How does sporadic long term use affect withdrawal?

[[Buddie]]

I posted the following question and the following reply on the Post-withdrawal Recovery Support Forum, but I think I should have posted it here:

Question:  I still don't understand if my prior sporadic use of Valium has any bearing on the benzo WD that I am now in, caused by recent daily use.  Is there any relationship?  Could my prior occasional low dose Valium use contribute to the difficult WD I am having now?  Could it have made me more predisposed to becoming addicted?  Colin wrote that "if your use was very intermittent .... there was no opportunity for addiction/dependency/habituation to develop....."  That leads me to think that my prior use of Valium is unrelated to the addiction I developed when I started taking it daily and unrelated to this WD.  Is that a correct assumption?  Does anyone know?

My followup reply to buddies' responses:  This experience has made me want to educate myself on all things benzo.   I was incredibly ignorant prior to this.  I have been extremely cautious taking medications of any kind my entire life, only taking medication, whether prescription or OTC, when necessary or for infrequent situations, and then only taking child doses.   I probably should have posted this question in the "Chewing the Fat" forum.  In fact, I think I will either move this thread or repost my question there.  I know so many people, and many people on this forum, who intermittently and naively took or take a benzo or sleeping pill - the latter on overseas flights, for example, to help avoid jet lag.  If there is any scientific or anecdotal evidence that suggests intermittent use sort of "primes" the system for addiction, I think that would be a significant piece of information for people who occasionally take a benzo - like before a big public speaking engagement, or, like me, for a dental procedure.  I think most people would probably decide not to take these drugs ever if they knew that even intermittent and judicious use were perilous.  Antidepressants are different because they have to build up in your system to be effective.  They are not taken as a one-off, like benzos often are. I don't know about a kindling effect.  I thought kindling meant something else - like repeated withdrawal attempts - and did not apply to intermittent and infrequent use.  But I could be wrong.

History:  I took 4 mg Valium, at most 3 times a year, probably for about 20 years.  Never two days in a row, usually only once every 4-6 months.  I took it for dental and medical procedures and flights, at times for anxiety over life events.  Then from Nov. 2020 through February 2021 - when I was in Prozac CT WD without knowing it - I started taking Valium 2 mg a day on and off, then 2 mg daily, eventually up to 2 mg twice a day.  I was having a terrible reaction to the Valium and the WD from Prozac (didn't figure that out for months).  Anyway, an ER doctor gave me Ativan In march 2021, and I took that instead of Valium for one month (.50 mg 3 times day) before transitioning to Tranxene for 3 days then stopping, basically a CT.  I was suffering terrible paradoxical reaction and interdose withdrawal on the Ativan.

[[Buddie]]

I really doubt that such rare infrequent use really affected very much. In fact, if there is any appropriate use of these drugs that sort of use would be it.

Of course, the details of what these drugs are doing to us is a bit of a mystery so take my opinion with a grain of salt.

It's the constant daily use of these drugs that causes the brain to start making various changes that leads to drug tolerance and dependence which results in such horrible issues once you try to ween off. This can happen very rapidly with daily use, in as short of a time as weeks to a month or so. It appears that some people are more or less susceptible to these issues depending on individual genetics.

Are you off all drugs? If not, I would advise you to take them on one at a time. Weening off of one of these drugs is bad enough, weening multiple drugs can make it quite a bit worse.

Your benzo use sounds relatively short term. People can certainly have issues discontinuing these drugs even after short term use, but I think it weighs in your favor that you weren't on them so long. It may be painful in the short term but hopefully you'll be able to put this past you and move on with your life soon.

[[Buddie]]

[...], Thanks for the reply.  I am off all drugs except for Prozac, which I started tapering two months ago.  I have made only one 10% cut and have held for two months.  I got scared of it making my benzo WD worse.  Off benzos 8 months now.  Feels like an eternity. I was in acute for 5-1/2 months.  Now just in a relatively stable symptom pattern that is still at a high level of intensity.  Barely manageable, but manageable.  I am older, too, 71, so I might be a slow healer.  What is your recovery story?  I hope you are at 1000+%.

[[Buddie]]

I'm 6+ years off and still having a lot of problems. But I took these drugs every day without fail for almost 20 years for insomnia.

I'm one of those low percentage long protracted cases. You're going to do much better.