes and the inappropriateness of long-term prescriptions of highly addictive drugs based on very soft and subjective criteria that almost any patient would be smart enough to fake. Silence in this case is appropriately interpreted as acquiescence to the status quo.

      Similar arguments could be made about the use of opiates, but of course, the blame in this case would not be on psychiatrists, but on the pain management specialists for not making it clear to doctors and patients around the world that the long-term use of opiates for pain management is dangerous and generally counterproductive, and other more effective and/or less addictive options exist.

      Psychiatrists are supposed to be the leaders in the field of medical treatment of mental health issues. When will the profession speak out against pharma manipulation and against the inappropriate long-term use of benzodiazepines?

      —- Steve

      • Um, there are writers in the Psychiatric literature of late noting the inappropriateness of the pervasive use of benzos, yet, people here must be a bit clueless or delusional to think that a profession controls 90% of its specialist providers. Is there a column here about outrage regarding that oncologist who abused people with chemotherapy agents for years simply for a buck, now at least going to spend the rest of his life in prison? I guess I missed it.

        Besides, I think a lot of readers gloss over the fact that over 70% of many psychotropics are written by non psychiatrists, and I think simply because it does not fit the narrative of this blog. Sooo, you want me to pound away at all the providers who write inapproriately? Sorry, not taking on that responsibility, I can only control myself, and I think if anyone here actually knew me by interacting with me in an office I have or am currently working at, you would know I am a responsible and wary providers, especially with controlled substances.

        Oh, and yeah, part of the drive for benzos these past 7 or more years is being created by the onslaught of opiate scripts, either to minimize the withdrawal symptoms a lot of patients are experiencing with reckless misuse of their Rx opiates, or, poor support with dealing with chronic pain and thus dealing with the endless “what if’s” that chronic pain creates in patients’ minds. But again, is that being prescribed by psychiatrists more often than not? NO.

        I get it having read here in the past, the APA and KOLs in psychiatry are losers, but this site extrapolates that to anyone with the title MD and psychiatrist after one’s name is guilty. Your (as in the MIA readership as a whole) points of true validity get lost with the overgeneralizations and demand for abolishment of all providers.

        I am just curious by the way, what are the author’s credentials to write these repeated columns of such specific allegations and statements alluding to psychotropic expertise that, to my knowledge, aren’t in this author’s background of training or treatment ability? I have no problem with someone being critical, but these posts come off as peer equivalent criticism. Isn’t that a bit unprofessional at the very least, if my opinion is valid?

        Anyway, to Steve, thank you for what was a more respectful reply.

        Joel Hassman, MD

        • Hey, Joel, I sure don’t expect you to change the tune of the KOLs in the psychiatric profession, nor do I hold you personally responsible for their pronouncements! I do recognize that there are and always have been responsible psychiatrists (several of whom have blogged for MIA) and I appreciate that such people are swimming against the stream. It is definitely not acceptable (though it is in some ways understandable) to tar all psychiatrists with the same brush, based on the APA’s intransigence.

          But the buck has to stop somewhere, and I’m not OK allowing the institution of psychiatry off the hook when they really have created the circumstances under which things have come to this pass. I really do think it comes down to the DSM (which again, I understand you have practically speaking zero influence over) providing an opportunity for the pharma companies and corrupt elements at the top of the APA to create a marketing strategy that doesn’t put patient/client best interests at the top of our considerations. Does the same thing happen in oncology, pain management, and obstetrics? (Oh, God, especially obstetrics!) Yes, yes, and yes. But I think that’s a job for another blog.

          Corruption is a huge issue in medicine and in our modern society in general. It appears to me you are well aware of that, and I am guessing doing what you can in your limited circle of influence to change that. That’s all I’m trying to do here, and I think most of the posters as well. While some may express themselves more artfully than others, and some may have more direct reason for hostility toward specific psychiatrists, I think we all know this is a systems issue that starts and ends with politics. It’s an unfortunate fact that professionals don’t always make decisions based on what’s best for their clients, but instead on what benefits them personally, but again, that’s human nature. What I really think we need is a system where the incentives to medicate normal behavior and emotions are taken away, and where serious interventions are limited to acutely serious situations where they are merited. (And I could use almost exactly the same words to describe my views on childbirth and obstetrics!) I am guessing from your comments that you’d agree with me. I just wish we were in somewhat better company in forwarding that viewpoint.

          —- Steve

        • “over 70% of many psychotropics are written by non psychiatrists”
          You want to know why we beat up at the psychiatrists, primarily?
          Well, Steve has kind of answered that for me but I’ll just add: what percentage of other doctors (or “real doctors” to be more specific) prescribe benzos vs what percentage of psychiatrists? It may be a pathology in other areas of medicine but it’s not a founding block of these areas but a spillover from corrupt and broken psychiatry.

          • Psychiatrists and drug companies lead the charge. They are the ones who trumpet the “Safe and effective” meme over and over again. If not for them, perhaps other doctors might exercise more discretion when prescribing. That’s why I lay most of the blame right where it belongs- at the feet of psychiatry (and pharma).

    • Dr. Hassman:

      You raise a good point. Dr. Mark Foster after experiencing an ‘ephiphany’ after reading Anatomy of an Epidemic’ by Robert Whitaker gradually changed his prescribing practices. Eventually’ he was fired by his employer, an HMO in CO for ‘not prescribing enough medication’. I’m sure this didn’t happen overnight. The
      Process undoubtedly started with patient complaints. Patients can be adverse to lifestyle changes and are encultured to believe that there is a pill for every challenge.What to do in this environment? Considering the level of integrity left in the profession of medicine, one can hardly call it a noble profession, therefore if one generously desires to heal others, consider a lower standard of living or become a badly needed activist and usher in choice in the mental health system and change the billing practices so that every person in distress could get a free massage from an LMT, free reikki, free peer counseling; Demand that alternative serve providers who ‘first do no harm’ receive the same authority and respect as physicians in every legal and economic institution under the law. Until this happens there is no choice in mental health and people in crisis will continue to get the same sh*tty treatment for mental health unless they have privilege and are people of means.

      My brother retired after practicing medicine for twenty years. He is now a landscaper and an unpaid caregiver for our father. Is it financially difficult for him to no longer have a six figure income? Of course but I’ve never seen him happier.

      • Yeah, I would love to bolt from psychiatry if I could, but, like many people in this country, I just can’t pick up and leave my career and abandon my family who depends on my income, which I know most readers will either blatantly deny or try to falsely rationalize otherwise, is not so large for the training and experience I have logged these 20 plus years. But, that day probably will come sooner than later once certain obligations are completed.

        I have been critical of many of my fellow psychiatrists for a lot of years, but, like most of this country, money, power, and influence have more control than pride, ownership, integrity, and responsibility to Hippocratic Oath principles. People here seem to allude that psychiatrists are the primary villains to what ails the field, yet, I don’t read many columns going directly after Big Pharma, managed care, and health care administrations of hospitals and large outpatient groups.

        Is that because it is too hard to effectively go after these organizations, or, is it really a narrative about a select group easy and convenient to attack?

        I have established this site will not consistently and responsibly name the role of patients to these psychotropic problems, because, well, that would possibly alienate a needed portion of the blog audience??

        Cue Michael Jackson’s song “Man in the Mirror”…

        Sincerely,

        Joel Hassman, MD

        • Joel,

          In my view, the fundamental flaw in psychiatry is that the human problems it purports to address are not medical in nature. Individual psychiatrists obviously vary, as do the members of any other professional group. But none can escape the consequences of the spurious medicalization of non-medical problems or the drug-pushing that this entails. It’s not a personal or individual matter. It’s an enormous wrong turning in human history, with dreadful consequences.

    • I never demanded mine and did not know what they were until my psychiatrist prescribed them to go along with an SSRI. He did not tell me I could be come dependent and in fact, told me I would need them “for the rest of your life” (his words exactly). So yeah, maybe psychiatry should take a fair share of the blame. When psychiatrists hand them out like candy, why shouldn’t general practitioners, internists and gynecologists do the same, right?

      • Yup. I was told that same lie about needing benzos for life because of a “chemical imbalance.” Benzos. For. Life. And that was by not one, but several psychiatrists and countless other psychiatric lackeys. This is not a case of a few rotten apples. The barrel is rotten and needs to be thrown out.

        Thanks as always to Philip Hickey for exposing the truth. Psychiatry is an illegitimate medical specialty and should not be allowed to exist.

    • Joel,

      This is a common response from psychiatry to this issue. But it ignores the fact that psychiatry invented the “illnesses” for which these pills are prescribed. The notion that anxiety is an illness for which benzos are a treatment is a hoax; a hoax perpetrated by psychiatry, generously abetted by pharma resources.

  6. Thanks for the informative Blog, Philip.

    I don’t find it very surprising that “psychiatric illnesses” are judged longterm. Have you ever heard of anyone recovering through psychiatry?

    I always think that psychiatrists have dumbed themselves down through doling out tranquillisers and antidepressants trying to pretend they’re medicine.

  7. Psychiatrists and other physicians prescribe benzodiazepines indefinitely, as if they were dispensing cups of warm milk or camomile tea.

    Many of these “professionals” also practice polypharmacy, adding SSRIs, neuroleptics, etc., to the brew. So, in addition to not knowing what harm the benzos are really doing, they don’t know what the other psychotropics are doing, nor about the adverse synergistic effects that are also likely being produced.

  8. Thanks Phil. This is a good analysis of why most psychiatrists are still non-doctors, and how we would be better off if the vast majority of psychiatrists were fired and forced to retrain in other professions. In my opinion, a small minority of psychiatrists should be retained for zombification of people in extreme/suicidal states when necessary for safety reasons.

    Since most psychiatrists being dismissed is not likely to happen soon – not likely due to the constant deceptions which psychiatrists and Big Pharma are using to trick the American public into believing their lies about emotional distress being an illness which psychiatrists are needed to “treat” – since this is not likely, my opinion is that people are better off avoiding psychiatrists whenever possible and seeking real sources of emotional help, i.e. support groups, friends, family, therapists, and one’s own initiative and common sense.

  9. Phil, I just want to express my appreciation for the many articles like this one you have published in MIA. Once again, you make really important points, clearly and well thought out. I am going to use this article in a letter I am writing to a certain candidate to bring to his attention the dangers of psych drugs.

    Thank you again.

  10. “Extreme anxiety is the normal and adaptive response to extreme situations. (…) The notion of dissipating these anxieties with neurotoxic, addictive drugs isn’t just ill-conceived, dangerous, and disempowering; it’s a dehumanizing obscenity.”

    I could not agree more.

  11. “I have resolved this problem by the simple expedient – and this is not Einsteinian stuff – of avoiding fast-moving, congested traffic! ”

    Thanks for another excellent piece, but watch out Phil…they’ll diagnose you with avoidant personality disorder.

    The more I see and read, the more dangerous I think psychiatry is to the very survival of our species and the angrier I become about the hell that was forced upon me by the corrupt institution that is psychiatry.

    For anyone here who hasn’t read it already, “Psychiatry Under the Influence” (Whitaker [MIA founder] and Cosgrove) is an excellent read and gives further insight into the ongoing crimes against humanity that psychiatry is perpetrating and how it is getting away with it.

    • Philip

      There can’t be enough written about the dangers of benzos and the onerous role of psychiatry and Big Pharma in promoting and profiting from their prescriptions and sales.

      It must be repeated over and over again that over 30% of all people who die from opiate overdoses have benzos in their bloodstream. In fact, the expansion of the heroin/opiate epidemic in this country parallels the rise in benzo prescriptions in the same time period. This combination of drugs represents “The Perfect Storm of Addiction.”

      In Massachusetts the governor just came out with a new plan to address the opioid epidemic that has taken so many lives in recent years.. While this report targets prescription drug abuses related to opiates, there is not a single mention of the benzodiazepine problem. Formal complaints about the benzo problem have recently been made to the Ma. Department of Public Health and they have refused to take any action.

      Richard

  12. While everything written here about benzodiazepines is true, the sad reality is that they are among the safest of the psychiatric medications. As it has been pointed out, most psychiatric drugs are prescribed by non-psychiatrists. These days, partially because of the bad reputations these the benzos have gotten, many family doctors are prescribing SSRI’s or anti-psychotics for anxiety and sleep problems. While I agree with Philip that it is society’s problems that lead to anxiety, when a person comes in to see a doctor in great distress, one can’t change society or have the person avoid the stress caused by society. Sometimes the short-term use of some medication to help with sleep can greatly help an individual, and avoid the situation where a person eventually gets put on a long-term medication that will have greater negative impact. One also has to look at the impact and negative effects of the Z drugs that are being used to commonly for sleep problems. Given the options, I’d rather give a highly distressed individual a little oxazepam for a few days to help them sleep while starting a therapeutic process, then to have the person fall apart more, or end up on more dangerous medications.

    • There are sooooo many safe and natural ways to reduce anxiety in the moment and everyone has a pool of self-soothing resources they can tap into for lifetime anxiety management. Even in cases of super-extreme chronic anxiety (which was the major component of my disability, back in the day when I was disabled), starting with exploring new perspectives and grounding, I feel it is more than possible to avoid ever giving chemicals that will suppress challenging emotions, which, in the end, are what guide us to our integration, true selves, and inner peace.

      Although I will admit that the way society is now, and how challenged our person-to-person communication has been, even in the same language, short-term medication use seems to be a reasonable option for some. For me, that only led to more anxiety and of course way worse problems than that, as often described on this website.

      It was when I stopped taking the benzos, and all other related drugs–following a horrific withdrawal–and began to listen to the music that most touched my heart and soul, and made that my anti-anxiety practice, was I able to heal from chronic anxiety.

      Now, music has become a big part of my professional life, and I have found it to be not just one of the best anxiety-soothers I can imagine, but it is one of my best healers, overall. Music may not have that kind of power for everyone, but I know it does for a lot of people.

      If not, music, I’m sure everyone has something creative, artistic, and personal that works for them in this regard. Art is way more powerful than drugs as a healing path, and it teaches us our creative process, which is quite useful when looking to create change in one’s own life. Life is art, all creativity.

    • Don’t know about that Dr Hoffman.

      Mines a long story but I was ‘spiked’ with benzos by my wife, and then incarcerated in a mental institution by a Community Nurde. The Community Nurse decided to change the ‘spiking’ to ‘self administered’ on the documents and concealed the criminal offense from the following Doctor. This guy then calls the effects of being ‘spiked’ with benzos “psychosis, bi polar” and prescribes, more benzos, olanzapine, and quetiapine, to be forcefully administered should I become agitated.

      Given that I had been ‘spiked’ and kidnapped from my bed, kind of likely.

      My little ‘social experiment’ shows that the effects of benzos are psychosis and bi polar. Not dangerous?

      • Very clearly the way you were treated was very dangerous both on a humanistic and psychopharmacology level. There is no question that all psych meds are potentially dangerous and that they all interfere with normal brain functioning. The main issue to remember is that so many doctors are using more dangerous medications like antipsychotics and SSRIs that people end up being on for years. The short term use in small doses of benzos with proper education and consent and used only as an adjunct to other forms of therapy is preferable and safer than so many of the other approaches to medication. I am not calling any of these medications safe.

        • “…is preferable and safer than so many of the other approaches to medication. I am not calling any of these medications safe.”

          So it’s safer but still not safe. Somehow, I don’t see how this would be comforting news to someone facing this option.

          And you are saying there are no safe alternatives, so dangerous is better than extremely dangerous? For people looking for healing? That doesn’t add up to me.

          Why can’t psychiatry find safe and effective healing for its clients? Is there none of that in psychiatry? Not all healing perspectives require high risk treatment that put a client’s quality of life in question, or worse, their life in danger. I just don’t get this. There is such a thing as safe and effective healing out there in the world. Why is psychiatry so messy?

  13. Yes, a most prudent, logical, commonsense use for a benzodiazepine would be to prescribe it short-term and sparingly to an emotionally upset person who needs sleep and rest after weeks or months of insomnia and anxiety. This will also facilitate a therapeutic process, as you further stated.

    A most dangerous use for benzodiazepines was perpetrated against me (and countless others), in that I was prescribed a daily combo of a benzo (either Ativan or Klonopin) and an SSRI (either Prozac, Zoloft, or Paxil) for 20 years by my former psychiatrist. I can attest from first-hand experience that the aftermath of being so severely overmedicated is horrendous!

    • “A most dangerous use for benzodiazepines was perpetrated against me (and countless others), in that I was prescribed a daily combo of a benzo (either Ativan or Klonopin) and an SSRI (either Prozac, Zoloft, or Paxil) for 20 years by my former psychiatrist. I can attest from first-hand experience that the aftermath of being so severely overmedicated is horrendous!”

      Yes, I was one of the countless others, same time frame and drugs, 20 years on Klonopin, combined with Ativan, SSRI, also mood stabilizers, 9 in total during the last year, which is when I finally caved to the toxicity of this all and made the decision to taper for good–big, HUGE mess for a good long while, that didn’t need to happen, but it did, and I got through it.

      I am free of them, and finally healed from the disabling damage this did to my body, and indeed, it was a learning and creative process like no other, and my best life education.

      But NO ONE should have to go through that! Absolutely no reason to, other than to be the target of blatant and unambiguous malpractice. There are gentler and more self-loving ways to grow in life. This is nonsense, and everyone knows it.

      That’s really the most clear and personal target of my wrath in psychiatry–the obvious grossly over-medicaters, and there are tons of them out there.

      Perhaps for some, there is still gray in other areas of psychiatric practices, but I don’t see how anyone can either justify or defend the obvious suffering caused by such insane over medication, and it is unfortunately rampant. Let’s start with that, then perhaps the more subtle truths will become more clear.

      • Same here…10 years of Xanax with an SSRI which culminated in suicidal and homicidal ideation, humiliating and alarming behaviors, and more culminating with an ER visit. I too am free. The psych said it was perfectly fine to be on benzos long term. Lied to my face! How can you trust such a person? Or profession, for that matter?

    • “The norm” is what I’m talking about here. If this is what is ‘normal,’ then we need a new normal because this is unacceptable, as it is genocide.

      After the dark ages (which we have been repeating, here) came the Renaissance. This is why I talk about art, nature, and awareness of energy as healing.

      • These are also unifying elements among humanity. Obviously, these days, dialogue is not.

        As I say in the film which I’m currently producing about bringing music to assisted living facilities, I express that I feel the world has become somewhat of a tower of babel, whereas music tends to bring a sense of clarity because we’re all responding to it with our hearts, so we feel moved and perhaps, a bit more open and loving.

        In dialogue, we are all interpreting things differently, and not really allowing this, so we speak past each other and become defensive quite easily, which results in chronically stuck dialogue.

        Art, music, and nature connects us on a soul level, and from there, perhaps we could find some unity and cohesion as a community. Not only does that increase individuals’ feelings of connectedness, but as a collective, we would have much greater power to make desirable changes in our environments.

  14. Norman

    You said: “While everything written here about benzodiazepines is true, the sad reality is that they are among the safest of the psychiatric medications.”

    What do you mean by “safest”? Do you mean that it is hard to overdose or die by taking a handful of benzos. While that may be true you seem to have missed the essential issues being raised here in this blog and discussion.

    Benzos are the perhaps the most abused and dangerous and yes, least “safest” of all categories of drugs (especially outside of a medical – non-psychiatric – environment) based on the overall harm and damage done in the world.

    When benzos are combined with other sedative-hypnotics or opioid drugs this combination actually becomes one of the most lethal drug cocktails on the planet.

    Benzos create dependency and medically induced addiction leaving millions of people, mainly women, in a heightened state of almost perpetual fear. These drugs are emotionally crippling, stripping its victims of any confidence in using or developing natural coping mechanisms.

    Today, it is the EXCEPTION for benzos to be prescribed for two weeks to get some one through a brief emotional crisis. No one HERE is suggesting that should NEVER be done.

    I believe the vast majority of the 90 million benzo prescriptions in 2013 (40-50 million for Xanax) were LONG TERM prescriptions; this is a crime of immense proportions.

    I have a close friend who suffers terribly after 20 years of being drugged with benzos, as part of a cocktail of other psych drugs. The clinic where I work has probably well over a thousand long term benzo prescriptions written every month.

    Richard

    • Hi Richard,

      I agree with you. It is a very sad and dangerous affair that benzos are among the safest of psychiatric medications. It points to how bad and potentially dangerous they all are. But they are among the safest in some ways:
      1) When people are put on them it can be for the short term unlike SSRI’s where people are usually put on them for years with the message that they have a “chemical imbalance:
      2) There are millions of people being given anti-psychotics fro anxiety ans sleep problems with major side effects. These drugs are more dangerous than benzos.
      3) I have never had a patient who I prescribed benzos to who became addicted or was on high doses. When used appropriately almost all people use them sparingly and for short periods of time, unlike other psychiatric medications that people tend to be on for long periods of time.

      There is no question that these drugs have caused major problems to many people. A large part of the problem is not in the drugs themselves but in the people who prescribe them. Long term benzo prescriptions are never okay. That is the problem.
      As you clearly state, no one here is suggesting appropriate short term use should never be done. So we basically agree on just about everything. We may just be presenting the argument differently

      • You might be interested to know that my board certified psychiatrist, known as an “expert” in pharmacology, told me that I needed Xanax “for life” because my brain didn’t make enough of it’s own natural benzo. This is what psychiatrists are telling patients. This is what must stop.

        • Psychiatrists like that should have their licences revoked. There is no justification for such blatant disregard for facts and such misinformation being thrust on a patient.
          One big problem with psychiatrists who call themselves experts in psychopharmacology is that they usually know nothing about people or therapy. Their only knowledge is of the DSM and a superficial understanding of biased research.

  15. What’s frustrating is that I have been trying to get off Benzos for a while. I had a good doctor who was starting to taper me, but they cut him from my insurance plan a year & a half ago. My current doctor ramped me back up & the past few months, I’ve been pushing him to taper me. He knows nothing about it. He told me to “play around with it, skip doses & split pills”. Not good advice. I tried cold turkey once & ended up curled up in a fetal position, having convulsions, & sweating like crazy. I’ve been calling other doctors all week & have gotten nowhere. I guess I’m on my own with this one.

  16. This is my experience with the benzo drugs. These are drugs. They are addictive and usually the patient is uniformed of that. It is wrong to blame the patient that he needed the benzos for a few night’s sleep and then got addicted on his own. These drugs are prescribed by psychiatrists and physicians. Never forget that. In the late 1990s I was put on 5 mg klonopin at breakfast and again at bedtime. I guess for anxiety, ocd, whatever the psychiatrist made up with his disorganized pencil and paper. I remained on klonopin until October 2002 after my sister died of cancer. My then psychiatrist, who eventually left the clinic I went to and went to the county; abruptly changed my klonopin to 10mg valium in the morning and 10 mg at bedtime. I remained on that dosage even with another change in psychiatrists until April of 2013 when I was very abruptly taken off all the psychiatric drugs I was taking at the time; due to an alleged diagnosis of “sleep apnea.” I had been hospitalized. I could not awaken enough to even eat, go to the bathroom, or dress myself. There was absolutely no tapereing off of any of the meds; even the valium. My psychiatrist said that he hospital doctors did what was right.
    After that, I was subjected to some type of “pap machine” in the hospital that was very loud, noisy and the oxygen/wind in the mask moved one of my teeth until it touched another tooth. (I have had a gap in my teeth since early childhood) This movement was so severe that I can barely eat on that side of my mouth and it times of stress or bad food; it causes a sore on my tongue. Each day, I feel it in my mouth as if I had an impediment there. I was then put on one of those “pap machines” at my home after the hospital. At this time, I used a nasal mask; because my face was too small to accommodate any other mask. This nasal mask caused some strange noises in my nose that I believe would have caused damage and needed surgery; if I had not stopped the use of that machine. The respitory therapist thought it was caused by not having a special computer card in the machine. So, here, we see Big Brother inserting himself into our most intimate time of sleep and dreams; which I had none when using the machine. I still have trouble getting dreams at night. Throughout this time; I had insomnia which lasted over an hour, intense anxiety, and a never-ending heart palpitations that lasted both day and night. I brought this up with several doctors. they either did not want to help me or tried to give me more toxic unhelpful drugs like Zyprexz. I now believe that the results from the computerized sleep study could be manipulated to suit the health provider’s needs and that the reason I could not wake up was due to the excessive use of medications for nearly twenty years and particularly in the last eleven years; including the benzos. My poor drugged body had just had it and all it could was sleep. It was in its sadly ineffective way trying to heal itself. The psychiatrist who said the hospital did right by me by abruptly taking me off all the meds except lithium left within six months to the west coast; never to be seen again. The mental health clinic I was going to no longer had psychiatric/medication services available. I had to go elsewhere if I wanted that kind of service. The other doctors left their practices and went to other practices. One went to another part of town and affliated himself with another health care organization. The other went to a concierge service charging $1,000 a year for just regular doctor service you could get anywhere in town. I moved from that town. I had also been “abused” by other doctors; including a gyn doctor who refused to help with my problems. I now believe that most what I went through was a definite horrific combination of psych drug withdrawal; including the benzos and the nighttime use of the “pap machine” I no longer take any drugs except an occasional liquid Tylenol for a headache or a “charley horse.” I can not even take a vitamin. I am now so distrustful of the entire medical community; I have yet to set up a relationship with a general practitioner since moving to a new town in different part of the state. I have seen a dermatologist in town; as he is the only one who treats me with respect! I have come to the conclusion that if you desire to live to be 100 years old and I do; it is healthier to stay away from the entire medical community in this day and time. I should add one more thing; I was on so many different psych drugs over the years; that I can barely remember them all. These drugs can kill you and at the very least make your life a total mind , body, and spirit terror. Thank you very much.