The Opiate Crisis has taken a huge toll, however, the mobilization by communities and government has started to have an impact. But many people speak of another drug crisis at least as severe that is already upon us. In any given year more than 40 million Americans are given this drug family and it is estimated that there are currently 6 million Americans addicted –triple the estimated 2 million addicted to opiates. This is the family of drugs known as Benzodiazepines, or “Benzos” for short.

Benzos made their debut with Librium in 1955, Valium in 1963 and many others since. Common varieties include Xanax, Klonopin, Ativan and Diazepam. Benzos are prescribed for anxiety, as muscle relaxers, for minor surgical procedures, sleep disorders, as an anti-convulsion agent and for alcohol withdrawal. These drugs can be very useful, even life-saving. But when used long term, they affect nearly every aspect of brain function. And, like alcohol, withdrawing from Benzos can be fatal.

Dr. Heather Ashton of England spent decades researching Benzo use and withdrawal before her death last September and was considered by many to be the expert in the field. She wrote “The Ashton Manual,” a comprehensive guide to how Benzos work and how to withdraw from them. In theory, Benzos are recommended for short-term use, not to exceed two weeks. Ashton describes how longer-term usage of Benzos affects nearly every aspect of brain function, teaming up with naturally produced chemicals to “quiet” the brain. Like alcohol, they inhibit coordination and motor skills, dull concentration, lead to short-term memory loss (blackouts) and inappropriate impulsive behavior. They can also lead to irritability, argumentativeness and can bring on depression. When prescribed for anxiety coming from depression they often bring on suicidal thoughts, and as people age these side effects worsen. Consequently, it is a terrible strain on family, social and work relationships. Ashton covers many other effects and details the withdrawal process. If you or someone you know is struggling with this issue, this manual is a great place to start your search for information.

I spoke with several locals who have recovered from Benzo use whose stories were eerily similar. They all started on a low dosage to help them through a temporary crisis, but the need for the drug quickly escalated to where they were taking doses 20 times more potent and much more frequently. Carey shared that he was prescribed it after a hurricane wiped out his community and he couldn’t sleep.

“It is great for a one time use – maybe no more often than once every few weeks or months, but I don’t know of anyone that can use it that way. The next thing I knew I was having more issues getting to sleep, so I took it more often. Then I needed stronger doses. Then I started having withdrawal symptoms during the day, so my prescription was increased so I could take it throughout the day. Soon I couldn’t get enough of it to do what I started using it in the first place for – to sleep. And my doctor – he didn’t know anything about withdrawal so he kept on prescribing more,” Carey said.

Everyone also agreed that withdrawing from Benzos is painful, and that when you withdraw from them it seems that the condition you started taking them for comes back worse than it was to start with.

“Drug withdrawal reactions in general tend to consist of a mirror image of the drugs’ initial effects. In the case of benzodiazepines, sudden cessation after chronic use may result in dreamless sleep being replaced by insomnia and nightmares; muscle relaxation by increased tension and muscle spasms; tranquility by anxiety and panic; anticonvulsant effects by epileptic seizures. These reactions are caused by the abrupt exposure of adaptations that have occurred in the nervous system in response to the chronic presence of the drug. Rapid removal of the drug opens the floodgates, resulting in rebound over activity of all the systems which have been damped down by the benzodiazepine and are now no longer opposed. Nearly all the excitatory mechanisms in the nervous system go into overdrive and, until new adaptations to the drug-free state develop, the brain and peripheral nervous system are in a hyper-excitable state, and extremely vulnerable to stress,” Ashton said.

“You know it’s bad when heroin addicts say they feel sorry for you” said local resident David. “I didn’t sleep for months, and doubted I would ever feel “normal” again. I was always anxious and couldn’t concentrate on the most basic things for a long time.” Robert, a local financial consultant said: “Once I decided to get off of them, my symptoms kept worsening for a few months. I am told that this is because they are stored in your fat cells. It almost sets you up for failure. I felt seasick for a year. For months my ears rang so loud I couldn’t hear the television. I sweated through two to three sets of t-shirts and dress shirts a day for months and soaked the bed with sweat every night. I couldn’t sleep right for over a year, and was convinced I was losing my mind. I had terrible vertigo – I always felt off balance and as though I was going to fall down. I couldn’t focus my eyes on anything – everything was fuzzy and grainy for at least a year.”

Casey spoke about mysterious lumps of knotted muscle the size of a baseball appearing on his leg, which would just as mysteriously disappear after a few days. Sometimes the limbs on his right side would go numb, and then as soon as feeling came back the ones on his left side would go numb. And everyone I spoke with talked about feeling disconnected from everyone and everything emotionally – as though they were a stranger even to themselves. Suicidal thoughts are common. I spoke with local Dr. Richard Bowen at his practice on Long Point Rd. Dr. Bowen has experience in helping patients go through withdrawal from numerous substances such as opiates, alcohol, nicotine, and Benzos. He states that Benzo withdrawal is the most difficult, primarily due to its prolonged duration.

“Short term usage of Benzodiazepines is fine when properly prescribed and taken. But the consequences of long term Benzodiazepine use is just now being realized. Long term users suffer from terrible anxiety, feelings of doom and depression, and they keep increasing the dosage until it quits working. The acute withdrawal lasts 90 days and the post acute withdrawal can last for years. They truly are harder to get off of than opiates,” Bowen said.

“Getting sober is one of the hardest things that a person can go through – the pain is incredibly intense for a long period of time. And all that while they know that all they need is just one little pill and the pain will go away. But that one little pill puts them right back in the cycle. Today there are treatments and non-addictive drugs that ease the pain of withdrawal. Some folks think that an addict needs to go through severe pain to stay clean, but I say that if pain alone served to modify behavior there wouldn’t be any women having more than one child,” Bowen said.

“In early sobriety, my regimen includes daily visits to the office to administer the treatments they need. This allows me to gain their trust and steer them towards long-term solutions. Mark Twain said ‘Quitting (addictions) isn’t hard, I’ve done it hundreds of times.’ It is staying quit that is the challenge, because once addicted, it will only take one drink or drug to start the whole terrible cycle over again. In my experience, those that seek out others who have stayed sober before them and are willing to help are the ones who are successful long term,” Bowen added.

Everyone also emphasized two other points very emphatically. First, if you are struggling with Benzodiazepine use, do not attempt to quit without consultation with a professional in addictions. Secondly, when it comes time to quit, you will have a much greater chance of success doing it with a professional like Bowen helping you. Symptoms of Benzodiazepine withdrawal vary widely from one person to the next, and addressing those symptoms effectively will have much impact on your chances of success.

One final word – those who have gone through with kicking this habit say their life today is better than it has ever been. The process is difficult, but the consequences of continuing use weighed against the huge rewards of accomplishing escaping the addiction may well lead you to seek out a professional. My hope is that you ultimately find that freedom and peace of mind and you have given up on.

This article series is meant to educate the community about addiction in general and the Opioid Crisis in specific that is affecting communities nationwide. We are hopeful that this series will make a difference. When appropriate the names will be changed of those the articles feature. The author welcomes inquiries or shared experiences, and can be reached at David@PhoenixSC.org. Dr. Bowen’s office can be contacted at (843) 480-2273.