Cautiously using prescribed klonopin for kratom/MIT WD

[vdjill]

I have gotten off 7-OH alone before but it never stuck. Wasn't too bad either, but one time it was assisted with K. Had a full blown kratom WD in 2022 that was brutal, also used K for the worst of it.

This time was mostly MIT extracts, and I had fluctuated doses in recent months but still had a strong dependence. I had some real scary experiences with benzos as a teenager, but seemingly learned my lesson and was previously on it maybe 3 years to manage anxiety. Only 1mg and 2mg a day at max iirc, I didn't even need to be titrated I just gradually stopped filling it.

I was hoping it would be the same this time. I had tried unsuccessfully already a few times last month, and my therapist recommended in lieu of detox facility (cause let's be real, kratom does not require inpatient detox), my doc prescribe other drugs that might help with the WD from the MIT.

Started with .25mg xan 2x day but it didn't touch it until I took half the script and so I just went back to using until my follow up. Got .5milly clonazepam 2x day, but this time the psychological and emotional symptoms were so severe that I was not at all prepared for it. I had also gotten off vraylar for bipolar (marketed for manias and psychosis which was never an issue for me without drugs) recently.

I was harboring so much sadness and a dam just burst. I also suffer from ptsd and various anxieties and the kratom was barely keeping it at bay but I just found myself beside myself at all times every day, and so I kept taking the prescribed benzos until I felt definitive relief from symptoms.

That dose was usually 3 milly, and so I got my doc to hesitantly up me to that, given my history of responsible use. I am really trying to stick to it.

The other week, I found a bottle of 200 or so .5mg alprazolam footballs, and they weren't mine, but had long been untouched so I took as much as I could reasonably get away with. I later came clean about it and they are my support so we resolved to dispose of all the xan and let it be water under the bridge, but I was coming up short on my kpin that week which at the time was either 1.5 or 2 a day, so I kept enough to make up for it, and a small handful for 'a rainy day.'

I used the ones I alotted, but I also used all of the spares in roughly the same amount of time.

I told my doc about the experience with WD and outpouring of sorrow and constant worry and worry leading to depressive mood, and he said I was just depressed but that he would raise the klonopin because it does help me.

it's like it helps with depression symptoms because it makes you not care at all at a certain point, or because it can change your frame of reference without the persistent filter of fear and anxiety.

it's not worth chasing this because it just makes it worse sometimes, and makes you say dumb shit or even blackout, but I haven't been at risk of that.

currently sitting at 3 millies a day, and really trying to stick to it. originally, thinking it would help me reduce my intake, I filled my pill container with one for each evening and morning for the fill and kept the 3 as spares to use as PRNs, but that led me to just take them more, so I split the 1mg between morning and evening, but then realized maybe trying to start the day with less is better, and makes me think before using another. Right now, I have enough, albeit a tad short but 3 a day is a bit much if I am being real, I have only been prescribed it 5 weeks after not being on it for years. my hope is that i can keep using it because the anxiety is going to take a long time to be at peace with and that I will just naturally taper.

psychiatry is such a clusterfuck of a discipline, they should just trust patients.

another therapeutic and harm reduction goal goal I set with my analyst that was part of an ultimatum to myself and my support to not go inpatient treatment (I disagree with each and every aspect of it in this country, I could go on and on, and if there is a board to shit on 12 step and scam rehabs in the U$A please let me know), was that I was not allowed to drink at all with the klonopin. I had been drinking more before the detox and benzo involvement, and so I would pick up a single of vodka sometimes even if I had a couple millys in me. when SWIM was still basically a child, SWIM took 10mg of etizolam and drank a 1/2 fifth of rye, and had to be intubated. SWIM was not trying to repeat, that.

alcohol has been a persistent danger for SWIM. it took years to wrestle it down, but SWIM was to a point where they could drink socially every now and then, after a period of total sobriety, but then back to daily beer or more, and yeah. it's much easier to put it down these days, cause I hate the shit and I think it's a garbage drug, and I don't like the way it makes me feel or the things I say on it and how I come off, so it's easy enough.

No alcohol, no kratom for 3 weeks now. tentatively, klonopin dependence and lessening/breaking it is a goal that will be tackled later.

I need to be constantly vigilant, but sometimes it's just too difficult to function without taking 2/3 my dose early, leaving me dry at night. I legally use cannabis, and my therapeutic needs have increased to be about 1g of concentrate every 2 days, or roughly 3g a week. Not much in the way of obligations, but I've got something of a difficult weekend coming up where I will be alone and away to avoid a family function where I would see an abuser.

How does one use klonopin, a drug that is like really good at what it is intended to do, without becoming overly dependent on it?

When I resolved to kick the anti-psychotics and opioids, it was because I wanted to decrease my dependence on chemicals prescribed and otherwise, but also on externalities in general. I don't want to find myself in a position where I need to take 2 millys of klonopin to go get my mail or some shit

 

[Vastness]

This is a harm reduction forum (obviously, lol), and this is potentially a dangerous thing to say depending on how you take it - but I'll say it anyway in the interests of relieving some of your psychological stress, while noting that you should be mindful that just this very sentiment has a danger of lulling you into a false sense of security, so my thoughts that follow are not a license to change your current behaviour.

It sounds like you have a more complex history of substance dependence than perhaps I have - or... hm, is that even true - I've withdrawn from kratom multiple times. Never touched 7-OH. Dabbled with benzo dependence multiple times. Maybe we have similar histories, it's just that you've had more medical interventions, living in a country notorious for overprescription and medico-hypercapitalism and a twisted enmeshment of pseudoreligious 12-step doctrine with the legal and medical systems... whereas I live in the UK, which hasn't updated it's primary mental health prescription guidelines since the 70s and where doctors are terrified of prescribing anything stronger than prozac or even fucking breathing exercises and going for a walk for suicidal ideation, or paracetamol/acetaminophen for a broken arm... and where half the population don't really believe that mental health is even something that exists... kinda the opposite problem, I guess, as far as the help available for people when it comes to substance use...

Anyway I'll say this about benzos, and klonopin specifically since it's the one I've settled on using the most to quell my own constant struggles with the overwhelming weight of just being alive, sometimes. I think the dangers of long term benzo use, honestly, are quite overblown. I could go into the reasons for this, and there are many, and they are somewhat dangerous substances in the sense that you need to treat them carefully. But it's important to remember that on the whole, they are still, physiologically speaking, in reasonable doses, very, very safe substances, on the whole, and none of the supposed longer term psychological negatives as far as increased dementia risk have actually been proven, what has been shown is correlation but not causation.

There are multiple studies on the use of klonopin/clonazepam specifically for mental health interventions, and looking at the ones outside the USA, IIRC, a large proportion of patients prescribed klonopin specifically for mental health reasons did not uncontrollably escalate their doses and in some cases reduced their dose over time. I'm choosing my words a little carefully here because I don't have the exact studies to hand, maybe I'll come back with them, or you can try to find them yourself, they're out there - I said outside the USA also specifically because there's a weird conflict going on in the medical system there right now where everyone in the industry is still reeling from the opioid crisis and trying not to repeat it with another class of drugs but there's still the ever present capitalistic incentive to deal with increased tolerance to any drug just by prescribing more of that drug, so it's hard to get a real read on patient's ability to self-regulate, absent the somewhat false comfort of having an authority figure of a doctor and/or psychiatrist tell you that escalating doses is just fine and dandy. Doses prescribed for actual depression were typically higher than we're all told is safe, 2-3mg on average IIRC, maybe rising to 4 in some cases, and duration of treatment was longer than we're all told is safe to take benzos - like years, rather than the few weeks to months before our brains will start rotting, supposedly. Outcomes were not severely negative by any means. Of course - the fact that these patients were studied at all means that they were under the care of fairly open-minded, independently thinking medical professionals who were prescribing and monitoring these usage patterns - just the very fact that many of us here (although not you, actually, I just realised, right?) are self medicating is it's own risky spanner in the works, potentially. But the point is there's evidence that benzo dangers are, in many cases, for many people, just a little overblown.

To get back to the crux of your question -

How does one use klonopin, a drug that is like really good at what it is intended to do, without becoming overly dependent on it?

...the answer is basically, what you're already doing. By being aware of how much you're taking, not escalating the dose uncontrollably, and being just very careful. This might feel like a bit of a psychological load to be dealing with on top of whatever the issues are that are leading you to be medicated with benzos in the first place - and for some people it's too much and dose escalation is unavoidable. For others (like myself) it's an acceptable psychological load to just be a bit careful with the dose, every day, to avoid feeling like life's barely worth living, anxious all the fucking time, just trying to endure pure sobriety in service to some abstract nonsense internalized ableist, prohibitionist ideal, and when the available medical services to me offer no help.

I'm currently taking about 2-3mg of klonopin a day myself, and have done for about a month now. I'm probably going to continue for at least another few months. Some days I'll take as little as 1mg, some days I'll go up to 4mg. I'll gradually taper down at some point, I think, when, perhaps, I've established enough of a stable life routine of other things that I'm already at 1mg or so... or maybe I won't. I do not think it is really that impairing for me. Quite the opposite, actually. I also don't think that jumping straight off at 1mg or so is really that dangerous, for me, again, YMMV, since I've done something similar for a couple of months a year for most years out of the last 5.

I did have some more troublesome patches, I'll admit. I escalated doses up to maybe 6mg a day at the peak, a good few years ago now, and I jumped off too early and experienced pretty uncomfortable psychological withdrawals. I know, people talk about kindling and that and this has scared me away from it and sometimes lead me to just enforce sobriety on myself to my own detriment and psychological incapacity, but honestly for me I just do not seem prone to massive dose escalation and I'm a bit tired at this point in my life of being told everything is so damn dangerous when some things just aren't necessarily, IMHO, and in my personal experience. My life has improved a lot since the time I accidentally escalated up to 6mg a day which also kinda reinforces my own point that klonopin is not innately a strongly reinforcing substance, but it's addictivity is very proportional to one's actual life circumstance (in which state of mind plays a big part, of course! but sometimes you need to use a crutch to get to a better state of mind - our minds are all different).

So I guess my point is essentially just try not to worry about it too much, out of the substances you mentioned, kratom, 7-OH, alcohol, klonopin - klonopin is BY FAR the smallest evil out of all of them, if we must insist on assigning a moral character to inert substances. 2-3mg / day is, IMO/IME, just not that bad, and is in line with the studies that have used clonazepam to treat more treatment resistant forms of depression. If you take, say, 4 or even 5mg in a day... the next day if you can try to just clear your schedule, hunker down, and limit it to 1, 1.5, 2mg, whatever you can manage. If you can do that a few days, you can consider yourself mostly back on track. If you start escalating multiple days and just can't get back down then this advice may well just not apply to you. Drugs affect everyone differently.

But don't allow yourself to start thinking that you have an actual problem just because you've internalized prohibitionist, psychologically-ableist BS that you must not ever feel like you need to take anything at all just to feel OK in this brutal world. It's not a problem until it's a problem, and if you don't have any reason to think it's a problem yet, just that it might become a problem (although - I'd point to your history of overcoming addictions to arguably more intrinsically problematic substances as evidence to the contrary)... then just try to be a little kinder to yourself about doing what you need to survive, and realize that what you're doing right now is actually very measured, responsible, and in no way extreme or excessive usage at all.

 

[vdjill]

Hey, @Vastness

Thank you for your thoughtful reply.

On the first part, that largely correlates with my experience with them. Re the ODs as an adolescent, I started self-medicating with my father's xanax when I was 15, and then he noticed and gave me a small handful to use as needed; he had good intentions, but all I knew was that it was an anxiety med with some nebulous potential for abuse, I didn't know how careful you had to be with them, and he did not tell me. It was fine, but then my adult sister got wise to it and she had her own habits and she started using me to acquire them from my father. I ODed later on with the etizolam because I started abusing it after a traumatic event that caused me to be alienated from my family and had little support and used them without regard for any sort of harm reduction, I didn't even know such a concept existed back then, and all that had been pushed on me previously for alcohol abuse (if you could call it that) was outpatient clinics that heavily encouraged 12 step and total abstinence. I learned the etiz+pg+sugar cube bars method in rehab too, lol, and was introduced to the drug by family anyway. I would also walk and drive around in brownouts or full blown blackouts for days and be abhored afterwards.

But I digress, I was prescribed them as a young adult during a time of heightened anxiety, and stayed on a low-medium dose for 3-4 years and just naturally came off them. I figured it would be the same this time, but I'd been repressing it (anxiety) so much the temptation was there.

I think now that I am further along with the kratom recovery, I am becoming less dependent on them. I still enjoy taking higher doses, and I can easily abstain from alcohol, but I don't like coming up short on my scripts.

Considering staying on them to deal with the anxiety I was carrying for years, thanks.

I was self-medicating with kratom for a long time, and experimented with morphine and lower opiates as a younger adult and adolescent but it never had the same draw for me that other things did. I was on the kratom for the better part of 4 years in some form and the main reason I quit this time is because I have no income.

That being said, I still want to be less dependent on externalities and substances to build personal resilience, but also because this whole country is going to hell in a handcart- kit and caboodle- and I don't wanna be left high and dry. I can stockpile seeds and materials for other things but that requires equipment too.

Drugs will always be part of my life in some capacity. In recent years, it has become increasingly easier to moderate, reduce harm, keep my cool, etc. I am inclined to say that my issues early on were from undiagnosed mental health issues, but I don't even believe in mental illness as the DSM describes it. I had a real traumatic adolescence and early adulthood from institutions and people close to me, and I think that explains most of the past stuff. The only thing that really drives me to use in an unhealthy manner these days is hopelessness for the world and my personal prospects.

Thanks again btw, you are great

 

[vdjill]

My main concern is psych meds of other classes. Maybe it is cope, but I am cool with taking vyvanse+gaba(wish they would give me pregabalin)+klonopin is fine becaues I am familiar with them all and the long term side-effects are minimal and they all work for me, but I got off vraylar because I realized that being on an anti-psychotic was for me at least totally unecessary and probably detrimental in the long term.

And I was right! Each time I titrated down in dose, I would get a touch of hypo-mania for a week or so but balance, out, and once I finally got off it I started feeling much more creative again and thinking about things I haven't thought of in years. I think the long-term effects of things like anti-depressants, anti-psychs, and mood stabilizers are not fully understood and probably worse than we think. I have been on each one, multiple of each, for varying periods of time, and I think that each one kills a small part of you slowly over time, and often have noticeable and negative side-effects, and just aren't good at what they do, and the fact that permanent psychiatric med regimens have become the standard, if not sole treatment for mental health in this country (and the only therapy offered is CBT which is a whole other thing. DBT is alright though but it is not the standard in institutions).

Kratom cessation was a financial necessity, but I am glad to be off of it because I didn't realize how numb it was making me.

I studied IT and cybersecurity(offsec mainly) as a professional path for a long time, but after quitting both of those things, I don't want as little to do with computers as possible. I wanna keep up to date on the tech in case I ever need to put my hat back on, and for media preservation and sharing, but the internet has become totally unusable, and even working for a private firm doing red-team is just strengthening the military/intelligence/security blob by proxy. Could work for a Chinese firm but the numbness made me machinic and inclined towards machines, but I can't for now. I just use it to listen to and make and practice music mostly.