Ashton's wrong: alcohol/benzo use during/after withdrawal

While Ashton Manual states that alcohol in moderation and rescue doses (for dental treatments, surgeries, etc.) are fine, many members report anecdotal evidence of it causing setbacks. I myself have been thrown into full-on cold-turkey withdrawal by two-day benzo use. Some may be able to tolerate GABAergic disturbances like these just fine, but many aren't and I find it irresponsible to have something like that in the Manual. There are people who were even setbacked by supplements, so it's probably safer to avoid drug-strength stuff like benzos and alcohol.

 

From "The natural history of tolerance to the benzodiazepines" by A. Higgitt, P. Fonagy and M. Lader:

Benzodiazepines or cross tolerant drugs, substances such as alcohol should be avoided after discontinuation, even occasionally. These include the nonbenzodiazepines Z-drugs, which have a similar mechanism of action. This is because tolerance to benzodiazepines has been demonstrated to be still present at four months to two years after withdrawal depending on personal biochemistry. Re-exposures to benzodiazepines or cross tolerant drugs typically resulted in a reactivation of the tolerance and benzodiazepine withdrawal syndrome.

 

Now we know this is where that anecdotal rule of "three years of no symptoms" before you can safely drink alcohol comes from.

 

 

Edit: Removed all caps from subject title.

I respect Dr. Ashton, but she's not infallible.

FYI to future readers of this thread ...

 

The quote in the first post is misattributed.  It does not appear in the monograph cited (‘The natural history of tolerance to the benzodiazepines" by A. Higgitt, P. Fonagy and M. Lader, 1988).  Also, the studies presented in the monograph did not investigate post-discontinuation use of alcohol.

That book has been very helpful but I think it's outdated and it should cease to be regarded as the Bible.

She is wrong on a lot of things.

 

She did not include the role of glial cells, mast cells etc in WD.

You need to have a look at the time she wrote her books etc. A lot of things just were not researched yet.

You need to have a look at the time she wrote her books etc. A lot of things just were not researched yet.

 

Aye, credit where its due. She hasn't took a penny from that book and is been downloaded millions of times. She could have asked for £1 and she'd have made a few million.

 

It's not that it was wrong, it's just outdated. She looked like she was retired to me so someone else should carry on her research but no one wants to fund it.

 

 

She is wrong on a lot of things.

 

She did not include the role of glial cells, mast cells etc in WD.

 

Or general relativity or dadaism.

You need to have a look at the time she wrote her books etc. A lot of things just were not researched yet.

 

Aye, credit where its due. She hasn't took a penny from that book and is been downloaded millions of times. She could have asked for £1 and she'd have made a few million.

 

It's not that it was wrong, it's just outdated. She looked like she was retired to me so someone else should carry on her research but no one wants to fund it.

 

She died on 15 September 2019. But she's still doing more to help us than most doctors.

 

Yes!

Science is movement, its improving and working with new variables and factors again and again. You cannot blame someone for not knowing the hole truth - if that was the case you would end up with a so called guru.

It is wise to look for people who have already searched for answers a long time, have worked with the data and still are doing research. As far as I know professor Ashton was that kind of a person and I highly appreciate it.

Professor Ashton later verbally retracted her written statements about ‘the odd glass of wine’ and ‘adding an antidepressant’.

 

The reason why it’s still in ‘The Ashton Manual’ print is because she actually originally wrote the ‘manual’ to be added as a chapter/appendix in someone else’s book.

 

So it kinda’ can’t actually be changed as such

 

It was also written three decades ago.

 

That’s the history and the reasoning... 👍🏻

 

 

She is wrong on a lot of things.

 

She did not include the role of glial cells, mast cells etc in WD.

 

Or general relativity or dadaism.

 

Lol

I think she was generally correct. It's just those of us who reached a certain level of kindling/damage and used a certain benzo (e.g clonazepam, alprazolam, lorazepam) that need to be very careful. I kindled about 3 or 4 times with Valium and alcohol, using for 2-5 months at a time and had a pretty average w/d each time. I was able to drink beyond excessively without issue and take the odd benzo about 4 months after each w/d, drinking earlier than that would create weird hangovers. It was only on the 4th time around using alprazolam for 3 months at 8mg average with alcohol that I had a severe w/d and grew an intolerance to the usual drugs, exercise etc. Just to mention this is from 20-25 years old so my age probably helped a lot. Yes I'd be angry reading this too, I'm an idiot and wish I stopped while I was ahead. I would have stopped sooner with the alprazolam knowing how bad it can be but the lack of anxiety convinced me everything would be fine lol. Ironic.

 

Something that I can personally compare your setback to is my opioid kindling (I do understand they are very different but hear me out). After about 7 w/ds from oxycodone it only takes me about 2-3days of use before I am physically dependant again. I may even have a slight withdrawal after 1 day at this point but it's hard to tell while in benzo w/d. I have used opium twice during this alprazolam w/d for some relief, first time actually seemed to make me feel better for the following weeks (almost like it reset something, I have seen someone mention feeling better after drinking a certain amount too, but feeling worse if they only had 1 or 2 drinks, very interesting). The second opium use 3 weeks later either caused a slight withdrawal, or a benzo wave coincidentally came on after. Not sure, but my point is, even after all this opioid kindling as far as I know I can take a "rescue" opioid without issue as long as they are adequately spaced. But if I take it for 2 days or more I'm going to withdraw. I'm not willing to test how long it takes at this point because if I withdraw again I may not even be able to take a rescue opioid.

 

I feel like once a reasonable amount of time/healing has passed taking something once isn't enough for the body to become re-accustomed to it unless you are severely affected by kindling, which can be hard to gauge. The brain definitely remembers and gets a ton more relief than the first time you ever took said substance, but that's usually just the first sign of becoming dependant again. Either you're damaged/kindled on a very high level, didn't wait long enough, or the fact you took it for 2 days in a row could all be factors why you had a set back.

 

That being said I personally would never take a benzo again because risking this hell again is too much. I do plan to occasionally drink again so long as I see an adequate amount of healing within myself. If not for my age and shitty personality I probably wouldn't risk that either.

 

An interesting thought that I've had is this: some people drink alcohol and don't have a setback but it revs them up for a few days or so. I feel this rev up may be caused by a damaged system reacting differently than what it used to (an altered hangover), rather than down regulation of GABAA causing a resurfacing of w/d sx. So a lot of us that might have a weird reaction to alcohol might not even be kindling ourselves, just poisoning the system temporarily with a twist lol.

 

In any case I'm very sorry this happened to you and I hope you recover more quickly this time around. For my own curiosity how long were you on/off benzos, which benzo, and what benzo caused the setback? Also did your rescue dose act like a benzo normally would? Much love and sorry for the anecdotical ramble