Dr. Heather Ashton’s benzodiazepine guide is the exit from benzo addiction and withdrawal hell

Dr. Heather Ashton's benzodiazepine guide
Dr. Heather Ashton’s benzodiazepine guide is the exit from benzo addiction and withdrawal hell. Image: MikeB

Dr. Heather Ashton’s benzodiazepine guide is the exit from benzo addiction and withdrawal hell. This is not about cats, which is pretty obvious but indirectly it possibly is because quite a lot of people are on benzos as prescribed by their GP because they suffer from the effects of anxiety in its various forms including, in this instance, insomnia. And a lot of people live with a cat to help with anxiety. I have never suffered from anxiety myself but I am extremely sympathetic towards those who do. Hence this post.

In the United States, a significant number of people are prescribed benzodiazepines, but precise numbers can vary depending on the data source. However, based on recent studies and reports, it is estimated that between 30 to 40 million people receive prescriptions for benzodiazepines each year.

How to taper off benzos by Dr. Heather Ashton. An important video.

In this instance, I’m referring to a disturbing story by Anna in the UK as reported in The Telegraph newspaper today who was prescribed temazepam, a benzodiazepine often used to treat insomnia. It’s meant to be a short-term treatment and in my personal view (I’m not a trained medic) as a last resort because when reading her story, you realise how horribly addictive benzos are and how incredibly hard it is to come off them while suffering enormously debilitating side effects and possible long-term damage to one’s body. Her story is harrowing and you can read it by clicking on this link if you wish.

To summarise her story; her GP prescribed temazepam because she simply couldn’t sleep more than about 30 minutes at night after her mother died. The drug never produced restful sleep but it was better than struggling all night trying to get off to sleep.

But she was left on this drug by her GP for 10 years at which point she experienced “a whole constellation of neurological symptoms” including panic attacks and a lot more besides.

Her GP then prescribed a second benzo called diazepam which is better known as Valium to manage the anxiety attacks but this was ill-advised as two benzos together are highly un-recommended.

It made matters worse and to cut a long story short she was provided with less than optimum advised by GPs about coming off the drug but at the end of the day she discovered Dr. Heather Ashton’s benzodiazepine guide.

The reason why I am writing this your post is to spread the word about this guide because it seems to me that it’s entirely plausible that a lot of people are struggling with coming off benzos and they’ve not discovered this guide which according to Anna probably saved her life in conjunction with advice from the UK-based support group Beating Benzos (which recommended it). Such a useful organisation.

It’s a long read and I haven’t read it but it’s long! And it’s in PDF format online and therefore free. You can access the ‘manual’ by clicking on this link. It can be downloaded to your computer too.

It took Anna 18 months to come off temazepam and during that time she was essentially bedridden and “even something as simple as listening to an audiobook was impossible”.

She found hope in the messages of others harmed by benzos, who had been through the same ordeal. That’s another reason why I’m writing this post because they are ‘lost’ people trying to find their way through this terrible maze created by benzos and based on what Anna says, Dr. Heather Ashton’s manual provided an exit from that maze to a more normal life but a life, according to her, which has been irreparably damaged by this drug.

She says that “To this day, the damage inflicted on my mind and body means I struggle with memory, focus, processing information, constant headaches, dizziness, extreme light and noise sensitivity, coordination, and debilitating gastrointestinal symptoms”.

Now off the drug, she’s still suffering badly and there appears to be no light at the end of the tunnel but her life is far better than it was when at the end of her ten-year term in using the drug and trying to come off it.

Personally, I can only conclude that it is best to avoid these drugs completely unless you are really desperate and then only use them for a very short time, perhaps a few weeks. And if a GP tells you otherwise I wouldn’t believe them!

Extra reading on benzos

Benzodiazepines (often abbreviated as “benzos”) are a class of psychoactive drugs that are primarily used to treat conditions related to the central nervous system, such as anxiety, insomnia, and seizures. They work by enhancing the effect of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which has a calming effect on nerve activity.

Key Characteristics of Benzodiazepines:

  1. Mechanism of Action:
    Benzodiazepines enhance the action of GABA, a neurotransmitter that inhibits or slows down brain activity. By boosting GABA’s effects, benzos have sedative, anti-anxiety, muscle relaxant, and anticonvulsant properties. This makes them useful for treating several neurological and psychiatric conditions.
  2. Common Uses:
  • Anxiety Disorders: Used to alleviate symptoms of generalized anxiety disorder (GAD), panic disorder, social anxiety, and phobias.
  • Insomnia: Some benzodiazepines are used as short-term sleep aids due to their sedative effects.
  • Seizure Disorders: They are often prescribed to manage epilepsy and other seizure disorders.
  • Muscle Spasms: Due to their muscle-relaxing properties, benzos may be prescribed for conditions involving muscle stiffness or spasms.
  • Alcohol Withdrawal: Benzos can help prevent or treat alcohol withdrawal symptoms, including delirium tremens (DTs), which can be life-threatening.
  1. Common Types of Benzodiazepines:
    Different benzos vary in how quickly they act, how long their effects last, and their specific uses. Some of the most commonly prescribed benzodiazepines include:
  • Diazepam (Valium): Often used for anxiety, muscle spasms, and seizures.
  • Alprazolam (Xanax): Commonly prescribed for panic attacks and anxiety disorders.
  • Lorazepam (Ativan): Used for anxiety, seizures, and sedation.
  • Clonazepam (Klonopin): Primarily used for seizures and panic disorders.
  • Temazepam (Restoril): Often prescribed for insomnia.
  1. Duration of Action:
    Benzos are categorized based on how long their effects last:
  • Short-acting (e.g., Triazolam): Useful for procedures or situations requiring quick but short-term sedation or anxiety relief.
  • Intermediate-acting (e.g., Lorazepam, Alprazolam): Commonly used for anxiety and sleep disorders.
  • Long-acting (e.g., Diazepam, Clonazepam): Suitable for managing conditions like chronic anxiety, seizures, or alcohol withdrawal.

Risks and Side Effects:

While benzodiazepines are effective, they also come with certain risks:

  1. Tolerance and Dependence: Over time, the body may develop tolerance to benzos, meaning higher doses are needed to achieve the same effect. This can lead to physical and psychological dependence.
  2. Withdrawal Symptoms: If used long-term, stopping benzodiazepines suddenly can result in withdrawal symptoms, including anxiety, tremors, seizures, and rebound insomnia.
  3. Sedation and Cognitive Impairment: Common side effects include drowsiness, dizziness, and impaired motor skills or judgment, which can increase the risk of falls and accidents.
  4. Risk of Abuse: Because of their calming effects, benzodiazepines can be abused, leading to misuse or addiction.

Alternatives and Safer Long-Term Solutions:

For long-term management of anxiety or insomnia, healthcare providers often prefer alternatives that are less likely to cause dependence, such as:

  • Antidepressants (SSRIs or SNRIs) for anxiety.
  • Non-benzodiazepine sleep aids (e.g., Z-drugs like zolpidem).
  • Therapies like cognitive behavioral therapy (CBT) for both anxiety and insomnia.

Conclusion:

Benzodiazepines are powerful, fast-acting medications with a range of therapeutic uses, primarily in managing anxiety, insomnia, seizures, and muscle spasms. However, their potential for dependence, tolerance, and abuse makes them best suited for short-term or carefully monitored use. For long-term management of anxiety or sleep disorders, non-drug therapies or other medications are generally preferred.

Are they used as sleeping pills?

Yes, benzodiazepines are sometimes prescribed as sleeping pills (hypnotics), especially for short-term management of insomnia. Because they have sedative and calming effects, they can help induce sleep. However, their use as sleep aids is generally limited due to concerns about dependence, tolerance, and side effects.

How Benzodiazepines Are Used for Sleep:

  1. Short-Term Insomnia: Benzos are often used to treat insomnia caused by acute stress or temporary life events. Since they are fast-acting, they can be effective in helping people fall asleep quickly.
  2. Specific Benzodiazepines for Sleep: Certain benzos are more commonly used for sleep disorders because of their short or intermediate half-life, which helps induce sleep without causing excessive daytime drowsiness. Examples include:
  • Temazepam (Restoril)
  • Triazolam (Halcion)
  • Estazolam (ProSom)

Why Benzodiazepines Are Not Ideal for Long-Term Sleep Use:

  1. Risk of Dependence and Tolerance: Just like with their use for anxiety, prolonged use of benzos for sleep can lead to physical dependence. Over time, the body may build up a tolerance, requiring higher doses to achieve the same effect, which can increase the risk of addiction.
  2. Disrupted Sleep Architecture: Benzos can affect the structure of sleep, particularly by reducing the amount of deep, restorative sleep (slow-wave sleep) and suppressing REM (rapid eye movement) sleep. This can result in less restful sleep in the long run.
  3. Withdrawal and Rebound Insomnia: When benzodiazepine use is stopped, especially after long-term use, individuals may experience “rebound insomnia,” where sleep problems return and may even be worse than before starting the medication.
  4. Daytime Drowsiness and Cognitive Impairment: Benzos can cause next-day drowsiness, memory problems, and impaired coordination, particularly in older adults, which can increase the risk of falls and accidents.

Alternatives to Benzodiazepines for Sleep:

  1. Non-Benzodiazepine Hypnotics (“Z-drugs”): These medications, such as zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata), are often preferred for treating insomnia because they have similar effects to benzos but with a lower risk of dependence and less disruption to sleep architecture.
  2. Melatonin and Melatonin Agonists: Supplements like melatonin or medications like ramelteon (Rozerem) can help regulate the sleep-wake cycle without the risk of dependence.
  3. Antidepressants: Certain antidepressants with sedative effects, like trazodone or doxepin, are sometimes used to treat chronic insomnia.
  4. Cognitive Behavioral Therapy for Insomnia (CBT-I): This non-drug treatment is highly effective for long-term management of insomnia, addressing the underlying causes of sleep problems.

Conclusion:

While benzodiazepines can be effective as sleeping pills in the short term, they are not recommended for long-term use due to risks of dependence, tolerance, and side effects. Safer alternatives, like non-benzodiazepine sleep aids and behavioral therapies, are generally preferred for managing chronic insomnia.

How many people are on benzos in the US?

In the United States, a significant number of people are prescribed benzodiazepines, but precise numbers can vary depending on the data source. However, based on recent studies and reports, it is estimated that between 30 to 40 million people receive prescriptions for benzodiazepines each year. Here are some key statistics:
  1. Prescription Prevalence: A study published in the journal JAMA Network Open in 2020 reported that about 12.6% of U.S. adults had used a benzodiazepine at least once in the past year. This translates to around 30 million people.
  2. Chronic Use: Around 2% to 5% of U.S. adults are considered chronic users of benzodiazepines, meaning they use them regularly over extended periods, often beyond the short-term use guidelines recommended for benzos.
  3. Increase Over Time: Over the past few decades, benzodiazepine prescriptions have increased significantly. Between 1996 and 2013, the number of adults filling a prescription for a benzodiazepine rose by 67%, from 8.1 million to 13.5 million annually. While the number of prescriptions has stabilized somewhat in recent years, benzodiazepine use remains common, especially among older adults.
  4. Demographic Trends:
  • Older Adults: Benzodiazepine use is more common in older populations, particularly among adults over the age of 65. It’s estimated that around 9% of older adults use benzos, often for anxiety, insomnia, or other age-related issues.
  • Gender Differences: Women are more likely than men to be prescribed benzodiazepines, with women making up about two-thirds of users. This is particularly true for middle-aged and older women.
  1. Risks of Overuse and Misuse: Along with legitimate medical use, there has been concern about the overprescription and misuse of benzodiazepines. Misuse includes taking them without a prescription, using higher doses than prescribed, or mixing them with other substances, such as opioids, which increases overdose risk. Studies suggest that around 17% of benzodiazepine users misuse them, often to self-medicate for anxiety or sleep problems.

These figures indicate that while benzodiazepines are widely used in the U.S., there are growing concerns about their long-term use, dependence, and the risk of overdose, particularly when combined with other drugs.

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