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Benzos Chronic (therapeutic) benzo use vs chronic Alcohol use

I dont find any benzos particularly euphoric. There have been a few times in high stress situations and at the hospital when i was IVd with benzos for hallucinogen ODs, as well as klonopin and xanax and surprisingly chlordiazepoxide have given me euphoria. The first benzo I ever had was chlordiazepoxide and I remember feeling so light and everything i saw had a nice sparkle to it. Besides that though, the euphoria is nonexistant and acts as a blanket for my emotions.
 
Good topic.

I've been in an awful rut all year. Like hellish. And I'm convinced that an ongoing ativan prescription would have prevented considerable suffering and allowed me to nip the relapse in the bud.

It is a cruel double standard that opiate addicts get prescribed replacement medications but Doctors adamantly refuse to prescribe benzo's to alcoholics.
 
This happens with Klonopin for me but only if the situation is high stress. My best guess is you may have been so anxious that the dose they gave you (being larger than normal) allowed you to fully feel that buzz while also not becoming drowsy due to the situation.

To me taking Klonopin on a flight does the same thing. It's like I feel that my adrenaline is sky high but I don't actually feel it's effects on me. This cancels out the mopy drowsiness I'd normally have and instead I feel more loopy. I don't consider it recreational because it can't be recreated without a specific scenario.

Well I wasn't really anxious before that surgery. I've had a few so I'm used to it so I don't think it's that I was so anxious, I think it's that they IV'd me the Valium so that gave me more of a rush and that that's the only reason that that's pretty much the one and only time I've ever really gotten any euphoria from benzos.

As you've said, the most I can get is relief from anxiety which if the anxiety was high enough might feel a bit euphoric but really I don't get euphoria from my Klonopin, which I think is a good thing.
 
Nice discussion, and I haven't read it all... just wanted to point something out:

Gabapentinoids (Phenibut, Gabapentin, Pregabalin etc) directly bind to the GABAB receptor.

This is not true. Gabapentinoids work by blocking voltage-dependent calcium channels (VDCCs) which is not actually a GABAergic mechanism. Phenibut, however, additionally is a GABA-B agonist and does bind directly to GABA-B, but gabapentin and pregabalin do not. Baclofen is a very potent GABA-B agonist and is not a gabapentinoid. Another well-known GABA-B agonist is GHB (not at light doses, where it binds to the GHB receptor type, but once taken a bit higher).

In terms of the effects on one's health, benzos are far and away safer to use chronically (therapeutically) than alcohol. Benzos are pretty non-toxic and safe drugs, whereas alcohol is one of the most toxic drugs people typically use. It's a shame the withdrawal syndrome is so long-lasting with benzos, but as mentioned, a slow taper using the Ashton method can get you off of a therapeutic dose relatively painlessly. Acute GABAergic withdrawal is neurotoxic because of an excess of glutamate causing excitotoxicity (I think that's why, right?), but a proper taper will avoid this.
 
Alcohol is directly toxic to the liver (hepatoxicity) and pretty much every other system of the body, notably: The Brain. Alcohol interferes with your ability to absorb Vitamin B1 (Thiamine). This is a major contributer to the gradual loss of executive function among Alcoholics.

The end stage, if you will, is Wernicke-Korsakoff Syndrome or "Wet Brain". This renders the Alcoholic unable to live independently. Folks will operate at the mental level of a child.

You can overdose on Alcohol. Benzodiazepines are benign unless combined with other CNS Depressants. Both can and do cause Blackout. Literally anything cam happen in a blackout so they really are no laughing matter.
 
Acute GABAergic withdrawal is neurotoxic because of an excess of glutamate causing excitotoxicity (I think that's why, right?
Exactly, a glutamanergic storm. I also believe that large amounts of NMDA is released during rapid WD as well, further contributing to the neurotoxicity.
 
Any long term use of a mind altering substance causes long term changes. Particularly as we age our bodies become more fragile. A huge mistake that young people make is to think that their invincibility will last forever.
Theres a lot of research regarding alcohol abuse. So much that it’s easy to pick any combination of use/time/age and know the probable outcome. The Benzo research has been done but the specific long term effects to an elderly person’s mind after decades of heavy abuse are not as cut and dried as it seems.
However, there is no question that heavy Benzo abuse for years does permanently alter the chemistry of one’s brain. Sort of like a smoker having wrinkled skin even if they quit. In my opinion it is more dangerous than alcohol, specifically at low doses. I have used both at different times in my life and for me, benzos are much scarier and more dangerous than alcohol.
 
Any long term use of a mind altering substance causes long term changes. Particularly as we age our bodies become more fragile. A huge mistake that young people make is to think that their invincibility will last forever.
Theres a lot of research regarding alcohol abuse. So much that it’s easy to pick any combination of use/time/age and know the probable outcome. The Benzo research has been done but the specific long term effects to an elderly person’s mind after decades of heavy abuse are not as cut and dried as it seems.
However, there is no question that heavy Benzo abuse for years does permanently alter the chemistry of one’s brain. Sort of like a smoker having wrinkled skin even if they quit. In my opinion it is more dangerous than alcohol, specifically at low doses. I have used both at different times in my life and for me, benzos are much scarier and more dangerous than alcohol.

I have to disagree. Benzodiazepine have been studied extensively, with doses in the 12mg+ range with years long usage in literature. Alcohol, while more extensively studied, is still not as understood as benzos because it is a receptor whore. It has affinities for a ridiculous amount of different receptors in the brain and body and thus it had been difficult to identify exactly how it works on a biochemical level. GABA, NMDA, Glutamate, MOR, Dopamine, 5-HTP, just to name a FEW receptors that alcohol has an impact on. It is hard to pinpoint what is going on in the body when consuming alcohol just because there is so much activity happening throughout the entire CNS and PNS.
 
Also, while chronic use of any drug causes temporary changes (even if long-lasting) due to receptor downregulation, these changes are not damage per se, and you can recover from them by withdrawing and then letting time up-regulate them. Whereas alcohol causes organ damage to nearly every organ in the body, it is a toxin (particularly its primary metabolite, acetaldehyde, is very toxic). So it causes receptor downregulation (across more systems than just GABA, unlike benzos), and also is toxic. Daily use of a single drink, like a glass of wine at dinner, is unlikely to be particularly unhealthy. But daily use of alcohol to combat anxiety involves multiple drinks, since alcohol lasts so short. A single high-dose alcohol experience causes organ damage from a single time. Chronic alcohol users deteriorate over time until their liver or pancreas shuts down, and they lose more and more critical thinking abilities as the brain damage sets in. Truly, benzos are much, much safer to treat anxiety with. That said, the safest and most effective treatment is therapy to attempt to actually solve the problem and move past anxiety. Daily benzo use long-term to treat anxiety has its own problems, such as dependence, and losing effectiveness over time, but it's a far cry safer than daily alcohol use.
 
I was on Benzos for years at my peak 6mg Clonazepam ED, When I finally got help my GP almost died when I told her, It took me a 18months to get down to 1mg then I swapped to Diazepam and It took another year to come off. Wasn't pretty and I couldn't function at the end anxiety through the roof insomnia, depression.
 
Any long term use of a mind altering substance causes long term changes. Particularly as we age our bodies become more fragile. A huge mistake that young people make is to think that their invincibility will last forever.
Theres a lot of research regarding alcohol abuse. So much that it’s easy to pick any combination of use/time/age and know the probable outcome. The Benzo research has been done but the specific long term effects to an elderly person’s mind after decades of heavy abuse are not as cut and dried as it seems.
However, there is no question that heavy Benzo abuse for years does permanently alter the chemistry of one’s brain. Sort of like a smoker having wrinkled skin even if they quit. In my opinion it is more dangerous than alcohol, specifically at low doses. I have used both at different times in my life and for me, benzos are much scarier and more dangerous than alcohol.
We aren't talking about heavy abuse

I was on Benzos for years at my peak 6mg Clonazepam ED, When I finally got help my GP almost died when I told her, It took me a 18months to get down to 1mg then I swapped to Diazepam and It took another year to come off. Wasn't pretty and I couldn't function at the end anxiety through the roof insomnia, depression.
This is wrongfully considered theraputic. I've been on Klonopin for years and more often than not just 1.5mg is overkill for most bouts of anxiety.

The blame is not on the drug. It's the doctor who let you crawl up to 6mg. If you drop a hammer on your foot you don't blame the hammer.
 
The less you dose the less toxic it will be of course, doesnt matter whether is benzos or booze. But the fact still stands that drinking chronically (a chronic drinker isnt your average glass or two a day consumer for relaxation, they need the alcohol) is worse for your body and mind as a whole than a daily dose of 1.5mg clonazepam or alprazolam or (almost) any benzo. I feel like this thread is running in circles now but it's good to have the studies and data posted on the comparison between alcoholism and benzo dependency.
 
Any long term use of a mind altering substance causes long term changes. Particularly as we age our bodies become more fragile. A huge mistake that young people make is to think that their invincibility will last forever.
Theres a lot of research regarding alcohol abuse. So much that it’s easy to pick any combination of use/time/age and know the probable outcome. The Benzo research has been done but the specific long term effects to an elderly person’s mind after decades of heavy abuse are not as cut and dried as it seems.
However, there is no question that heavy Benzo abuse for years does permanently alter the chemistry of one’s brain. Sort of like a smoker having wrinkled skin even if they quit. In my opinion it is more dangerous than alcohol, specifically at low doses. I have used both at different times in my life and for me, benzos are much scarier and more dangerous than alcohol.

I totally disagree.

First off, you basically cannot deny that it is easier to overose and die from alcohol by itself than benzos by itself. I mean the studies have already shown that it is extremely hard to overdose on benzos without mixing them with anything else.

We also know that alcohol is far worse for the liver, and I believe there are also studies showing that heavy alcohol abuse can sometimes lead to certain types of cancers yet there aren't any showing that benzo use can.

Finally, although it would probably be unlikely that very heavy benzo use for years would ever be something that your brain would literally ONE HUNDRED PERCENT recover from if you stopped...meaning like as if to your brain you'd NEVER taken that am all....yeah, that's unlikely in that at least SOME changes to the brain will probably persist, but how significant those changes to the brain are or how damaging is going to differ dramatically between different people based on all sorts of factors and I definitely think that some people can use benzos even heavily (MEDICALLY, NOT recreationally) for many years and then stop and have their brains MOSTLY recover and not have serious horrible long term effects.

I have been taking 1.5mgs of Klonopin for about 15 years and generally feel ok but I bet I am the sort of person who you would say is DEFINITELY going to have HORRIBLE long term after effects, when that is NOT NECESSARILY TRUE AT ALL.

It COULD happen, and IMO most likely my brain has been permanently been changed in certain ways TO SOME EXTENT even if/when I stop, but I'm not going to believe that my brain is destroyed beyond repair unless it happens, and frankly, it REALLY pisses me off all the people who have told me that my brain is basically fucked because of my benzo use when they have no way of knowing that.

Now I do also drink alcohol, but I bet your anything that if instead of taking any benzos I had drank 4-5 beers a day everyday (I'm picking that number cause it's probably equivalent to me for 1.5mgs of Klonopin) every day for 15 years I'd be in FAR worse shape than from taking benzos.

Also, not all benzos are created equal and a moderate dose of Klonopin like I take, because it's a long acting benzo, is probably not damaging to the extent that a short acting one like Xanax is.

Of course, you are entitled to your opinion, but I think there is no question that alcohol is overall a more toxic substance to the body than benzos, and frankly all the "benzos are going to destroy your brain hysteria" that I have had to endure over the years pisses me off to no end.

I mean sure, they are FAR from harmless and can have significant dangers, but there are a lot of people, many on this forum but also elsewhere, who have told me over the years that my brain is already fucked beyond repair and I think that they just don't necessarily know that that is true at all, and that the hysteria over long term MEDICAL usage of benzos is really over exaggerated.
 
I was on Benzos for years at my peak 6mg Clonazepam ED, When I finally got help my GP almost died when I told her, It took me a 18months to get down to 1mg then I swapped to Diazepam and It took another year to come off. Wasn't pretty and I couldn't function at the end anxiety through the roof insomnia, depression.

That is a VERY high dose.

May I ask you why you were prescribed that much and if lower doses were not effective?

I've never heard of that much being prescribed so I am guessing it was recreational but I could be wrong.

I have been on 1.5mgs for 15 years (I was off for 9 months but needed to get back on for anxiety) and have never needed to raise my dose and often less than that works for anxiety.

I was also able to get off of it for 9 months and basically had no real taper at all because the doctors fucked up, and while I know that I am an unusual case I had ZERO withdrawal.

But the kinds of doses you were using are really just WAY WAY too high so no wonder it was so bad.

I think that benzos, especially long acting ones like Klonopin, are not that dangerous if used under medical supervision, but it is true that the withdrawal can be deadly at high doses, and I was told by a doctor at the hospital when I withdraw that I was not at risk of death withdrawing off of 1.5mgs but that death from sudden withdrawal-cold turkey does start to become a risk at 4mgs so at 6mgs you were definitely in a situation where if you were to quit cold turkey death or at least massive grand mal seizures would be a real possibility.

IMO Klonopin has really helped me a lot, but you have to be careful and that dose is REALLY REALLY high.

Glad you are ok.
 
We aren't talking about heavy abuse


This is wrongfully considered theraputic. I've been on Klonopin for years and more often than not just 1.5mg is overkill for most bouts of anxiety.

The blame is not on the drug. It's the doctor who let you crawl up to 6mg. If you drop a hammer on your foot you don't blame the hammer.

Yeah seriously, I've never heard of 6mgs being prescribed, I mean that's just insane and I have a hard time believing anyone could ever need that much for anxiety for any reason other than having already abused benzos or other gabagerics at such a high dose that you need it because of the withdrawal or rebound anxiety.

That's a very negligent doctor IMO.

I also have been taking 1.5mgs for years and often only need 1mg, sometimes less for anxiety, and while I have taken higher doses at times, (VERY rarely over 2.5), I still have never needed to raise my dosage and it has never lost effect.
 
The less you dose the less toxic it will be of course, doesnt matter whether is benzos or booze. But the fact still stands that drinking chronically (a chronic drinker isnt your average glass or two a day consumer for relaxation, they need the alcohol) is worse for your body and mind as a whole than a daily dose of 1.5mg clonazepam or alprazolam or (almost) any benzo. I feel like this thread is running in circles now but it's good to have the studies and data posted on the comparison between alcoholism and benzo dependency.

Yeah, I really don't understand how that one poster "Squeaky" could think THERAPEUTIC MEDICINAL use of moderate doses of benzos could be as dangerous as serious alcohol abuse.

The only way we can even compare the two is to talk about long term damage to the brain, and I don't believe that moderate doses of benzos usually do harm the brain that badly, but while benzos CAN be riskier for the brain they are not toxic towards the body, whereas heavy alcohol use also does bad damage to the brain AND the liver AND can lead to all sorts of different complications and cause massive weight gain or weight loss and can also cause death from overdose in a way that benzos can't.

There's no comparison for anyone who really knows what's up IMO.
 
I also have been taking 1.5mgs for years and often only need 1mg, sometimes less for anxiety, and while I have taken higher doses at times, (VERY rarely over 2.5), I still have never needed to raise my dosage and it has never lost effect.
I agree
I take 3mg alprazolam a day and I have found only a very small drop if efficacy as well, and this is with the short-acting benzos. Been taking em for years. While I have noticed a drop in the actual feeling of relief or "high" I get, it still negates my anxiety and keeps me stable. I am prescribed it for my stomach oddly enough, for IBS-D, and it is literally 100% as effective now as it was when I started taking them. IMO most people tend to raise their dose when they stop feeling the punch that benzos pack, but just because it isnt getting the user high doesnt mean it's not working just as effectively for treatment of their condition. The body adapts to the drug and stabilizes, just like every other psych med out there.
 
I agree
I take 3mg alprazolam a day and I have found only a very small drop if efficacy as well, and this is with the short-acting benzos. Been taking em for years. While I have noticed a drop in the actual feeling of relief or "high" I get, it still negates my anxiety and keeps me stable. I am prescribed it for my stomach oddly enough, for IBS-D, and it is literally 100% as effective now as it was when I started taking them. IMO most people tend to raise their dose when they stop feeling the punch that benzos pack, but just because it isnt getting the user high doesnt mean it's not working just as effectively for treatment of their condition. The body adapts to the drug and stabilizes, just like every other psych med out there.

Yeah, I mean we all know benzos have risks but I think some people over exaggerate them.

I REALLY hope though that i can someday get off my KLonopin (mostly just cause it makes me tired sometimes and don't always want to need it) and really hope that if it has done long term permanent damage of any kind that at least it would not be the kind of extensive damage that would mess with my quality of life, like memory problems or long term worsening of anxiety or depression etc...

One thing I tend to wonder that you might have an opinion on, is that like I said, I was able to get off of it for 9 months with pretty much zero WD, but had to get back on it because my anxiety returned, and I am hoping that the anxiety returning was not a WD effect or even worse, a long term brain change in terms of worsened anxiety, and just the same anxiety returning.

I tend to doubt it was a WD effect because actually for about the first 2 months off of it, maybe even 3, I did not have my anxiety return (or really ANY noticeable WD), and it wasn't until around the 3rd month and on up until the 9th that the anxiety showed up.

I also think it would be hard to prove it was a worsening of anxiety or long term damage leading to it because it was just exactly the same sort of anxiety I had always had before taking it and which caused me to start taking it in the first place.

It wasn't necessarily worse anxiety (or less severe) than it ever had been before I took Klonopin, it was just that same bad anxiety that I needed it for in the first place.

What do you think?

Do you think it was just the re-surfacing of the anxiety I hadn't had because I was on the meds, or do you think even at 3 months it could still have been WD or some kind of worsened long term brain effect from taking it?
 
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@Mycophile
I can guarantee you had some degree of WD, but it didnt sound very bad luckily. You were one of the lucky ones especially for your length of use. The delayed onset of anxiety sounds like it might have been post acute withdrawal syndrome "PAWS". After the 3 month mark of abstinence of most drugs especially opiates and benzos, there tends to be a series of psychological withdrawal symptoms such as anxiety and insomnia and depression. These symptoms usually last around 3-6 months but in some individuals they can persist for ove a year. I havent looked into PAWS too much, but my thought is that the brain is repairing itself slowly. After the acute WD is over, your brain is still chemically imbalanced and PAWS is the process of the brain regaining it's natural chemical balance without the drug.
 
@Mycophile
I can guarantee you had some degree of WD, but it didnt sound very bad luckily. You were one of the lucky ones especially for your length of use. The delayed onset of anxiety sounds like it might have been post acute withdrawal syndrome "PAWS". After the 3 month mark of abstinence of most drugs especially opiates and benzos, there tends to be a series of psychological withdrawal symptoms such as anxiety and insomnia and depression. These symptoms usually last around 3-6 months but in some individuals they can persist for ove a year. I havent looked into PAWS too much, but my thought is that the brain is repairing itself slowly. After the acute WD is over, your brain is still chemically imbalanced and PAWS is the process of the brain regaining it's natural chemical balance without the drug.

But the thing is, how can you necessarily say that it was either 100% a WD effect, 100% returning of the very same symptoms of anxiety, or a little of both??

I get what you are saying, so I guess unfortunately chances are that at least SOME of the anxiety was a WD effect, but at the same time, wouldn't it be most likely that some of it was also just the return of the same anxiety that had been masked by the benzos for so long since it was the exact same type of social anxiety I was taking them for in the first place, and there's really no reason to believe I wouldn't still have that anxiety while off the meds??

Seems like the strong bet is that it was the return of the same anxiety that had not gone away but just been masked by the Klonopin, but perhaps that also some of it was a WD effect to some extent, but if it was really PRIMARILY a WD effect wouldn't I have had other symptoms of WD other than ONLY the EXACT same type of social anxiety symptoms I'd had in the first place that I took the Klonopin for??

Seems I'd at least have had ONE other WD/PAW symptom other than ONLY the same anxiety as before doesn't it??


See, IF the anxiety I got was even 50% a WD symptom (which I'm not sure it was) then that would bother me cause then that means that maybe I could have continued to stay off of the Klonopin had I just not given in and eventually that anxiety would have subsided, but I honestly don't believe that's the case as we all know benzos don't cure anxiety and if I needed them in the first place for the anxiety then it makes sense that the anxiety would still be there once off of the Klonopin...

So...yeah, I'm interested to know what you think, but while I agree it's unlikely that PAWS was not even a SMALL factor in the equation, I tend to think that much more of the anxiety had to do with the same old anxiety returning in the first place once the Klonopin was no longer there to mask it, and that had it been PRIMARILY an after effect/WD symptom then I'd have had some others OTHER than just the exact same kind of anxiety as before...


Also, you mentioned depression and insomnia as WD effects but I did not have anxiety or depression...in fact, my mood and energy levels were higher off the benzos (no surprise as they make me tired and sometimes depressed and that's why I want to get off if possible) and my sleep was better than before, it was ONLY the anxiety that returned.
 
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