How I've been dealing with cross-tolerance (co-addiction to alcohol and xanax)

I'm copying this over from Introductions, as I think I wrote too much there that may not be seen by most ongoing members, and I'd welcome more input, suggestions, observations, etc.

 

As you can see below in my signature, I reached a shocking 6mg of xanax a day, and was averaging a bottle of wine every other day - sometimes more. But I was so "high-functioning" that few (if anybody) knew that I was so loaded. Before anyone's jaws drop off, let me fill in some background to perhaps explain how I could have sunk to such horrible circumstances with high cross-tolerance to both alcohol and xanax.

 

I've had an anxiety disorder most of my life, punctuated by severe panic attacks and days of paralyzing depression, and plenty of nightmares.

 

I was severely abused as a child/adolescent by a raging alcoholic mother and a father who stated he "never wanted kids" and treated me and my siblings like he meant that. It was mostly terrifying emotional abuse. I was often abandoned in strange places then ridiculed and/or scolded for crying and being a "sissy" when I finally found my parents again; harshly criticized or ignored in everything I tried to accomplish; blamed for almost every problem including my parents' marital problems, my mother's "needing" to drink; moved 13 times during 12 years of public school.

 

There was some unpredictable physical abuse, e.g. my father whipping me with his belt when I was about 8 because I called my grandmother by her first name like grampa did; my mother shooting me in the leg with the pistol she carried in her purse when she imagined I had done something I never even knew about. (Okay, I know you're saying, "This guy's crazy and making this sh** up!" I assure you that I am not making this up. I wish I were.)

 

Somehow, I survived and managed to work two part-time jobs to earn a BA and an MA, as my parents would not help fund my college education. My so-called parents did not attend either of my graduation commencement ceremonies. My brother was not so lucky - he basically committed suicide by drinking and drugging himself to death after leaving home at an early age. My sister also was a runaway who became addicted to illegal drugs and ended up in prison.

 

After decades of self-medicating my anxiety/panic/depression with benadryl, chlortrimeton, and alcohol, going from periods of total but very tense abstinence to moderate drinking to weekend binges and back to abstinence, around and around, always worried that I would become a mentally ill alcoholic like my mother, I was at last diagnosed with PTSD in 2004 - so late in my life. After SSRI's, klonopin, and valium caused terrible side effects in me, so much that I couldn't function at work, the psychiatrist prescribed xanax (but added offhand that cognitive therapy might help some). Xanax worked immediately and "beautifully", and both the psychiatrist and my PCP actually told me that I would probably have to take it the rest of my life, as my PTSD would not go away on its own.

 

This was the first I'd ever known or experienced benzos, but for a while, xanax really stopped the constant anxiety, difficulty sleeping, night terrors, even lessened the periods of depression, and lowered my blood pressure from its borderline hypertensive 140/90 to around 120/80 for the first time in decades. And it helped me drink less (I know that last part sounds alarmingly stupid, but at that time, I was ignorant of the consequences). The shocking thing I realize now is that neither the psychiatrist nor my PCP ever advised me to stop alcohol - in fact, my doctor encouraged "a glass of red wine every day for cardiovascular health" while writing out another prescription for xanax!! Most unfortunately, he prescribed benzos freely, not recognizing their potential for nightmarish addiction or their cross-tolerance with alcohol. He didn't take benzos himself. Just wine.

 

Somehow I managed to stay at 2 to 2.5mg of xanax for a few years, wondering why it was taking more than one glass of wine to feel any "relaxing buzz" at all. The original xanax buzz disappeared after a couple of years of use, and eventually I didn't (and still don't) feel even the slightest euphoria when it kicks in - it just stops the anxiety or the panic and leaves me feeling just kinda "blah", dead-headed, inert. But the amount needed to quell panic was already slowly creeping up and up.

 

These last few years have been filled with tragic deaths and catastrophic losses in my life, and my PTSD was fully re-activated. I made the awful mistake of taking more xanax out of desperation, trying to cope with fear and anguish on my own, as the techniques of the therapist assigned to me during this time only seemed to upset me more during our sessions - this therapist has since been dismissed. I kept escalating both xanax and alcohol, being so stressed and grief-stricken by almost non-stop traumatic events that I wasn't really caring about the horrifying levels of addictions that I was reaching, the extreme spikes of blood pressure, and not trying to figure out the actual cause of such frightening tolerances.

 

After a few very scary "close calls" (some involving the police and a couple of medical crises - I think I was blest somehow and was protected from the worst consequences), I finally woke up and realized the horror of my situation with addiction. I was terrified that I was going to die like my brother had.

 

So now I'm working hard to decrease my dosage of xanax from the shocking 6mg I reached to at least as low as it was originally - 2 mg - or hopefully, none at all.  But I'm having a hard time as most everyone in this forum is or was.

 

I've tried numerous times to taper both alcohol and xanax at the same time, but failed again and again. The slightest upset and I was back on both of them again. But I was finally advised on another forum that alcohol alone had to go first - completely - before I could even begin to tackle the xanax problem. I accepted this more experienced person's strong advice. So I again went through a week of the usual pure hell with alcohol withdrawal - but maintaining the xanax dosage during that time made it a little more bearable and do-able. I found a little glutamine helped reduce the cravings (but not the symptoms) - but too much glutamine made things worse - such a difficult balancing act!

 

I finally got through it, and was alcohol-free for over a week when I was astounded and pleased that this soon after the acute alcohol withdrawal, I suddenly needed much less xanax to quell the anxiety/panic and to sleep. I rapidly tapered from 6mg xanax a day to 4mg-4.5mg, depending on the stress of the day. I've been taking the least I could to keep a lid on my anxiety and get enough sleep, and forcing myself to walk, to exercise much more really helps. 4-4.5mg was the dosage I was taking a few years ago - suddenly it was all that was needed to bear life again. Alcohol itself was making me need 2mg more xanax to keep things bearable.

 

I never knew until recently that xanax and alcohol are medically known to be cross-tolerant, i.e., the more alcohol you drink, the more xanax is needed to stop anxiety or panic; and the more xanax you take, the more alcohol is required to reach any pleasant "high" at all - the two keep "one-upping" each other, so the amounts needed to get any effect from either one get greater and greater. (I know they both  supposedly act on the same brain receptors, even though their effects feel quite different - at least, they do to me. As I said, xanax gives me no "buzz", no euphoria, but alcohol does; however, it is unpredictable now - sometimes it makes me feel horrible - which is good, actually - but I can't be certain anymore that alcohol will feel pleasant. But no problem as it's out of the scenario now.)

 

To give you an idea of how bad my cross-tolerance became, at 6 mg of xanax a day, a full glass of wine had no more effect on me than a glass of water - it took a bottle of wine to affect me like one glass of wine used to. And the 6 mg of xanax was quickly becoming insufficient to keep me from insomnia and anxiety.

 

I know this does not reflect initial experiences with the very dangerous combination of alcohol and xanax, which can make the user pass out into a coma-like state and even die.) But I had reached this horrifying tolerance after years of xanax and alcohol jacking each other up.

 

I'm meandering now, but as I said, my PCP knew nothing about the cross-tolerance of alcohol and xanax, or even the dangers of going cold turkey from benzos! When I finally expressed to him my great concern about my tolerance and addiction, he just told me to quit taking xanax cold turkey if I didn't want to continue - which, from 6mg to 0mg, could have killed me!! I talked to my wonderful old pharmacist, who promptly called him to tell him how dangerous that was! It's sad and unnerving that some physicians have little understanding of the benzodiazepines they prescribe. And for a decade, I had believed and trusted a doctor who didn't know anything about the poisons he was prescribing.

 

I'm going to plateau at 4mg xanax until the symptoms that I get at present - Raynaud's syndrome, hot and cold flashes, poor sleep patterns, racing mind, dissociation (feeling unreal, spacey, "on remote control"), agoraphobia - lessen some more, and then try slow 0.5mg cuts, as I did (quite rapidly) after alcohol. I may have to change my mind about how much to cut.

 

But given my own personal impatient nature, once I finally get going on something, I would rather bear uncomfortable symptoms for a while than do meticulously small cuts - the painstaking process itself makes me as anxious and nervous as withdrawal - but please, that's just me - it's a very good method for many others.

 

I continue to take a full array of nutritional supplements, making sure that C, B1, and magnesium are never lacking, and eat healthy meals. I continue to have 2-3 cups of coffee in the morning, as stopping that would add another unnecessary withdrawal - I know b/c I tried it - not good. Besides, some on the forum believe that coffee may actually help with the xanax withdrawal - up-regulating the GABA process. And the most important thing I've learned is tackle only one addiction at a time.

 

I've just had a complete blood analysis done again (by a new doctor), and everything looks just fine. The numbers look so much better than I feel, actually, but blood tests rarely show brain and nerve damage from benzos! At least my liver has not been seriously damaged by the alcohol, but I have always taken NAC, milk thistle, and coffee (proven to lower risks of cirrhosis) along with all my other vitamins and minerals.

 

Today is Day 15 of being 100% alcohol-free. And I haven't had any xanax since I got up this morning. But I'm beginning to feel weirder and spacier (the dissociation) and my hands are getting colder and wrinkly in a warm room and my feet are freezing (Raynaud's), and I know this post has become insanely long and probably disorganized, so it's obviously time for my first milligram of xanax today. But I've lasted longer than yesterday! As you see, my quirky approach in tapering is "when badly needed" - I'm just not able to follow a strict tapering schedule, but I seem to be making progress anyway. (If anybody's into astrology, "Verseau" is French for "Aquarius", which is what I am, and we're always the weird ones who can't seem to follow the rules.)

 

Thanks for putting up with me. I feel better having "dumped" all this pain and fear among all of you who really understand. I promise - I won't post any more overwhelming autobiographies.

 

Verseau

Congrats on being alcohol free! I personally, am 17 years sober. But I wasn't taking benzos at the time. Some people say alcohol withdrawal only lasts for three days, and this is the case medically speaking. But you still can have residual w/d effects for a few months. Mainly insomnia and anxiety. Now that you plan to taper off Xanax, the best thing to do is find a dose you can stabilize on, form a taper schedule that is doable, and stick to that schedule. Sometimes you may have to hold for a while if your sy/x rear up. But you should do this. Never skip a dose because you feel, OK. This will come back and kick you in the butt. Don't go up, and then down, with your doses. You need to keep a steady supply in your bloodstream. And since you have just basically kindled off the alcohol, please, take things slow. A 5% to 10% drop every one or two weeks is what many people do. But that schedule is not set in stone. Rather, let your body tell you when its time to drop and by how much. I err on the side of caution and drop no more than 5% every two weeks. I've never updosed or reinstated because I let my body tell me what to do. Good luck to you. You have had a lot of misery in your life and have not been overly smart by taking alcohol and benzos together. If you continued on this path, in the future, you just may not have woken up one day. fwiw, my dad was exactly like yours. I'm glad he's dead. And I really feel terrible for your siblings. Ah, how life can turn on you. But now it can turn on you in a good way. Hugs, Bets

So Verseau. Wow.  That was really hardcore.  Man, I feel for you.  It's astonishing how we must have permits to adopt animals, but anyone is allowed to breed. 

 

You've accomplished a lot in spite of the crap piled onto you as a child.  So kudos to you.  That's awesome, because that was some serious abuse to overcome.  But you did it anyway.  So you should be proud of that fact.  And don't allow your inner judge to be so critical of your actions.  You used alcohol and benzos at the same time.  So what?  Do you know how many people do that?  A lot.  I did, and I got clean from both cocaine and alcohol a really, really long time ago.  (I'm not sober from alcohol anymore as I do drink a beer or a glass of wine now and then, but I never overindulge and I never get drunk.)  I've used so many different kinds of drugs over the years (way back in the dark ages, lol), and I almost always combined drugs with alcohol.  Maybe not really bright, but back then I was going for the buzz factor, so I didn't care.  Recently, I also would drink a beer when I was taking xanax, this wasn't for the buzz factor, but because I wanted the pleasure of drinking a really good beer.  The point I'm trying to make, is, it isn't some kind of character flaw on your part that it happened.  Just forgive yourself and move on. You were trying to overcome an intense problem, and you did it the only way you knew how. 

 

It's a real shame that hallucinogenic plants have gotten such a bad rap, because many people believe they can be used in severe cases of PTSD to help people heal.  There are people going to Peru now to take Ayahuasca, and there are therapists using MDA to help patients with PTSD and it's helping a lot of people, including soldiers.  (In fact, I recall reading an article a few years ago about the mlitary using MDA to help treat soldiers for PTSD, but I never heard anything else about it.)  DMT (the active compound in Ayahuasca) occurs naturally in the human body, so it isn't like people are ingesting something not natural to the brain.  (I'm not suggesting you do this, I'm just bringing up a point that's interesting to me.)  Anyway. 

 

Since you've now stopped the alcohol, I agree that you need some kind of plan.  It doesn't have to be really strict (mine isn't), but, you do NOT want to keep going up and down in your dose because it might cause a kindling effect, which would be very bad.  So, make a plan, and then go with it. 

 

Here's what I decided to do:  I stabilized at 2mg after a 5 day CT that was horrible.  The first cut I made was .25mg, which was too much, but I also cut after stabilizing for only 5 or 6 days, after a 5 day CT, so that might be why it felt like it was a little too much.  After that I started cutting .125mg (half of a .25mg pill) every 9-12 days.  The recommendation is to cut 10% or less, but after I got to 1mg I made two more cuts at .125 (which is more than 10%, but it was fine for me) and then moved on to cuts of .0625mg (which is 1/4 of a .25mg pill).  Now that I'm doing that I'm cutting every 6-7 days.  I dose twice a day, once in the am and once before bed.  I try to stay within a 3 hour window, so I'm not real strict about what time I take it.  So you can make it work it for you and have some flexibility and still have some kind of plan.

 

I hope some of this helps.  Good luck to you.

 

Namaste.

 

~K   

Hi Bets!

 

Thanks for suffering through my life story. I don't know what made me write so very much, so very fast - kindled, withdrawing neurons shifting to warp drive, I guess.   But I feel cleaned out after that.

 

And sincere thanks for the very clear and logical advice. You've also confirmed what I have suspected - my pattern of alcohol use is one that causes kindling, and I suspected many of my current xanax w/d symptoms are still being worsened by prolonged alcohol w/d, or even solely due to continuing alcohol w/d. But at least I'm off of it completely now. Oh how I know I wasn't smart - I was placing too much trust in uninformed doctors to stop the pain in my mind. And trusting people in my life who did not deserve my trust and only broke my heart. Quite honestly, there were times when I didn't want to wake up again.

 

Now my life and my health are under my control and increasing knowledge, and you have added substantially to that. My deep appreciation, Bets. And fwiw, I'm glad both my parents are dead - they each seriously damaged three lives in their "care" and did nothing but harm in this world.

 

Hugs to you,

Verseau

You've accomplished a lot in spite of the crap piled onto you as a child.  So kudos to you.  That's awesome, because that was some serious abuse to overcome.  But you did it anyway.  So you should be proud of that fact.  And don't allow your inner judge to be so critical of your actions.  You used alcohol and benzos at the same time.  So what?  Do you know how many people do that?  A lot.  I did, and I got clean from both cocaine and alcohol a really, really long time ago...The point I'm trying to make, is, it isn't some kind of character flaw on your part that it happened.  Just forgive yourself and move on. You were trying to overcome an intense problem, and you did it the only way you knew how....

Oh damn, ~K, you brought me to tears! :'(  I'm sitting here crying, reading your touching, caring reply. You really understand...I can't tell you how moved I am, how much your understanding, your validation of my pain, means to me! You have a beautiful heart. Thank you, thank you, thank you...

 

When I dry up these tears - good tears of deep gratitude for your compassion - I'll get to work on the more planned approach to withdrawal that you and Bets are urging me to do. You two have been there, done that, and I need to listen to you and work hard to follow your advice. Oh, yes, all of this helps!

Dhan'yavāda 

 

Verseau

 

 

 

 

Oh damn, ~K, you brought me to tears! :'(  I'm sitting here crying, reading your touching, caring reply. You really understand...I can't tell you how moved I am, how much your understanding, your validation of my pain, means to me! You have a beautiful heart. Thank you, thank you, thank you...

 

When I dry up these tears - good tears of deep gratitude for your compassion - I'll get to work on the more planned approach to withdrawal that you and Bets are urging me to do. You two have been there, done that, and I need to listen to you and work hard to follow your advice. Oh, yes, all of this helps!

Dhan'yavāda 

 

Verseau

 

I am deeply humbled by your kind words, Verseau.   

 

Keep us posted on how you're doing.  There are a couple of xanax threads that have many wonderful people on them as well, in the "Support Groups" section.  They keep me going.

 

Namaste.

 

~K