Benzos -- how do people get addicted?

[K.B.Fante]

So I've been prescribed Lorazepam for anxiety and for HPPD, however my doctor only wants me to use it as a last resort because it's a controlled substance and people get hooked, therefore he won't prescribe me very many pills at one time. This has been fine for the most part, but I've been having trouble sleeping lately so I've been taking a lot of my benzos and am therefore running out. The other problem is that Lorazepam really works for me. It really helps my symptoms and has no negative side effects. It would certainly make my life a hell of a lot easier if I could take a bit more but of course I can't because too many people out there abuse them when they don't need them and people like me who really do need them end up paying the price. 

 

My real question, however, is how people even get addicted in the first place. Even when I take two pills, which is more than my doctor recommends, I still don't feel anything except a little bit of warmth inside my chest -- that's it. So how is this that great? What is it that makes people addicted? I understand alcohol, weed, cocaine, yada yada yada, because you can actually feel those, but I can't really feel the benzos that much, so I'm a little bit confused here. 

 

Perhaps someone can enlighten me. I'm sure there's a logical answer -- I just can't see it right now. 

[umit]

No problems when you take it buth once you want to quit or like if you geth run out of it then the problems starts and runnig out of it to quit cold turkey can realy be dangerieus i recomed you supply on time its realy not a joke i used klono 0.5 for six months in a row and took 3 months to tappering of and it was a hell to come of it

I think you can better ask jay because using when you needed is not a good choise you can better take it in a routine

[VisualDude]

The word ‘Addiction’ is tricky, so psychiatrist often prefer the term “substance use disorder”.  While there are various lists of signs of addiction, it comes down to three features:

 

1  Abuse – For behavior to be considered an addiction, it has to lead to significant negative consequences for the addict

2  Dependence – Addicts often get to the point that they depend on their drug.

3  Craving – When not using, addicts often report extremely strong desire or urge to resume

 

These above criteria are vital in distinguishing addiction.  And they can be applied to non-drugs.  Gambling is a behavior, not a drug, yet is widely recognized as something that can be an addiction.  More recently – and for similar biological reasons as with hard drugs – junk food, porn, video games and even exercise can become an addiction.

 

The mechanism of addiction involves the role of the reward center: VTA, Nucleus Accumbens, and the PreFrontal Cortex.  This is an interesting, but lengthy topic

For context of this thread, focus on #2 – Dependence.  If this is the only feature in ones life, then it is not an addiction.  But the brains response to drugs that affect neurotransmitters is why there are problems with long term use of benzos as well as others.  The medical term is ‘tolerance’ and simply means that the affects of the drug diminish and so the dose must be increased to compensate.  What is physically happening is called receptor down-regulation.  That means that because receptor sites are being over stimulated, the synapsis removes the number of sites to compensate.  See https://en.wikipedia.org/wiki/Drug_tolerance

 

What happens when you stop taking the drug, there is an under-stimulation on the receptors.  They will compensate by up-regulating but this takes days or even weeks.  In the meantime, the person will suffer an increase of the very symptoms that were being treated.  For example with benzos, typically they reduce anxiety and help sleep.  But when you stop, anxiety will be worse and so will insomnia.

 

So if you use up your pills ahead of time and run out, you’ll have some unpleasant days.  As far as being a medical danger, alcohol is just about the only one that is truly dangerous – the DTs can literally kill a person.  Withdrawal for other drugs merely make you wish you were dead.

 

You can read various members use of benzos on this site and others.  There is one lady who has been on 6mg Klonopin daily for ~25 years.  God help her if she stops getting it … but it helps her as much now as it did when she started, so there is no reason to stop.

 

 

[Jay1]

It can be addictive, psychologically, because it is taking away your anxiety, insomnia and even your hppd symptoms. Feeling like shit, or feeling almost normal, which sounds better?

 

It is also physiologically addictive. Your brain gets used to those chemicals in your blood and the receptors begin to require them, if tolerance builds, they require more and more.

 

If you can do the 3 day on, 4 day off routine, like I do... You might be able to do it for life. I've experimented with 4 days on, 3 days off too and it seems fine, though I am a little nervous about doing that long term.

 

I am trying this for 3 months:

Thursday 6pm - 0.75 mg Klono

Friday 8am - 1 mg Klono

Saturday 8 am- 1mg Klono

Sunday 8am - 2.5mg Lorazepam

 

By taking the Sunday dose early with a faster half life benzo... then taking the Thursday dose later in the evening... I still give my body a good window to clear itself and for the receptors to recover.

 

Once the 3 months are up...  I will go benzo free for 2 weeks to monitor any addiction/tolerance build up. Currently, I feel no different during the off days as when I was on the 3 on, 4 off routine.

[K.B.Fante]

Wow, thanks guys. Great information here. I do feel enlightened. 

 

It's interesting... I first started taking one pill of Lorazepam every other night or so about a week ago because I had anxiety and couldn't sleep. Then towards the end of the week one wasn't putting me to sleep so I upped the dosage to two. That worked great and I felt great during the daytime but realized I couldn't keep up on this pace with how many pills my doctor allows, plus I don't have anxiety anymore, so last night I tried to go without any and was wide awake at about 2:30 a.m. and couldn't go back to sleep -- even without anxiety. Just goes to show how quickly the brain adapts. I almost had mini withdrawals today. 

 

It's pretty painful recovering the natural way but I'm gonna keep trying. Thanks again for the info and sorry to seem so naive on this issue. I'm fairly new to medication at this point. 

[K.B.Fante]

OK, I now understand why benzos have such a bad rep. Sure I didn't feel much when taking them and they helped me sleep and relieved some of my symptoms, but I've had absolutely horrible withdrawals over the last three nights and I was only taking them for two weeks! I haven't slept more than four hours each night and lie in bed completely wide awake for hours on end. I even had to call in sick to work yesterday because I was so sleep deprived. 

 

Lesson learned. When something sounds too good to be true, it always is. Benzo withdrawals are the worst. 

[umit]

Yes exactly like that i have been passed that road

[K.B.Fante]

Going on five days now with pretty much no sleep. I actually have no problem falling asleep but after about two hours I wake up wide awake and can't go back to sleep. Don't know what to do here. I tried all kinds of sleeping meds last night (valerian, magnesium, lavender, hops, melatonin, etc.) and nothing worked. I hope this post can act as a cautionary tale for those looking to take benzos with regularity. Take them daily and you're destined for hell when you decide to come off. 

[umit]

Can take a week to recover to sleep back like normal just dont grab benzo again or you wil start over again

[DonDraper]

To clarify one thing Visual mentioned - it's actually both benzos and alcohol that are potentially lethal if withdrawn too quickly. Both act on the brain's calming neurotransmitter, GABA, which means that sudden withdrawal can cause hyperexcitability of the central nervous system. Indeed, benzos and alcohol are so similar in their effect on GABA than benzos are sometimes prescribed to alcoholics to assist with their taper. Do not go cold turkey from benzos if you've been using them for a extended period of time.

 

Probably best to taper under the supervision of a doctor, but the following is a very good guide: www.benzo.org.uk/manual

[K.B.Fante]

Yeah, I wish someone had told me that a bit sooner Don, but good to know anyway. It's now been over a week. I haven't slept more than five hours per night the entire time and have had a few nights with only two to three hours of sleep. The problem also for me was that I was waking up in the middle of the night and taking a benzo and so I became dependent on that for falling back to sleep. Ever since I got off of them I wake up in the middle of the night but can't go back to sleep for at least a few hours. 

 

Oddly enough my HPPD hasn't been affected at all by my lack of sleep. In fact, as crazy as it sounds, I actually think it's helped. I have no idea how but this is as clear as I've been in eight months. I really do want to sleep though... 

[VisualDude]

Its very common for benzo discontinuation to leave one with sleep problems.   Tapering is key.

 

 

As for benzo withdrawal deaths, As of 2009, "This is only the second case within the English literature of death because of benzodiazepine withdrawal." - See http://www.ncbi.nlm.nih.gov/pubmed/19465812 .  Perhaps (probably) it is under reported and there are more languages than English.

 

As for alcohol withdrawal deaths (for long time alcoholics), without tapering or medical treatment, "Death may occur in up to 5 percent of patients with DT’s." - See http://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf

 

What makes alcohol worse is that it is a allosteric modulator for both Glutamate and GABA receptors ( https://en.wikipedia.org/wiki/Allosteric_modulator ) so it down-regulates GABA receptors and up-regulates Glutamate receptors.  This is a double punch compared to benzos which only down-regulate GABA.

 

Ironically, SSRIs are not considered addictive but, as many report, withdrawal is hell.  The pharmaceuticals use the term 'discontinuance' problems to make is sound safer.  Don't know of any reported deaths "within English literature" ... so at least it is safer by a margin of two souls.

 

 

In the end, most meds should be tapered up and tapered down.  Exceptions might be if you are allergic to one.  Also, most antibiotics need to be started strongly and stopping allergic reactions require starting high (then tapering down such as a methylprednisolone  pack).

 

Lastly, HPPD is fickle.  I've taken a med and had a negative experience right away, then waited a week and tried it again with neutral or positive results.

 

 

Some on the forum have reported lack of sleep reducing HPPD symptoms.  It does seem strange, but then HPPD is strange...

[K.B.Fante]

Thanks again Visual. That information certainly puts this all into perspective. And good news! I've slept an average of six hours the past few nights and only woke up once last night! Lesson learned, although just as is the case with HPPD, it came at a cost.