While the world is convulsed by COVID-19, a dramatic admission has been made by the US Food and Drug Administration about dangerous benzodiazepine drugs (BZDs). The FDA has acknowledged that patients can become “physically dependent” on them after taking them for as little as “several days.”
They have also admitted that stopping the drugs abruptly or reducing the dosage too quickly can cause severe withdrawal reactions, “including seizures which can be life threatening.” They also finally accept that these severe withdrawal side effects can last from “weeks to years.”
The FDA has not produced a report on the hundreds of thousands of complaints that have been made to them about BZDs, but just 104 “focused case series,” in the FDA Adverse Event Reporting System (FAERS).
Critically, the FDA now acknowledges a serious problem for those prescribed BZDs:
“Physical dependence can occur when benzodiazepines are taken steadily for several days to weeks, even as prescribed. Stopping them abruptly or reducing the dosage too quickly can result in withdrawal reactions, including seizures, which can be life-threatening.”
The statement goes on to say: “The current prescribing information for benzodiazepines does not provide adequate warnings about these serious risks and harms associated with these medicines so they may be prescribed and used inappropriately.”
This is an historic U-turn for the FDA, a return to form for an agency which garnered national and international fame for refusing to licence Thalidomide in the 1960s, saving the US from the widespread devastating birth deformities the drug caused.
The FDA was first formally asked a decade ago to accept the real dangers of BZDs and do what they are now doing. This came in a Citizens’ Petition in 2010 signed by thousands of those injured by prescribed BZDs, as well as concerned professionals, led by the late Professor Heather Ashton, a renowned world expert on BZDs who died last year.
The Petition called for a black box warning on the packaging of BZDs, but that was ruled out in a breathtaking complete denial and refusal of the entire Citizens’ Petition in 2015. Then, in 2017, the FDA rowed back, but very narrowly, conceding a request from just two doctors for a black box warning not to take BZDs with opioids while the controversy about opioid deaths was raging.
It’s worth putting the FDA’s use of the 104 FAERS cases to decide their new position on BZDs in context. Up to 2018, there had been 300,000 cases of reported complaints to FAERS about BZDs and the so-called Z drugs (mainly sleeping pills which, while not strictly classified as benzodiazepines, have the same mechanism of action). The number of complaints about BZDs outstripped complaints about opioids until 2018.
“Approximately 80% of the FAERS cases described benzodiazepine withdrawal, including CNS effects (e.g., insomnia, increased anxiety or panic attacks, memory impairment, depression), cardiovascular effects (e.g., heart rate or rhythm fluctuations), and gastrointestinal effects (e.g., abdominal pain, nausea, diarrhea). These cases reported a wide range of time to dependence, with some describing the onset as early as days to weeks after the start of a benzodiazepine. Similarly, there were variations in the duration of the withdrawal symptoms that lasted from weeks to years,” the FDA says.
“While this is a small subset of FAERS cases received for benzodiazepines as a whole, we selected a focused case series to identify the most descriptive reports of dependence or withdrawal. Most patients reported that dependence and subsequent withdrawal symptoms developed even when the benzodiazepine (clonazepam, alprazolam, lorazepam, diazepam, triazolam, or oxazepam) was prescribed for therapeutic use.”
This is very clear. Most patients reported that physiologic dependence and side effect injuries happened when they were taking therapeutic doses of prescribed BZDs. And, note too the statement “withdrawal symptoms that lasted from weeks to years.” This is a clear acceptance by the FDA of an injury syndrome caused by BZDs where some patients suffer long after stopping the use of these drugs. This protracted injury syndrome after ceasing BZDs was publicly revealed in medical studies by two leading international experts on the drugs, Professors Heather Ashton and Malcolm Lader, over 30 years ago.
In my 2016 documentary, “The Benzodiazepine Medical Disaster,” the late Professor Lader said he had spent forty years trying to convince the medical profession that exactly this was happening—people were being injured on prescribed therapeutic doses of BZDs, and additionally they were not escalating the dosage.
The FDA laments the lack of epidemiological research into these drugs, but campaigners have been asking for this for many decades. It begs the question as to why the FDA does not commission detailed research into the huge number of complaints that it has available to it, or why it does not specifically recommend to the health agencies in the US that such epidemiological, and indeed long-term injury research should be carried out.
In the documentary, Lader also called on Roche, the drug company that discovered BZDs and made a fortune with Valium from the 1960s onwards, to fund such research “from past profits.”
While it is progress for the FDA to recognize the dangers, it is far too late and far too limited in listing the severe long-lasting side effects that can injure patients, many of whom suffer multiple symptoms. It is also worth noting that, ironically, the danger of seizures from abruptly ceasing the drugs was first reported in a 1961 US study carried out by Dr. Leo Hollister on the first Roche benzodiazepine, Librium, even before Valium was launched. Hollister’s study of a group of patients taking and stopping Librium was ignored.
The FDA says that it will update the black box to include these new warnings, but the wording is still awaited.
Bernie Silvernail, founder and director of the Alliance for Benzodiazepine Best Practices, noted that “More than 20 voluntary organizations with over a hundred thousand members worldwide have been dedicated for years to informing the world of the dangers of benzodiazepines. Dozens of books by patients and physicians have called out their problems, and legislation designed to protect patients from benzodiazepine over-prescription has been proposed. In October, 12 MDs and researchers published the most authoritative work on these problems, The Benzodiazepines Crisis: The Ramifications of an Overused Drug Class. Some 30 years after Ashton and Lader warned us, it is good to see that the FDA has finally reviewed the data it collects, and agrees with the need to change benzodiazepine prescriptive practice.”
There is still an issue of concern about the FDA statement, mixing misuse, abuse, and addiction with the distinctly separate and more insidious issue of continuing harm and injury that is caused through medical prescriptions. It’s called iatrogenic (doctor induced) harm. While it may not be the intention of the FDA, this use of language is suggestive of bad behaviour on the part of those who become injured taking the drugs, as prescribed—implying, in effect, that they are the authors of their own misfortune. The language too feeds a belief in the public domain that those “addicts” are weak and irresponsible, and deserve no sympathy for their condition.
It is an unfortunate aspect of BZD injury that uncounted numbers of those affected are afraid of the stigma of “benzo addiction” and agree to other diagnoses of their drug injury to avoid this stigma. This, in my experience, also can happen where patients need to get access to insurance coverage. In my opinion, it is worth investigating the occurrence of the diagnosis of fibromyalgia alongside the prescription of BZDs. The well-documented severe neurological pain caused by BZDs is remarkably similar to that associated with fibromyalgia.
It’s of course probably a truism that all psychoactive drugs can be misused, and abused in a form of addiction. And it might be that some who are prescribed BZDs go on to misuse and abuse. But the vast majority of people prescribed these drugs just want to have a cure or alleviation of illness, and as Lader reported in the 1980s and said in my interview with him, they did not escalate the dosage. The conflation of those using the drugs as prescribed with “addicts” has done almost as much harm as the drugs themselves.
So BZD campaigners are concerned that the FDA, in its statement, is still focussing on issues of misuse, abuse, and addiction—issues which have in the past been used, not just in the US but worldwide, to marginalise the serious dangers of iatrogenic (doctor-induced) physical injury as a result of the normal dosage, therapeutic prescription of these drugs.
This is the way the FDA made its new Boxed Warning announcement:
“To address the serious risks of abuse, addiction, physical dependence, and withdrawal reactions, the U.S. Food and Drug Administration (FDA) is requiring the Boxed Warning be updated for all benzodiazepine medicines. Benzodiazepines are widely used to treat many conditions, including anxiety, insomnia, and seizures. The current prescribing information for benzodiazepines does not provide adequate warnings about these serious risks and harms associated with these medicines so they may be prescribed and used inappropriately.”
The FDA rejected this latter statement in the 2010 Citizen’s Petition, but are now including it.
“Benzodiazepines can be an important treatment option for treating disorders for which these drugs are indicated. However, even when taken at recommended dosages, their use can lead to misuse, abuse, and addiction.” A clear example of the FDA’s innocent, but harmful approach: acknowledging the prescription dangers, then turning immediately to words facilitating patient blaming. So when a patient is prescribed the drug and takes it as prescribed, and is injured, the patient can be accused of misuse, abuse, and addiction.
That, unfortunately, is what has been happening for more than half a century: patient blaming, affecting the lives and wellbeing of countless thousands—if not indeed millions—worldwide, burying the real dangers of BZDs, including the protracted injury syndrome revealed in the published works of Ashton and Lader a long time ago.
Campaigners are hopeful that the newly-aware FDA realises that this complex situation requires an approach that stresses the harms and injury from the drugs, as their small study has revealed, particularly the disabling, long-lasting side effects. That would have a hugely beneficial effect on the health of citizens prescribed BZDs, making doctors and patients much more careful. If it had been done in the US decades ago, many among the 300,000 FDA complainants could likely have avoided their suffering.
Dr. Steven Wright, a leading US expert on BZDs said: “Benzodiazepine use disorder or addiction is very uncommon. Physiologic dependence, however, is quite frequent and can result in severe and protracted symptoms. The term “withdrawal syndrome,” though, is insufficient, because there are many individuals who experience major problems long after complete cessation of these drugs and “withdrawal syndrome” implies universal symptom resolution. That term should be replaced with benzodiazepine injury syndrome (BZIS) as this better expresses the long-lasting agony experienced by many benzodiazepine survivors. In turn, this should compel prescribers to limit initiation and limit duration of benzodiazepine use to 2-4 weeks.”
I suggest these Box Warnings:
WARNING: DO NOT TAKE FOR MORE THAN 2-4 WEEKS – RISK OF SERIOUS LONG-TERM DISABLING INJURY.
IN WITHDRAWAL DO NOT STOP ABRUPTLY – RISK OF SEIZURE AND DEATH
Ashton ran a clinic in the UK for 12 years, treating victims of iatrogenic BZD injury, and reported that side effects/withdrawal symptoms could start while patients are taking benzodiazepines, as prescribed, at normal therapeutic doses. Everything acknowledged and proposed by the FDA was indicated in her studies of the 1980s and her legendary Manual on benzodiazepines, Benzodiazepines: How They Work and How to Withdraw, published on the web in the early 1990s.
When I interviewed her for the documentary, she stressed that her understanding of the harms caused by BDZs grew because she listened to her patients. They, she said, were the experts on the symptoms they were suffering. With its review policy, after examining a focused group of 104 of the many thousands of complaints, the FDA is now finally using this best practise.
Ashton (and her Manual) was the friend, consultant, and advocate for patients, doing the job of governments, medical bodies, and consumer protection agencies worldwide for decades when patients got no succour from those responsible for caring for and protecting them.
The FDA now has an opportunity to change that story. Let’s hope they continue to advance beyond the important Rubicon they have already crossed with their new warnings of the dangers of benzodiazepines.
“The Benzodiazepine Medical Disaster” can be viewed freely on Vimeo or YouTube.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
“The conflation of those using the drugs as prescribed with ‘addicts’ has done almost as much harm as the drugs themselves.”
Yes, all of psychiatry’s – and the mainstream medical industry’s – patient blaming does need to end. The psych drugs are the problem.
I’ll never forget a video, made by a concerned husband, who documented his wife’s battle with benzo withdrawal. I wish I could find it online, it was absolutely heartbreaking.
“Ashton (and her Manual) was the friend, consultant, and advocate for patients, doing the job of governments, medical bodies, and consumer protection agencies worldwide for decades when patients got no succour from those responsible for caring for and protecting them.”
“succour (ˈsʌkə) or succor,” as apparently this word is spelled in the US, is a noun meaning “help or assistance, esp in time of difficulty.”
It is truly shameful that the big Pharma deluded doctors, particularly the psychiatrists, have been behaving as hypocrites for decades.
Thank you, Shane, for your documentary. The systemic crimes of the psychiatrists, and mainstream doctors who’ve bought into the psychiatrists’ “bullshit” and “invalid” DSM, and the harmful psych drugs, really do need to be exposed and documented.
Their systemic crimes against humanity are truly heartbreaking in scope. And it’s sad people no longer should trust in the big Pharma deluded, and psychiatric deluded, mainstream doctors.
I am 69 years old and have had a prescription for benzos most of my adult life as well as my mother due to anxiety. I have gone and off them many times without any serious withdrawal problems. Anxiety has been proven to be real and hereditary. Due to the actions of the FDA, doctors are now afraid to prescribe these medications that are needed by patients. I have suffered needlessly from anxiety and insomnia from the FDA policies forced on the medical community. These are real problems that have been made worse by coronavirus and isolation. I have a question for all of you. I am retired, never been arrested, cause no problems or dangers to community. Why am I forced to suffer needlessly by government action, that really benefits no one. Antidepressants are truly awful drugs with horrible side effects. I’m am old small person with no criminal history and would seriously like to know the harm in allowing me, and others like me to continue with my previous prescriptions that were low dose prescriptions that help to make life bearable.
I don’t know that anyone here wants to prevent you from doing something you find helpful. However, it becomes different when doctors lie to people about the supposed causes of their problems and try to force “treatment” on them that is really just giving a drug and hoping it works. Not to mention the incredible levels of denial that occur when the clients themselves report that the drug is making them worse.
I’m interested by your comment that “Anxiety has been proven to be real and heredity.” Anxiety is certainly real, but I’m pretty familiar with the research on this point, and I am not aware of anything that suggest that “anxiety” IN GENERAL is hereditary. I’m not denying the possibility that some people may struggle more with anxiety (including me) for reasons that may be significantly affected by heredity. But these same anxious people may have lots of other good qualities, like empathy, commitment to bigger goals, willingness to sacrifice, sensitivity in social situations, and so on. And of course, it is obvious that anxiety is HUGELY impacted by environmental factors. It is, in fact, a survival mechanism to help us avoid dangerous situations. So to decide that anxiety is hereditary is, as far as I know, not supported by evidence (please share if you have some!), but more importantly, anxiety is not a “disease state” that needs to be “treated,” even if some people find that there are drugs or other physiological interventions that can ease anxiety.
Hope that makes sense!
I wonder if a doc said, here is a prescription for leaving the situation that is causing anxiety, this script is for a week long canoe trip etc etc….I wonder if many anxieties would be calmed by a change in daily living? Not a ‘cure’, but neither are benzos.
Talking about anxiety as being hereditary is a huge subject. Of course it and any other difficulties could be hereditary in the sense that perhaps role modelling plays a huge role. But there is a ton of information in our ancestry. Incidents or life circumstances that go back generations do indeed follow us. Our great great grandfather might have had extreme hardships under extreme conditions. This stuff, it follows us. Not in that bio bio way.
And despite it’s ability to cause ‘disability’, it is not “illness”. No more an illness than being born without a physical body that can endure heavy labor all day long. I might say that 3 out of 5 (choose a number) people cannot do hard labour, without being affected by it. We are not born with equal heart or lung strength, or resistance to heat.
Many therapists or researchers go the route of “anxiety used to serve us if we met a dinosaur, but there are no more dinosaurs, so we need rid of anxiety”. It’s ludicrous to suggest it has no purpose anymore. It is part of society, our society causes it, or makes it worse, as does our ancestry. It is part of humans just as a different bodies are. How many shrinks do you see who could compete in a boxing ring? Or would it be stressful to their bodies? Are there drugs for that? And no, most of us can ever attain physical ability to fight, or endure, despite training.
We can make it better, but not “cure” it. We live in a society that allows for many bodily capabilities, or incapability.
At the moment, emotions or feelings, reactions, are what gets drugged. No other efforts are being made to construct a myriad of schools, environments that click with who people are. In a different environment, that “anxiety” might never have become an issue.
But it is with us so it is a needed mechanism.
Benzos have their place. They are ugly but have their place.
But first and foremost, if those physically lacking docs want to prescribe HEALTHY and HELPFUL things, drugs would ABSOLUTELY be the very last thing.
Medicine should be ALWAYS about “do no harm”. However, it is far from that.
Our doctors and psychiatrists should be screaming at the top of their lungs for our politicians to develop accessible programs for EVERYONE according to their needs.
Drugs cause more disability than there ever was before drugs.
I’m super glad that you recognize the “anti-depressant’s” harm. And yes, if you have anxiety that cannot be calmed with other attempts, you should be allowed to decide what works best for you, especially at your age. For a doc to pretend that “anti-depressants” are better is ludicrous.
Yes, I do think “benzos” have their place, but it’s extremely limited, in my opinion. I have had family members be given “benzos” before certain tests like CT-Scans, etc. or before “being put to sleep” for surgery. However, these are basically medical uses, not “psychiatric” uses and are definitely not intended for anything but extremely short-term use.
The other point you are stating is that each one of us is unique; for many that would be “uniquely made.” Not to belabor a point, this is why “drugging” people “en masse” which I think they have tried to do with “benzos” and other “psycho-drugs” never works. Thank you.
Yes anxiety is absolutely real but what they don’t tell you is that benzodiazepines can make it worse, making you believe you NEED the benzos hence long-term use.
With all due respect, your comment is doing the very thing that the article is suggesting. You are accusing patients of misuse of them thereby making your own use justified. Let’s be clear, no one is advocating to take your drugs away. All of us who are lobbying to change laws and to bring attention to this problem are advocating for informed consent. That you be told BEFORE your first pill the very real harms that can come of taking them.
Did you know that benzo use can increase your risk of cancer, falls, dementia? Especially in old age? Do you think that’s okay that no one told you that? Don’t you think it’s responsible that FDA is warning doctors to not abruptly withdrawal patients? We advocate that people who have been on them long-term be left to decide for themselves if they’d like to stay on them or withdraw. That no one be forced off for any reason whatsoever.
So, I would invite you to take this article in and not be so quick to have a defense against so many people who’s lives have been RUINED just taking them AS PRESCRIBED. Just like you are. Maybe you read something that scared you but it’s no reason to accuse us advocates for taking your drugs away. That is not what we are doing. I also find it extremely troubling that you know antidepressants are “truly horrible drugs” but you can’t see that for benzos. You can’t die from seizures from coming off SSRI but you can from benzos.
Not to belabor the point, but he did refer to the FDA policies forced on the medical community, and concurrent reluctance of many doctors to prescribe them. This is mostly a separate issue from the role of advocates/activism, although it seems to align with much of what they want such as the reduction, if not banning, of use. The move IS taking it away from long term users and forcing stopping, despite the will of those who feel it helps them and feel the risks are acceptable. It’s understandable that if he has used them such a long time with no perceived harm, that he would prefer to continue using them, despite other factors and methods that might be helpful.
First off, I don’t see doctors being particularly reluctant to prescribe benzos. Xanax is the second most commonly prescribed psychiatric drug, and Ativan comes in at #7, in 2016. (https://psychcentral.com/blog/top-25-psychiatric-medications-for-2016/)
Second, restrictions on long-term use appear to be advisory at this point, and the recommendations for short-term use only are well established and long standing. There are exceptions to every rule, but it seems to me that it would be irresponsible not to give appropriate warnings regarding the difficulties of discontinuing Benzos. The guidelines seem appropriate to me, just as it is appropriate to warn adults and youth that stimulants are drugs of abuse, even though it appears that a certain percentage of users report being pleased with the results.
The difference between a legal mandate and a warning/guideline is well taken. You pointing out that certain benzo’s were in the top tier of common prescriptions is also notable, and despite that number being from 2016. I believe the benzo advisory warning from the FDA is newer, but I’m sure they are still virtually as common. I would be curious to see if the updated advisories have or are making an impact, not so much for the ‘most severe cases of anxiety’ but rather the more run-of-the-mill and common ones. Also, whether the guideline are affecting if prescribers minimize the time-frame rather than never start the regimen at all. The time-frames for acid reflux prescriptions hardly make a difference, even though the clinical trials and the prescription info. emphasized the very short-term use.
Perhaps not only the reluctance but firm denial of my prescriber was due in part by his being very young…..someone who did not have the background of commonly prescribing it like many of the old-timers. It is also notable that benzo’s are not prescribed as much if people use illegal drugs like cannabis. I don’t know if this same practice applies in states where it is legal for medical or recreational, although I would like to know.
I was not questioning the efforts at warnings, advisory guidelines, or COMPLETE informed consent for these things. The idea of informed consent, let alone with ‘newer’ warnings, black box or otherwise, is virtually non-existent it seems to me. The point has been made from commenters, quite rightly, that if people were completely informed before hand, it’s not clear that anybody would choose to take these things. But my guess is that absent apparent alternative or supplementary options, many people will feel so desperate, so at-wits-end, or so fragile, unconscious, or timid, that they would still sign the consent form. Not to mention in the face of family or legal pressure, waving their finger at them, or threatening them with punitive or restrictive measures.
I understand everything that people are writing about the warnings of benzodiazepines, when I come to my doctors office with chronic pain from many injuries, and PTSD my doctor wrote me a prescription for benzodiazepines just to try to help me live every day. Now with the opioid crisis and the panic about prescriptions that can be abused it has caused my doctor to renegotiate all his patients to a forced taper of all controlled medication‘s. In my particular case my doctor told me that his medical opinion was he advised against me dropping any of these medication‘s but his hands were “ tied“ because of the government; in other words the DEA the FDA and politicians have been running my medical care. With regards to my Valium prescription rather than doing the taper as was in our agreement the physician’s assistant stopped my Valium I had been on for about 15 years cold turkey and ignored the taper program for some unknown reason, (I never had a overdose or abuse issue). I didn’t know until I saw the video above what might be causing all these additional symptoms on top of the ones I have for chronic pain with my back being completely destroyed… right now I just know I managed to bear through today and I’m trying to prepare myself for having to do the same exact thing tomorrow and the next just like I did the day before, I just want to know what I can do to try to have a life that I’m not just trying to manage getting through a day and not living. When I was on a steady dose of benzodiazepines I was able to function, I was able to work moderately, I was able to sleep, I was able to eat and infrequently have a nice day. Now I’m just “getting through it“. What should I do?
There is zero scientific evidence anxiety or any psychiatric label is genetic.
Benzos are deadlier and more addicting than “antidepressants”. Note the study found Benzos are 9% deadlier than antidepressants, which increase all cause mortality by around 70%.
The majority of people who suffer from anxiety and other psychiatric labels who don’t take drugs recover and it goes away. There is zero evidence Benzos provide a single long term benefit, in fact all long term data shows the drugs worsen all outcomes. Your insistence that you suffer so much and are angry because you struggle maintaining a drug addiction contradicts your insistence that the deadly, dementia causing drugs with zero evidence of any benefit are helping you.
You’re probably suffering because of the drugs. After a days to a few weeks of use Benzos cause a large increase in anxiety, cognitive impairment, death, 4x increase in depression and other negative effects
(Chapter 7 the Benzo trap)
4 Freedom: I believe you. Thank you for speaking up on this topic. I have taken benzos for most of my adult life. I am older, too– early 60s– and I’ve had an immune disorder since I was a teenager, but I don’t consider myself ‘small,’ and I hope you don’t think of yourself that way, either. Your voice is important.
My life is big. Daily, low-dose benzodiazepenes and low dose opiates, the former started 20 years ago and the latter started 15 years ago, have helped me manage the wild fluctuations my body goes through. I do not know anyone else my age who has my disorder and who still can work a 40-hour week, mountain bike, and bodyboard. I was a black diamond skier, too, until the pandemic. My stamina has never been great, but I did my best sports, my biggest shows, and my best work within the last 5 years. Before these drugs, I was stuck in a dead-end job.
The two least-popular and most reviled drugs in modern history also helped me quit drinking, quit smoking cannabis, and quit smoking cigarettes, all of which, in my opinion, were far more debilitating to physical and mental health.
Like you, I’ve never had any legal trouble and have been a productive member of society for all of my life.
Angela, I’ve been hearing this line about dying from seizures coming off of benzos since I was in clinical training. I’m sure it must happen, but I’ve never actually seen this. When I hear people in AA talk about seizures from benzos, they were generally drinking to wild excess at the same time, which of course is terribly dangerous. I tell my patients what I’m supposed to tell them– consult your doctor, don’t go off benzos cold-turkey, and of course I know that some people must have this issue.
But when people ignore my advice? What I hear is, “Yeah, I was pretty wound up for a couple of days, but that was it.”
I know there must be some people who have terrible problems with them, but I just can’t believe the numbers are what this documentary (linked above) says they are. There is obviously a population which experiences the symptoms they describe– the narrators and experts aren’t terribly convincing, but I don’t think they’re lying– I just strongly suspect what I’ve seen in my own practice: Comorbid factors. And very significant ones.
In contrast, I hear about the devastating effects of SSRIs EVERY WEEK in my practice– not just withdrawal, but initiation and dosage change, just as Healy, Whittaker and so many others have warned. There’s literally no comparison; of course SSRIs and SNRIs are far more dangerous. It’s absurd to even mention them in the same breath.
When people right about SSRIs on this forum, I don’t hear anyone saying, “Gee, SSRIs saved my life, what’s the matter with you people?” In my personal and professional life, I know ONE GUY who says this. Everyone else either says, “maybe it works, maybe it doesn’t” or “My God, what is that terrible crap, I took it for three days and they were the worst days of my life” or they complain about the side effects and withdrawal. A lot of folks taking SSRIs make little progress in therapy because they can’t experience emotions normally. These are drugs that alter consciousness profoundly 24-hour-a-day.
Sure, you can die from benzo withdrawal– but usually only if you are drinking and/or using LARGE amounts of opiates or other CNS depressants at the same time.
You generally won’t hang yourself in the damn garage, where your spouse will find you as soon as they come home from work, if you’re taking benzos. You probably won’t take an AR-15 and shoot up a school, either. You usually won’t be chemically castrated from benzos, or lose the ability to feel pleasure, either– though you are at significant risk of having all those things happen to you if you are unfortunate enough to be prescribed SSRIs and SNRIs.
Of course it is ‘advocacy’ that is making it nearly impossible for people like 4Freedom to get their prescriptions refilled. So come on, let’s get real. Of course SSRIs are more dangerous than benzos. There’s no comparison.
Catalyzt, you make some valid points.
I find it amazing that the same watchdog and advocacy approach is not used for other “mental/nervous system” drugs.
You don’t see government policy telling subscribers to stop prescribing the likes SSRI’s or neurotoxins.
Because I agree that those are so very dangerous. Of course at the start some people’s brains are so scrambled that they might experience a type of euphoria, but it is brain damage.
Like the opioid “epidemic”, to take them away from people who have extreme pain, is absolutely disgusting. Yes they are crappy drugs, but they pull some people through the day. I personally know people who opted out of life because of uncontrolled pain and the fear around opioids.
But benzos are not candy and brains are not all alike.
I’m a recovered alcoholic, and Rx drug (non-opiate) addict. In my near 30-year now RECOVERY, my thoughts and feelings have changed with both more wisdom & experience, and more education. I WISH I KNEW THEN WHAT I KNOW NOW….
And I continue to do my best to share my wisdom, hope and strength whenever and where ever I can. Doctors have played the BLAME THE VICTIMS GAME for decades now.
(My own benzo experience supports the MiA-presented evidence 100%…..)….
I won’t go into the complexity of the Amazon jungle. But I would like to say that rather than prescribe me a benzo, I was prescribed hydroxezine pamoate (due to the points of hesitation and FDA warnings). I found it almost worthless, yet he stuck with it and apparently had no other alternative. (I’m saying that only within the psychiatric context). I was given gabapentin, I can’t remember if that was partly for anxiety, I think so. It made me slower and stupider, it seemed to me, and I refused to continue. I’ve also been prescribed very small benzo doses that were questionable in terms of their ‘effect’ (not just perceived benefit).
When I was involuntarily committed for 2 weeks, I learned that I could request a benzo every 6 hours. I was so anxious and uncomfortable (partly bc of commitment) that I requested it on the dot. I often still paced the halls constantly, but I felt it at least was a placebo, if not a crutch, if not a relief. But when I was released, it was the lithium that made my hands, head, and MIND shake (as tremors). And it was the Zyprexa that made me fat, tired, and slower.
I’ve experienced benzo withdrawal when I had no prescriber anymore and was running out. It was extended-release Xanax so cutting the pills wasn’t exactly right. Probably or definitely wrong. I also now take Xanax before bed. My sleep was so bad, I had to do something more. I can’t sleep without my nightly low-dose neuroleptic, and I take melatonin.
I know I still need a lot of work! I can relate to 4 freedom’s comment, just as I support the article’s message and activism on this issue.
(Note to moderator)
Hi, I noticed two of my comments haven’t been posted in a couple days. Should I expect them not to be? If so, could I understand why, so that I know what I shouldn’t do in the future? Are we notified if our comments are not accepted? Thank you.
Probably a technical problem. Sometimes I approve them and they don’t register as approved. I’ll get back to you on this.
Thank you, Steve
Sometimes anxiety is assumed to be hereditary only because it may occur in several members of the same family. That’s a weak assumption. Haven’t we seen attitudes enforced in families. “We’re an XYZ sort of family” indicates that a characteristic is enforced.
I remember way back when. In class we saw family members “catching schizophrenia ” from one member. Learned behavior is the fashionable cause today. Could anxiety be learned? Yep!
Another question: Where are these studies that we hear about? An opinion is not a study. Review of hospital records is more hearsay than study. Where are the elements of a study either double blind or clinical trial? Dr. X made a study 30 years ago? Where is it? We see its shadow as in mentioning it, but where is the evidence that it ever existed? This is too common today especially when speaking of psychiatric drug problems.
Show us the actual studies if they exist.
Speaking Chinese tends to run in families. Must be genetic, eh?
Medical issues should not be dictated by politics. Patients should not be evaluated by social government policy but by individual need. I am 69 years old and seen medical propaganda go from coffee will kill you to it’s good for your health, the same with butter. People should be treated as individuals and not by guidelines issued by government which is influenced by big pharma and money. Antidepressants are truly bad, at least in my experience. Benzos used as prescribed are not evil or cause societal breakdown but are truly helpful for people who suffer from anxiety disorders. There is no other help available.
I suggest to you that you are not as informed as you think.
I’m just now feeling ‘better’ (still have long term issues that flare up with stress) after nearly *7* years. I can truthfully say that most people would not be able to handle what I went thru the first 6 years or so.
It might behoove you to check out BenzoBuddies or Surviving Antidepressants (there’s a benzo section) and the get back to us.
I also agree that forcing someone such as yourself, at your age and duration of “therapy” is not at all compassionate.
ps just because you successfully got off benzos before does not mean you cannot now experience a traumatic withdrawal (I personally tapered 0.5 mg of Klonopin for a year and a half and still became deathly ill).
Best of luck to you. I can’t say I’ve seen a lot of success with the very elderly and benzos; they invariably decompensate, or suffer a bad fall…you do know they’re linked to dementia, right? Right? What? Your doc didn’t tell you that part??
Will Medicare pay for benzo prescriptions? I don’t think so. Okay they’re not out-of-sight expensive as antipsychotics.
You have the right to know the possible consequences and take the risk.
As I shook and violently quaked in front of him, my doctor said: “The only problem that you could have is difficulty in sleeping for three days.” This is not simple lack of informed consent; it is a lie.
4freedom, I reinforced your original comment above and below, and I stick to them. However, I do disagree with you that there are no other techniques or complementary/supporting/alternative help available. I won’t give all the examples here, unless you press me harder. And I say this despite using xanax before sleep and not wanting/able to get off right now. I hope to try in the future according to my individual needs and the slow tapering method that is advocated. See below for my comment on prescribing hydroxezine pamoate instead of a benzo.
“People should be treated as individuals”
The trouble is there isn’t enough time. The avg primary care appointment is 7 minutes. There is a coming pcp shortage because it’s not attractive to med students. There also aren’t enough drs because the AMA purposefully limits the amount of med schools they will certify thus guaranteeing high salaries w a supply-side shortage. It would take a decade minimum to fix this problem and I don’t see it happening.
I disagree that they are not evil and certainly are not to be compared with a butter health scare. There are a ton of bad drugs, with bad effects and it’s the denial of the medical community about the bad effects that is outrageous. They go from denial to taking people off them cold turkey. And they will never offer a substitute strategy, because often the medical community actually perpetuates anxiety. People feel anxious just talking about anxiety. Even after short term, small dose, I learned to recognize “interwithdrawal”. Everything drug related is ALWAYS blamed on the patient as just another “disorder”. Basically they expect the impossible from people. And that is that people should not suffer from anxiety for any reason.
There are millions of people that need a better safer enriched environment instead of benzo. There are lazy governments that gave medicine and psychiatry their own laws and rules, to be the druggers where the governments/leaders fail and suck off public vital energy. The government provides the ads that if you should feel anxious, to take that to a provider who has the drugs to stupefy.
I would never advocate for Benzo to be something safe or reliable. It is very difficult to realize what is effect of drug or whatever else is happening.
Actually and unfortunately, the prescription of these “benzos” as they are called by some, have been dictgated by politics and not always necessarily governmental politics. This “BLACK BOX” warning does not stop the doctor from prescribing them; it just further advises and warns both doctor and patient of both the grave potential for addiction and other side effects. The medical community has known about the issues with these drugs for years. In fact, there is a book called “Stopping Valium and Ativan, Centrax, Dalmine, Librium, Paxipam, Restoral, Serax, Traxene, Xanax” by Eve Bargmam that was published in 1982/1983. I had a copy at one time but lost it during a recent move. This book is available on Amazon; but, it’s rather expensive at present. I agree with those who say that this “BLACK BOX” warning is almost “too little, too late.” I am the biggest advocate for health freedom, especially after my years of basically being terrorized by the psychiatric industry, including the psychiatrists and other doctors doing all the things with these drugs they should not do, such as abruptly stopping them which according to the warnings, can cause seizures or death. There are extremely dangerous drugs. This “BLACK BOX” warning which is still inadequate and should have been done years ago, actually gives me and others hopefully the freedom to just say “NO” to these and other drugs. And, with all due respect, there is lots of help available for anxiety and it is found in about every religious tradition on Earth. It’s called Prayer. I do not mean to be so blunt; but, in almost all cases, and, almost all conditions, drugs should be the last resort, not the first choice. Thank you.
Everyone familiar with the graph?
The ‘model’ of anxiety/panic? The circular
thingy with the words and arrows?
I’ve always gotten a kick out of those simple circular graphs.
Shane, thank you for this update. For me, there are two issues here that need attention.
First, there are the neglected issues of “first do no harm” and “informed consent”. When these practices are ignored or misrepresented then I no longer have any freedom of choice when I need to decide whether or not to take a drug. When I am misinformed, for whatever reason, my freedom of choice dissolves.
Second, when I take a drug as prescribed and this drug turns out to be harmful to me as prescribed this result is not my fault. And, no one can make this result my fault by confabulating me with drug abusers.
The medical community, and all of its iterations, are responsible for the harm I have experienced from using and withdrawing from a benzodiazepine. Immediately I became aware of the possibility of harm from benzodiazepine use as prescribed for me, I set about determining if this possibility was real and sought out a way to withdraw safely from the drug. At no time during this process was I given any positive assistance from the medical community. The assistance I did find consisted solely of peer support.
I find it completely negligent that information that has been in the public domain for more than sixty years was ignored and not passed on to me by the medical community when I was prescribed a benzodiazepine.
NovaScotia, this podcast by MIA is related to “AD’s” (not that such a thing exists) but it
shows that the proper way to seek help is strictly from community. There is nothing unsafer than psychiatry, but real medicine is actively engaged in prescribing also.
I listened to the podcast and when I listen to Mark, regarding the response from the “treatment” community and the colleges, I can tell that it is the usual BS. They pretend to “talk” about it, but any interference is NOT welcomed, and they will ALWAYS change only if forced to. And the changes are never about actually changing.
I am dead convinced that there are certain personalities that are drawn to these environments where they can be assholes and that would be the only reason why they keep prescribing, and denying.
I can see it would be hard as heck to be a doc with a conscience. And really, it’s not just them, there is a whole community of bullshitters and assholes and spineless, in the power holding communities.
Thank god for the people that started withdrawal websites.
I suffer from severe anxiety and panic attacks that are resistant to non pharmacological interventions. For years I’ve tried CBT, DBT, meditation and other mindfullness based techniques, yoga and several other counseling methodologies, and in the end the only thing that helps me to reduce severe acute anxiety are benzodiazepines. I am very concerned that, similar to opiates, these drugs will be swept up in the hysteria of side effects, addiction, harm, etc. and people like me will no longer be able to access them, and hence no longer have a functional life. If prescriptions were limited to 2 weeks I would be unable to work or have meaningful interactions with the world. Cases like mine must be considered at the same time as considering the potential for harm to others. I should not be collateral damage in what I view as an ideological war against pharmaceuticals.
I will assume you won’t actually hear me as I respond to your comment here but someone else reading it might. The injury caused by these drugs is so unimaginably torturing and debilitating that you will beg for your original level of anxiety back. It is on a level that you CAN NOT fathom. None of us could prior to suffering the injury. I am in my 6th year of recovery and while I remain disabled I do recognize many of the most agonizing symptoms have gradually resolved over time, gratefully. You need to just know that you are actually, and literally playing a type of Russian Roulette with your brain and CNS using these neurotoxic agents. These dangerous drugs can turn on you at any time, and they will. Your body will reach a critical mass and then you will truly know why we sound the alarm in warning everyone. If you enter any number of benzo support groups online, you will have crossed into a portal to hell itself. I have no issue with banning these drugs for good. But I also do not agree with forcing people off of them abruptly.
It seems that there are some who are concerned their “health freedom rights” might be taken away by this “BLACK BOX WARNING” regarding “Benzo” and that that if needed or requested, the prescriber may not prescribe them. Now, I know this was in the late 1990’s before the “opioid epidemic” but I was prescribed a specific high-powered cough syrup that had some “opiates” as ingredients for a bad case of pneumonia. I was prescribed about a week’s worth and then when I returned to the doctor for my follow-up a week later after being diagnosed pneumonia, I pleaded with the doctor for a refill. He denied me on the grounds of the opiate ingredients in the cough syrup and he was concerned at the time, I would become addicted. Although, my later dealings with this doctor were suspicious and even discounting to me; this was the wisest action he ever did for me. Unfortunately, as it became the twenty-first century, his bedside manner changed drastically and I dropped him as I did other doctors. Maybe, it takes courage to say no to a patient who is asking for a drug that might or is addictive. Sadly, doctors are less and less courageous. And the sadness is seen in the lives hurt, the lives lost, the pain and suffering that hides behind the curtain of “better living through chemistry.” Thank you.
Dr. Jordan Peterson on taking benzos as directed and suffering akathisia as a result:
He calls the akathisia he got from benzos “a fate worse than death”.
In this article try substituting “benzodiazepine” for “antidepressant” …
Here are two quotes which stopped me in my tracks:
“the symptoms are due to a problem in the way the body is functioning, even though the structure of the body is normal”
“Most urgently, we urge individual prescribers to always raise with their patients possibilities such as antidepressant adverse effects and/or potential dose-change and withdrawal issues before initially prescribing an antidepressant for any patient – and before attributing patients’ subsequent development of ‘unexplained’ ‘functional’ symptoms to psychosomatic ‘medically unexplained’ or ‘functional’ syndromes and disorders. This is vital to the all-important doctor/patient relationship, to properly informed consent – and to reduce prescribed drug damage and resulting nervous system chaos.”
Such a simple request. So much “professional” resistance.
The resistance is due to it being a ‘service’ based on lies, and more lies.
I find it interesting of how many views this article had.
Growing up in an abusive household has scientifically been proven to change the actual structure of a person’s brain. I have struggled with anxiety most of my life; some of it is because of Hashimoto’s autoimmune disorder, and some of it is because of growing up in a household that was abusive. My brain will never be normal because of this.
I was prescribed paxil, starting at a 10 mg dose and then upping it up to 20. I told three different doctors that I was having problems with hostility on it. Somehow that was not heard, and because I was not heard, I did end up in jail because of uncharacteristic violent behaviour. Because the part they don’t tell you about that black box warning on hostility is that it is a violent hostility.
I have been prescribed gabapentin, topamax, hydroxyzine pamoate, another kind of hydroxyzine, Benadryl, and benzodiazepines.
On gabapentin I gained 30 lb in 6 weeks. There is a reason why topamax is also called stupaMax, and both of those anti-epileptic drugs made it dangerous for me to drive, which was a requirement of my job. Both the hydroxyzines made me sleepy and anxious, what a combination!
My experience with benzodiazepines has been one where the side effects of the medication are the least intrusive to my life. And on top of that, every time I take it, it works. I do not have many choices available to me. And when I consider the fact that it also has the added benefit of being a muscle relaxer, I gain two benefits from this drug.
And whoever it was that said that they haven’t noticed doctors not prescribing benzodiazepines, I can point you to Swope Behavioral Health services here in Kansas city, Mo. No doctors in their psychiatry department will prescribe diazepines under any circumstances. Even if it’s the only drug available for the patient that does not produce intrusive life side effects. In fact the whole state of Missouri has declared It to be a “dangerous drug.”
Even the doctor I’m seeing now won’t prescribe more than 30 pills in 90 days. And then on top of it, I can’t get my pain meds either.
I am an oddly educated patient. I can read medical texts and biochemistry notes and understand them, with only an HS Chem class and college level Bio 101 class. I failed Anatomy. I’m also quite adept at studying how prescription medications function within the body and what mechanisms they manipulate or affect. But this natural ability just makes me look like a drug seeker.
But now that I have some access to diazepam 10 mg, I’m doing something I haven’t done for a long time, accomplish stuff. I did not realize just how disabilitating my general anxiety disorder and social anxiety was, until I started taking this medication again.
Look, I’m not saying that these medications don’t hurt people, obviously they do because then there would be no need for a black box warning. But the overreaction that doctors are having to these guidelines set down by the FDA is causing an excruciating amount of distress, pain, and inability to function within one’s life. There is no measured response happening to either the opiate restrictions or the benzodiazepine restrictions in the medical community. Some benzodiazepines are more dangerous than others, just as some opiates are more dangerous than others. But they are all being treated as if they prescribe this medication to their patients, that their patients will die or suffer and they’ll end up sued. Or even worse, they will use a measured approach to these drugs and prescribe for the patient’s needs, and end up in jail.
But if it’s okay to prescribe paxil with the black box warning of hostility (read: violent hostility) then it should be okay to prescribe other medications with black box warnings. But doctors have to listen to their patients when they complain that they are having problems.
I agree, you should be allowed to take them.
And no one needs psychiatry to prescribe benzos. Responsible prescribing of tranquilizers IF the client says that is what works, or it’s the only thing that works, should be the precedent for prescribing.
AD’s are not “anti-depressants” or “anti-anxiety” and should not be marketed in that way.
All benzodiazepines carry equal risk for injury. Drug companies are shielded from all liability. Those of us who have endured and survived the unfathomable that is benzo injury are living proof that anxious states can absolutely be managed without depending on a neurotoxin. The same dependable tools we use are available to everyone – and they carry zero injury risk. It is one of the gifts of the freedom we earn as survivors. Many of us remain injured, but we discover coping skills that we can rely upon. These should be the first approach for managing anxiety – not harmful synthetic compounds. So many of the injured wish they could return to their original levels of anxiety.