America's Most Dangerous Pill? [Benzos]

[kokaino]

you want a rapidly acting benzo like triazolam or midazolam. Clonazepam for temazepam is switching one intermediate duration benzo for another. Compare the half-lives of these four that I just mentioned:

clonaz 18-50h
temaz 8-20h
midaz 1.8-6.4h
triaz 1.5-5h

Note to whomever: is there a table of benzodiazepine onset times anywhere? My hunch is that intravenous triazolam (HCl) is close to the fastest.

The study which I linked above in my other post says that ORALLY, temazepam is the the most rapidly absorbed and has the quickest onset of effects of all benzo's. While oxazepam was at the other end of the spectrum (the slowest acting benzo).

Because it's so over-prescribed, and there is such a massive abundance of it on the black market, that it's the benzo that most people are getting addicted to without a prescription.

It just happens to be the one benzo every doctor is so willing to prescribe. That's why. If most doctors were more willing to prescribe lorazepam instead, then they would have done the article on just that.

Xanax is the most widely prescribed benzodiazepine in the United States BY FAR. No benzo in the US is prescribed like alprazolam is. This guy just picked clonazepam out of the bunch and decided to write an article on a "killer pill". Most of the article is inaccurate and full of bullcrap. Studies and scientific research say totally different things. Clonazepam is one of the safest benzo's with a fatal toxicity index of 4.3 (average for all benzo's is 5.7). Lorazepam's fatal toxicity index is 6.6, alprazolam is 5.9, nitrazepam is 7.6, and temazepam is a whopping 11.9 - the highest of all benzo's by far (that 11.9 fatal toxicity index is higher than some tricyclic antidepressants and equal to some barbiturates).

The beginning of the study says this:

Benzodiazepines are generally thought to be safe in overdose.1 2 Death after admission is rare and due to respiratory depression with aspiration of gastric contents.2 Over 10 years in the United Kingdom, however, 1512 fatal poisonings have been attributed to benzodiazepines with or without alcohol.3 These were compared with prescription data to establish a fatal toxicity index (deaths per million prescriptions) for each benzodiazepine. Similar indices have been derived for antidepressants4 and barbiturates.5 There were clear differences between benzodiazepines. Of drugs frequently prescribed, temazepam had the highest number of deaths per million prescriptions at 11.9 (95% confidence interval 10.9 to 12.8
); above that of some tricyclic antidepressants.3 4 In contrast, oxazepam had an index of 2.3 (1.2 to 3.4), and the index for all benzodiazepines combined was 5.7.

British Medical Journal

 

[23536]

ok the winner of the benzo olympics is the newcomer remimazolam!

The study which I linked above in my other post says that ORALLY, temazepam is the the most rapidly absorbed and has the quickest onset of effects of all benzo's.

yep and this table says temaz has a relatively slow oral onset (which is consistent with my experience)

slightly off topic: ROA is limited with many benzos because they get destroyed when reacted with a strong acid. The salts are hard to make, so water solubility is not readily attainable. However, midazolam can be reacted with HCl to get the salt, and the intravenous formulation. The high is great if you can stay awake for it.

 

[kokaino]

ok the winner of the benzo olympics is the newcomer remimazolam!



yep and this table says temaz has a relatively slow oral onset (which is consistent with my experience)

Yeah that has intermediate or slow for almost every single benzo on the list. It's a list that I wouldn't take seriously. That British study was corroborated by 2 independent studies in Australia, a study in Ireland, and a study in Scandinavia. Its the reason that Norway and Sweden banned temazepam and listed it under the most restrictive schedule back in 1992 when "jelly" temazepam's were killing people left and right.

Temazepam is highly lipid soluble and has a high cerebral uptake. Oral administration of 15 to 45 mg temazepam in man resulted in extremely rapid absorption with significant blood levels achieved in less than 30 minutes and peak levels at approximately 1.5–2 hours (0.5 to 3 hours). In a single and multiple dose absorption, distribution, metabolism, and excretion (ADME) study, using tritium (3H) labelled drug, temazepam was well absorbed and found to have minimal (8% ) first pass drug metabolism. There were no active metabolites formed and the only significant metabolite present in blood was the O-conjugate. The unchanged drug was 96% bound to plasma proteins. The blood level decline of the parent drug was biphasic with the short half-life ranging from 0.4-0.6 hours and the terminal half-life from 3.5–18.4 hours (mean 8.8 hours), depending on the study population and method of determination. Temazepam has very good bioavailability with almost 100% being absorbed from the gut. The drug is metabolized through conjugation and demethylation prior to excretion. Most of the drug is excreted in the urine, with about 20% appearing in the feces. The major metabolite was the O-conjugate of temazepam (90% ); the O-conjugate of N-desmethyl temazepam was a minor metabolite (7% ).

That's from Wiki, but it's originally from the FDA.

 

[kokaino]

Another that suggests basically the same thing:

Following ingestion of 30 mg temazepam, measurable plasma concentrations are achieved 10–20 minutes after dosing with peak plasma levels ranging from 666-982 ng/mL (mean 865 ng/mL) occurring approximately 1.2-1.6 hours (mean 1.5 hours) after dosing. Strong hypnotic, sedative and anticonvulsant effects are noticeable 20–30 minutes after ingestion.
In a 7 day study, in which subjects were given a 30 mg temazepam capsule 1 hour before retiring, steady-state (as measured by the attainment of maximal trough concentrations) was achieved by the third dose. Mean plasma levels of temazepam (for days 2-7) were 260±210 ng/mL at 9 hours and 75±80 ng/mL at 24 hours after dosing. A slight trend toward declining 24 hour plasma levels was seen after day 4 in the study, however, the 24 hour plasma levels were quite variable.
At a dose of 30 mg once-a-day for 8 weeks, no evidence of enzyme induction was found in man.

That's from Rxlist.com (type temazepam and go to the "Professional Article")
And also from this link.

You also have to remember that different formulations play a role in the metabolism of drugs. Restoril is known as the WORST temazepam formulation in the world. Of course the "jelly" variety was the best. Take out the powder from the capsules of the temazepam the next time you do them and parachute the powder or put them in a tiny bit of water (I know they aren't soluble in water) and just drink the water real fast. Any powder u see left there put more water, swirl it around and drink it like you're taking a shot of alcohol. If u keep seeing powder, then just keep doing that. But usually, I just do it once or twice. Drink some water after all of it and swish the water around your mouth in case any powder is left and take swallow the capsules too, cuz there will always be some powder that you wont be able to get out. You'll see how temazepam is really absorbed. 10 Minutes and I can feel it. At 20 minutes you're fucked up.

 

[phatass]

It's not Adderall or Oxy. It's Klonopin. And doctors are doling it out like candy, causing a surge of hellish withdrawals, overdoses and deaths.

I was astounished to hear that ativan (lorazepam is within the top 3 deadliest benzoes)

temazepam YES
FlunitrazePam Yes
Lopprazolam or lormetazepam Yes

at least those would be my top 3 orallled

 

[kokaino]

It's not Adderall or Oxy. It's Klonopin. And doctors are doling it out like candy, causing a surge of hellish withdrawals, overdoses and deaths.

I was astounished to hear that ativan (lorazepam is within the top 3 deadliest benzoes)

temazepam YES
FlunitrazePam Yes
Lopprazolam or lormetazepam Yes

at least those would be my top 3 orallled

Where did you hear that lorazepam was in the top 3 deadliest?

Lorazepam has a fatal toxicity index of 6.6, lower than nitrazepam's 7.6, flunitrazepam's 8.3, and temazepam's 11.9. Lorazepam is up there, but it's not third.

The article is full of shit. It claims that Klonopin kills more people than Adderall and Oxycontin. No such thing.

 

[Pegasus]

you want a rapidly acting benzo like triazolam or midazolam. Clonazepam for temazepam is switching one intermediate duration benzo for another. Compare the half-lives of these four that I just mentioned:

clonaz 18-50h
temaz 8-20h
midaz 1.8-6.4h
triaz 1.5-5h

Note to whomever: is there a table of benzodiazepine onset times anywhere? My hunch is that intravenous triazolam (HCl) is close to the fastest.

The triazolo- benzos (alprazolam / triazolam) are definitely among the fastest absorbed, I'm not sure if there is one that beats them out but I can't imagine it would be by much. I don't know of a list to confirm anything beyond this.

Edit- Remimazolam is the fastest absorbed, is that what you were saying?

 

[23536]

Edit- Remimazolam is the fastest absorbed, is that what you were saying?

no, it's meant to be IV'd. It's meant to hit you very fast. It's meant to make you not care that a tube is being shoved down your esophagus.

(and also wear off within a relatively short amount of time. An hour?)

 

[kokaino]

The triazolo- benzos (alprazolam / triazolam) are definitely among the fastest absorbed, I'm not sure if there is one that beats them out but I can't imagine it would be by much. I don't know of a list to confirm anything beyond this.

Edit- Remimazolam is the fastest absorbed, is that what you were saying?

I've said this about 10 times now. Research has shown temazepam to be the most rapidly absorbed benzodiazepine with the quickest onset of effects. This is why temazepam has the highest fatal toxicity index (11.9), which is above that of some tricyclic antidepressants and equal to some barbiturates. This is why temazepam overdoses where a common thing in Europe back in the 1980's and early 1990's, especially the UK, and is especially Scotland where hundred upon hundreds died of temazepam overdoses (mixes with heroin, alcohol and even when taken alone). It's why Sweden and Norway banned temazepam. It's why the UK put it in Schedule III, but it is treated as a Class A controlled drug in practice (i.e. storage, dispensing, prescription writing format, etc.). That's why in some parts of Asia it's scheduled the same way morphine, heroin, cocaine,etc are scheduled.

The sedation produced by benzodiazepines in therapeutic doses and overdose has a poor correlation with measured drug concentration but is increased with rapid absorption. Temazepam is more rapidly absorbed and oxazepam is more slowly absorbed than most other benzodiazepines. Further research is required to determine if the rate of absorption is different in overdose and is sufficient to explain the differences in sedation. Slowing the rate of absorption may reduce toxicity, but this would also reduce their sedative effect in therapeutic doses. Drug regulatory authorities should be aware that changes in formulation of benzodiazepines may affect toxicity in overdose.

Sources:
1. Gaudreault P,
2. Guay J,
3. Thivierge RL,
4. Verdy I

.Benzodiazepine poisoning. Clinical and pharmacological considerations and treatment.Drug Safety1991;6:247–65.

1. Busto U,
2. Kaplan HL,
3. Sellers EM

.Benzodiazepine associated emergencies in Toronto.Am J Psychiatry1980;137:224–7. (Link to article)

1. Fucella LM,
2. Bolcioni G,
3. Tamassia V,
4. Ferrario L,
5. Tognoni G

.Human pharmacokinetics and bioavailability of temazepam administered in soft gelatin capsules.Eur J Clin Pharmacol1977;12:383–6

1. Greenblatt DJ,
2. Harmatz JS,
3. Engelhardt N,
4. Shader RI

.Pharmacokinetic determinants of dynamic differences among three benzodiazepine hypnotics.Arch Gen Psychiatr1989;46:326–32. (Link to article)

1. Mitler MM

.Evaluation of temazepam as a hypnotic.Pharmacotherapy1981;1:3–13.

 

[TheTwighlight]

I mean, I have to agree that benzos are the most dangerous drugs there are. They are also what I am most addicted to and don't take them anymore.

Alprazolam & Clonazepam are the most addictive drugs I've ever done - more than meth, coke or crack, oxycontin, H, whatever.

The craziest shit I've ever seen people do was on benzos. I am included in this category. I've landed in the hospital multiple times after taking ridiculous doses of benzos (with other drugs of course).

So I don't know what to say. Yeah, the story is one-sided, but I consider Klonopin & Xanax the most addictive, dangerous drugs on earth.

I was hooked on Xanax for 8 years and hated myself and my life so much, it was awful. I've got ALOT of drug experience, and this is just my personal opinion.

This is all just my $0.02, thought.

 

[LSDMDMA&AMP]

yeah i did restorils how kokaino did, and they kicked in FAST

 

[jspun]

I've done heroic doses of xanax, temazepam, and clonopin in combination with little or no effect. Soma, on the other hand, knowcked my dick in the dirt. You get these parckinsonesque symptoms at high doses and then black out suddenly- thats potentially dangerous and schedule V in the USA I think (a % of the drug is converted to memprobamate). benzos have a ceiling effect unlike barbs and some other clases of anxioytics/ sed-hypnotics which makes them safer in overdose and a competative antagonist- romazicon (flumazenil).

I think clonopin is safe- I am currently Rxed 4 mg a day and it has no noticebale effect on my mentation- ceratinly more subtle than xanax but seems to mix with opiates well.

And Barbituates- Nirvana.%) Too bad the har hard to come by today. drs onlt seem to script them in Oregon as the final solution to a terminal condition in heroic amounts- 100- 100 mg tabs to get the job done. Nembutal is used less because the costs is 10 times that of seconal- and seconal was re-released last year ostensably for insomnia but really for physician assisted suicide most likely.

Now the withdrawls do suck- especially the panic symptoms from benzo withdrawl- thats why a taper is the most rational startegy.

 

[Lady Codone]

Almost all benzo deaths occur because of ignorance or irresponsible dosing: taking outrageously high doses, combining with alcohol and other depressants or driving under the influence. I'd say this is more a "drug education" problem than a "benzo" problem. Benzos themselves are likely less harmful than alcohol when used responsibly, though their effects are very similar.

I do agree that they're overprescribed, though. All the women over 40 I know are on Xanax or Ativan. Benzos are much better used for acute anxiety/seizures/etc. than on a daily basis. Opiates get such a shitty rap in the media when benzos are somewhat more dangerous due to the seriousness of withdrawals, which can be fatal.

 

[Love In Vein]

Are you seriously trying to imply that benzodiazepines are less addictive than caffeine? Are you out of your mind or are you just plain [edited for civility] stupid?

I'm saying that in my experience, when used as directed, I have suffered no withdrawals.

Whereas I seriously cannot function without a caffeinated drink. And I don't know whether or not to describe my addiction to nicotine as physical, but it is absolutely the most psychologically addictive substance I've ever used.

I was an IV user of OxyContin and heroin for roughly a decade. So I'm pretty sure I know what withdrawal is like.

Benzodiazepine withdrawal is potentially deadly! It can induce seizures among other horrible effects. It is an extensively studied withdrawal syndrome that is recognized by the orthodox medical community, how much more evidence could you possibly need?

Alcohol withdrawal is the most dangerous if you want to go by what the orthodox medical community goes by, which is actual stats.

I've witnessed people seizing from alcohol withdrawal and I've known someone that actually died as a result.

I've witnessed people go through withdrawals of ketamine, DXM, amphetamines, opiates, cocaine, benzos, et cetera.

You may want to reread my initial response. Because you completely missed the context and point I was making.

I'm not disputing that people can have very harsh withdrawals and even die from benzodiazepines. I'm simply saying that when you look at it statically, not very likely with the exception of alprazolam. If you're using them as prescribed by a competent doctor, you're not going to simply die. Nor would any competent doctor not know how to taper one off if they were addicted or showing signs of withdrawal.

 

[ugly]

My doctor took me OFF xanax. He put me on clonazepam. Started at 3 mg. No reduction in stress or panic. Put me up to six mg. Now I'm up to 9 mg and I still get fits of rage. I got so sick of feeling so pissed off and so stressed that I just dumped a load in my hand and swallowed them all. Fuck if I cannot get rid of these mood swings I'll just keep taking more. When I was on Xanax, a few mg and I'd calm down in a few moments. With kpins, I took three an hour and a half ago, nothing. I stilll want to hurt somebody. I decided to just take a fistful. See what happens.