Benzos Addiction misconception

[tricomb]

I've been on alprazolam, temazepam, AND triazolam for quite some time and the worst WD I've ever been through was alprazolam but I was taking in excess for ten years, mainly consisting of triple digit dosing, regularly exceeding a quarter gram per day (bottle and a half of 100 count 2mg bars). The idea of this now makes me *sick*.

Of the others, triazolam has the easiest WD it's almost unnatural. Temazepam is definitely hardcore as far as Benzodiazepine WD's go.

I see valid points here and there on both sides but tend to agree with kokaino on the temazepam and triazolam topics.

 

[THC2LSD]

Regarding the toxicity of various benzos, you are dead wrong. Not one set of data, but several have all come to the same result and that is that temazepam is the most toxic benzo. Where do you get the idea that triazolam and midazolam are the most toxic?

WARNING

Adult and Pediatrics

Intravenous midazolam has been associated with respiratory depression and respiratory arrest, especially when used for sedation in noncritical care settings. In some cases, where this was not recognized promptly and treated effectively, death or hypoxic encephalopathy has resulted. Intravenous midazolam should be used only in hospital or ambulatory care settings, including physicians' and dental offices, that provide for continuous monitoring of respiratory and cardiac function, ie, pulse oximetry. Immediate availability of resuscitative drugs and age- and size-appropriate equipment for bag/valve/mask ventilation and intubation, and personnel trained in their use and skilled in airway management should be assured (see WARNINGS). For deeply sedated pediatric patients, a dedicated individual, other than the practitioner performing the procedure, should monitor the patient throughout the procedure

It seems to be more likely to cause respiratory depression than other benzos, in the US it's generally not given out-patient. Although to be fair it seems that combining it with other depressant accounts for the bulk of deaths.

Because of the potency of triazolam, some manifestations of overdosage may occur at 2 mg, four times the maximum recommended therapeutic dose (0.5 mg).

Manifestations of overdosage with HALCION (triazolam) Tablets include somnolence, confusion, impaired coordination, slurred speech, and ultimately, coma. Respiratory depression and apnea have been reported with overdosages of HALCION (triazolam) . Seizures have occasionally been reported after overdosages.

Death has been reported in association with overdoses of triazolam by itself, as it has with other benzodiazepines. In addition, fatalities have been reported in patients who have overdosed with a combination of a single benzodiazepine, including triazolam, and alcohol; benzodiazepine and alcohol levels seen in some of these cases have been lower than those usually associated with reports of fatality with either substance alone.

Triazolam has one of the worst therapeutic indexes of any benzo. Mostly bizarre behavior, but sometimes dangerous respiratory depression.

Humans are not mice.

It's LD-50 in animals about like diazepam, though blood levels raise higher in humans than animals.

Perhaps I should have emphasized this.

The fatal toxicity index of temazepam is far higher than any other benzo, as per a 1991-93 British study and a 1995 Australian study.

Let's see it does appear that in Britain temazepam was more associated with a worse outcome(coma/death) compared to oxazepam(the least toxic/addictive benzo) and benzos in general. IMHO I would bet that Flunitrazepam would come close to temazepam if they had a larger group(thank god they didn't). But they didn't say temazepam was the most toxic.

Flurazepam, now rarely prescribed. in the United Kingdom and Australia, had the highest fatal toxicity index of any benzodiazepine (15.0).3

They said they controlled for other drugs, drug and alcohol abuse, age/gender, excluded those on other drugs and it would appear that temazepam is one of the more toxic ones. But I wonder what the causes of the OD were, like suicide, poisoning, accidental OD, or from getting high. And what was the ROA. I do think it's interesting that the 2 deadliest benzos were the one's you could shoot.
But if I'm reading right they factored drug abuse in.Here something that says IV benzos and short acting ones are more toxic http://emedicine.medscape.com/article/813255-overview#a0199

I just think your ignoring social factors that could contribute to the death rate Your own source says that in Sweden the most common benzo that caused death in suicide was flunitrazepam. And this study http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884537/?tool=pubmed says that Alprazolam is the most toxic. CDC also says that in the US the benzo that caused the most trips to the ER was Alprazolam

Regarding the bolded part, is that fact or did you just pull numbers out of thin air and claim it to be true?

While the severity and incidence of withdrawal phenomena appear to be related to dose and duration of treatment, withdrawal symptoms, including seizures, have been reported after only brief therapy with alprazolam at doses within the recommended range for the treatment of anxiety (eg, 0.75 to 4 mg/day). Signs and symptoms of withdrawal are often more prominent after rapid decrease of dosage or abrupt discontinuance. The risk of withdrawal seizures maybe increased at doses above 4 mg/day (see WARNINGS).

I could have sworn that I read that in some unlucky people it could take as little as two week, I think I was wrong. Usually it takes high doses for prolonged periods. But it can happen at low dose or a short duration.

I've been on alprazolam for over 5 years, I've been through withdrawals and not once have I had a seizure.

Well aren't you lucky. My grandma was like that too. Not everybody is that lucky. Benzo withdrawal can kill some people.

I think you are making up your own facts as you go. Medical literature on benzodiazepine, particularly temazepam withdrawal, is aplenty. It is the only benzo that had a serious abuse epidemic(BULLSHIT) and so research was done as it took its course. I suggest you do a little research before you begin making up numbers and making unfounded claims.

I've done plenty of research. Why don't you actually read shit. You just cherry pick shit to fit your beliefs. Valium is the number one benzo in the world. Temazepam doesn't even come close. It does have hotspots like UK, Australia, and Vietnam.

Seriously why are you so antagonist? Take some Restoril and chill out.

 

[kokaino]

Antagonist? No I just don't like the spread of misinformation and I certainly don't like personal opinions being reported as facts.

Okay it is now abundantly clear that you are not versed in this topic at all. You just like to make up your own facts.

Midazolam nor triazolam are the most toxic benzos (despite your little "Prescribing Information" tidbit, I bet you it would claim the same for clorazepate or oxazepam), neither is flunitrazepam. The reason flunitrazepam (and nitrazepam) are the #1 cause of deaths among benzos in Sweden is because Sweden banned temazepam way back in 1992. Get your facts in order before you make misinformed comments. Where they are both on the market (flunitrazepam and temazepam) in Australia, temazepam is responsible for far more deaths annually than all other benzos. That is a fact as I already have shown you in the above 1995 Australian study.

The British study included many different benzodiazepines including flunitrazepam (and yes, it was a viable sample), nitrazepam, midazolam, triazolam, alprazolam, oxazepam, lorazepam, diazepam, bromazepam, clonazepam and others. The indices were obtained for each benzo in the same way that indices were obtained in studies for tricyclic antidepressants and barbiturates. Temazepam had by far the highest fatal toxicity index of any benzo, exceeding even some tricyclic antidepressants.

The review on ER visits for alprazolam which you wrongfully call a "study" is nothing more than a stat report on the number of alprazolam ER visits in the United States (being the most prescribed benzo, it would be obvious that it would have a higher tally of ER incidents). It isn't a study, it's a review - get it right.

You claim that "Triazolam has one of the worst therapeutic indexes of any benzo. Mostly bizarre behavior, but sometimes dangerous respiratory depression." Where is the evidence for this? I have brought forth evidence that claims temazepam does. You have just made a statement without any research to back your claim up.

And as to your "more bizarre behavior" - again you are wrong. A study found that triazolam produced less behavioral impairment and less disruptive behavior than temazepam did. (Source).


If you had the entire study from the BMJ (which you have to pay for), you'd know that the set of data/sample for flurazepam was way too small and therefore its FTI is flawed. At the same number of samples, temazepam had an FTI of 22.4 (far highr than flurazepam's 15.0).

Again, temazepam was implicated in 491 out of 921 benzodiazepine related deaths in the UK between the years 1991 and 1993. That is more than 53%.
Even Dr. Ashton agrees with the facts - that temazepam is the most toxic benzodiazepine. (Source). So who are you to challenge her expertise?
So before you come back at me with your personal views and opinions, please get your facts straight. Goodbye.


Here is page 1 of the full British study.

 

[xxxyyy]

since this thread obviously stemmed from something i said, let me clarify. i meant that most z-drugs are comparable to midazolam and triazolam (which i've both used extensively) in the sense that due to their short half-life, and if you take either for recreational purposes you'll find that you continually need to redose. i also said short acting drugs are more addictive than long acting ones which, in retrospect and after reading a few studies, was obvious bullshit, and i apologize for that. however, short acting hypnotics have long since fallen out of favor here, and are rarely prescribed, because of what i mentioned before. here in germany, flunitrazepam caused an epidemic of abuse sufficiently huge and wide spread that they moved it as the only benzo into the same schedule as morphine and oxycodone and so on, so i'm guessing it'll be hard to get it prescribed anymore or we'll see an influx of clandestinely manufactured ones. flunitrazepam used to be readily available on the streets at a pretty high price, since demand was so high.

 

[kokaino]

^xxxyy, this was absolutely not your fault. This is nothing more than a misinformed poster stating personal opinions as if they were fact. He keeps repeating the same things over and over yet he has not brought a single shred of research to back up his claims. I hate the spread of misinformation.

 

[THC2LSD]

You have no clue what your talking about kokaino. I fucking agreed that temazepam has a higher death rate then most benzos! I'm not making shit up. Your study on triazolam/temazepam showed triazolam had worse impairment. Only when they used a higher than equivalent dose of temazepam did it produce comparable impairment but more disruptive behavior. 80mg of temazepam is not dangerous at all. 2mg of triazolam has caused OD. The UK pulled Halcion from the market, but still has temazepam. The later study said temazepam had a death rate of 11.9 per million, other benzos 5.7 and oxazepam( which I fucking already knew it and clorazepate have lower toxicity)2.3. It would be nice if you could find the older study that said it's death rate was much higher than 11.9 at 22.4 . Did they factor in other variables like the later study?

Either way, I'm fucking done with this thread.

 

[kokaino]

You have no clue what your talking about kokaino. I fucking agreed that temazepam has a higher death rate then most benzos! I'm not making shit up. Your study on triazolam/temazepam showed triazolam had worse impairment. Only when they used a higher than equivalent dose of temazepam did it produce comparable impairment but more disruptive behavior. 80mg of temazepam is not dangerous at all. 2mg of triazolam has caused OD. The UK pulled Halcion from the market, but still has temazepam. The later study said temazepam had a death rate of 11.9 per million, other benzos 5.7 and oxazepam( which I fucking already knew it and clorazepate have lower toxicity)2.3. It would be nice if you could find the older study that said it's death rate was much higher than 11.9 at 22.4 . Did they factor in other variables like the later study?

Either way, I'm fucking done with this thread.

You keep talking out of the side of your mouth. You were wrong, so admit it and move on. You keep talking but you have brought no research here. Show me where 2 mg of triazolam has caused overdose. Show me a case. Again, you don't get it. Temazepam is the most toxic benzodiazepine there is bar none. Whether you agree with that or not is not my problem. I am only reporting the facts. You choose to ignore them and make your own facts and fantasies. Suit yourself. Ignorance is bliss I guess. So UK pulled Halcion off the market? Sweden and Norway banned temazepam also, so what? The study did not show that triazolam had higher impairment, it showed that it had lower impairment. This was concluded by the scientists right at the end of the study. It was when they evened out the dosages temazepam showed a much higher incidence of side effects, which isn't surprising since it is the most toxic benzo out there.

You have absolutely no clue about this subject. So you can believe what you want but the facts speak for themselves.

You're "done" with this thread because you cannot back your own fantastic and outrageous claims.