I hereby grant Dr. Cathal Cadogan, Lecturer and Research Supervisor, Royal College of Surgeons in Ireland (BenzoBuddies username: [...]) to use my withdrawal- and recovery-related data contained within my Success Story for the study - [ study, as detailed here:
http://www.benzobuddies.org/forum/index.php?topic=250579.msg3187012#msg3187012 ]
1. Background
I was prescribed Diazepam (Valium) 6-12mg per day for 22 months, between March 2018 to January 2020.
I self-tapered over approximately 7 of those months from July 2019 to January 2020. I completed my taper on January 14th 2020. I have been medication free since that time (currently 13 months).
Why were they prescribed?
Sept 2017: I was the victim of a violent crime (a random home invasion by a stranger who was suffering from psychosis), from which I sustained severe physical injuries and an understandable physiological trauma response.
I suffered a Traumatic Brain Injury from the attack and was unable to manage normal activities of daily living. I was unable to cook, shop, schedule, organise, manage my finances. Having been an independent human who lived alone, this was untenable. I needed practical support. I became more distressed over time as I failed to impart my need or secure the requisite practical assistance while I watched my life unravel. (nb I have since secured that support and I now board with a full time attendant carer).
I had been seeing a psychologist since the attack and eventually, 5 months after the attack, I relented to her persistent urging that I 'trial' Sertraline, supposedly to 'calm neural excitability'. She told me that my brain could suffer permanent damage if my distress levels didn't change. In reality, the drugs were intended to subdue me in lieu of any provision of the practical support I needed and was due.
In January 2018, at my Psychologist's initiation, Sertraline and Quetiapine were prescribed to me 'off label' by my GP. For conditions I didn't have and for symptoms I wasn't troubled by. What ensued was the worst torment of my life. Worse than the recent assault that caused my injuries.
Sertraline and Quetiapine caused an extremely adverse reaction over the course of 6 weeks, resulting in a medical emergency in March 2018. I had to stop taking them both, on instruction of a Psychiatrist. I was diagnosed with Serotonin Syndrome, Akathisia and a visible movement disorder and verbal tourettes.
Valium was then prescribed to me at that time, to mitigate the effects of the medication toxicity. In fact Valium was only ever prescribed to me to mitigate the effects of other psychotropic medication, (iatrogenesis) and never for any underlying condition.
Originally it was prescribed 2mgs, 3 times per day (6mg daily total).
The label always said 'prn/as required' but in reality I was told by the prescriber to take the full and complete dose every day.
2. Decision to stop
I had never wanted to start taking the Valium, so I always wanted to stop.
But I was trying to be responsible and follow instructions that said I should not stop abruptly, and I should do so only under medical supervision. Every time i saw my precriber I sought the oversight of a taper. Months and months passed by and still I could not secure the oversight I sought to actively document and communicate a plan to reduce and cease Diazepam use.
In August 2018 I had been additionally prescribed Carbamazepine. I also experienced adverse effects from that medication. This resulted in the Diazepam dose being doubled to 4mg 3 times per day, 12 mgs daily total (again to mitigate the adverse effect of another psychotropic medication).
The drugs were not helping me to resolve the outstanding issues (e.g. of not being able to look after myself alone anymore), and I hated taking them. I hated their effects (which in hindsight were paradoxical ie. I suffered relentless agitation/akathisia throughout the period of their use. The neurotoxic movement disorder/verbal tourettes persisted. I had gone from being a presentable, sociable human being (even after the attack and my injuries) to become a dribbling, jerking, mess with increasing cognitive deficits - confusion, dizziness, memory loss, lack of focus.
The treatment providers response to my clear deterioration was to . . . increase the medication.
In May 2019 I was told to increase the dosage of Carbamazepine.
That was my turning point. I was terrified of ramping up the (paradoxical) effects any further. My treatment providers weren't listening to me.
I decided I would have to take things in my own hands and get off the meds on my own.
3. Discontinuation process
How did you go about reducing and stopping your long-term use of thIe benzodiazepine or Z-drug medication?
Did you have a particular process? What did that involve?
Did you have help from anyone?
I had been trying for months and months in advance of my taper to get information about how to safely proceed.
I was amazed that I couldn't seem to find information online.
When I put appropriate words in online search engines all that kept appearing in response were adverts from American rehab or detox facilities, for 28 day programmes that seemed to involve substitue medications. I live in New Zealand. I wasn't an 'addict'. 28 days seemed quite abrupt. And I didn't want to be on any medications.
I had bought some books on line but these didn't provide taper guidelines and they didn't focus on Benzodiapine reduction.
It is possible that forums like Benzobuddies popped up in the search, but at that time it is unlikely I would have looked at them. I was wary of 'signing in' to anything online. And I was also wary of online forums. I had a prejudice that forums could be dangerous and misleading ie. that they might strongly represent the distortions of a minority.
In the end, I made a decision to taper off the Carbamazepine first, and then the Diazepam.
I tapered off the Carbamazepine over 6 weeks in May/June 2019.
I inadvertenly decreased by Diazepam use by one dose around June 2019, as I no longer had the night-time 'cue' of taking the Carbamazepine.
I held on 4mg total for July/August 2019 as I was experiencing new or increaed symptoms (which I now understand were 'withdrawal' effects) eg. burgeoning agoraphobia, photophobia, sociophobia which had not been evident before.
In September 2019 I formally sought oversight from a Psychiatrist for a Diazepam reduction/cessation. She fobbed me off, saying she would get back to me (in 6 weeks) after she had consulted with her colleagues at the Drug Addiction Department. Despite being a presciber of Diazepam, she clearly didn't have familiarity with cessation.
So I proceeded by myself, to reduce my Diazepam by half a mg per week from 30th Sept 2019. This involved splitting my 2mg tablets in half and then quarters, to be able to take a reduced dose.
By the time I was down to 1mg at the beginning of November 2019, things had really spun out of control for me symptomatically. I didn't understand what was happening. And I had no way of knowing that my deteriorating condition was associated with withdrawal.
But by late October, I was desperate. I thought I was going insane. I had started to experience symptoms of derealisation and depersonalisation and loss of will to live. It was my partner who suggested that perhaps this deterioration might be linked with my Diazepam reduction.
I was too 'spellbound' and congitively blurred to make the link. But it made sense. They symptoms were commensurate with my taper.
And that's when i found Benzobuddies on line.
And that's what changed everything for me. I think it saved my life.
Finally, I had a resource and some reliable information. I think I had already found the Ashton Manual, which I was basically following. But it was Benzobuddies that allowed me to realise that at this rate of symptoms and deterioration in my condition, I needed to slow down my taper.
I managed to secure access to liquid Diazepam (through the pharmacist via the Psychiatrist). This was a game changer for me. Pill splitting at reductions less than 1mg were unreliable. The liquid Diazepam enabled me to complete my taper, more like a slide, than bumping down steps.
I took a further 10 weeks to reduce down from 1mg to 0mg at a rate of approximately .05mg every 3.5 days.
4. Challenges
What were the biggest challenges to you successfully stopping your long-term use of the benzodiazepine or Z-drug medication?
1. Lack of information and assistance from the Prescriber/s. Lack of Knowledge from the Prescriber.
Gaslighting by the Prescriber/s e.g. not acknowledging that 'withdrawal' symptoms were associated with Diazepam taper. Appropriating other diagnoses for me and implausible explanations to deny the medication harm I was exposed to.
2. No formal, documented taper plan. No preparation for what I might expected during withdrawal. No knowledge guidance and support during withdrawal from an actual provider (versus online community). My memory and cognition were compromised by Diazepam so in particular for this reason, some kind of reliable guidance, documented plan and schedule with oversight were key (Solved tby trying to construct my own and keep my own record but it took many attempts and was very difficult for me)
3. Difficulties with pill splitting (solved by access to Liquid taper).
4. Physical symptoms and incapacity.
5. Psychological symptoms.
6. Another challenge for me was that I couldn't get my head around some discrepancies in information about duration and rate of taper e.g. I coudn't find or access the research that documented tapers of 10% reduction every 2 weeks, which are touted by many. The Ashton Manual says something different ie. set reductions and jump off at .5mg Ashton says 'recovery only starts after the medication is stopped'. I have been told by some that my taper was too fast (6 months), but I notice that people who take longer don't necessarily have a better result post-taper in terms of ongoing symptoms. So, it seems like there's a variety of unreliable information about duration and rate of taper. I coudn't do a 'symptom free' taper because I was having a pardoxical reaction (?tolerance) while I was taking the medication. I just had to monitor my symptoms as to what felt 'manageable' and slow up if things got worse rather than stabilised or improved.
How did you overcome those challenges?
Lack of Prescriber knowledge and oversight
I had to 'divorce' myself from the prescribers/medical model/treatment providers. Their denial of what I was experiencing has been profoundly harmful and not conducive to my recovery. I recognised them to be a hindrance and even a threat to my health and wellbeing and so I had to remove myself from their reach. I feel very lucky that I avoided their clutches, because I truly believe if I had continued to leave myself in their hands, they would have used the symptoms of 'withdrawal' (medication harm) and labelled me and medicated me into one of their institutions and I then may have suffered the same fate as others who are sidelined, marginalised and die from prescripticide.
I relied on online sources instead. Through Benzobuddies I became aware of othe sources like Benzodiapine Information Coalition and Alliance and even other online forums, you tube vlogs. I didn't spend a lot of time on Benzobuddies and i didn't actually find a way to build a network within the forum, but BB was always there to validate my experience, provide information, offer suggestions, and that was vital.
Knowing there were so many other people out there going through the same thing was a huge source of support for me. It saved me from losing faith in myself, which is what the Treatment Providers would have had me do, seeing as they'd already written me off as 'complex' and 'difficult'. They imply that I'm 'treatment resistant' when in fact, I'm only 'harm resistant'. Their medications have harmed me and never helped me.
Physical symptoms.
I have a stoic disposition. The thing that enabled me to endure the physical symptms was the reassurance I gained from BB that all these worrying issues were part and parcel of the recovery process and that it wasn't any other more sinister pathology. That reassurance was the thing that enabled me to endure all of the incapacity and pain and suffering. "this too shall pass".
Psychological symptoms were most intense before I slowed down my taper once I got to 1mg, and luckily the worst of them stopped pretty quickly once I held and slowed down the rate of my taper.
At times the 'withdrawal' (neurological sympoms of medication harm) have felt insufferable and intolerable. And it is hard to find complete success stories to give me hope. I was very encouraged by a video posted by an American man who vlogged his recovery. he came back after 4 or 5 years to apologise for not 'posting' but it was because he was really too busy getting on with his life and it felt better to put the whole benzo thing behind him. that's the thing I hang on to.
5. Help/Assistance
What helped or assisted you the most in successfully stopping your long-term use of the benzodiazepine or Z-drug medication?
It has been these things that kept me going.
1. The unwaivering support of my partner who has taken care of everything included me while I've been so incapacitated. I feel so bad for people who are sick like this and who have noone to care for them and sometimes family who don't really believe them.
2. The online community who validate my experience and give me access to the information I needed.
3. That I had some measly level of economic security that meant I have been able to survive financially while so incapacitated.
4. A personal and requisite attitude adjustment 1: to trust that this too shall pass, and 2: to try and focus on what is good and what I can do, rather than what feels hurtful and all that I have lost and can't do. I have been bedridden and housebound for most of my post-taper experience. But I found that I still had access to my imagination, and during my incapacity I spent hours and weeks 'imagining and planning' a garden outside the house. Which my partner has now planted out.
5. Another thing that has been vital to me to help me with succeeding in my taper, even while I've had to suffer all of the onslaught of 'withdrawal' (neurological/CNS damage from medication harm) is some of the benefits I gained from finally not having those drugs in my system anymore. The first one was an experience of 'inner calm' that intercepted my otherwise constant agitation. It grew and grew. And now, the windows of calm in my day, take up more space on a good day, than the discomfort of at heightned threat response with the 'on' switch jammed on. The second one is the clearing of the brain fog. I stopped feeling constantly dizzy. I felt clearer in my thinking. And my short term memory has improved significantly, as has my abiilty to concentrate. I am so grateful for the return of those things. My treatmnet providers believed that the agitation was caused by PTSD and that the cognitive deficit was secondary to my TBI. I believed them. But now, I have living evidence that they were both caused by the Diazepam. So much of what I have suffered in the aftermath of an assault was not the attack or the injuries themselves from that attack, but the iatrogenic harm prescribed by physicians. And that has been the worst trauma for me.
6. Advice for others
If you were to offer one piece of advice to someone who was currently taking a benzodiazepine or Z-drug medication on a long-term basis, what would it be?
Avoid the attentions and input of medical providers or anyone who undemines you and the process; turn to where you feel supported in what you are doing wherever that may be. That support and encouragement is vital.
Additional comments or thoughts regarding discontinuation of benzodiazepine or Z-drug use
Feel free to add any additional relevant information.
Thank you for your research Tom and Cathal
My user name on BB refers to something I was told ironically by the Psychiatrist who first prescribed Diazepam to me. He said "You need to be the agent of your own recovery". No truer words said.