Angela Peacock – Medicating Normal

This week on MIA Radio we present a special episode of the podcast in advance of the events being held to mark World Benzodiazepine Awareness Day, July 11, 2020.

The reason we are sharing this interview early is to help draw attention to a special screening of the film Medicating Normal which will be shown on World Benzodiazepine Awareness Day itself. Following this special screening of the film, there will be an online panel discussion featuring people with lived experience of taking and coming off benzodiazepines. If you haven’t yet seen the film, this screening is not to be missed. The film will be shown at 1 pm EST on July 11 and you can get tickets here.

The film is presented by the Benzodiazepine Information Coalition, a non-profit organization that strives to educate about the potential adverse effects of benzodiazepines taken as prescribed and the Periscope Foundation which is a non-profit organization that funded the making and continues the outreach of Medicating Normal.

For our interview this week I am delighted to get the chance to chat with Angela Peacock who appears in the film and will be a panel member for the online discussion.

Angie served in the US Army from 1998-2004 and was medically retired after one tour in Iraq. She was medicated for post-traumatic stress since that time, going on and off benzodiazepines several times under a doctor’s care until coming off for the final time in January 2016.

She holds a Bachelor of Science in psychology and graduated in May 2019 from Washington University in St. Louis- Brown School of Social work with a Masters in social work. As a 2019 Veterans of Foreign Wars-Student Veterans of America, Legislative Policy Fellow, she is advocating for change in Benzo policy at the Department of Veterans Affairs. She is embarking on a community outreach effort to improve medication and health literacy among military veterans and their family members.

Angie chats about her experiences of being prescribed benzodiazepines, her journey off multiple medications, her continuing work in veterans advocacy and her thoughts about the film Medicating Normal.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

James Moore: Angie, welcome. Thank you so much for taking the time to chat with me for the podcast. We are going to go on to talk a bit about the film Medicating Normal, which you’re part of, and which will be shown on World Benzodiazepine Awareness Day. But before we get to that, I’d like to ask a bit about you. So can you tell us a little bit about you and your background and how it was you came to be prescribed benzodiazepines in the first place?

Angela Peacock: Well my story starts when I was in the U.S. Army for about seven years and I did one tour in Iraq and got extremely sick while I was there. I went from 140 pounds to a hundred pounds and you could see all my bones and I had fainting spells and low-grade fevers and fast heart rate, something was happening, but I continued to work like that. I was doing like two to three convoys a week. So then you had to worry about getting killed by enemy fire. And just that combination of feeling like I was dying from some physical disease and the stress of combat at the beginning of the war in Iraq. I was medically evacuated out of Iraq back to Germany. And then the day after I got home our convoy got hit.

So then there was more trauma. There was trauma from riding on an airplane with a lot of really sick and injured people. So after my soldier told me their story, I walked down the hallway, I just knew that I needed help. Like it was overwhelming the capacity for me to be able to cope with what I had just witnessed and dealt with, and I just could not contain it. I don’t know how else to explain it.

So I walked down the hallway and I saw the sign for psychiatry, I walked in the office and I said, I need help. And that led to my very first prescription of a benzodiazepine. It was Klonopin, also known as clonazepam. And I feel like that decision took my life off course into a polypharmacy nightmare, which lasted for 13 years. I was prescribed over 40 psychiatric drugs over those 13 years, mostly by the Department of Veterans Affairs, but some by Civilian providers. But over all of those years, I sought treatment, I sought therapists, I went to social workers, I went to a psychologist, I went to retreat programs, equine therapy, service dogs. I tried everything just to feel better and not once did someone say it could be the medication that you’re taking.

 

Moore: When you were first prescribed to, were you told much about adverse effects or risk of dependence? And if not, did that lead you to want to make sure that others weren’t treated the same way?

Peacock: No and I should answer the last part of your question about how did I become active in the benzo world and part of that was research. I read things that said veterans with PTSD are 2.5 times more likely to die by suicide with just exposure to a benzodiazepine. So I should not have been exposed to them in the first place.

Years later you read all this stuff and you find out, so no, at my first appointment that was never discussed. It was literally a 10 minute thing and I remember the exact words I used “I’m having a hard time readjusting to Germany” which I should have been that’s normal. You just came out of a war zone, you’re dropped off at a hospital and you’re scared because you don’t know what’s wrong with you. Of course, you’re going to have a hard time adjusting from Iraq to Germany overnight.

 

Moore: And did you get any benefit at all from the benzos in those early days?

Peacock: No. I remember very quickly I had these problems. I had low-grade fevers, gastrointestinal problems, headaches, high heart rate. Then within two weeks, I couldn’t sleep. Every time I heard a noise, I would jump. I remember being scared of standing outside, I became agoraphobic.

So all these new problems started, but they kept saying, “that’s the post-traumatic stress disorder”. No one said you could be having a paradoxical reaction. So I’m sure that I had some remnants of trauma that would appear to be post-traumatic stress, but how much was it? Was it a reaction to the drug? I’ll never know.

 

Moore: That’s so common isn’t it, for the prescriber to reject any suggestion that the drugs are the problem while they are not listening to the person in front of them, who is the expert in what they are experiencing.

Peacock: In 2006, I was prescribed 18 drugs at the same time. What’s sad about this is when you’re prescribed that many, you lose the ability to even know that there’s something wrong with that. I didn’t even know this is wrong. I went to a doctor at the VA and it was kind of my last hope.  I had already made up my mind. I’m probably going to jump off the highest building in St. Louis. I had already researched which one it was going to be.

I went to that doctor and he said “I’m a psychiatrist who doesn’t believe in psychiatry, you need to come off all these meds, it’s way too many”. Then he took me off from 18 to 10 overnight. I had withdrawal symptoms in the hospital and he kept me there for thirty days.

After I was still seeking out what could make me feel better, but I wasn’t quite sure it was the meds. I really thought it was all this trauma that I had been through. So it was just a slow unravelling over the years. I remember so clearly in 2005 I went to a new therapist and he gave me a test in the office. I had just met him, he’s asking me all these anxiety questions. I have an undergraduate degree in psychology, so I know what this test is, and I know what he’s trying to do. I just got really angry with that. He’s not talking to me like a human being, he’s giving me a test.

Then when I filled in the little bubbles, he looks at it and looks in his DSM and he hands it to me. He says, “okay, well now you have generalized anxiety disorder”. It was at that moment, I was just like, I’ve done everything you told me to do. I’ve gone to all the doctors you told me to go to, I’ve taken all the pills and now you’re giving me another diagnosis for what? I don’t understand what this is?

I was just so jaded by that point and then maybe a month later I started getting extremely suicidal again during my taper. I didn’t know about the Ashton manual. I didn’t know about the support groups, I was just tapering. The benzo was my last drug to get off under a doctor’s supervision and I became extremely suicidal. Not once did they say “this is from your taper”.

So I went into the hospital and it was when they greeted me with a plastic wheelchair and two police officers. I said, “I’m here voluntarily”. I had to almost beg to let them admit me. I can’t believe this. This is what I get when I ask for help?  So for me, I’ve lost all faith in the mental healthcare system.

 

Moore: How did you approach getting off all those drugs? Was there a key moment when you realized that you had to get off to reclaim your life?

Peacock: So over those years I tapered everything off. I saved the benzo for last and when I came off the benzo it was extremely horrific withdrawal that I would not wish on my worst enemy. It was way worse than any other drug I ever came off of. I still have effects four and a half years later. So those first two years, I barely left my house. I tried to stay in school and I took the minimum amount of classes that could just to keep me in reality. I felt like I was in an extreme state constantly, but those first two years were the hardest. Then I felt that I want to get outside, I want to talk to other people and I want to reengage with life again.

It’s almost like a reawakening. I don’t even know who I am anymore now that all the chemicals are erased, but I have these lasting neurological deficits.

I was told for years that I would never finish school, I would never have children, I would be on meds for the rest of my life. There are all these messages, subtle or explicit that I internalized. Now at four and a half years off, I still feel like I lack confidence. I still can’t work. So then there’s that thought “who am I if I can’t work and I’m still disabled but don’t want to go to the psychiatrist all the time?”

You know, it’s like this whole reprogramming that you have to do. Then when I look at my trauma compared to the original trauma, that’s minimal now compared to the medical trauma that I experienced. So, I’m trying to heal from the medical trauma, but how do you heal from medical trauma when the medical people don’t even want to talk about it? So the only healing that I’ve found is through advocacy, through Medicating Normal, through the Benzodiazepine Information Coalition. Through what I can do to raise awareness about this problem to help other people. That’s where my healing has come from.

 

Moore: Angie, you’ve done so incredibly well to get your life back after that experience and to go on to help and support others just shows your courage and determination. You’re a board member of the Benzodiazepine Information Coalition and you’ve lobbied for changes to the policies that guide how the department of veterans use benzos. So can you talk us through what you’d like to change in benzo prescribing?

Peacock: I think in the year 2019, they gave out 8 million 30-day prescriptions, which is to me astronomical. We don’t know if that’s 30 days for a novel prescription, or if that’s a continuation of someone that’s been given 30-day prescriptions for years. The way that they track benzodiazepine prescriptions is minimal at best.

I found an interesting inspector general report while I was doing this research that showed a veteran who had been on it for 20 years and then his doctor decided he shouldn’t be taking it anymore. They showed a chart that as he tapered his suicide attempts increased. He ultimately died by suicide. It was directly tied to the way that he was deprescribed. The recommendation from the inspector general was that veterans that are on long-term benzos should be left alone. That is hard for me to even say because these drugs are so harmful, but when you take them away, that can also be equally harmful, especially when you take them away abruptly.

I think the VA needs a complete overhaul with the way that doctors are taught about deprescribing and how they’re taught about prescribing them in the first place with them knowing the evidence that it puts us at greater risk of suicide, greater risk of dementia, greater risk of falls. So many other effects, especially among my generation of Iraq and Afghanistan, vets who have traumatic brain injury, post-traumatic stress disorder, exposure to burn pits. There are just so many things coming together that adding a benzodiazepine to the mix is just not good for any of us. So we need the pharmacies to be aware. We need tapering schedules that are patient-centered, education about withdrawal symptoms, support for withdrawal.

There was support that I could have used that I couldn’t get. No one believed what I was going through. I had doctors telling me that I had MS, that I had a microscopic brain injury, that none of this was really happening. There was gaslighting and trauma from that.

The VA needs a complete overhaul with benzos. They made an attempt to try, there are webpages that show they are trying. The tapering, it looks like they took a little bit from Malcolm Lader and a little bit from Heather Ashton, but then they shortened it. I don’t know who’s coming up with this guidance, but it’s not evidence-based even though they claim to want to use evidence-based medicine. It’s disheartening to me. Every time I hear of a suicide in the veterans community, I want to know what were they taking?

 

Moore: I also read that you support and advocate for veterans and you have a Master’s in social work. So what kind of help and support do you provide to people? I know myself that the best advice I’ve ever gotten is from people that have been there, never from a prescriber who only has an ‘in theory’ understanding of what’s happening for people.

Peacock: While I was going through this, I went back to school because I wanted to work in the system to help change the system from inside. I found school very traumatizing, like the way that they talk about patients and the way they talk about people with mental health problems. I would sit there always and think “you’re talking about me”. It’s like when your parents are talking about you and you’re in the other room, that was the feeling I constantly had. Any pushback that I ever gave, even saying simple things like antidepressants cause withdrawal. It was always like, “no, we don’t need to talk about that right now”.

So it’s like the whole system is complicit and I don’t want anything to do with that. I did 14 months of giving therapy to people without diagnosing them, without referring them to psychiatry, without calling people when they were suicidal. I enjoyed that, but I thought “I need to reach more than just one person at a time”. So for now, I do what I can. I’m involved in several non-profits within the veteran world. Sometimes they’ll call me and say like, what do you think about this? I did a fellowship with Veterans of Foreign Wars and talked about the prescribing and deprescribing of benzodiazepines at the VA level. I helped with the peer support group with the Wounded Warrior Project. I talked with lots of veterans. I run a group for St. Louis veterans. I just do what I can, where I can.

 

Moore: That brings me onto the film Medicating Normal. The first thing to say is that it’s immensely powerful. It made me very angry watching it because of the way that we treat people and the way that it’s explained that we take someone’s grief or trauma and we turn that into a medical illness and we label them. Then the label only leads in one direction and that’s drugs and more drugs. So I wondered Angie how did you come to be involved in that film?

Peacock: I didn’t find the online support group community until I was four months off everything. I guess there was an ad or something and I saw it and thought “I’m not doing that”. Then someone on Facebook said, “you should talk to Angie Peacock, she’s a warrior”. So the producer messaged me and she said, we are doing a film, would you like to be in the film? I said no again and then she said “I want to fly out there and talk to you in person. Do you mind if I fly out?” And I said ok.

So she flies out and we talked and she basically said: “you have to do this”. So I thought to myself, now I can’t kill myself because there’s this film and if I’m going to be part of it, you don’t want them to say that you died at the end, you know? So in this roundabout way, it kind of saved my life because they would come back every few months to see my progress. I’m really grateful that I’m a part of it. I really am.

 

Moore: I was so pleased to see personal experience front and center in that film because it’s the people that have been through this that are the biggest source of the caution that we should all have about how freely we’re prescribing these drugs. I was really struck Angie, I hope you don’t mind me saying, during the film you relived the trauma of losing a comrade from your troop. You think “was this grief muted and blunted by the drugs for so many years” and you still had to go through that process of grieving and it’s captured in the documentary. I really felt for you watching that.

Peacock: Thank you so much. I felt really robbed that I could’ve grieved a lot of this trauma earlier. All the therapy that I did when on medications, I don’t think you fully get to really repair, I don’t even know how to explain it. You just can’t fully feel what happened to you and you can’t integrate it. So now that I’m off, there’s a systematic way that I have to go through things to repair those feelings that I should have had 15 years ago, but I’m just now getting to do that. So in a way, I feel robbed of my own healing process.

 

Moore: The film has been screened a number of times now, and, and it’s going to be shown on World Benzodiazepine Awareness day itself. I just wondered what reaction you’ve had from others about your role in the film and the film overall?

Peacock: This is a cool story. When I graduated from social work school, my lease was up, so I sold everything and jumped in an RV and drove off into the sunrise and started screening the film across the United States. We’ve done about 75 screenings. I’ve done 40 or so by myself on the road through Texas, New Mexico, Arizona, California North Carolina, all over the place.

So I’ve met maybe 3,000 people in person and the reaction has been almost 99% positive. It’s just undeniable when you see the lived experiences of five people and then you hear the experts too, there’s very little that people can say to refute that. If you were to refute that, you’re refuting, someone’s personal lived experience. I think they just did a beautiful job.

I’ve seen people go from knowing zero to understanding the things that you talk about on Mad in America within 76 minutes. The best part for me is the discussion after the film, which you’ll see on World Benzo Awareness Day. It’s that chance for the community to talk back and related what happened. This is what moved me. This is what I learned. I’ve seen people have revelations about their life. Like this explains why my daughter can’t heal right now. Or this explains my marriage break up. So there’s this education level and awareness and I think it changes every person that sees it.

That’s the way that I prefer to do advocacy now, instead of this huge systems change or me being in the mental healthcare system, it’s one person at a time hopefully to prevent further harm as much as possible.

 

Moore: The film definitely spoke to me and validated a lot of what I’ve been through, but I think it’s so important also for family members. Close family who are with you, they get it, because they’ve seen the misery that you’ve been through, but extended family might be thinking “the drugs can’t be that bad, surely this is all part of the illness or part of the diagnosis”. The film does a brilliant job of dispelling all that and showing real people, suffering real things and having an inappropriate response made to those experiences.

Peacock: And prescribers too. I’ve even had prescribers in the audience say “ Oh my God, I didn’t know”. I’ve had prescribers cry and say, “how can I give informed consent if I’m not even given informed consent?” A lot of times we want to blame the doctors, but they’re a victim of this too, in a different way.

 

Moore: And so Angie given your experiences and through advocating for others, if there are people listening to this who are having a tough time either taking benzos or trying to get off them, are there any general words of support and encouragement that you give to people to help them come to terms with what’s happening to them?

Peacock: Read as much as you can, talk to people that have been through it. It’s okay to look for support to rule out any other illness, rule out any other medical causes that could be causing the way you feel. Take it one day at a time, sometimes it’s one minute at a time, one breath at a time live absolutely in the day if you possibly can.

It’s extremely hard for many people, and there’s very little support, it can be a very stigmatizing, isolating experience. So hang on tight to your healing buddies, find a healing buddy that you can relate to. Wait for time to pass because healing is definitely real. I mean, if I can heal from more than 40 psychiatric drugs in a 13 year period, and I’ve had a few brain injuries on top of it, I’m here to say that you’re going to heal too.

 

Moore:  Thank you Angie, that encouragement so important for people. It’s the long haul, isn’t it healing from, from these things. As we said, the film is going to be shown on benzodiazepine awareness day itself. I was delighted to hear that you’re part of a post-screening panel along with Nicole Lamberson and some recognized experts too. You’ve obviously experienced these panels before, so what are they like?

Peacock: I think the best part is just hearing from the audience but also when we add different perspectives to the panel it’s a chance to unwind some of the complex issues raised in the film. There are talks in the film on informed consent, side effects, withdrawal, the evidence base for the mental health system. So when we bring experts on the panel, they can unwind those complex issues.

So it’s a unique opportunity. I don’t think these conversations are taking place anywhere else like this where the power structure of prescriber and patient is levelled after watching the film. There are people that are currently taking meds, those that are off, doctors, board members from BIC, teachers, therapists, everybody in the same room having the same conversation after watching the same film. So please come.

 

Moore: I can genuinely say that if I’d have had a chance to see that film and experience that around the time that I was first prescribed to, I’d be in a very different place in my life now. I thank you and all the people involved in the film because it’s crucial viewing.

Peacock: Thank you so much. It’s been great to be involved with it.

 

Moore: It just remains to say thank you so much for making time for this and for everything you’ve done with the film. I know people listening will get a huge amount from watching it and the panel discussion afterwards.

Peacock: Thank you so much. Thank you for having me.

Links and further information:

Medicating Normal special screening and panel discussion

World Benzodiazepine Awareness Day

Benzodiazepine Information Coalition

Three Suicides: Honoring Lives Lost to Benzodiazepines

The Many Battles of a Benzo Injury: Jean’s Story