Benzodiazepines: Psychiatry’s Weakest Link  

Richard D. Lewis
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Benzodiazepines may be the most popular, widely used, and immediately effective of all the psychiatric drugs. At the same time they are perhaps one of the most dangerous, addictive, and abused mind-altering substances on the planet. Since the 1980’s psychiatry and their partners in the pharmaceutical industry have spent billions of dollars marketing these drugs and justifying their efficacy in the “treatment” of anxiety and insomnia. Psychiatry has been able to create a patient base of millions of people who are dependent on these drugs and are forced to remain “co-dependent” customers of psychiatrists and other medical doctors in order to procure them.

Closely paralleling the timeline for the ‘benzo’ explosion was an equally nefarious promotional campaign by Big Pharma and certain leaders in pain medicine, called The Fifth Vital Sign Campaign. Starting in the early 1990’s the results of this campaign led to a proliferation of pain clinics throughout the country and millions of people becoming dependent on opiate pain drugs. This widespread expansion of opiate prescriptions became the impetus for the rapid growth of heroin addiction that now extended well beyond the boundaries of urban ghettos into middleclass, and even upper class communities.

Psychiatry could never have known or predicted that benzodiazepines would soon become the drug of choice, frequently added to an opiate/heroin drug cocktail because of its synergistic ability to greatly magnify the effect of the overall drug high. They could never have foreseen a time when as many as 60% of all opiate users end up taking benzos on a regular or part time basis, and 30% of all fatal opiate overdoses involve the deadly combination of these two drugs. 

Both psychiatry and the leaders in the pain “medicine” industry could never have imagined that in 2015 the opiate overdose epidemic would be so catastrophic that it would, in a powerful way, become interjected into the upcoming presidential election. A situation where multiple candidates have been confronted in public meetings by voters demanding to know what their solutions are for the opiate overdose epidemic sweeping the country.

Today this situation has progressed to the point where there is no turning back or safe way out for psychiatry when it comes to their promotion and prescribing of benzodiazepines. Millions are now dependent on these drugs and they will suffer horrible withdrawal if their drug prescriptions were somehow restricted or removed from the marketplace. The outcry and outrage would be thunderous, and justifiable so.  And at the same time, opiate prescriptions and heroin use has become so pervasive in our society that there is no turning back from “the perfect storm of addiction,” that is, the ever popular, and oh so deadly, drug cocktail of opiates and benzodiazepines.

Because there is no obvious or immediate way out of this institutional conundrum for psychiatry and the medical establishment, things will only get worse in this country, with even more drug related deaths that continue to devastate families and create greater public outrage. Could the benzodiazepine crisis and its connection to the opiate overdose epidemic be part of psychiatry’s fatal undoing? Could it be the weakest link in a chain of oppression that ultimately demands and requires our activism to ultimately crack it open and shatter it once and for all?

The institution of psychiatry wields enormous power in our society. It has been granted legal power and authority to restrain, psychiatrically label, Electro-shock, drug, and hospitalize (some would say, imprison) people against their will. Some people would declare that millions suffer from these particular abuses of power. Psychiatry, along with its partners in the psychiatric/pharmaceutical industrial complex, have also coerced and/or persuaded millions of people that their mind numbing (and often brain damaging) psychiatric drugs are the so-called solution to the inevitable conflicts that human beings encounter within their environment in a world filled with trauma based experiences.

A growing minority of people on this planet see all this power and control by psychiatry as various forms of psychiatric abuse, or, more pointedly, as major violations of human rights. These same people are actively searching for ways to permanently end these violations. Some even believe (like me) that psychiatry lacks any legitimate claim to medical credibility or legal authority, and therefore should be stripped of all such coercive power and control in our society, and be left to wither away into obscurity. However, any honest and objective assessment of today’s movement against psychiatric abuse would have to conclude that we are, at best, only a serious nuisance to the institution of psychiatry at this time in our history.

So what is to be done and where do we start? History tells us that “where there is oppression there will be resistance.” Today, there are only the very beginnings of serious resistance against the institution of psychiatry. Many activists against psychiatric abuse have suggested that the following struggles are presently some of psychiatry’s weakest links, and each one could be strategically identified as the main target of our organizing efforts at this time: Electro-shock (ECT), the drugging of children and the elderly, anti-psychotic/neuroleptic drugging of those labeled as psychotic, the widespread use and dependency on SSRI/antidepressants, or the spate of mass shooting by individuals psychiatrically drugged and “mistreated” by the current mental health system.

All of these struggles are clearly legitimate targets and each has its own strategic merits. But along with certain potential strengths comes some inherent weaknesses. Some of these struggles mentioned above have specific limitations based on the difficulty of its victims having the current ability to be aroused into action, and also on how the masses at large view certain segments of the population who have been psychiatrically labeled. Some of these limitations certainly apply to the issue of mass shootings, where the related fear mongering generated by these tragedies, and the calls for MORE mental health treatment, has substituted for any objective critique of the actual damage already done by a harmful mental health system. And additionally, are we just sort of waiting around for another tragedy of even greater proportions to happen before we can spring into action with exposure of psychiatry’s harmful “treatments” that all too often push certain vulnerable people over an emotional cliff?

There is another struggle that, so far, has not yet gathered as much momentum as a suggested area where our movement could gain much needed ground against the institution of psychiatry. This struggle may very well have the most potential to actually weaken the overall chain of psychiatric oppression in today’s world. I am proposing that psychiatry’s mass promotion of benzodiazepines and the related prolific medical prescribing of this category of drug, and especially its connection to the opiate overdose epidemic that is sweeping the country, is today’s weakest link in the powerful chain of oppression that the institution of psychiatry wields within present day society. What follows is a list of some of the strengths and objective criteria that support the idea for making this the main focus of our organizing efforts in the coming period:

  1. Millions of people have been prescribed ‘benzos’ and continue to take them for many years. In the year 2013 there were 94 million prescriptions in the U.S.; most of these are long term prescriptions creating major dependency issues with serious emotionally crippling effects for many of its daily users.
  2. There is a significant schism within the ranks of medicine regarding the safety and efficacy of prescribing benzos for more than 2-4 weeks. An emerging number of medical experts, doctors, and other activists are now speaking out about the dangers of long term benzo use and the related withdrawal problems when trying to taper off of these drugs. At the same time, many of these people are also publicly criticizing those in the medical establishment who still deny or downplay the dangers of benzodiazepines.
  3. These drugs are not just prescribed and causing damage to people who are declared disabled with major psychiatric diagnoses, but their damage has spread widely to so-called higher functioning segments and strata within our society. The benzo problem has clearly become pervasive among broad sections of the people.
  4. Women are two times more likely than men to be prescribed benzos, and these gender issues dovetail with other related issues of women’s oppression and related resistance within our society.
  5. There are major examples of both more subtle and overt resistance on various social media and the internet, as evidenced by such websites as Benzo.orgUK; Benzo buddies.org; Benzo support.org; Benzo withdrawal.org; and Benzo Beware on Facebook. These sites offer underground support and highly active forums helping benzo users find ways to lessen the damaging effects of these drugs and aiding these people in their struggle to safely taper off of them. A process that we now know could take years for some survivors.
  6. Those people (perhaps in the tens of thousands or more) seeking help on internet forums and social media are often fighting through feelings of confusion, desperation, shame, and quilt. They often feel (with good reason) betrayed and abandoned by their prescriber who will frequently blame the patient for problems managing these drugs as their dependency often escalates into multiple forms of iatrogenic crises. And while there is great desperation for those folks currently dependent on benzos, there is an incredible amount of justified anger and fury directed towards psychiatry and organized medicine, as well as, an active search for the answer to the question: “how the hell did this happen to me!?”
  7. Many of today’s more outspoken survivor activists have educated themselves and discovered the real answer to this question. Some very articulate writers have even published books and written numerous magazine articles about their odyssey through the world of medically induced benzodiazepine dependency. Authors such as Matt Samet (Death Grip: A Climber’s Escape from Benzo Madness), Melissa Bond (Killer Brain Candy and Cracked Open), and Barry Haslam (Benzodiazepine Drugs: My Story of Survival) are also well known bloggers at Mad in America (MIA) with very powerful stories to tell. And Stevie Nicks, the famous rock singer, has written and spoken out angrily about losing 8 years of her life to Klonopin. Blog postings about benzodiazepines and their related problems are some of the most popular and widely read and discussed articles at MIA.
  8. Popular movie stars and other famous people such as Heath Ledger, Phillip Seymour Hoffman, and Whitney Houston, to name a few, all died with benzos in their system; Ledger and Hoffman both died from the combination of opiates and benzodiazepines and Whitney Houston had benzos, alcohol, and muscle relaxants in her bloodstream.
  9. Fifty to sixty percent of all opiate drug users also use benzos on a regular or occasional basis. Opiate addicts readily seek out benzos because of their ability to potentiate or magnify the effect of the overall drug high. The benzodiazepine crisis (a major issue in its own right) also intersects in very decisive and deadly ways with the epidemic of opiate overdose fatalities that is presently sweeping the U.S and other countries in the world. In the recent period 25,000 or more people are dying yearly of opiate drug overdoses in the U.S. This figure combines both legally prescribed opiates with illegally procured heroin. It is most likely an overall low ball figure due to the fact that toxicology reports are often not completed on certain deceased individuals. This amounts to at least 68 deaths per day; almost 3 deaths per hour. The World Health Organization estimates that 69,000 people die worldwide from opiate overdoses.
  10. Stanford researchers sent out warnings in 2014 (based on a significant JAMA study by Jones et al., 2013) that at least 30% of all opiate overdose fatalities involve the combination of opiates and benzodiazepines. The significance of this 30% figure cannot be underestimated or repeated enough times. Using this percentage as a guide, almost 15 or more people die every day from the very lethal added effect of benzos to an opioid laced drug cocktail.
  11. The rise in benzo prescriptions, starting in the early 1990’s, parallels the similar rise in opiate pain drugs prescriptions and the related proliferation of financially lucrative pain clinics spreading throughout the country. This new trend in opiate drug prescribing was carefully engineered by Big Pharma with their infamous Fifth Vital Sign Campaign. From the years 2002 to 2009 benzo prescription rose at a rate of at least 12.5% a year paralleling the rise in opiate drug use and the much written about epidemic of fatal opiate overdoses.
  12. Many opiate users/addicts know how to use their opiates, but they often forget about the benzos they consumed earlier in the day, as well as, underestimate the dangers of combining these two categories of drugs. By themselves benzos are usually not life threatening when taken in excess (unless you are driving heavy machinery etc.), but it is their combination with opiates and other sedative/hypnotics that, all too often, depresses lung and heart function to life threatening levels. Death always lurks very close by in these situations.
  13. Some government and public health officials are now speaking out about the dangerous high number of opiate drug prescriptions in this country. It has now become well known to drug experts that 50% or more of all new opiate addicts move on to heroin use through legally prescribed opiate pain killers. However, no government or public health officials are speaking out about the intimate connection between the record high number of benzo prescriptions and the raging epidemic of opiate overdose fatalities. Psychiatry and their partners in Big Pharma, have been the key initiators and promoters of the dangerous explosion of benzo use and dependency in our society over the past 40 years. So far they have been able to skate relatively free with little public exposure or condemnation for their particular role in this explosion in drug use, and the high number of deaths it causes, especially with opiate overdoses.
  14. The opiate overdose crisis is a major problem in society that even the most arrogant politicians, public officials, and other so-called experts are humbled by. They are totally unable to provide any real answers or viable solutions. This particular drug crisis has already become a significant issue in the upcoming presidential election. The very first question addressed to Hillary Clinton at her first N.H. public gathering was focused on asking what she would do about the opiate overdose epidemic. Other candidates from both parties have also faced similar questions. Carly Fiorina, a rising candidate in the Republican Party, had a step daughter who died in 2009 from an opiate drug overdose; there is no public evidence that benzos were also involved in her death (although research tells us that there is a 30% chance of this being the case). None of these candidates will be able to provide any realistic answers to these questions. The often promoted idea of putting more opiate addicts on methadone and suboxone/buprenorphine (both synthetic opiates), without addressing the benzo problem, will only exponentially increase the dangers of more fatalities occurring in the future.

The purpose of this blog is to shine the spotlight on the dangerous and sometimes deadly role of benzodiazepines in present day society, and to get people to start to think strategically about how we can take advantage of the opening that psychiatry has provided us given their instrumental and complicit role in this crisis. Here are some beginning thoughts on what we could do in the coming period to exploit psychiatry’s weakest link:

  1. Attend and speak out at all the town and city meetings happening all over the country that have been organized by government and health officials to address the opiate overdose epidemic. Focus exposure on the role of psychiatry and their intimate connection in the involvement of benzo promotion and prescription, and its significant connection to opiate overdose fatalities.
  2. Write Op-Ed articles like here http://www.southcoasttoday.com/article/20140422/Opinion/404220303 and http://www.southcoasttoday.com/article/20150802/OPINION/150809968 in local newspapers exposing the benzodiazepine crisis and its’ connection to the opiate overdose epidemic.
  3. Research the amount of benzodiazepine prescribing in your area by using the Propublica.org website. For example, I discovered that, in the year 2013  with Medicare prescriptions, 4 out of the top 5 and 15 out of the top 25 prescribers of Xanax in the state of Massachusetts (out of 30,000 doctors) were all located in the New Bedford/Fall River area of the state. This area happens to also be a major hotspot for opiate overdose fatalities.
  4. Speak to certain local politicians and representatives in your cities and towns and educate them about the critical role of benzos in the opiate epidemic. For example, I approached one representative in a local city and she was so outraged by the material I gave her that she asked me to create a power point presentation on the dangerous role of benzos for a government subcommittee on mental health and addiction issues.
  5. Organize and promote major educational conferences in key U.S. cities, such as Boston, New York, Chicago, and Los Angeles, that bring together some of the best scientists, doctors, and survivor activist/authors who can educate and speak out with experience and authority on the benzodiazepine crisis.
  6. Have those people already involved in various internet forums dealing with benzo dependency raise these issues (in the forums) as part of survivor’s attempts to liberate themselves from these drugs and the very direct experience of psychiatric oppression.
  7. Everyone needs to get aroused and become creative in their thinking in order to develop a definitive strategy for the coming period, including those tactics that pertain to the upcoming elections and the platform that it may provide for voicing certain anti-psychiatry activist causes.

It is becoming more and more obvious that today’s benzodiazepine crisis, and its connection to the opiate overdose epidemic, lays bare psychiatry’s weakest link and provides enormous future opportunities to greatly weaken the overall chain of psychiatric oppression.

However, these opportunities for political exposure and organized resistance also have some important challenges that need to be addressed. While benzos are clearly very highly addictive and many drug addicts frequently use them, we must be very careful not to allow the spotlight in the benzo crisis to somehow focus on the millions of people who are tragically dependent on these drugs through no fault of their own. People dependent on these drugs have been victimized and suffer from iatrogenic damaged by psychiatry, Big Pharma, and the medical establishment. For this reason it is necessary to avoid labeling people dependent on benzos as addicts, which only tends to imply some element of choice and intentional involvement in a pattern of self-harm.

At the same time we must be aware that people using benzodiazepines on a regular basis have great fear (and for good reason) that they could run out of or be denied access to these drugs by doctors who often betray and/or abandoned them. Given the horrible effects of withdrawal symptoms, those people dependent on benzos might be afraid that all of this attention we raise about the dangers of this category of drug could make it more difficult for them to both access the drugs and/or safely (over a long period of time) taper off of them. For this reason, we must include, in all our political exposure on this issue, specific demands that the people damaged by benzodiazepines need to be given compassionate help and the very best that science and medicine can provide in order to aid them in overcoming dependency problems. Fighting back in an organized way against the institutions that have abused them will also help benzo survivors in their difficult personal battles.

To all those desirous of a world free of human rights violations, psychiatry has unknowingly gifted us a tremendous opportunity to expose and weaken their institutional chain of oppression. We must not fail in our historical responsibility to “seize the time” and give psychiatry its own version and taste of the highly pervasive condition called the “benzo blues.”

* * * * *

References:

  1. American Academy of Pain Medicine press release March 6, 2014, Stanford University researchers (Ming-Chi Kao) warn: Prescriptions for Benzodiazepines Rising and Risky When Combined with Opioids.
  2. American Society of Addiction Medicine; Opioid Addiction Disease 2015 Facts and Figures.
  3. Fiore, Kristina; Killing Pain: Xanax Tops the Charts; MedPage Today; Feb. 25, 2014.
  4. Jann, M; Kennedy, WK; Lopez, G; Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics; J Pharm Pract.; Feb. 27, 2014.
  5. Jones, Jermaine D.; Mogali, Shanthi; and Cormier; Sandra D.; Polydrug abuse: a review of opioid and benzodiazepine combination use; Drug Alcohol Depend.; 2012, Sept. 1; 125(1-2); 8-16.
  6. Jones et al; Pharmaceutical Overdose Deaths, United States, 2010; Journal of the American Medical Association (JAMA)2013; 309:657-9.
  7. Ornstein, Charles; Jones, Ryann Grochowski; One Nation Under Sedation: Medicare Paid for 40 Million Tranquilizer Prescriptions in 2013; Propublica.org; June 10, 2015
  8. Skepticalscapel blogspot.com, Pain is Not the 5th Vital Sign; Aug 29, 2014
  9. Whitaker, Robert; Cosgrove, Lisa; Psychiatry Under the Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform; 2015

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37 COMMENTS

  1. Ya its evil.

    After psychiatry gets you dependent/addicted , same thing, to take the blame of them selves they pull a blame the victim and say you are an “addict” and send you off to drug rehab to blame yourself 20 times a day saying hello my name is ____ and “I am an addict” over and over in the groups and meetings.

    “I am an addict”

    No, wrong .

    Hello my name is _____ and I was screwed up and screwed over by the greedy dishonest psycho pharmaceutic industrial complex.

  2. Here’s a scene from one of my favorite movies, Jason and the Argonauts, showing the process of finding the Achilles heel of a seemingly invincible opponent, the giant Talos:

    https://www.youtube.com/watch?v=fdgY9vgRcRw

    At about 1:00 in this clip you can see Jason realizing how to defeat the monster. Watching these types of scenes reminds me of the experience of gradually uncovering the fraudulent architecture behind psychiatric diagnosis and treatment. If you expose it enough, it all comes crashing down.

    Contrary to benzos, I think the Achilles heel of psychiatry is the DSM. None of the diagnoses in it are valid nor reliable; and this lack of validity and reliability is what is making all of psychiatry’s theories, treatments, and medications increasingly open to attack and exposure.

    Another good metaphorical scene is the final battle in the Dark Knight Rises:

    https://www.youtube.com/watch?v=fdgY9vgRcRw

    In this movie, the evil Bane has dominated and tortured Batman throgh most of the film. But finally at around 2:25 in this clip, Batman gains the upper hand by revealing a fatal weakness in Bane’s body. Once the weakness is revealed it doesn’t take long for the bad guy to collapse, as will hopefully happen with psychiatry’s lies being exposed ever more widely.

  3. Thank you for this great article, Richard. It is always good to see some kind of strategizing going on. To me, the key point you make about why this is a good strategy is that the issue is already coming into public awareness.

    Of course, there are other issues worth working on. My touchstone for this is, can we get anyone to work on it? That is very difficult. Activism is in short supply.

  4. For the record I would consider psychiatry’s weakest characteristic to be the logical and material impossibility of a mind having a disease. But that’s academic, I know what you mean and understand the tactical significance you ascribe to the exposure of benzos.

    You might be right, if not you’re close. Personally I believe that the mass shooting connections once established in the public mind as “psychiatric drug murders” could be the tipping point that will make the difference and start people questioning not only the drugs but the mentality behind drugging and other psychiatric machinations.

    I’ve put some suggestions of my own regarding this in the comments following Peter Breggin’s blog. But I didn’t mention this: I believe that leftists, or at least those who are most often characterized as such, are at least equally clueless and hostile to us as are those on the right. So exposing the psychiatric drug crisis should not be left to liberals and liberal media outlets. I think it would be great if the Limbaughs and Hannitys decided to seize upon this using whatever posture or pretense of genuine concern they might choose. It doesn’t matter if they think they’re using it as a weapon against the Democrats or whomever; the point is that the information be spread about psychiatric drugs. Our crack spokespeople can sort out the correct analysis for the public in due time.

    Hope to see more responses to this article (as well as to Bonnie’s blog, which is slipping away too fast).

  5. When discovering my eldest daughter had gotten hooked on Ambian and Oxy and not was rx shopping between her different DRs getting a ton of meds, was taking them way beyond the prescribed dosing. We got her into a supposed “addiction specialist ” Psych via her health plan. Can you imagine my horror when after seeing her stumble and pass out, acting totally drugged we discovered this Dr. not only put her on Valium but gave her a rx for 120 pills a month with multiple refills?!! Which of course she had refilled or replaced claiming they were “lost” or stolen. By best approx she was taking at least 60mg or more at a time, at least a 2-3 times a day.
    We had a family intervention, got her to go into residential treatment and she been clean and attending NA for 2 years now….. as for the Dr. there wasn’t anything I could do but I did call and leave him a voice mail saying if he filled one more rx I’d sue the hell out of him.. but could not get anyone in his HMO to accept my formal complaint, no find anyone in the medical community to help me red flag this guy.
    Interestingly enough, we found during rehab this guy had a “rep” as being a candy dish psych.. there ought to be a whistle blower system for reporting these guys.

  6. Two disparate points:

    >>>”psychiatry lacks any legitimate claim to medical credibility or legal authority, and therefore should be stripped of all such coercive power and control in our society, and be left to wither away into obscurity.”

    Right. If psychiatry is anything, it’s an art, definitely not a science. And most of the drugs prescribed cause more harm than good.

    However – Benzodiazepines are not just a “psychiatric drug.” – Many years ago, I had a digestive problem where about half an hour after a meal, I would feel terrible, like I was about to pass out – or die!

    Many tests and medications were tried. Nothing helped, and most made me feel worse. Then a doctor prescribed Ativan. I obtained instant relief with zero side effects, and it has kept me free from that problem for all these years.

    I know many people are addicted and/or abusing this drug. But it has been a lifesaver to me. Let’s be careful about casting too wide a net, or throwing the baby out with the bath water.

  7. Benzos, not particularly useful. Cause most people who take them don’t need them, and have no real benefit from them. Like a measurable one. Like suddenly a crippled paralyzed man can walk again seizure free style, and goes on to get his PhD.

    ObamasWeapon.com DrRobertDuncan.com

  8. I am very sad to read this. As a patient that is being very successfully treated and my very real Bipolar disease managed, I fear a great knee-jerk reaction in this country when the political right seize on yet one more issue that they chose to control for political ends. Death from drug overdose is an epidemic. People dying from drug cocktails is such a shame. However, instead of doing away with a legitimate science, and a form of treatment, educate the public, warn them of the real dangers of the mixture of drugs. The lack of education is as great if not greater problem. Do some people abuse medicine, Yes. Does everyone, absolutely not. We need to find a path that will keep healthy functioning people who use Benzodiazepines from having to suffer again and intensely from the illness that caused them to seek treatment rather than take the ultimate step suicide to alleviate their terrible suffering.

    Which is worse, suicide in order to find a permanent solution to a problem that can be managed, or accidental death by a cocktail of drugs, taken by an under educated patient. People have abused alcohol for centuries, It has destroyed homes and families, it has killed innocent victims over and over again. Neither the right or the left is willing to address this issue in any meaningful way. Do I advocated prohibition? No, it doesn’t work nor is it needed. Personal responsibility is what is lacking. No one is responsible for their own actions any longer. The Dr. addicted me , the tobacco company addicted me, the soda industry made me fat, the fast food industry made my children obese. This is all hogwash. Ultimately the issue is, who is responsible for ME. All things in moderation, will that end abuse? No. Will it stop addiction and possible death? No. Will educating children that there are in fact consequences for their actions? I am not sure, however I do know, that it can be a major first step in changing a culture that has become all too willing to blame others for their fate in life. Education, love, compassion, and the interventions of family and friends can help. There is no magic bullet for drug abuse. Careful examination can help. Maybe if the insurance “racket” was not in control of the profession of medicine it would help. Allow the Dr.’s to spend the time with their patients, to evaluate them. Do not reduce medicine to a 15 minute visit, to which the Dr. is often late for due to the fact that patients are run through like cattle in order to make a living.

    In conclusion, people have abused many substances since time began. The answer is not to create another huge crisis in the world by the elimination of psychiatry which is an absurd idea on its face. The answer is education, love and compassion and help. The place to find that, is somewhere in the middle of the road.

    • Hello, I’d like to share with you what a wise therapist said to me when I asked him, “Is Bipolar Real?”

      —————-

      Yes, I have worked with people labeled “bipolar”. I try to stay clear of formalized techniques of treatment for this or that client. What I do with all my clients is to discuss with them the human process they are going through; those processes we call “bipolar”, in this case. I explain that all human beings go through periods of oscillation with an expansive mood on one side of a continuum, to restricted mood on the other. This is expected given the changing nature of reality over time. The problem with people who have been labeled bipolar is a problem of managing mood. The desire consistency that just doesn’t exist in the world, and their push towards the extremes is a futile attempt by them to escape this reality. Extremes are easy; balancing in the middle is hard.

      When things are going good, we all wish for that good feeling to stay. This why gambling works, it is why people have trouble with alcohol, with sex, with food, etc., etc. So a “bipolar” person pushes the limits of good mood, noticing how well they are feeling, noticing how exciting and interesting something is, noticing how capable they are, noticing how good it feels to excel. But then they may notice that sleep takes 1/3 of their life away; 8 hours of valuable time when they could be feeling great instead of sleeping. This goes on and on unchecked and eventually the crash occurs. We can’t withstand such a pace of excitement, without sleep, without rest, without restricting and setting limits on ourselves without dire consequences.

      They then fall to the depths of despair. Life isn’t worth it because I can’t stay in such a wonderful feeling of grandeur all the time. This sucks. Why even try if it is always going to crash like this. But then something triggers the excitement again. Perhaps an idea for a book, a movie, a play. Perhaps they gain special insight into how to solve a math problem. They notice the value to visualization when doing a task. They start the climb again towards greatness.

      I see this over all process very similar to the general idea in parenting: successful parenting requires true nurturing and loving, coupled with respectful limit setting and discipline. Either of the two by themselves is disastrous. A completely nurtured kid will turn out to be dependent; a completely disciplined kid will turn out to be fearful. The trick is to manage these “interventions” of parenting so that the child doesn’t experience it as too disruptive. “Bipolar” people don’t do a good job of parenting themselves.

      “Medication” (actually they’re just chemicals, they don’t medicate anything because there’s nothing to medicate) only helps in the sense that they can deaden emotions. If the person is not feeling excitement or despair, the conventional reaction is to say the chemical is “stabilizing mood”. That’s bullshit anymore than we would say 5 stiff drinks stabilize mood. What’s actually happening is that the chemical is preventing the brain from reacting the way it was constructed to react to different environmental cues (including one’s thoughts/feelings). Chemicals just put off the inevitable challenge to live within limits in our world.

      “Bipolar” is not a thing, a defect, or an illness. There is no evidence that “it” is caused by some brain pathology. While there certainly are brain happenings going on while “bipolar” is going on, that is only an obvious observation as all human activity is accompanied by brain happenings. We typically don’t say those happenings are signs of illness, or even problems. Imagine the ridiculousness of saying singing is an illness because we can show fMRI scans of people singing look different than those not singing.

      “Bipolar” is a human process. It may be a problem and it might not be a problem. But whether or not it is a problem depends on the real world consequences of the process, not a checklist of items one endorses.

      —————-

      It really isn’t a disease. Even extreme bipolar symptoms are part of normal human experience, and are curable.

    • Bucky,

      I think it is true that there are is more to learn from failure than from success– or maybe it is just that failure is a stronger motivator when it comes to seeking answers. My observations with regard to both diagnosing and treating *bipolar disorder* from a ring side seat for over 20 years, is that failure was almost inevitable– There must have been someone making claims like yours, some patient I met during my 20+ years as a psychiatric nurse who believed completely in their diagnosis and the treatment for *bipolar disorder*– but I just can’t recall a satisfied patient tagged with that label.

      If you appreciate scholarly writing, I suggest you read, “Mania- A Short history of Bipolar Disorder” by psychiatrist, David Healy- it stands proudly in the archives of Johns Hopkins Biographies of Disease. It is a very well documented history of the creation of this disorder in America, where the drugs came first, then the disorders were matched to them.

      Also, I have to point out that there are some major deficits in your education regarding Benzos and psychiatry’s role in handing them out like Pez. Psychiatrist have been Totally irresponsible prescribing, completely ignorant of adverse effects, oblivious to addiction and the horrific withdrawal process– that has led many people to attempt suicide. Additionally, the stigmatizing of patients who are addicted to Benzos, by psychiatry– and filtering down to the front line staff who encounter these poor souls is, as Richard says, one of the most damning indictments against a sub specialty in the field of medicine.

      The truth of this scourge is both well documented and fairly easy to access– but it may be that only those who have *failed* to benefit from crap shoot psychiatric drug prescribing, that seek this information– And those of us who bear witness to this destructive practice, who first needed to understand what we witnessed, are bound to assume responsibility for protecting the public from harm.

      Happy psych patients are rare, but their pontificating about our ignorant, irresponsible society, is quite common. I hope you are able to well up some concern for the many who are suffering, more form the ignorance and inhumanity of psychiatry than their own shortcomings. I doubt that any of them, or anyone writing from lived experience here on MIA would begrudge you access to whatever treatment you desire.

  9. I just thank my lucky stars and the goddesses to be alive and out the other end of taking these (plus other psych. medications) given to me at the end of a love affair in the 1970s.
    Of course, the shrinks never spoke of short term – only that I had a “family disease”….
    Once I finally figured out the game, I tapered off – first the lithium – to deleterious social effects, and then the benzos….paranoia raging….thrown in a psych hospital for two weeks – terrifying….
    Here I am, out the other end. Fine. On nothing but a little red wine.
    This is a criminal thing.
    And it must end.

  10. Thanks for this article, it was an interesting read. I live just outside Boston, and we too have been badly hit by the opiate addiction epidemic. I lost two friends to overdose recently, so this was a timely read. I feel you are connecting dots that few others are.

    I actually have a prescription for Ativan (lorazepem, a benzo). I was originally prescribed it some time ago for anxiety and was supposed to take it every day, something like three times a day. But I couldn’t do that and function as a person. So then I was told to take it as needed.

    Somewhere along the line I determined that it works great for certain recurrent GI issues, and now have a PRN prescription for such. You mention benzo prescriptions for GI issues briefly in a comment. As far as my GI issues go, Ativan has worked when nothing else would. After I had been through many many other medications and treatments. It’s use has prevented me from being a lot sicker. And I’m very grateful for that.

    So I do think there are “legitimate” uses for Ativan and other benzos. Ativan is often prescribed to kids with “failure to thrive” due to things like cyclical vomiting when other stuff doesn’t work, and is literally a lifesaver in such cases. It’s an unpopular opinion on here, but I also think there are some legitimate psychiatric uses of benzos, such as short term use for severe panic attacks. I know several people who take it very occasionally when their usual coping mechanisms don’t work, and they are as grateful for it as I am.

    But I am shocked at how flippantly I was prescribed it, after just a few visits with a new clinician. I was asked if I had a history of prior addiction before it being prescribed, and I have to hand deliver the prescription to the pharmacy. But no one checks in with me about its use or how many pills I have left. I could easily be abusing it or selling it on the street – I’m not, but I could.

    I do think there are times when a benzo is the right prescription, but I also think prescribers need to put in more effort to ensure the health and safety of their patients. I think this is just good care that should be used for any prescription, but especially controlled substances that have addiction potential.

    One thing you didn’t touch on (unless I’ve missed it) is the impact of benzos on employment. I don’t mean the zombie-ifiying effects it has on people, though that’s surely a problem. But more and more work places are doing drug tests on employees/new hires, generally by urine sample. It’s tough having to provide proof of a prescription to employers in such cases. It basically marks you as being “mentally ill” and/or being an addict, depending on the employers personal experience with benzos. And I think that the over-prescription of benzos is adding to the stigma of using them.

    Benzos are detected in urine for a long time after use, far longer than even most street drugs. So even short term use can cause issues with employment. As someone who’s trying to get back to work after a long time away, this is definitely added anxiety for me, one that I surprisingly get little validation about from my prescriber.

    Anyway, thanks for the thoughtful article.

  11. Richard,
    A superb article and hard hitting.

    Benzodiazepines and Opiates are a deadly combination as you rightly point out. I am one of the fortunate ones who survived the daily equivalent of taking 15 mgs of Klonopin and 12 Opiate painkillers, again on a daily basis and all doctor prescribed.

    I withdrew myself from these poisons on the 19th March 1986 , a date which my wife calls my second birthday, over a 15 month period and have campaigned for change and recognition of the issues involved for nearly 30 years.

    Thanks again.

    Barry.

  12. Richard, THANK YOU SO MUCH for shedding light on the elephant in the room, benzodiazepines.

    I have struggled with withdrawal symptoms for almost two years, after an 8-1/2 month taper. I was prescribed Ativan for anxiety (and given absolutely no information on side effects and potential addiction). I was one of those patients who trusted what doctors prescribed for me (not any longer, though). Once I realized why I was experiencing such bad symptoms (by searching online), I asked my primary care doctor if he would help me taper off. He said no and prescribed Paxil, which thankfully I didn’t end up taking. Instead I joined an online forum and was switched over to Klonopin for three weeks, then began tapering off that. I’m still experiencing cognitive difficulties. It’s been nothing short of pure hell to get through withdrawal with all its very unpredictable, frightening symptoms.

    The tapering part of the process, although very difficult, was made a bit easier because I had a goal of being off at a certain date, which I looked forward to. The really difficult time has been going from month 12 to month 18, after tapering was finished, since I had no idea when symptoms would begin to let up. It seemed never-ending. In month 18 I finally began to see more accelerated progress, although I have no idea how to integrate back into society because I’ve been mostly agoraphobic.

    One of the most troubling aspects of benzos is that VERY FEW primary care doctors understand these pills, and very few know that a low dose is still very potent and can lead to a long withdrawal. No doctor seems to understand what “short-term” means in benzo usage. People have been addicted in a few weeks or less. I certainly was addicted very quickly to Klonopin.

    Also, very few doctors know that withdrawal can last for months or years. Two doctors flat out told me that withdrawal should last only a month, max. They both said it with such authority that I wondered where they were getting such incorrect and potentially dangerous information. Who is telling them this? Pharma reps? Word of mouth from other doctors? Botched clinical trials? I’ve heard of doctors telling patients to just quit taking their 8 mg. of Xanax, which can lead to seizure and a very protracted withdrawal. How is it possible that PCPs don’t understand the nature of the benzo pills they easily write prescriptions for? They seem to be, for the most part, clueless. Although no studies have turned up regarding the amount of ER admissions there are each year due to benzos, I’m betting that it’s a great number. I went to the ER a few times due to extreme anxiety while on Ativan.

    Unfortunately, lack of knowledge in the medical field about benzos has led to scant informative articles on the subject. The patient’s family and friends don’t understand why the person they see before them, who visibly looks okay, is constantly complaining about symptoms. The complaints (absolutely legitimate) can go on for months or years, leading family and friends to turn their backs or feeling that the patient is just trying to get more attention. Or the patient isolates himself or herself. We sufferers become part of a secret club of sorts that communicates with each other because there is little, if any, outside understanding or compassion, particularly from doctors who scoff at our symptoms and think it’s all in our heads. Lives have been shattered, bankruptcy has occurred because the patient couldn’t work, marriages have fallen apart, people have committed suicide because they can’t handle the continual torture of withdrawal and don’t understand why they’re feeling the way they do. Or the patient has had to give up and go back on the benzo drug.

    I can’t tell you what a breath of fresh air you’ve been, Richard, in bringing the benzo problem to light. Because there are no long-term studies done on benzo drugs, there’s no reliable information on how many people go through such hell in withdrawal, not understanding what they’re up against or for how long. Polydrugging is a very real problem because doctors don’t understand, either, and prescribe yet more drugs for the patient to take, all too readily, which can delay healing and lead to more side effects.

    Due to the exploding opiate epidemic, it’s time for benzos to come out of the closet and to be dealt with once and for all. Patients SHOULD NOT EVER be told by their doctors to just quit taking benzo drugs. They need to be carefully tapered off. Doctors need to get on board and research the drugs within this classification. Hopefully, because the opiate epidemic is in the headlines, benzos will also be a large part of the discussion also and will be researched INDEPENDENT of pharmaceutical companies.

    This is very long, but thank you again, Richard, for talking about a very real problem that could be an epidemic in itself, which few people recognize, and, mixed with opiates, can be fatal.

  13. Hi Richard ,

    Nice to read your excellent article and to also see you are close by.

    I m presently helping out on a website dedicated to giving people who are withdrawing from this poison , hope and encouragement. We are helping ” victims ” one by one and step by step.

    I live and practice nearby and wondering if you might want to become involved with our cause.

    Please email me if you would like more information.

    Thank you and please continue to write . Something needs to be done about this epidemic. There are so many dear people who suffer in silence.

    Blessings ,

    Michelle