Benzodiazepine Withdrawal: Why Don't Doctors Know from Mad In America

I haven't seen this article mentioned, and I think it's very important since Rebecca is both an NP, working within the medical community, and someone who, unfortunately, had terrible withdrawal from Klonopin and tried a multitude of drugs, went to rehab, and had many tests.

 

 

Benzo Withdrawal: Why Don’t Doctors Know?

 

By Rebecca Belschner May 13, 2018

 

This question runs through the head of so many who have experienced benzodiazepine withdrawal: “Why? Why doesn’t my doctor/provider know what is happening to me? Why does he/she disregard that I do know what is happening to me? Why do they refuse to confirm my concerns or support me?” Benzodiazepine tolerance and withdrawal are not new. Many have endured and more will in the future. So, why isn’t it simple to diagnose and treat? As both a health care provider and a withdrawal sufferer, I’d like to offer an inside and outside perspective on this question.

 

I am a 48-year-old wife, mother, grandmother and nurse practitioner. I am now 26 months off of 0.5 mg of Klonipin that I took as prescribed, once daily, for 15 years. I was prescribed this medication to treat my insomnia which was a side effect of the Cymbalta I was taking at the time (which I have since discontinued). In 2015 I began having symptoms of heightened anxiety/agitation, terrible intrusive thoughts, fatigue, palpitations, feeling like the skin on my arms was burning, gastrointestinal disturbance, shakiness and dizziness. I went to my providers (I was seeing a family doctor and an endocrinologist) who, after many tests, said my symptoms were likely because of my anxiety and that I should increase the dose of the Klonipin. I refused. I did not want to “play that game” in which I would have to keep increasing my dose to get the same effect. I knew that the long-term effects could be damaging; I knew, as well, that I would eventually hit a maximum dose… and then what? It was then that I decided I wanted off of this drug.

 

My primary doctor disregarded my concerns, saying that this drug was “tame” and “such a low dose” that I shouldn’t have any concern and that I would “likely need it for life” because of my “chemical imbalance.” At that time I was also seeing a psychiatrist, who was actually the prescriber, so I went to her and discussed my concerns. She was supportive of the fact that I wanted to stop but her suggestion for tapering was quite fast. By now, I had been reading the Ashton Manual (which my doctors had never heard of) so I suggested to my psychiatrist that I cross over to Valium — which, with her approval, I did, but I went from 0.5 mg of Klonipin (the equivalent of 10 mg of Valium) to 2 mg of Valium overnight.

 

It was much too big and too fast of a cut and I immediately went into a tailspin. My symptoms were as follows: severe agitation/anxiety, intrusive thoughts, dizziness, heart palpitations/pounding, nausea/vomiting, severe cold intolerance, a burning sensation in my arms along with an icy sensation in my bones, inner restlessness, shallow breathing, urinary frequency, and probably more. The thoughts that were entering my mind were frightening so I went to the E.R. They performed multiple lab tests and an abdominal CT, all which were normal. So what did they do? They gave me Ativan. The LAST thing I needed. The way they treated me was very unprofessional and uncaring, as if I were an irresponsible addict. But, believe me, more drugs were the last thing I wanted. I just wanted help. Help to get through it WITHOUT being loaded up on drugs.

 

I couldn’t do life anymore. I couldn’t work, be a wife, mom or grandmother. I couldn’t cook, clean, nothing. I was scared. Not one doctor knew how to get me through this and I was desperate. All I wanted was my life back, but I felt trapped. So I reached out to a detox center. They “promised” they could help me get off of the benzodiazepine and get my life back. I believed them, so I went. They tapered me off of the Valium over three weeks. In the detox center I was offered drug after drug (Gabapentin, Baclofen, Trazadone, Seroquel, Visteral, Propranolol, etc.) to “help” with the symptoms I was continuing to endure. I even asked the addiction psychiatrist at the detox center whether the other medications that were supposedly meant to help might be causing further problems. His answer was: “I don’t know, just stop those medications then.” Basically, he didn’t know. Who knew? Does anyone know?

 

I came home a month later and attempted to get back into the workforce, but failed. The symptoms continued and my providers kept saying, “It’s reemergence of your anxiety” and “It cannot be withdrawal, the drug is out of your system.” But it WAS still withdrawal. There are many studies out there that confirm that withdrawal symptoms can continue after the drug is out of the system. My body has downregulated the gaba receptors after many years of taking Klonipin, so I basically have no working receptors, and glutamate (the excitatory neurotransmitter) is dominant, for now. Why don’t you know this, doctor? Why are you making me feel as though I am crazy?

 

The symptoms drove me to have thousands of dollars in tests. I was admitted to Duke to rule out adrenal failure. All tests were negative, of course, so what happened while I was inpatient? They brought in psych to evaluate me. What did they do? They put me on yet another psych drug, Prozac, which made me much worse, so I stopped. I was admitted to two separate psychiatric hospitals for suicidal ideation because I could not function and I did not know how long it would take to heal. My family depends on me and I couldn’t be there for them. All the psychiatrists at these hospitals wanted to do was stack more medications on me. It’s like they scanned down a menu of medications to see “what we could try.” I went to rehab, where staff members promised they could help me. They couldn’t. I saw two naturopaths, both of whom wanted to pile supplements on me, none of which helped.

 

No one knew how to help. Not one. Why? Why didn’t I know this could happen to me? I mean, I’m medically educated, right? But I didn’t know, and neither did my doctors.

 

I lost faith in the medical system, but I gained faith in my Holy Father. I had to keep fighting and maintain patience. I did. Am I healed? I feel that I am healed from benzo withdrawal, but I still have to taper off the “other” drugs that the detox center started me on, which I am working on now. I feel this is an endless cycle of withdrawing from drugs that, if I had known then what I know now, I would have never started.

 

So why don’t doctors know? When doctors and mid-level providers are in the midst of their education, prior to practicing, the main focus is diagnosing and treating. Our education begins with learning the basics of anatomy and physiology, biochemistry and microbiology. So basically we are learning about the human body and how it works, down to the cell. This is where the infamous gross anatomy class comes in, which entails dissecting a human body. All of this is taught over a few courses over a few semesters at the beginning of our college career. Later on in our medical education, the knowledge expands to pathophysiology — basically, what happens physically/chemically to the body when things go wrong. In medical school, they break the education down into systems (i.e. neurology, respiratory, cardiovascular) with each system covered over a number of weeks. Students are given one, maybe two, semesters of pharmacology class (typically 15 weeks each semester, meeting two or three days a week for 1-2 hours). So as you can see, in-class learning is minimal for what is needed to know out in the real world. In the later semesters, learning continues in the clinical setting (i.e. residency, etc.). It is nearly impossible to learn everything about every condition through our medical education. Over the years of education we are formally tested through exams as well as hands-on demonstration of our knowledge, and, finally, through a board certifying exam. However, much of the learning is through our continuing education, depending on new practice guidelines, and is basically a “learn as you go” process.

 

During our education we are taught that, based on a patient’s history of present illness (what the patient tells us their symptoms are) and physical (what we see and lab or radiological testing), we should come up with a list of differential diagnoses (or list of possible diagnoses) and based on the most clear possible diagnosis, treat for that condition. However, if the treatment given does not improve the symptoms, we start going down the list of differentials we compiled. For example, here is a case study:

 

Mrs. Jones is a 45 year old female who comes into your office with complaints of the

following: dizziness, nausea, gnawing abdominal pain, increased agitation/anxiety,

palpitations, shakiness, cold intolerance, fatigue and a 10 lb weight loss over the last

month. Patient denies headache, loss of consciousness, fever, cough, wheezing, shortness of breath, chest pain, diarrhea, constipation, blood in stool or extremity swelling/weakness.

 

Past medical history:

Hypothyroidism, Premenstrual dysphoric disorder, anxiety

Surgically postmenopausal

Medications:

Levothyroxine 75 mcq once daily, Clonazepam 0.5 mg once daily,

Monthly estrogen shots.

Has been taking levothyroxine for 20 years and Clonazepam 15 years.

Estrogen replacement started after hysterectomy

Allergies: Erythromycin

Past surgeries:

Septoplasty (septum repair), Tubal Ligation, Tonsillectomy, Total Hysterectomy

Social history: 

Non-smoker, denies alcohol or illicit drug use

Married, 3 adult children

Works in healthcare

Physical (by systems):

Mildly anxious female, alert and oriented with normal BMI

HEENT: normal

Respiratory: Lungs clear, respiratory effort unlabored

CV: Heart rate/rhythm normal, no murmurs

Musculoskeletal: Normal strength and range of motion of all extremities

GI: Mild epigastric tenderness on palpation, abdomen non distended, soft, liver not enlarged. Bowel sounds normal

Neuro: Cranial nerves, balance and pulses normal

Skin: Color normal, no lesions, warm, dry, intact

 

Based on the history and physical, what is your possible diagnosis? Breaking the symptoms down into systems, the diagnosis could be cardiac (palpitations, dizziness, fatigue), neurological (extremity burning, dizziness, anxiety, agitation), endocrine (fatigue, dizziness, weight loss, cold intolerance, anxiety/agitation), GI (nausea, abdominal pain, weight loss), psychiatric (increased anxiety/agitation, weight loss, palpitations, GI disturbance, fatigue) or medication-induced (too much hormone replacement). So from this list, there are a multitude of diagnoses that could be given from the symptoms of this patient. The next step for the provider is to start from the most likely diagnoses and work through the differential list. In order to do so, he/she will need to start out with testing (i.e. laboratory, radiological, etc.). If he/she is unable to do so, then there is one of two possibilities that you will likely run across: 1) You have anxiety/depression, so let’s start you on some medication to help you, or 2) You will be referred to a specialist (i.e. cardiology, neurology, endocrinology, etc.).

 

This patient’s tests all come back normal. So, what could it be? The most likely diagnosis will be reemergence of her anxiety. So what is the treatment? You guessed it: medications. Either increase the clonazepam or add another psychiatric medication (SSRI, SNRI, etc.).

 

Now here is the big question: Why didn’t the provider even have a clue that the patient’s symptoms could be from the reduction of the clonazepam? Four words: they did not know.

 

Back to pharmacology, the class where our future providers learn about the medications they will be prescribing. In this class, the primary focus is on pharmacokinetics (what the body does to the drug) and pharmacodynamics (what the drug does to the body). This is based on what I will call a “control” person. Although the pharmacodynamics of a drug will likely be the same or similar for all of us, the pharmacokinetics will not. That is because we are all biochemically different. Our DNA, illnesses we may have, environmental chemicals we are exposed to as we grow up, and so forth, all contribute to how our bodies react to the medications we ingest or inject.

 

Additionally, in this one — maybe two — semester course only the most common medications are covered, which is a fraction of all existing medications. According to the FDA’s Orange Book, which lists approved drug products with therapeutic equivalence evaluations, page 9 of 64 of the Cumulative Supplement for March 2018 shows a total of 19,294 prescription drug products as of December 2017. It is simply impossible to learn about all of the FDA approved medications and their interactions with each other in one or two semesters.For example, on Georgetown University School of Medicine’s pharmacology department webpage, description of the class is written as follows,

 

“The second year’s course in pharmacology introduces the student to the scientific basis for the use of certain drugs in medical practice and the essential principles of clinical pharmacology. Since it is impossible to learn about each of the several thousand prescription drugs currently available, the course concentrates on selected prototype drugs and general pharmacologic principles that govern the action of all drugs in the body.” [emphasis mine]

 

After these classes, the future medical provider’s education is in the clinical setting, or “learn as you go” and mandatory annual medical continuing education (CME); however, many states do not have mandatory specific pharmacology CME requirements. The number of CME hours required by state varies but averages only between 20-50 hours annually.

 

So having been on the inside as a nurse practitioner, as well as on the outside, I can see why benzo withdrawal sufferers go years without being diagnosed properly. Bottom line is that there is a lack of education. It is 100% impossible for any one doctor or provider to know the pharmacokinetics (for YOUR biochemical makeup) and the pharmacodynamics, potential interactions, and potential adverse reactions of every medication available and prescribed.

 

Where am I now? I have slowly eased back into working again. I could not physically or mentally help patients during the worst of my withdrawal, but now that more than two years have passed, I am ready. Since I am basically a new provider for the patients I see, I am not prescribing benzodiazepines; however, I am helping with weaning. I am hoping and praying that I am contributing to the increase in education of the ramifications of long-term prescribing and the necessity of a slow taper, as well as the reduction in prescribing in our medical offices.

 

There are also 31 comments following the article. Very interesting, and I hope you'll read them. WHY are doctors so uneducated about the very drugs they prescribe and know that people will be taking for some time or maybe even for life? And since we are so lucky to have the Internet, we've got to be proactive when it concerns our health, researching every pill, weighing the pros and cons.

 

https://www.madinamerica.com/2018/05/benzo-withdrawal-why-dont-doctors-know/

 

 

Excellent article~ So very true.  Well written too.  I am grateful that you posted it Terry.

 

SO in today's news:  https://www.cnn.com/2019/05/28/health/oklahoma-opioid-trial-start/index.html

 

Let's just replace the word Opiod with Benzos - shall we? 

I haven't seen this article mentioned, and I think it's very important since Rebecca is both an NP, working within the medical community, and someone who, unfortunately, had terrible withdrawal from Klonopin and tried a multitude of drugs, went to rehab, and had many tests.

 

 

Benzo Withdrawal: Why Don’t Doctors Know?

 

By Rebecca Belschner May 13, 2018

 

This question runs through the head of so many who have experienced benzodiazepine withdrawal: “Why? Why doesn’t my doctor/provider know what is happening to me? Why does he/she disregard that I do know what is happening to me? Why do they refuse to confirm my concerns or support me?” Benzodiazepine tolerance and withdrawal are not new. Many have endured and more will in the future. So, why isn’t it simple to diagnose and treat? As both a health care provider and a withdrawal sufferer, I’d like to offer an inside and outside perspective on this question.

 

I am a 48-year-old wife, mother, grandmother and nurse practitioner. I am now 26 months off of 0.5 mg of Klonipin that I took as prescribed, once daily, for 15 years. I was prescribed this medication to treat my insomnia which was a side effect of the Cymbalta I was taking at the time (which I have since discontinued). In 2015 I began having symptoms of heightened anxiety/agitation, terrible intrusive thoughts, fatigue, palpitations, feeling like the skin on my arms was burning, gastrointestinal disturbance, shakiness and dizziness. I went to my providers (I was seeing a family doctor and an endocrinologist) who, after many tests, said my symptoms were likely because of my anxiety and that I should increase the dose of the Klonipin. I refused. I did not want to “play that game” in which I would have to keep increasing my dose to get the same effect. I knew that the long-term effects could be damaging; I knew, as well, that I would eventually hit a maximum dose… and then what? It was then that I decided I wanted off of this drug.

 

My primary doctor disregarded my concerns, saying that this drug was “tame” and “such a low dose” that I shouldn’t have any concern and that I would “likely need it for life” because of my “chemical imbalance.” At that time I was also seeing a psychiatrist, who was actually the prescriber, so I went to her and discussed my concerns. She was supportive of the fact that I wanted to stop but her suggestion for tapering was quite fast. By now, I had been reading the Ashton Manual (which my doctors had never heard of) so I suggested to my psychiatrist that I cross over to Valium — which, with her approval, I did, but I went from 0.5 mg of Klonipin (the equivalent of 10 mg of Valium) to 2 mg of Valium overnight.

 

It was much too big and too fast of a cut and I immediately went into a tailspin. My symptoms were as follows: severe agitation/anxiety, intrusive thoughts, dizziness, heart palpitations/pounding, nausea/vomiting, severe cold intolerance, a burning sensation in my arms along with an icy sensation in my bones, inner restlessness, shallow breathing, urinary frequency, and probably more. The thoughts that were entering my mind were frightening so I went to the E.R. They performed multiple lab tests and an abdominal CT, all which were normal. So what did they do? They gave me Ativan. The LAST thing I needed. The way they treated me was very unprofessional and uncaring, as if I were an irresponsible addict. But, believe me, more drugs were the last thing I wanted. I just wanted help. Help to get through it WITHOUT being loaded up on drugs.

 

I couldn’t do life anymore. I couldn’t work, be a wife, mom or grandmother. I couldn’t cook, clean, nothing. I was scared. Not one doctor knew how to get me through this and I was desperate. All I wanted was my life back, but I felt trapped. So I reached out to a detox center. They “promised” they could help me get off of the benzodiazepine and get my life back. I believed them, so I went. They tapered me off of the Valium over three weeks. In the detox center I was offered drug after drug (Gabapentin, Baclofen, Trazadone, Seroquel, Visteral, Propranolol, etc.) to “help” with the symptoms I was continuing to endure. I even asked the addiction psychiatrist at the detox center whether the other medications that were supposedly meant to help might be causing further problems. His answer was: “I don’t know, just stop those medications then.” Basically, he didn’t know. Who knew? Does anyone know?

 

I came home a month later and attempted to get back into the workforce, but failed. The symptoms continued and my providers kept saying, “It’s reemergence of your anxiety” and “It cannot be withdrawal, the drug is out of your system.” But it WAS still withdrawal. There are many studies out there that confirm that withdrawal symptoms can continue after the drug is out of the system. My body has downregulated the gaba receptors after many years of taking Klonipin, so I basically have no working receptors, and glutamate (the excitatory neurotransmitter) is dominant, for now. Why don’t you know this, doctor? Why are you making me feel as though I am crazy?

 

The symptoms drove me to have thousands of dollars in tests. I was admitted to Duke to rule out adrenal failure. All tests were negative, of course, so what happened while I was inpatient? They brought in psych to evaluate me. What did they do? They put me on yet another psych drug, Prozac, which made me much worse, so I stopped. I was admitted to two separate psychiatric hospitals for suicidal ideation because I could not function and I did not know how long it would take to heal. My family depends on me and I couldn’t be there for them. All the psychiatrists at these hospitals wanted to do was stack more medications on me. It’s like they scanned down a menu of medications to see “what we could try.” I went to rehab, where staff members promised they could help me. They couldn’t. I saw two naturopaths, both of whom wanted to pile supplements on me, none of which helped.

 

No one knew how to help. Not one. Why? Why didn’t I know this could happen to me? I mean, I’m medically educated, right? But I didn’t know, and neither did my doctors.

 

I lost faith in the medical system, but I gained faith in my Holy Father. I had to keep fighting and maintain patience. I did. Am I healed? I feel that I am healed from benzo withdrawal, but I still have to taper off the “other” drugs that the detox center started me on, which I am working on now. I feel this is an endless cycle of withdrawing from drugs that, if I had known then what I know now, I would have never started.

 

So why don’t doctors know? When doctors and mid-level providers are in the midst of their education, prior to practicing, the main focus is diagnosing and treating. Our education begins with learning the basics of anatomy and physiology, biochemistry and microbiology. So basically we are learning about the human body and how it works, down to the cell. This is where the infamous gross anatomy class comes in, which entails dissecting a human body. All of this is taught over a few courses over a few semesters at the beginning of our college career. Later on in our medical education, the knowledge expands to pathophysiology — basically, what happens physically/chemically to the body when things go wrong. In medical school, they break the education down into systems (i.e. neurology, respiratory, cardiovascular) with each system covered over a number of weeks. Students are given one, maybe two, semesters of pharmacology class (typically 15 weeks each semester, meeting two or three days a week for 1-2 hours). So as you can see, in-class learning is minimal for what is needed to know out in the real world. In the later semesters, learning continues in the clinical setting (i.e. residency, etc.). It is nearly impossible to learn everything about every condition through our medical education. Over the years of education we are formally tested through exams as well as hands-on demonstration of our knowledge, and, finally, through a board certifying exam. However, much of the learning is through our continuing education, depending on new practice guidelines, and is basically a “learn as you go” process.

 

During our education we are taught that, based on a patient’s history of present illness (what the patient tells us their symptoms are) and physical (what we see and lab or radiological testing), we should come up with a list of differential diagnoses (or list of possible diagnoses) and based on the most clear possible diagnosis, treat for that condition. However, if the treatment given does not improve the symptoms, we start going down the list of differentials we compiled. For example, here is a case study:

 

Mrs. Jones is a 45 year old female who comes into your office with complaints of the

following: dizziness, nausea, gnawing abdominal pain, increased agitation/anxiety,

palpitations, shakiness, cold intolerance, fatigue and a 10 lb weight loss over the last

month. Patient denies headache, loss of consciousness, fever, cough, wheezing, shortness of breath, chest pain, diarrhea, constipation, blood in stool or extremity swelling/weakness.

 

Past medical history:

Hypothyroidism, Premenstrual dysphoric disorder, anxiety

Surgically postmenopausal

Medications:

Levothyroxine 75 mcq once daily, Clonazepam 0.5 mg once daily,

Monthly estrogen shots.

Has been taking levothyroxine for 20 years and Clonazepam 15 years.

Estrogen replacement started after hysterectomy

Allergies: Erythromycin

Past surgeries:

Septoplasty (septum repair), Tubal Ligation, Tonsillectomy, Total Hysterectomy

Social history: 

Non-smoker, denies alcohol or illicit drug use

Married, 3 adult children

Works in healthcare

Physical (by systems):

Mildly anxious female, alert and oriented with normal BMI

HEENT: normal

Respiratory: Lungs clear, respiratory effort unlabored

CV: Heart rate/rhythm normal, no murmurs

Musculoskeletal: Normal strength and range of motion of all extremities

GI: Mild epigastric tenderness on palpation, abdomen non distended, soft, liver not enlarged. Bowel sounds normal

Neuro: Cranial nerves, balance and pulses normal

Skin: Color normal, no lesions, warm, dry, intact

 

Based on the history and physical, what is your possible diagnosis? Breaking the symptoms down into systems, the diagnosis could be cardiac (palpitations, dizziness, fatigue), neurological (extremity burning, dizziness, anxiety, agitation), endocrine (fatigue, dizziness, weight loss, cold intolerance, anxiety/agitation), GI (nausea, abdominal pain, weight loss), psychiatric (increased anxiety/agitation, weight loss, palpitations, GI disturbance, fatigue) or medication-induced (too much hormone replacement). So from this list, there are a multitude of diagnoses that could be given from the symptoms of this patient. The next step for the provider is to start from the most likely diagnoses and work through the differential list. In order to do so, he/she will need to start out with testing (i.e. laboratory, radiological, etc.). If he/she is unable to do so, then there is one of two possibilities that you will likely run across: 1) You have anxiety/depression, so let’s start you on some medication to help you, or 2) You will be referred to a specialist (i.e. cardiology, neurology, endocrinology, etc.).

 

This patient’s tests all come back normal. So, what could it be? The most likely diagnosis will be reemergence of her anxiety. So what is the treatment? You guessed it: medications. Either increase the clonazepam or add another psychiatric medication (SSRI, SNRI, etc.).

 

Now here is the big question: Why didn’t the provider even have a clue that the patient’s symptoms could be from the reduction of the clonazepam? Four words: they did not know.

 

Back to pharmacology, the class where our future providers learn about the medications they will be prescribing. In this class, the primary focus is on pharmacokinetics (what the body does to the drug) and pharmacodynamics (what the drug does to the body). This is based on what I will call a “control” person. Although the pharmacodynamics of a drug will likely be the same or similar for all of us, the pharmacokinetics will not. That is because we are all biochemically different. Our DNA, illnesses we may have, environmental chemicals we are exposed to as we grow up, and so forth, all contribute to how our bodies react to the medications we ingest or inject.

 

Additionally, in this one — maybe two — semester course only the most common medications are covered, which is a fraction of all existing medications. According to the FDA’s Orange Book, which lists approved drug products with therapeutic equivalence evaluations, page 9 of 64 of the Cumulative Supplement for March 2018 shows a total of 19,294 prescription drug products as of December 2017. It is simply impossible to learn about all of the FDA approved medications and their interactions with each other in one or two semesters.For example, on Georgetown University School of Medicine’s pharmacology department webpage, description of the class is written as follows,

 

“The second year’s course in pharmacology introduces the student to the scientific basis for the use of certain drugs in medical practice and the essential principles of clinical pharmacology. Since it is impossible to learn about each of the several thousand prescription drugs currently available, the course concentrates on selected prototype drugs and general pharmacologic principles that govern the action of all drugs in the body.” [emphasis mine]

 

After these classes, the future medical provider’s education is in the clinical setting, or “learn as you go” and mandatory annual medical continuing education (CME); however, many states do not have mandatory specific pharmacology CME requirements. The number of CME hours required by state varies but averages only between 20-50 hours annually.

 

So having been on the inside as a nurse practitioner, as well as on the outside, I can see why benzo withdrawal sufferers go years without being diagnosed properly. Bottom line is that there is a lack of education. It is 100% impossible for any one doctor or provider to know the pharmacokinetics (for YOUR biochemical makeup) and the pharmacodynamics, potential interactions, and potential adverse reactions of every medication available and prescribed.

 

Where am I now? I have slowly eased back into working again. I could not physically or mentally help patients during the worst of my withdrawal, but now that more than two years have passed, I am ready. Since I am basically a new provider for the patients I see, I am not prescribing benzodiazepines; however, I am helping with weaning. I am hoping and praying that I am contributing to the increase in education of the ramifications of long-term prescribing and the necessity of a slow taper, as well as the reduction in prescribing in our medical offices.

 

There are also 31 comments following the article. Very interesting, and I hope you'll read them. WHY are doctors so uneducated about the very drugs they prescribe and know that people will be taking for some time or maybe even for life? And since we are so lucky to have the Internet, we've got to be proactive when it concerns our health, researching every pill, weighing the pros and cons.

 

https://www.madinamerica.com/2018/05/benzo-withdrawal-why-dont-doctors-know/

Excellent article. This sounds like so many of us. I grappled with the idea of hospitalization again today. That certainly isn’t the answer. I may share this with my family. George

Thanks for sharing! Great article

Excellent article~ So very true.  Well written too.  I am grateful that you posted it Terry.

 

SO in today's news:  https://www.cnn.com/2019/05/28/health/oklahoma-opioid-trial-start/index.html

 

Let's just replace the word Opiod with Benzos - shall we?

 

Thank you for the article, Leslie! Yes, I feel strongly that benzos rip families apart, break up marriages, and cause much damage, the same things that the opoid crisis causes.

 

"When thousands of people die from drug overdoses attributable to prescription drugs, when you have hundreds of thousands of people who are addicted," Hunter said, "public nuisance law is the best and most efficient way for you to protect the people of your state." Interesting!

You're welcome, Coachgeorge and Restoration123!

 

I thought it was the classic benzo "style" doctors use to treat patients and the damage it can cause. It is very well written, and I gave my therapist a copy.

Thanks for posting this, Terry, but I don't think it's an excellent article at all. I think it's just this grandmother's chance to go on and on about herself and conclude with a gigantic anticlimax:

 

Bottom line is that there is a lack of education. It is 100% impossible for any one doctor or provider to know the pharmacokinetics (for YOUR biochemical makeup) and the pharmacodynamics, potential interactions, and potential adverse reactions of every medication available and prescribed.

 

You see? The problem is lack of education, because there are just so many drugs out there.

 

Huh? That's it? That's the point of this article? That's the explanation? The impossibility of adequately educating medical students because there are just oh so many drugs out there?

 

Give me a break! Of course there are a lot of drugs, but year after year after year, benzodiazepines are among the most commonly prescribed drugs, and have been since the advent of Valium fifty-odd years ago. Benzodiazepines are certainly not lost in some pharmaceutical avalanche. Even the briefest pharmacology course for medical students - or nursing students - would have to cover benzodiazepines, antidepressants, and antibiotics.

 

The problems with benzos are well known, and have been well known for quite a long time. I don't for a minute believe that doctors are unaware of the problem. I think they're in denial. They cannot admit that the problem is as serious as it is, because if they did admit it, they would have to stop prescribing these things as if they were aspirins or tootsie-roll pops. And on top of that, they might face civil liability for their past prescribing habits. That's the problem, and not "lack of education".

 

And by the way, what in the world does this author's being a grandmother have to do with anything? That's just a cheap rhetorical trick to gain the reader's sympathy and trust. As soon as I see something like that I'm put on my guard because, invariably, what follows will be a con. This article is, in fact, a defense of the medical profession. It absolves doctors of responsibility for their negligence, because don't you see? they just haven't been properly educated, and surely you must agree, it really isn't possible to educate them, because, oh Lordy and Land's Sakes Alive, there are just soooo many drugs, and she should know because she's a grandmother, and grandmothers are so wise, and they love you, and they'd never lie to you, would they? Well? Would they?

 

Again, thanks for posting this. I know your heart was in the right place, even if the author's was not. And please forgive me for not quoting the entire article as a preface to my reply, but I don't see any point in doing that. It just clogs up the thread. I hate it when people do that. But of course, they'll just continue to do it because it's easy and they're thoughtless - rather like the doctors who keep prescribing these benzos month after month, year after year. Thoughtless careless people. That's the problem, in a nutshell.

This subject remains a mystery to me. None of the many doctors I sought help from seemed to have any idea my problems could be caused by the drugs I was on, Benzos and ADs. Not a one of them ever said "you might want to get off those drugs and see if it helps. Why this happened, and with about 6 doctors, I do not know. My medical doc only began to figure it out after many years of being his patient. And once he did sort of get it, I was forced to go CT off it all. NOT right or fair but it happened and I do not regret it at all. I have to be honest here. After 30 years on nightly benzos, I was truly addicted both psychologically and medically. I would not have been capable of a taper. That is MY truth.

I don't find anything especially wrong about this article, because it is just another sad story about psych drugs that seems to have NO effect on them being prescribed. People keep trying to tell the public more about these drugs but for some reason, nothing ever changes. And THAT is perhaps the biggest tragedy. Doctors keep prescribing these drugs and people keep taking them. If they are lucky, they will remain okay but others, like us, will not.

Well, I added at the end, There are also 31 comments following the article. Very interesting, and I hope you'll read them. WHY are doctors so uneducated about the very drugs they prescribe and know that people will be taking for some time or maybe even for life? And since we are so lucky to have the Internet, we've got to be proactive when it concerns our health, researching every pill, weighing the pros and cons.

 

Did you read the comments at the end?

 

A Dr. Lawrence Kelmenson answered: I am a doctor, and I can tell you that doctors do know. They just like quick, easy, guaranteed monthly income. Psychiatry has never been about “treating illness”. It has always been about permanently managing society’s outliers. When it started to not have enough of these “patients”, it ventured into turning normal human experiences into “chronic mental illnesses”, and into dealing addictive drugs, in order to recoup its lost clientele.

 

The success of this business formula has been copied by “pain management” doctors, who also knowingly deal addictive drugs that turn transient pain into chronic/worsening pain, in order to create the permanently dependent customers which are their bread and butter. And the “hypothyroidism” you referred to is a similar way to produce eternal clients. Although levothyroxine isn’t physically addictive, if taken for too long, it causes the thyroid gland to “forget” how to make its own thyroid hormone, leaving the person dependent upon outside thyroid hormone. That’s why, when I went to medical school, we were taught not to rush in and treat abnormal thyroid levels unless they were very abnormal at several different visits, and accompanied by clear symptoms. That’s why thyroid hormone went from being a rarely prescribed to the most commonly prescribed drug. Before it became #1, vicoden was the most commonly prescribed drug for about ten years. For much of the ’80s it was xanax, and in the ’70s it was valium.

 

I also believe that many people (but not all) who go on benzodiazepines know they are physically addictive (just as many people who drink alcohol heavily know that it’s physically addictive), yet are willing to take the risk anyway. I don’t know the explanation for this, but it has something to do with American culture, since we lead the world in virtually every category of legal and illegal addictive drug use.

 

Here's another one: Haha… Yeah – it’s a complete mystery why patients think a medication is safe when a doctor has explicitly told them that it is safe.

 

Part of the reason I think this article is so good is that people at BB run into this very often. AND WHY SHOULD WE BELIEVE A PILL IS SAFE JUST BECAUSE A DOCTOR TELLS US??? I want to dispel that right now, but of course I'm preaching to the choir.

 

This is a difficult lesson I had to learn, but everyone has to learn it. The fact that we have the Internet and askapatient.com, as well as other sites to find out how the worst fared, the more educated we'll be.

 

But I think this story is very important because it helps us to see ourselves. Too many of us are still blindly trusting what a doctor tells us about pills, which, in many instances, the doctor learns about through hearsay and not necessarily the truth.

 

Can I ask what made you take the bait when you first started on benzos? Did you believe your doctor? How do you approach doctors today or do you even see a doctor? 

My feelings are on par with Redevan's, btw.

 

I was so desperate for a good night's sleep, I'd have taken heroin, had my doctor prescribed it, and I know how bad that stuff is. That being said, he should have pointed me in a non-drug direction first, like CBT or brainwave therapy. Drugs should be the last resort. But they aren't. They're first in line. CBT and brainwave therapy are hippie shit. Normal people take drugs. Alternatives are for new age freaks and losers. /s

 

But I was unaware of how hard Z drugs and benzos were to get off of. No clue. I would have thought twice about going on a drug with a 4 week acute WD time. I did know that if you got addicted to them, withdrawal was a bitch. But the tiny amount I was taking, I had no earthly idea you could get addicted to so little. I'm very grateful that I never asked to be given a higher dose. I didn't ask, because I was afraid that he'd take away my sleeps. Asking for a higher dose of something habit forming is just begging the doctor to take them away from you.

 

But it was taking more and more to get to sleep at night. I guess I finally hit tolerance.

My feelings are on par with Redevan's, btw.

 

I was so desperate for a good night's sleep, I'd have taken heroin, had my doctor prescribed it, and I know how bad that stuff is. That being said, he should have pointed me in a non-drug direction first, like CBT or brainwave therapy. Drugs should be the last resort. But they aren't. They're first in line. CBT and brainwave therapy are hippie shit. Normal people take drugs. Alternatives are for new age freaks and losers. /s

 

But I was unaware of how hard Z drugs and benzos were to get off of. No clue. I would have thought twice about going on a drug with a 4 week acute WD time. I did know that if you got addicted to them, withdrawal was a bitch. But the tiny amount I was taking, I had no earthly idea you could get addicted to so little. I'm very grateful that I never asked to be given a higher dose. I didn't ask, because I was afraid that he'd take away my sleeps. Asking for a higher dose of something habit forming is just begging the doctor to take them away from you.

 

But it was taking more and more to get to sleep at night. I guess I finally hit tolerance.

 

But did you not know that doctors generally don't point people in the direction of CBT or brainwave therapy? In my experience their first thought is "pill." Never have I been asked about other modalities. Did you not think to go on the Internet first? That was my mistake. Another mistake was telling myself, "It won't happen to me." I didn't consider myself an "addict," so why would I get addicted to this? I had nothing to compare benzos to. The third mistake was in not researching the comments from others on the Internet. I just closed my eyes to it and took the pill.

 

WE have to be proactive and search out other modalities. Doctors think "pill." If we want to go in another direction, that's up to us. We can't look at a doctor for all the answers. But I found out too late. I wish other people could avoid that.

I was not all that internet savvy at the time I was prescribed all that crap.

Thanks for posting this, Terry, but I don't think it's an excellent article at all. I think it's just this grandmother's chance to go on and on about herself and conclude with a gigantic anticlimax:

 

Bottom line is that there is a lack of education. It is 100% impossible for any one doctor or provider to know the pharmacokinetics (for YOUR biochemical makeup) and the pharmacodynamics, potential interactions, and potential adverse reactions of every medication available and prescribed.

 

You see? The problem is lack of education, because there are just so many drugs out there.

 

Huh? That's it? That's the point of this article? That's the explanation? The impossibility of adequately educating medical students because there are just oh so many drugs out there?

 

Give me a break! Of course there are a lot of drugs, but year after year after year, benzodiazepines are among the most commonly prescribed drugs, and have been since the advent of Valium fifty-odd years ago. Benzodiazepines are certainly not lost in some pharmaceutical avalanche. Even the briefest pharmacology course for medical students - or nursing students - would have to cover benzodiazepines, antidepressants, and antibiotics.

 

The problems with benzos are well known, and have been well known for quite a long time. I don't for a minute believe that doctors are unaware of the problem. I think they're in denial. They cannot admit that the problem is as serious as it is, because if they did admit it, they would have to stop prescribing these things as if they were aspirins or tootsie-roll pops. And on top of that, they might face civil liability for their past prescribing habits. That's the problem, and not "lack of education".

 

And by the way, what in the world does this author's being a grandmother have to do with anything? That's just a cheap rhetorical trick to gain the reader's sympathy and trust. As soon as I see something like that I'm put on my guard because, invariably, what follows will be a con. This article is, in fact, a defense of the medical profession. It absolves doctors of responsibility for their negligence, because don't you see? they just haven't been properly educated, and surely you must agree, it really isn't possible to educate them, because, oh Lordy and Land's Sakes Alive, there are just soooo many drugs, and she should know because she's a grandmother, and grandmothers are so wise, and they love you, and they'd never lie to you, would they? Well? Would they?

 

Again, thanks for posting this. I know your heart was in the right place, even if the author's was not. And please forgive me for not quoting the entire article as a preface to my reply, but I don't see any point in doing that. It just clogs up the thread. I hate it when people do that. But of course, they'll just continue to do it because it's easy and they're thoughtless - rather like the doctors who keep prescribing these benzos month after month, year after year. Thoughtless careless people. That's the problem, in a nutshell.

THOUGHTLESS..!! JUST LIKE THE PROBLEMATIC DRs..!! Hope my fkn spelling is up to scratch too.. I guess arrogance doesnt allow for a walk in others shoes.. You ever tried pulling apart a thread on a small phone screen, -with 4 swirling screens that try to blur into one on a good day, -and whilst ones multiple shaking fingers are trying to play pin the letter on the screen..?? Yes, Arrogant at the least because this has been pointed out to you before.. Perhaps a little more politely, but there you have it.. MY opinion on your judgements...

But dont mind me.. -carry on as you will...

 

Kinda not impressed...

 

Keep a close eye on the Oklahoma trial that was posted in this thread.  It could set a precedence for Big Pharma's role in the opioid crisis.  As another Benzo buddie said, just replace the word opioid with benzo!!!!

"Dr." Kelmenson is a horse's ass.  He has a poor rep with some MIA regulars for the silly habit of blaming the patient...read his blogs and see for yourself.  His "opinions" come right from his ass.

 

I also agree with redeven about the article.

 

If you aren't well versed on your weaponry, how safe can you possibly be?  To not know is the height of hubris.

 

First, do no harm, remember?

Well, we have a part to play in this, too. I stupidly didn't read all the horror stories about Ativan. I just trusted the PA and took the pill. We CANNOT trust doctors to give us solid information about pills. We have to take the steps to ensure that we'll be healthy.

 

We can't look to doctors for all the answers. That's something that each of us has to learn.

 

I'm wondering how you got involved in this, cookienose. Did you follow the doctor's instructions and not look things up? Did you know the pitfalls of Klonopin? Did you believe doctors?

 

I posted this in chewing the fat and no one seemed to be interested but if you want to listen to two clued in doctors talk about why doctors are "ignorant" you need to watch this video!

 

The general topic is their theories on the root cause of mental issues being diet but they dive pretty deep into the drug paradigm and the reason why we are seeing these problems.

Thanks, FG! I'll have to listen to it.

 

By the way, NO doctor has asked me about my diet.

 

 

By the way, NO doctor has asked me about my diet.

 

I think I might have had one doctor ask me in passing about my diet but it wasn't anything more than "Are you eating healthy"? No discussion about what actually is healthy and how it might improve any current issues or make me more healthy in general.

 

The more I learn about diet the more I come to understand that this is likely the root cause of most of these modern health problems. You think benzos are a problem? What if "they" have convinced us to eat a diet that is slowly poisoning us creating an epidemic of obesity, diabetes, hypertension, heart disease, anxiety and depression etc. If they can make you fat and unhealthy, imagine all of the drugs they can sell!

 

The problem goes much deeper than just benzos. Benzos might be some of the worst of the worst when it comes to the symptoms from the damage they can do but they are just the tip of the iceberg.

The video I posted isn't just about diet though, there is a ton of stuff in there that directly and indirectly relates to the benzo issue. It's just refreshing to see that some doctors actually understand that the current system of "symptom management" is broken.

Thanks again, FG! I wish more doctors would understand that symptom management is definitely broken...

Like a used car salesperson, your doctor may have a damned good spiel about a pill, but that doesn't matter. What matters is what you put in your mouth and take every day. Your body is the best tool you have to navigate this life. Read up on the pill BEFORE you take it. If you feel that you can't live without it, that is your choice.

 

The worst thing is to blindly trust what a doctor says about a pill which they don't know anything about or don't care to research. Maybe they're blindly following their colleagues' suggestions, who got their information from a pharma rep who has been a political science major for god's sake and is spouting off jargon he/she received from higher-ups.

 

Our bodies perform a delicate dance every day. Putting a foreign substance in it is apt to upset that delicate balance and cause a domino effect.

 

I know I'm preaching to the choir here, but the woman whose story is chronicled here is like many of us. I can only hope that people start really understanding the idea that doctors are not benevolently giving us pills always. They have an agenda just like anyone else. They may be following guidelines for the insurance company. They may be part of a group that has a "herd mentality" and follows certain practices.

 

So - buyer beware. 

"Dr." Kelmenson is a horse's ass.  He has a poor rep with some MIA regulars for the silly habit of blaming the patient...read his blogs and see for yourself.  His "opinions" come right from his ass.

 

I also agree with redeven about the article.

 

If you aren't well versed on your weaponry, how safe can you possibly be?  To not know is the height of hubris.

 

First, do no harm, remember?

 

Good call, Cookie. Doctors just trust the "science" behind these drugs, which is actually more like marketing. But how can you do anything but laugh when they claim they are responsibly weighing the risks and benefits when prescribing a drug? They don't even know the risks! Many of them quite happily prescribe benzos and antidepressants for 5, 10, or 20 years without the least idea of whether that is good for anyone. I have only met 1 out of 10 doctors who knew that benzos worsen anxiety and insomnia long term, and he was just out of med school. Or maybe he just made the rookie mistake of admitting he knew. From now on I will never actually know whether doctors are lying or just ignorant. I think the only way you'd find out is to become one. I do think the majority are decent people and it is mostly ignorance, but some are clearly just out to make money. They need to be ejected from the profession or held in line by guidelines with actual teeth.