benzo addiction?

[invisigone]

I don't take benzos in the daytime for anxiety, I take them at night for insomnia and I take pretty high doses, usually either 60mg temazepam or 40mg diazepam. I have been taking the stuff for about 15 years so I must be addicted but I have never suffered any withdrawal symptoms, would that be because I only take them for sleep and not to chill? I'm not worried about being cut off because the docs are good at leaving my script alone (maybe because its cheaper to dope me up than pay for a bed in a psyche hospital)

How would I know if I'm addicted? I took a week off recently when I finished my script early and suffered no withdrawals that I could tell, no cravings or physical symptoms, I didn't sleep much, only one or two hours a night, but I didnt feel tired so I didn't see it as a problem. I also take seroquel which may have masked any withdrawal symptoms?

 

[effie]

For physical dependence you need to have benzodiazepines in your blood all or most of the time (although levels can obviously fluctuate). Withdrawals occur when your brain has adjusted to having benzos around, then suddenly it doesn't have them anymore. They don't kick in instantly, because it takes time for your body to completely eliminate the benzos, so you can go short periods without them. Temazepam is a medium-short-acting benzo so if you only take that once a night there is less chance of dependence, as levels will drop during the day, although with high doses and long term use it can build up in your system. Diazepam is long-acting with a lot of metabolites which linger, so once a day dosing could certainly produce a physical dependence.

The fact that you can go a week without withdrawals indicates to me that physical dependence is not a problem, but I would still be careful stopping abruptly, just in case - benzo withdrawal can be fatal. The insomnia you experienced was likely rebound insomnia, which is common when stopping any sleeping pill. Seroquel could have masked anxiety and insomia to some extent, but it doesn't act on the same receptors as benzodiazepines so it wouldn't eliminate withdrawals.

I would try not to worry - if you are happy on your current script and not likely to be cut off, then there isn't a problem. Docs shouldn't stop a benzo script abruptly because of the dangers of withdrawal. If you are concerned then I would suggest sticking to temazepam and considering seeing if you can lower your dose, although if you are stable on what you are taking then the only reason to do so is to reduce the chances of withdrawal, which you are unlikely to experience as you've gone a week without and had no issues, and you don't plan to stop your script anyway. If you ever do want to come off them in the future then your doctor can plan a taper for you.

Hope that helps

 

[diazepaman]

u'r like me. they're the benzos i take. temazepam & valium & ive never got w/d from them. even when taking over 100mg of valium or 200mg of temazepam. I also take seroquel which i actually like & think is the best AP. guess some ppl just dont get w/d as bad as other.
gotta watch out though i dont take them every day & the half life of valium is about a week so w/d should peack at the 10th day. I know temazepam is a mid acting benzo. id have to look up its half life but anyways. u should do a taper if ya gunna cut back just to be on the safe side or atleast so u get normal sleep.
ive always found valium & temazepam to be weak. so i associate a weak effect with a weak w/d. maybe some ppl like us are just different & dont get w/d.

 

[effie]

Temazepam's half-life is 8-20 hours (longer than I thought) so actually, dosing once a day - especially high doses and over a long period of time - is enough to develop a physical dependency. OP, as I said if you are concerned I would stick to temazepam as it does have a shorter half life and reduce the dose if you are able. Physical dependence definitely is a possibility. It's less likely as you have gone a week without, but as diazepaman says it can take a while to kick in especially with diazepam, so don't take it for granted that you won't. It is not a good idea to ever stop benzos completely - you should always taper to be safe.

 

[kokaino]

effie, Temazepam's half life ranges from 8-20 hrs but I strictly remember when Restoril.com was up, they had a table which compared lorazepam, temazepam, alprazolam, and diazepam in average half life and temazepam had the shortest average half life than all of them, including alprazolam. It wasn't a range, it was just a number and it was because of the fact that alprazolam has an active metabolite and temazepam does not, so temazepam had a shorter half life on average. Too bad Restoril.com is not available anymore. Restoril.com was trying to show how fast temazepam is absorbed and how quickly it is eliminated without any active metabolites, they were basically promoting their product.

 

[invisigone]

many thanks effie & diaz

the tranqs are not something that bothers me, i've got no plans to come off them, if it ain't broke why fix it. It was causing me a bit of concern because i had not heard of benzo addiction until i read it on BL. I am also hooked on pain pills, the usual story, car wreck > narc's. I didn't know about the addiction possibility and didn't even realize i was hooked for ages. in fact i went CT a couple of times when i ran out and was not due to have my script filled for a couple of weeks, i had all the withdrawals and STILL didn't realize what was causing it

anyway, back to the subject. thank you for taking the time to give your explanations, i guess that benzo addiction and opiate addiction are not the same, i highly doubt my doc will ever bother to alter my script (mainly for the reason of relapse psychosis possibility, it has taken years just to get me to stabilize) but if that ever is the case i will make sure to do a VERY gradual taper.

 

[effie]

effie, Temazepam's half life ranges from 8-20 hrs but I strictly remember when Restoril.com was up, they had a table which compared lorazepam, temazepam, alprazolam, and diazepam in average half life and temazepam had the shortest average half life than all of them, including alprazolam. It wasn't a range, it was just a number and it was because of the fact that alprazolam has an active metabolite and temazepam does not, so temazepam had a shorter half life on average. Too bad Restoril.com is not available anymore. Restoril.com was trying to show how fast temazepam is absorbed and how quickly it is eliminated without any active metabolites, they were basically promoting their product.

Thanks kokaino, that's interesting! I had always thought it had a pretty short half life so I was surprised when I looked it up and it said 8-20hrs..

Ivisigone, benzo addiction is different to opioid addiction in terms of duration and effects, but they both have the same underlying principle. I am sorry about your opioid addiction and going cold turkey a few times. I hope your pain is managed adequately. Some people are more prone to picking up dependencies, and some seem to more readily pick up a benzo addiction where as others an opioid. Pattern of use could well play a role - you don't take benzos enough to become addicted, but you probably do with opioids.

I agree about the benzos - if you are stable, they are working and you are happy then no need to change it. The one thing to look out for is if your tolerance rose - 60mg is higher than most docs will prescribe for insomnia and I would be very surprised if they happily upped you to 90mng. They may switch you to another medication. Nitrazepam is a hpmotic but it has a long half life so dependence is more likely; Triazolam (Hacion) has a short half-life but is not available everywhere..Anyway, you can cross that bridge if you come to it - at the moment it sounds like all is well

 

[kokaino]

^ Yup. Temazepam is considered to be a short to intermediate acting benzo. Studies have shown it to be more rapidly absorbed than other benzos, but it still may linger up to 20 hrs after ingestion (individuals differ, some have faster metabolism others have a slower metabolism, etc). It's a range (the 8-20 hrs), I think in general it's quick in and quick out.

This is according to the FDA:

Following ingestion of a 30 mg Restoril capsule, measurable plasma concentrations were achieved 10 to 20 minutes after dosing with peak plasma levels ranging from 666 to 982 ng/mL (mean 865 ng/mL) occurring approximately 1.2 to 1.6 hours (mean 1.5 hours) after dosing.

Source for the above.

According to this study it is also the most rapid acting benzo (under the section "Discussion" second paragraph). This is claimed to be the reason why temazepam is so toxic compared to all other benzos. This corroborates what the FDA claims above.

 

[alkap555]

Keep in mind that for long-acting benzos like diazepam, it may take up to two weeks for w/d symptoms to manifest due to the lingering parent drug and metabolites.

It is possible that your body is saturated with benzos and one week was not sufficient for plasma levels to drop to a point where w/d symptoms became apparent. The fact that you had rebound anxiety (which is caused by GABAergic downregulation--the same mechanism as dependence) and that you have been taking large nightly doses for 15 yrs makes me think that you are in fact physically dependent. There really is no way to tell other than stopping for >2 weeks and waiting for the onset of w/d.

Considering the dose and duration of your use, however, I would recommend AGAINST stopping abruptly. The long-acting benzos are self-tapering to an extent, due to their pharmacokinetic profiles (large AUC, zero-order elimination kinetics).

Good luck

 

[drzing]

Benzo addiction is usually noticed when for some reason the patient/user refrains from the drug, of course it varies along with the half life of the drug in question. Withdrawing from benzos doesn't seems like a big deal, specially for a patient. But it is, doctors don't say it, but depending on how much you take, if you withdraw cold turkey you can do serious harm to yourself, so if you feel like you've been on them for too long, talk to your doctor, or get a new one that will help you out, just don't quit them cold turkey on your own.