Shrinks get patients hooked on drugs and then cut the cord

The subject of this post is so important I ask that people share it broadly. You have my permission to copy in full as long as you attribute it to this blog. Freeing the population of drugs is a great goal. I fully support it. But until the seriousness of withdrawal syndromes are recognized doing it wholesale like this is a very scary prospect. As these sorts of policies increase in popularity, it’s vital that those implementing them understand what the fallout might be.

I’ve been sitting on this article for a couple of days, feeling like I should say something but these issues tend to really disturb me these days so that I often don’t get around to this sort of commentary anymore.

A clinic in Louisville, Kentucky is going to stop prescribing Xanax, a benzodiazepine.

from the New York Times:

1xanaxBecause of the clamor for the drug, and concern over the striking number of overdoses involving Xanax here and across the country, Seven Counties took an unusual step — its doctors stopped writing new prescriptions for Xanax and its generic version, alprazolam, in April and plan to wean patients off it completely by year’s end.

The experiment will be closely watched in a state that has wrestled with widespread prescription drug abuse for more than a decade and is grasping for solutions as it claims more lives by the week. While Kentucky and other states have focused largely on narcotic painkiller addiction, experts say that benzodiazepines, the class of sedatives that includes Xanax, are also widely misused or abused, often with grim consequences.

Okay, not prescribing ANY benzo to any new users is a very good ida. Taking existing users off it, on the other hand is a scary proposition because the medical establishment is in complete and total denial about the seriousness and severity of withdrawal syndromes.

At Seven Counties, some of the roughly 3,000 patients who were on Xanax have been switched to clonazepam, a longer-acting benzodiazepine that does not kick in as quickly and is thought to pose less risk of addiction.

“They don’t get the high that’s associated with Xanax,” Dr. Hedges said, “nor the withdrawal associated with it.”  (read the article)

Unfortunately that last bolded section is complete and utter bullshit. The withdrawal from clonazepam is potentially just as ugly, debilitating and serious as it is for Xanax.

You know what is going to happen to this mostly poor and uneducated population when they start weaning people too quickly? Because they’re poor, they’re going to be labeled drug seeking when they have troubles coming off the benzos. They’re going to be blamed for their doctor created and prescribed addiction. And they’re going to be disbelieved when they present so sick they can hardly stand or do anything at all. They will be told they are crazy drug addicts. It will be thought that it’s a psychiatric issue and not a serious physical illness caused by medical iatrogenesis. And in fact, there will be great resistance to see the truth because the people treating them in withdrawal will be at fault for their condition.

The withdrawal syndrome creates so many odd and terrible symptoms that for some of us last years. It is much worse than opiate withdrawal from all accounts. Without great sensitivity from caretakers to the extreme nature of these symptoms some of these people will be lost to the system forever. It’s really horrifying to me. I know what social service mental health care is like. I worked in these systems the entire time I was a social worker.

I hope that perhaps if you live in Louisville and can talk to anyone with any influence you might share with them the benzo page on this blog as a first place to get some idea of how SEVERE and DANGEROUS benzodiazepine withdrawal is. There are many news items and from there one can proceed with even more research.

It doesn’t matter which benzo is being withdrawn from. Those of us who are sensitive can get grossly and dangerously ill.

Some of us get hypersensitive to ALL psychoactive drugs as a result of this process and cannot take ANYTHING else including and especially benzos ever again as a result of the particular damage to our brains. So without support that frankly DOES NOT exist at these sorts of clinics, we will have complete and total disaster for some of these people. Complete collapse and utter destruction of lives is  quite likely for some significant percentage of people if they don’t have the proper supports to make it through the ugly nature of withdrawal.

In Overcoming Prescription Drug Addiction: A Guide to Coping and Understanding  Rod Colvin quotes Ronald Gershman MD who says:

I have treated ten thousand patients for alcohol and drug problems and have detoxed approximately 1,500 patients for benzodiazepines – the detox for the benzodiazepines is one of the hardest detoxes we do. It can take an extremely long time, about half the length of time they have been addicted – the ongoing relentless withdrawals can be so incapacitating it can cause total destruction to one’s life – marriages break up, businesses are lost, bankruptcy, hospitalization, and of course suicide is probably the most single serious side effect.

I’ve needed 24 hour care for about 3 years. I still need almost that much. This is no joke. I have a sophisticated and loving partner who can tease out what is the drug withdrawal and who I really am. I’m sorry, but uneducated poor people won’t have that luxury. Partners of such people suffering from this illness have it really hard even in the best of circumstances. Even if they can understand. If they have no means of understanding what brain damage looks like everyone will suffer so much more terribly. 

Here are a few pieces from my Benzo Info page for a taste:

Much more information on benzos here: benzos and resources to more safely withdraw.

Included are stories of many different people who have lived through a withdrawal nightmare as well as my own documentation of what benzo (and other psychiatric drug) withdrawal has done to me.

Lastly I want to reiterate that it’s a great policy to no longer use these drugs for new users. To not create new iatrogenic addicts is exactly what we should be doing all across the country. But to force people off these drugs when there is so little acknowledgment of the seriousness and severity of withdrawal syndrome for some percentage of these folks is a dangerous and cruel thing for people who’ve already been made into addicts. Until there is a system of solid support in place we’re looking at an additional disaster waiting to happen.

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