Benzodiazepines

Investment Analysis Clubs Macro Economic Trends and Risks
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In 2001, when my mother was dying of lung cancer, I was under a lot of stress. I lived in DE and was shuttling between her homes in NY and FL. I went to my doctor and said, “I’m so anxious that I’m drinking alcohol every day. This is really bad because normally I don’t drink.”

My doctor prescribed 4 mg a day of Xanax.

I went to the internet to research Xanax and quickly learned that it was highly addictive. I decided to take a dose of 0.25 mg (1/2 of the smallest pill which is 0.5 mg) and only when I simply couldn’t stand the stress anymore which was about two or three times a week. I avoided addiction by never using continuously.

In 2019, the most recent data available, pharmacies dispensed an estimated 92 million benzodiazepine prescriptions, according to the U.S. Food and Drug Administration.

That’s almost one out of three of the entire U.S. population so it has Macro impact. Benzodiazepines are the pharmaceutical industry’s top-selling family of prescription drugs.

Coincidentally, both the Wall Street Journal and New York Times have published articles about the problems caused by benzos this week. The WSJ was first and its article is stunning in its powerful description of the horrors of trying to withdraw from benzo addiction. Maybe that’s why the NY Times addressed the issue. But the WSJ article is deeper and really shocking.

https://www.wsj.com/health/wellness/xanax-drug-benzodiazepines-research-harm-7a60f236?mod=hp_trendingnow_article_pos2

From the NY Times:
A 2019 study found that nearly 20 percent of people who take benzodiazepines misuse them. If someone develops a dependence, quitting can be difficult, in part because of the intense withdrawal symptoms.

Those symptoms can include sleep disturbances, irritability, sweating, heart palpitations, elevated blood pressure and stomach problems like dry heaving.

Tapering off the drug needs to be done in a gentle way, ideally under the supervision of a doctor. [end quote]

That doesn’t sound so terrible. But the WSJ describes the hideous problems in detail, even leading to suicide.

Benzos are like opioids – they are like playing with fire. Very helpful in extreme situations but only to be used minimally. If you are still in pain you are taking the right dose. If you take enough to be out of pain you are in danger of addiction.

The widespread use of benzos in the U.S. means that a large part of the population is probably addicted. But people aren’t dying of benzo overdoses the way they die of opioid overdoses so the issue flies under the radar.

Wendy

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Article notes that Valium was the first benzodiazepine. Xanax is the current one. Apparently there have been several generations of improvements and no doubt copy cats by competitors and generics.

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Benzos are way worse than opioids. They completely destroy your brain long term. Its “magical” the first couple of weeks but their ability to make you tolerant to them is 100%. After those few weeks you’ll need more and more to get the same effect. When you decide to come off pf them its already too late and you’ll have to tape so slow it might take years and even so you can develop PAWS which is another level of hell to deal with. Im still at g valium from 10. Been at this for 3 years scared to go lower because of all the withdrawal symptoms I’ve experienced already. Ive had them while on methadone, 3 times and im talking 100mg of it. The withdrawals from methadone dont come even close to that pf benzos. Its just the basement of hell :person_shrugging:

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Vako

Thanks for the potent description of the lived reality of benzodiazepines.

Please persevere in cutting back, and let us know how it goes. I am very sorry that the best I can offer is applause and to say “keep on keeping on.”

I have lost two friends, partly to misjudged prescriptions and use of the damn things.

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@Vako thank you for sharing your personal experience which is truly horrifying.

Medical Professionals Reference recommends up to a maximum dosage of 10 mg per day. Since I only take 0.25 mg about once a week I can’t imagine how that huge dose can even be legal even if it’s not fatal.

https://www.empr.com/drug/xanax/

There’s a lonnnnggg list of Warnings/Precautions including increased risk of drug-related mortality from concomitant use with opioids.

Nobody mentioned this to me as I was taking oxycodone after open-heart surgery in November 2024 at the same time as I had a prescription for alprazolam for anxiety. Fortunately, I didn’t feel especially anxious after the surgery since it wasn’t my first major surgery though I was in a lot of pain as you can imagine. So I didn’t take the benzos together with the opioids – though that was just good luck since nobody warned me about the danger of mixing them.

I wish you the best of luck as you regain sobriety. This is just one more example of why we have to do thorough research before following medical advice. I tell the doctors, “You have 1,000 patients but I only have one ME.”

Wishing you good health and peace.
Wendy

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Thanks and likewise. I didn’t know the effects and black box warning until about 4 years ago and ove been on it for over 15 years :enraged_face: not even for mood issues but for spasms. Doctors don’t tell you squat they just give them like candy and tell you to go your merry way. Its absurd but now i research everything and dont take their word for it l.

Just like a learned of Quinolones antibiotics wreaking your body causing a myriad of side effects some of which aggravated some issues i already have. I have recurrent UTI and kidney infections due to stones and ive been taking them for over 20 years not knowing until i finally caught wind of it. Now i flatly deny them and ask ID to find something other than quinolones :person_shrugging:

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It is very bad medicine. My dad in the 1960s could see valium was the most abused drug.

Male doctors savage female patients with this crap. Or the male doctors are far too ignorant to deserve their licenses.

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I asked my doctor for Valium for similar reasons, he said he used antihistamines instead. Now I know why!

The Captain

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Do you mean that you were given the two prescriptions at the same time by the same prescriber…or by two different individuals, at different times for unrelated reasons? Obviously, if it’s the former someone most definitely should’ve given very explicit information of the potential danger of such potent psychoactive drugs …even if any of my patients were receiving a very limited opioid prescription and denying any other such med or alcohol usage, I erred on the scary warning side in order that there was zero chance of misunderstanding my instructions.

However I suspect that a good many of the tragedies that occur with polypharmacy such as this come from multiple prescription from multiple providers. Quite apart from “doctor shopping” for illicit prescription. I’ve discovered for myself that different electronic medical record systems don’t necessarily “talk” to each other here in the US. So, if the person doing the prescribing isn’t the one doing the direct questioning of medical history etc (and the use of random “sous chefs” to do this is so commonplace these days that’s likely a rarity) then it’s quite possible for this sort of polypharmacy to put folk at risk.

I’ve started to wonder about refusing to complete the online pre visit questionnaire that my PCP office sends before my wellness visits…except that so far both the MA and my physician have double checked the information I’ve given…so any errors would most likely be down to me.

Corner cutting is the norm in these cost containment times…and probably the best it’s going to be moving forwards

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Yes, the meds were prescribed by two different individuals, at different times for unrelated reasons. However, all my doctors (including the surgeon) are on the same My Chart computer system. Before every visit with a doctor, a Medical Assistant goes through the entire list of medications to be sure that they are current and accurate. Of course, the MA isn’t a doctor but the doctor should be responsible for looking at the list after the MA has taken the time to ensure its accuracy.

Doctors are not taking the time to check details. My cardiologist and surgeon were both unaware that the synthetic tube used to replace my aortic aneurysm is rated “conditionally safe” for MRI (whatever the hell that means) since the temperature will rise 2 degrees C (4 degrees F) in a 3 T magnetic field. That information is on Page 10 of the product information sheet. I read the entire information packet after my operation by requesting the complete surgical notes and getting the exact part number of my implants from it. They never bothered to read the complete packet – they were too busy.

Now I plan to write to the company and ask if it’s safe to get an MRI in the future. Not “conditionally safe” which is a lawyer’s weasel words around a potentially fatal problem since marketing is only interested in selling the item.

This is why I say, “You have 1,000 patients but I only have one ME.”
Wendy

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I mentioned in a Grok thread, that Grok is “reading blood tests”.

Would you please run your info through Grok, or one of the other LLM, LRM and see if it catches these “polypharmacy” and “inattention to detail” situations?

This is the sort of thing I’m looking for in a “killer app” for AI.

TIA
:beetle:
ralph

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@rainphakir Ralph, I would oblige but I don’t know how.

Wendy

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I’ve not done it either.
Perhaps one of our board colleagues who has done it, will explain the process?

:slightly_smiling_face:
ralph

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@rainphakir I forgot to mention…

I agree that a search for drug interactions would indeed be a killer app for AI. There are literally thousands of drugs so it’s almost impossible for any person (even a pharmacist, let alone a doctor) to keep track of all the interactions.

Furthermore, many people take more than two prescriptions.

  • Percent of people using three or more prescription drugs in the past 30 days: 24.7% (2017-March 2020)

  • Percent of persons using five or more prescription drugs in the past 30 days: 13.5% (2017-March 2020)

Many of these drugs come in clusters – for example, people with diabetes often have high blood pressure and high cholesterol which are treated by different drugs.

AI would be helpful in sussing out which multiple combinations of drugs (not just pairs which can be found online) cause problems. Also specific drugs in a particular class (such as statins) which are more likely to interact than others.

This would be hard to do with U.S. data, which is highly fragmented. Huge databases would be needed, such as the UK or Sweden national health databases. (The U.S. has the VA database but this is all military so it omits important population segments.)

Wendy

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Anybody remember the song “Mother’s Little Helper”?

DB2

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@DrBob2 it’s in my original post.
Wendy

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…and let us not forget Prince Valium from Spaceballs.

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