Upcoming visit to a Narcologist

[kreativsniks]

Hi fellow Bluelighters,

Title of this topic may sound weird for many of you, I'm sure, because as far as I know, a Narcologist is a name for specialist which deals with addictions/substance abuse. This type of Doc is commonly found in former Soviet Union states and Russia. With that said, in reality, I guess it's just a fancy term for a psychiatrist specialized in drugs. My appointment is due in 3 weeks and I want to be as prepared as I can, because that specialist is quite expensive. From reading this forum for years (and, unfortunately, posting quite rare), I know many of you guys are very knowledgeable and maybe you can help me sort this out.

So, I was a long time weed smoker (15 or so years), for years on end I only used weed and it was a 'complete package' for me, I didn't need any other drugs (apart from a few flings with speed here and there during parties). As time went on, I grew older, got a respectable job and good income and started to notice that my little weed habit was making me too complacent, was destroying my drive, killing my memory; you know, the usual weed side effects. About 4 years ago I started to try to kick my weed habit with various success; I'd stop cold turkey and then suffer terrible insomnia for at least 4 weeks before starting to barely sleep; I had many attempts, but always relapsed after 3-4 months and was back to smoking a G a day (to keep Doc at bay, haha)..

About 2 years ago I decided that I need some other drugs to help with my insomnia from weed withdrawal; and so Benzos entered my life.. (I know, I know.. that was very stupid decision), I would try different Benzos and felt that they don't kill my motivation, they kill my anxiety, sort-of-kind-of helped with my depression too; while taking Benzos I could easily stop smoking.. but the problem is, I got addicted to Benzos which by itself is one of the worst addictions one can get.. my favorite Benzo being Diazepam and Clonazepam; I'm currently taking 2mg of Clonazepam (1mg during day, and 1mg at the evening), I'm also taking Bupropion (Wellbutrin SR 150mg/d), which helps with energy & motivation, but unfortunately it's making me more anxious too.

I wonder how addiction specialists deal with addicts like me? I know the famous Ashton manual, but my gut feeling tells me that the Doctor I'm going to visit is not going to prescribe me Diazepam; Instead, I think she will push for another anti depressant (possibly an SSRI) and maybe some antipsychotic drug like flupentixol or quetiapine; I've tried both drugs and I hate them, they make me dumb, make my brain foggy and generally I feel like a vegetable. Benzos on the other hand feel more 'clean' and efficient, but I don't want to be addicted to them for life, knowing that long term they're going to do a lot of damage to my already damaged brain.. I know that the current medical guidelines are against Benzos (which makes sense), so they push for something like an SSRI+antipsychotic drugs instead, at least in Eastern Europe where I'm from..

I guess what I want to ask is what are other pharmacological options besides anti depressants and anti psychotic drugs to use to kick the Benzo habit for good? Apart from pharmacology, my diet is very good, I'm physically fit, I work out 3-4x times per week and I'm planning to see a CBT (or something similar) therapist to hopefully cure my trauma which lead to my addictions in the first place..

Kind of conflicted feelings I have; I want to be sober, but when I'm sober for some months I always suddenly relapse, like, everything is good and then one day my mind starts to wonder => what's the point of being sober if I can't get some chill, I've done all my duties, my work, my bills etc. and then I relapse... so suddenly, like some switch turns on which makes me use something.. which is usually weed or Benzos.. or both.. I can't use weed responsibly, only abuse or not use at all; with Benzos it's stable dosage and no abusive dosages, but I have to use them daily..

I feel like I'm going into circles with all this, juggling from one drug to another and not being able to sober up.. so yeah.. for past 2 years I'm on daily Benzos, I've recently kicked (again) my weed habit.. so there's that at least..

Would appreciate some if you could give me some perspective (your experience) and perhaps help me prepare for my upcoming Doctor visit, e.g. some ideas of potential drug regiment I could use to sober up from what I'm using now (Benzos).

I'm sorry that this post is kind-of chaotic and long; I have a lot on my mind, I'm a bit scared and I wanted to vent and there is really nobody I can talk to about all this except you guys..

Also, excuse me for my broken English, it's my 3rd language (after Latvian and Russian)..

Anyway.. I really love this forum and have been reading it on/off for the last 10 or so years..

 

[jasperkent]

Sorry, I don't have any advice for you except to be honest with your doctors.

I really just wanted to tell you that your English is quite good-- better than that of most Americans I know!

Incidentally, I was raised by an English teacher with a PhD in Education.

 

[cdin]

ashton tapering is effective. I would push for a switch to diazepam and a taper. I would supplement that taper w amanita muscaria and kava to smooth it out.

 

[BK38]

ashton tapering is effective. I would push for a switch to diazepam and a taper. I would supplement that taper w amanita muscaria and kava to smooth it out.

I'd also add Kratom to that list to smooth things out.

 

[cdin]

I'd also add Kratom to that list to smooth things out.

with the caveat not to take kratom more than a couple times a week at the very most, or you will just wind up with an opioid habit as well.

 

[BK38]

with the caveat not to take kratom more than a couple times a week at the very most, or you will just wind up with an opioid habit as well.

Well said, it's all about the balance.

 

[hydroazuanacaine]

don’t take kava. certainly don’t take kratom. while additional psychiatric drugs might help with whatever issues were leading you to self-medicate, comfort drugs do not play a significant role in getting off benzos.

just taper. the only way to get off benzos is a slow taper. i would prefer switching to diazepam, but clonazepam can also be used to taper.

 

[Mjäll]

Benzos just need a taper. Not a huge dose anyway. You'll be able to manage that, i think.

If you want to change psychologically, psychedelic and dissociative drugs are tools available for that. These drugs can be used to break habits, such as your weed habit. Personally i like my weed habit but with the help of psychedelics and dissociatives i have managed to change other things that i was motivated to change, such as persistent depressive thought patterns.

Also i want to chime in with cdin on Amanita muscaria. It's an interesting GABAergic alternative, more recreational and mystical than benzos.

 

[neversickanymore]

Your English is far superior to mine and probably always will be.

I don't sugest tapering with the aid of kratom. This may.. may have some positive effects, but I don't think they will be of much help and as has been pointed out often lead to opiate dependence and addiction. Opiate addiction and dependence usually go very well with benzo dependence. so a likely outcome is you could just add opites to your list of problematic substances

Kind of conflicted feelings I have; I want to be sober, but when I'm sober for some months I always suddenly relapse, like, everything is good and then one day my mind starts to wonder => what's the point of being sober if I can't get some chill, I've done all my duties, my work, my bills etc. and then I relapse... so suddenly, like some switch turns on which makes me use something.. which is usually weed or Benzos.. or both.. I can't use weed responsibly, only abuse or not use at all; with Benzos it's stable dosage and no abusive dosages, but I have to use them daily..

I feel like I'm going into circles with all this, juggling from one drug to another and not being able to sober up.. so yeah.. for past 2 years I'm on daily Benzos, I've recently kicked (again) my weed habit.. so there's that at least..

This is typical, Its an addictive cycle




They are similar, but as you relapse when things are going well, so your a"positive relapser"

We need to identify the patterns of our additive cycles and learn strong techniques to treat parts of the cycle and thus skip other parts all together.


You can do this!

 

[cdin]

don’t take kava. certainly don’t take kratom. while additional psychiatric drugs might help with whatever issues were leading you to self-medicate, comfort drugs do not play a significant role in getting off benzos.

just taper. the only way to get off benzos is a slow taper. i would prefer switching to diazepam, but clonazepam can also be used to taper.

i agree with the kratom advice, it's not truly helpful and carries too many downsides.

but kava and amanita were absolutely instrumental in my benzo taper, and go a long way to facilitating transmission at GABA-A sites.
i also agree diazepam would be the preferred agent for titration.

 

[interrapax]

Would appreciate some if you could give me some perspective (your experience) and perhaps help me prepare for my upcoming Doctor visit, e.g. some ideas of potential drug regiment I could use to sober up from what I'm using now (Benzos).

Opioids are my problem so I don't know any specific meds for coming off benzos but my advice is this: if whatever meds your doctor puts you on isn't working, don't give up or get frustrated. Go back to him or her and ask to try another one. It can often take trying 2 or 3 different meds before you find something that works for you (especially when it comes to those which treat anxiety and depression, which I'm guessing are the root causes of your drug use).

Reading stories like yours inspires me, even if you're just getting started. I'm in the same position. (By the way, your English is incredible.)

Good luck friend.

 

[kreativsniks]

Guys, I wanted to thank you all for posting replays and cheering me up and giving me a perspective on things; I really, really appreciate it! Much love to y'all! Since making this topic I have also found a therapist and set a date (after hesitating to do it for... very long time, being afraid when I shouldn't) for my first meeting.
Reading this forum and other peoples struggles and insights have given me courage to do this; I know there is a long, long way ahead to sort all this out, but hey - getting on top of that mountain starts with taking those important first steps.

Once again => Much love to y'all! :*

 

[kreativsniks]

It's been a while and I thought I'd revive this thread (in case someone sometime is searching for helpful info/other peoples experiences regarding Benzos w/d) and briefly share how my first visit to the addiction Doc went.

For context, last couple of weeks been taking various Benzos (Bromazepam/Clonazepam/Diazepam/Alprazolam), basically, going "by the feelz" on particular day.. so pretty much mixing them up some days, and sticking with one on other days, not smart, but it is what is is when one is addicted; as of recently, started supplementing with some 300mg's of pregabalin before bed (sleep got better compared to just Benzos which are still helpful for anxiety, but doesn't do much for sleep).

Anyway, today was my long waited appointment. Spend some good 1/2 of my consultation talking about different modalities (read - meds) which are prescribed for Benzos w/d. Doc gave me two options, either it's stationary (12 days in hospital for a rapid detox), which I promptly declined, or out-patient taper which is slower (which I opted for, obviously). I know from Ashton manual and other people experiences, that w/d from Benzos is better done slowly than rapidly if situation permits.

We set a following protocol, with a starting dose of 35mg/diazepam per day, with some additional meds:

Morning => Wellbutrin SR (150mg), been taking this for past 2 months, so this is staying for the time being; if necessary, Doc said Brintellix is novel AD which is better than regular SSRI's (have 0 experience with it, so can't really comment); Sodium Valporate (Depakote)* 250 or 500mg and 10mg Diazepam

Midday => 10mg Diazepam

Evening => 15mg Diazepam, 50mg Quetiapine**, 500mg Valporic acid.

*Since I have no experience with Sodium Valporate, Doc said I shouldn't take it at first in the morning, since it can make me groggy/foggy, i.e. not suitable for my employment.
** 50mg Quetiapine can be split and 25mg taken; I've used this med before and didn't like it at all, AFAIK I took some 100mgs and next day was so groggy that couldn't function properly. Now it could be me taking too much or me reacting badly to this med, or -> me not being used to it; I'll give it another shot.

The Diazepam taper is taking off 5mg each week (with the condition that side effects are tolerable and generally I feel functional). I told the Doc that it is paramount for me to be sharp in the morning, Benzos don't make me sloppy (apart from glitches in my memory here and there), so I'm naturally wary of other stuff like anti-psychotics (Quetiapine) and Sodium Valporate (anti epileptic drug).

Quetiapine was chosen because it seems like this med is modern day go-to drug for people with insomnia (me), it's not a Benzo, so.. Doc think it has less abuse potential and it's not euphoric and not harmful when taken in 25-100mg dosages for sleep (I wouldn't be so sure about this, but I ain't no Doc).
Sodium Valporate was chosen for the supposed anti-anxiety benefits, reducing my Benzo intake will make me more anxious during morning/day and this should somewhat help.

My next appointment is due in 2 weeks; Will report with Doc how I like this med combo, if I can be functional on it; if not, we will be looking for other pharmaceutical alternatives.

If Mods are not against, I'd like to keep updating this topic with relevant info regarding how my relationship with Benzos is concluding.

Thanks to everyone spending time reading my topic/post and have a nice day/evening my fellow BlueLighters!

 

[interrapax]

Speaking for myself I'd love to hear more updates down the track. Best of luck friend!

 

[Painful One]

Great work @kreativsniks
That was courageous and a very hard step to take.

Sounds like you are doing really good.
Just switching from clonazepam to diazepam is a big difference l

Keep going!
Ya!

 

[BK38]

Benzos just need a taper. Not a huge dose anyway. You'll be able to manage that, i think.

If you want to change psychologically, psychedelic and dissociative drugs are tools available for that. These drugs can be used to break habits, such as your weed habit. Personally i like my weed habit but with the help of psychedelics and dissociatives i have managed to change other things that i was motivated to change, such as persistent depressive thought patterns.

Also i want to chime in with cdin on Amanita muscaria. It's an interesting GABAergic alternative, more recreational and mystical than benzos.

Exactly what I’m doing, 40mg Valium habit, cutting 5mg every day, then I’ll switch to phenibut once I’m in the 5mg diazepam range. Trade my NSAIDs for Kratom and smoke CBD

 

[kreativsniks]

A little update a week in.
Things haven't been going as smoothly as I initially (but cautiously) expected.

Although, the taper plan set by Dr. makes sense (by reducing diaz by 5mg each week), the other two medications prescribed I could tolerate for 4 days.
The problem was massive brain fog and generally feeling very weird and "not being myself" (for a lack of a better explanation); Initially, on the first day I took 50mg quetiapine and 500mg Depakine, the 2nd day I noticed that I can't wake up in time for work and when I did - I didn't feel like I had a good nights (restful) sleep.

2nd day, I cut quetiapine to 25mg's, Depakine stayed at same -> 500mg's before bed. Still, next day woke up groggy and again - missed start of work (waking up was never a problem for me) and same -> long hours of sleep, but not a restful sleep (which in my mind is a waste of time).
3rd and 4th days I stayed at 25mg's of quetiapine and 500mg Depakine and results were the same -> massive brain fog, weird emotional state, waking up in a bad mood.

I know that some (if not many) medications require some adjusting time and I've been struggling with being compliant taking these types of meds since I remember myself; as a (recovering) addict, perhaps, it's part of my (biased) thinking that only stuff which I can tolerate/makes me feel good/feel NOT bad I tend to use recreational or therapeutic. Perhaps, if I had continued taking quetiapine and depakine for said 2 weeks, my body would've adjusted, but.. I didn't.

Would like to add that after stopping quetiapine and dekapine (and wellbutrin too) the difference has been pretty significant; my head has been much clearer, waking up is pretty easy and very importantly for me - I don't feel foggy/sluggish/bad mood upon waking up. I guess what I'm trying to say is that probably for many people the previously mentioned med combo works great (and AD combined with epilepsy med, combined with an anti-psychotic), but my body & mind is not playing well with this modern psychiatry trifecta approach.

So, how do I proceed with this going further? I'll stick to my taper plan, via reducing BZD by 10% each week until I hit 5-10mg Diaz/day. Around that time I will re-introduce a med which has worked for kicking my BZD habit before - pregabalin (300mg before bed or 150mg day & 150mg night, depending on how cloudy it will make me, if it's too cloudy during the day, I will use it only after work). After stopping Diaz completely, I will continue using Pregabalin for ~3-4weeks and then either taper that to 150mg's day or get 75mg caps and do a split AM/PM.

My body tolerates Pregabalin pretty good, I get a decent nights sleep while taking it and there is very little brain fog/weird feeling in the morning which subsides after about 2 hrs and a strong cup of coffee.

As promised, I will keep posting here since I know there are plenty of BZD addicts around here and having a honest log of a fellow addict of what has worked and what - wasn't for me might help someone else looking for info on how to sober up in a safe way.

 

[kreativsniks]

It's been a while since the last time I've even mustered strength to open this forum and share my experience; The reason is very simple -> I relapsed and very hard at it. Let me share a little how it all went down from a reasonable progress I had made since I made the last post back in end of November 2022. I got my BZD reduction till 15mg/day + some 300mg pregabalin before bed. Then life happened (as it always does, innit?), I got into some pretty uncontrollable coke binge which, of course, stopped all my progress; within a week, I was popping Xannies 3-4mg/day just to comedown from Coke binges which were, basically, a daily thing (up to a G a day). Since I'm not fond of alprazolam in general because of my personal chemistry, I switched to clonazepam which is now going up to 4mg's a day.

Currently, I'm on and off with blow binges, but after doing it proper for past few months, I guess I've done everything is to be done while cocked out - lots of sex, lots of emotional talking with close people to me (a few of positive coke side effects), it helped me open up my emotions and actually fix some relationships. Of course, none of that is an excuse to do excessive blow like I did. Other than few positives, I'm amazed at how destructive this substance is; Perhaps the closest to feeling this toxic/unhealthy was back in the old days when I was young and abusing speed. But I'm going off topic with this so, let's stay on course.

As ashamed as I feel typing all this, I'm sure many of y'all can relate to how easy is to slip, relapse and destroy all the little progress I had made. My original aim to wean off BZD's is still relevant, I won't surrender until I make it; it will probably take much longer than I would like it to, but.. it is what it is.. The biggest problem is staying consistent and not going astray and relapse, because one session of blow can easily erase all BZD progress and jack up my tolerance (like it did).

I also stopped going to my therapist, because after visiting him for like 3-4 times, I felt that we didn't click they way I was expecting I guess; We managed to analyze my childhood a bit, managed to come up with some possible explanations where my childhood trauma might be coming from, but overall I felt that he is more into talking in general than, perhaps, applying specific therapeutic techniques (like CBT at least?); so after like 2 sessions I felt that there is nothing I really want to talk to him about. Sine this was my first therapist, it is pretty normal that I need to try others, because there definitely is a therapist out there who will click with me the way I expect/want

I'm also looking for a new psychiatrist who will prescribe me diazepam so I can start slowly my taper again (and after doing 4mg's of clonazepam/day, I will require A LOT of diazepam initially). The thing I'm nervous about is how to reduce these stupid, spontaneous urges to do blow from time to time which each time pulls me in like a devil and I do it for like a week minimum, which is expensive and very unhealthy.

I'm hoping that by finding a new psychiatrist and therapist, combined with the right anti depressants (something SSRI like to make me less spontaneous), It will help greatly to reduce these urges and a proper therapist will teach me some useful skills how to better handle situations where I'm about to relapse (which, usually, come very unexpected and aren't triggered by any specific event or place).

So yeah guys and gals, I'll be honest, looking back at Nov 2022' and now is March 2023, these months between my posts have been pretty terrible, so much progress can be made within that timeframe, but I did NONE; and, honestly, it's been very discouraging, but what choice do I have other than keep trying, trying and trying..

I wish I could be the one of rare good examples here where a person manages to kick this stupid habit and it motivates other people to try and shows them that it's possible; yet, here I am, back at square one.

 

[smokeymcpot42088]

I just want to thank you for explaining 'narcologist' up front I woulda read till I found it or asked.

 

[usual-suspect]

So yeah guys and gals, I'll be honest, looking back at Nov 2022' and now is March 2023, these months between my posts have been pretty terrible, so much progress can be made within that timeframe, but I did NONE; and, honestly, it's been very discouraging, but what choice do I have other than keep trying, trying and trying..

Any updates/progress? I don't think you are in the wrong path

I'd say relapses and setbacks are the bread and butter in any recovery progress. Don't let that erode your determination.

In my personal experience, I am not veryfond of benzos, but I appreciate the to help come down from cocaine. And is preciselly with cocaine abuse where I've been closer to abuse benzos daily. I mean: I feel cocaine is a benzo addiction detonant/helper so be carefully with that, as well as careful with the coke itself, of course.