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Benzos Chronic (therapeutic) benzo use vs chronic Alcohol use

BzCurio

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Which is going to be worse?

I ask because I stumbled across a very interesting study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321276/

...studies have shown that tolerance to the sedative and hypnotic effects occurs rather rapidly, followed by tolerance to the anticonvulsant effects, whereas tolerance to the anxiolytic effects of benzodiazepines are absent or partially develop after long-term treatment.

Furthermore, additional studies all show a continuing anxiolytic effect, at least for panic disorder [69–72], generalized anxiety disorder [73], and social phobia [74–76]. In conclusion, there is no solid evidence from the existing literature that anxiolytic efficacy declines following chronic benzodiazepine use in humans.

Importantly, there is no convincing evidence that tolerance occurs with (a) subunit subtype-selective compounds acting at the benzodiazepine site.
It seems a tolerance is developed to the sedative and hypnotic effects to benzos, which makes users think they are no longer working (subsequently upping their dose). However, there is no evidence that a tolerance ever develops to the anxiolytic effects and a therapeutic dose can be maintained.

Benzos also decrease circulating levels of cortisol, the stress hormone which is linked to many long term health problems. Yet again long term users (median 26 months) showed no tolerance to this effect: https://www.ncbi.nlm.nih.gov/pubmed/20520289

"long-term BZD use is not convincingly associated with HPA(cortisol) axis alterations"

Then we have withdrawal, which is always of concern. But at a therapeutic dose you haven't exactly dug yourself into a deep hole, and straight from Dr. Ashton herself: https://benzo.org.uk/manual/bzcha02.htm withdraw when done correctly (ie, not a viciously rapid detox) can be next to asymptomatic.

Many people are frightened of withdrawal, but reports of having to "go through hell" can be greatly exaggerated. With a sufficiently gradual and individualised tapering schedule, as outlined below, withdrawal can be quite tolerable, even easy, especially when the user understands the cause and nature of any symptoms that do arise and is therefore not afraid. Many "withdrawal symptoms" are simply due to fear of withdrawal (or even fear of that fear). People who have had bad experiences have usually been withdrawn too quickly (often by doctors!) and without any explanation of the symptoms. At the other extreme, some people can stop their benzodiazepines with no symptoms at all: according to some authorities, this figure may be as high as 50% even after a year of chronic usage.

Yet the stigma around benzos continues to claim they are ineffective long term. There is even speculation that benzos were so effective in the treatment of anxiety that they proved damaging to the business model of upcoming SSRI's, thus ensued the propagation of a smear campaign to push a "benzo-crisis":



Now lets compare this to Alcohol, where mechanism of action is similar as well as withdrawal. Yet is also neurotoxic and nukes your entire body with negative risks.


For men, it is defined as no more than 4 drinks on any single day and no more than 14 drinks per week. For women, low-risk drinking is defined as no more than 3 drinks on any single day and no more than 7 drinks per week.


Surely I am missing something here. They both act similarly on the brain in terms of GABA, so how can chronic alcohol use have a "low-risk" range, but benzos (being much cleaner across the board in terms of damage to the body) be so bad long term, even at therapeutic doses?
 

Phobos

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Alcohol is a direct agonist at the GABAA receptor, benzos do not directly bind to GABAA receptors but act as positive allosteric modulators.
Gabapentinoids (Phenibut, Gabapentin, Pregabalin etc) directly bind to the GABAB receptor.
That's a difference in the method of action that I know about, but I do not have how much tolerance one can develop with a usage of alcohol considered medically acceptable.
I have read reports that there are doctors that will allow patients to work their way up to dosages significantly higher than the recommended effective dose, and that some quite simply give a benzo script and say "take as needed" without warning about the potential for psychological and physical addiction and how hard it is to get off this drugs once you are hooked.
 

BzCurio

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I have read reports that there are doctors that will allow patients to work their way up to dosages significantly higher than the recommended effective dose
I 100% agree this is a problem

and that some quite simply give a benzo script and say "take as needed" without warning about the potential for psychological and physical addiction and how hard it is to get off this drugs once you are hooked.
I also agree this is a problem, but how difficult it is to get off is fairly subjective. Even the Ashton manual says withdrawal does not have to be hell, and many tapers are asymptomatic. Withdrawal has such a bad reputation because

1. Detox centers which restrict your access to meds give you nothing but anticonvulsants and let you go into severe withdrawals over 7-10 days so they can get you out of there as quickly as possible.
2. Street users, knowing nothing of the drug, will take large amounts recreationally and stop cold turkey.

These two scenarios lead not only the user but anyone who witnessed the events to swear by "evil" benzos.

Here's the thing: If doctors made patients more aware of the dependence and risk of withdrawal they would be less likely to request an increase to their dose. Then, if it comes to withdrawing, a proper tapering schedule can be used that doesn't put the patient through 2 weeks of hell, instead utilizing 6-8 weeks of calculated dose reduction.


Then we get to the real question, what is actually worse? 2-3 beers a night or 0.5-1mg Klonopin?
 

Phobos

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I'm afraid it's not as simple as that... We needs to also check which drug has he most potential to make you want to increase dosages.
 

Mycophile

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I 100% agree this is a problem


I also agree this is a problem, but how difficult it is to get off is fairly subjective. Even the Ashton manual says withdrawal does not have to be hell, and many tapers are asymptomatic. Withdrawal has such a bad reputation because

1. Detox centers which restrict your access to meds give you nothing but anticonvulsants and let you go into severe withdrawals over 7-10 days so they can get you out of there as quickly as possible.
2. Street users, knowing nothing of the drug, will take large amounts recreationally and stop cold turkey.

These two scenarios lead not only the user but anyone who witnessed the events to swear by "evil" benzos.

Here's the thing: If doctors made patients more aware of the dependence and risk of withdrawal they would be less likely to request an increase to their dose. Then, if it comes to withdrawing, a proper tapering schedule can be used that doesn't put the patient through 2 weeks of hell, instead utilizing 6-8 weeks of calculated dose reduction.


Then we get to the real question, what is actually worse? 2-3 beers a night or 0.5-1mg Klonopin?
I really like this post and I really agree.

Now, granted, I want to get off my Klonopin if I can because it makes me very tired and I think it has POSSIBLY increased my depression, but it has also allowed me to face social situations and work situations I could not otherwise because of my anxiety.

I am aware of the dangers that CAN result from long term benzo use, but they don't ALWAYS happen, nor do I necessarily believe they even happen 50% of the time, and I've been on Klonopin enough years that certain posters here have so nicely said things like "I am sure the damage is extensive". It's like "thank you very fucking much! You do NOT know that the "damage is extensive". Maybe it is, maybe it isn't. But even this forum, which I really like, goes WAY overboard I believe with talking too much about the dangers of benzos and not enough about how they CAN in the RIGHT contexts be INVALUABLE tools for anxiety if NOT abused, and they have been for me.

The thing is, recreational use and medical use are different animals and if you are using them, like I am, for anxiety that has not been treatable by other means, people kind of disregard the damage that your anxiety disorder can do to your life and ONLY consider the dangers of the drugs you are taking.

I mean, me personally, I think of this forum as BOTH a drug forum and a mental health forum. We have a mental health section, and I'd guess a large percentage of us users have some kind of psychiatric condition, whether diagnosed or not, and it's not quite fair to disregard the help that certain drugs can give people with these issues and throw the baby out with the bathwater in the way I have seen SOOO many people "bash evil benzos" as you have said.

I DID have an "asymptomatic taper" just as you mention, and I know it was PURE LUCK and that the doctors fucked up, and wouldn't expect it to happen again, but it did happen.

I had already been on 1.5mgs of KLonopin daily for 11 years and a messed up doctor cut me off, then a messed up hospital fucked up my taper and didn't even give me one.

The psychiatrist at the hospital said "you don't need a Klonopin taper. Klonopin is a long acting benzo so it just tapers itself. Just kind of divide up the rest of what you have in your bottle into whatever kind of small taper you want, taking gradually less per day till you run out, and you will be fine."

WHAT KIND OF BULLSHIT IS THAT??!!

Am I wrong or was that doctor not GROSSLY negligent??!!

BUT...he ended up being right that I had ZERO withdrawal even after 11 years on it.

I don't know how it was so easy as I was expecting hell. I just remember ONE day where I felt kind of sick like I am might be coming down with something for like probably around 4 hours give or take, and then it passed, and every other day I felt 100% fine. I'm not even sure what day that was in terms of how many I'd been off the Klonopin, nor can I even really be sure it was Klonopin WD as it was so vague and short lived without returning.

Unfortunately, after 9 months of being off Klonopin my anxiety came back and nothing else would work to get rid of it and I had to get back on them.

I want to taper off, but only if I can find something else that works for my anxiety.


But MEDICINAL benzo use AS PRESCRIBED cannot POSSIBLY be as dangerous as serious alcohol abuse, and I'd doubt that even the most reckless recreational benzo-binging (BY ITSELF NOT MIXED WITH OTHER DRUGS) is as dangerous as the most reckless drinking is:

Drinking obviously damages the liver which I don't think benzos do, I have heard it can even lead to cancers, it either puts on weight which is unhealthy, or at it's worst makes you lose an unhealthy amount of weight, and I'm sure the brain damage it does is as bad or worse than benzos.

I wish more people could BOTH acknowledge how helpful benzos are and at the same time their POSSIBLE dangers without talking about them as if they are the worst things on earth.

I actually have seen more people on this forum say that Heroin use is not all that bad as I've seen people talk about the horrors of benzos, and while yes yes, I know that AT ITS' WORST benzo WD can kill you (I was told by doctors at the hospital that 1.5mgs a day of Klonopin is not enough to cause death and you need to be getting in the 4mg range for that risk) and heroin WD can't kill you......in practically every other way Heroin is more dangerous.

And in over a decade of using Klonopin I have NEVER NEEDED TO INCREASE MY DOSAGE for my anxiety.

In fact, usually 1mg is sufficient and sometimes even 0.5 even though I'm prescribed 1.5.

I've also never really understood how people use Klonopin recreationally as it does not and cannot possibly get me high (I know I've taken larger doses before and they sucked...) and I'm glad it doesn't cause if it could I would as I'm a typical poly substance abuser.

I never have a desire to take more in terms of getting any buzz or anything, only if I need more for anxiety or more to help me fall asleep, as they are also prescribed for sleep.

I haven't take other benzos though other than Lorazapam which also did not get me high, but I have heard people say that Xanax is a different beast and will get anyone high, so I can't speak to whether or not someone like me would raise a Xanax dose for a buzz, but I certainly don't chase any high with Klonopin as there is no high to be had there for me.

Maybe people who don't have anxiety feel the anxiety relief as some kind of high, but for me it's just easing the discomfort from a symptom.
 
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BzCurio

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I'm afraid it's not as simple as that... We needs to also check which drug has he most potential to make you want to increase dosages.
But now we're talking recreational value. Benzo's vary in this department. It is fair to say someone using Xanax may be more inclined to chase the high, but lowly euphoric benzos just tend to make you sleepy if you dose higher.

While we're at it, since we're comparing with alcohol - it has euphoric properties and a "buzz" to chase.


The thing is, recreational use and medical use are different animals and if you are using them, like I am, for anxiety that has not been treatable by other means, people kind of disregard the damage that your anxiety disorder can do to your life and ONLY consider the dangers of the drugs you are taking.

I mean, me personally, I think of this forum as BOTH a drug forum and a mental health forum. We have a mental health section, and I'd guess a large percentage of us users have some kind of psychiatric condition, whether diagnosed or not, and it's not quite fair to disregard the help that certain drugs can give people with these issues and throw the baby out with the bathwater in the way I have seen SOOO many people "bash evil benzos" as you have said.
Great point. In many cases dose is the difference between medication and "drug". Adderall becomes closer to meth the more you increase the dose, but we give microdoses to children?

I DID have an "asymptomatic taper" just as you mention, and I know it was PURE LUCK and that the doctors fucked up, and wouldn't expect it to happen again, but it did happen.

I had already been on 1.5mgs of KLonopin daily for 11 years and a messed up doctor cut me off, then a messed up hospital fucked up my taper and didn't even give me one.

The psychiatrist at the hospital said "you don't need a Klonopin taper. Klonopin is a long acting benzo so it just tapers itself. Just kind of divide up the rest of what you have in your bottle into whatever kind of small taper you want, taking gradually less per day till you run out, and you will be fine."

WHAT KIND OF BULLSHIT IS THAT??!!

Am I wrong or was that doctor not GROSSLY negligent??!!

BUT...he ended up being right that I had ZERO withdrawal even after 11 years on it.
He was half right, i'd say. at 1.5mg your chances of having a severe withdrawal are honestly pretty slim, a seizure even slimmer unless some DNA whack is at play. It has a long lasting with a halflife of 60-70hours. It takes 7 halflives for a drug to clear from your system.

Was it the best way to do it to ensure you didn't have a bad time? Definitely not, a taper would have been a good safety precaution. But this is not the first time I've heard of a cold turkey stop on sub 2mg of Klonopin being asymptomatic.


people kind of disregard the damage that your anxiety disorder can do to your life and ONLY consider the dangers of the drugs you are taking.

I mean, me personally, I think of this forum as BOTH a drug forum and a mental health forum. We have a mental health section, and I'd guess a large percentage of us users have some kind of psychiatric condition, whether diagnosed or not, and it's not quite fair to disregard the help that certain drugs can give people with these issues and throw the baby out with the bathwater in the way I have seen SOOO many people "bash evil benzos" as you have said.

Unfortunately, after 9 months of being off Klonopin my anxiety came back and nothing else would work to get rid of it and I had to get back on them.

I want to taper off, but only if I can find something else that works for my anxiety.


But MEDICINAL benzo use AS PRESCRIBED cannot POSSIBLY be as dangerous as serious alcohol abuse, and I'd doubt that even the most reckless recreational benzo-binging (BY ITSELF NOT MIXED WITH OTHER DRUGS) is as dangerous as the most reckless drinking is:

Drinking obviously damages the liver which I don't think benzos do, I have heard it can even lead to cancers, it either puts on weight which is unhealthy, or at it's worst makes you lose an unhealthy amount of weight, and I'm sure the brain damage it does is as bad or worse than benzos.

I wish more people could BOTH acknowledge how helpful benzos are and at the same time their POSSIBLE dangers without talking about them as if they are the worst things on earth.

I actually have seen more people on this forum say that Heroin use is not all that bad as I've seen people talk about the horrors of benzos, and while yes yes, I know that AT ITS' WORST benzo WD can kill you (I was told by doctors at the hospital that 1.5mgs a day of Klonopin is not enough to cause death and you need to be getting in the 4mg range for that risk) and heroin WD can't kill you......in practically every other way Heroin is more dangerous.

And in over a decade of using Klonopin I have NEVER NEEDED TO INCREASE MY DOSAGE for my anxiety.

In fact, usually 1mg is sufficient and sometimes even 0.5 even though I'm prescribed 1.5.
As someone else who has had their life turned around by benzos I wholeheartedly agree. The reputation these drugs are getting terrifies me that I may one day lose my script to an over zealous anti-benzo doctor. Would I like to be clean of them? Sure. Would I like to go back to having no social life, never meeting my wife, never eventually owning my own home and just living with my mom? Absolutely not.


I've also never really understood how people use Klonopin recreationally as it does not and cannot possibly get me high (I know I've taken larger doses before and they sucked...) and I'm glad it doesn't cause if it could I would as I'm a typical poly substance abuser.

I never have a desire to take more in terms of getting any buzz or anything, only if I need more for anxiety or more to help me fall asleep, as they are also prescribed for sleep.

I haven't take other benzos though other than Lorazapam which also did not get me high, but I have heard people say that Xanax is a different beast and will get anyone high, so I can't speak to whether or not someone like me would raise a Xanax dose for a buzz, but I certainly don't chase any high with Klonopin as there is no high to be had there for me.

Maybe people who don't have anxiety feel the anxiety relief as some kind of high, but for me it's just easing the discomfort from a symptom.
This loops back around to my top reply about recreational value. Can I abuse Klonopin? Sure. But I get nothing out of it. Really I'll just ruin my day with apathy, usually resulting in napping or excessive coffee drinking to try and snap out of it.

In fact I have always been transparent with my doctor. I've said "Honestly, I scale my dosage based on the situation. For example a road trip with friends will probably be 2.5mg for the car ride and then I'll coast on 1.5mg during activities (I'm only prescribed 0.5mg 2x daily, to which he said ignore the label and do PRN). A small dinner date maybe 1mg-1.5mg, it depends if I've been to the place and am familiar with the menu and setting."

All he had to say was "Taking 5 (pills not mg), how often are you doing that per month?" and I said "At most twice, sometime none, if there is no anxiety to fight it will just make me drowsy." His final reply was "Haha alright, just want to keep an eye on that-" "dependence" since I cut him off in mid sentence. He just gave me the "thats right" nod and a 'bingo' finger gesture. A symptom of my anxiety has always been a fear of medication and excessive studying of anything I'm even considering, so at this point it's sort of a joke and we both have a mutual respect for the drug and in some ways he's talking to a wall. I refused to be medicated for 23 years prior.

I do see the relief of anxiety as euphoric but anxiety has to be present to experience it. I can't be bored and get that effect, I have to be in crippling mental discomfort. But even then it is not true euphoria, it's an illusion, like taking a sharp rock out of your shoe.
 
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Mycophile

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But now we're talking recreational value. Benzo's vary in this department. It is fair to say someone using Xanax may be more inclined to chase the high, but lowly euphoric benzos just tend to make you sleepy if you dose higher.

While we're at it, since we're comparing with alcohol - it has euphoric properties and a "buzz" to chase.




Great point. In many cases dose is the difference between medication and "drug". Adderall becomes closer to meth the more you increase the dose, but we give microdoses to children?


He was half right, i'd say. at 1.5mg your chances of having a severe withdrawal are honestly pretty slim, a seizure even slimmer unless some DNA whack is at play. It has a long lasting with a halflife of 60-70hours. It takes 7 halflives for a drug to clear from your system.

Was it the best way to do it to ensure you didn't have a bad time? Definitely not, a taper would have been a good safety precaution. But this is not the first time I've heard of a cold turkey stop on sub 2mg of Klonopin being asymptomatic.



As someone else who has had their life turned around by benzos I wholeheartedly agree. The reputation these drugs are getting terrifies me that I may one day lose my script to an over zealous anti-benzo doctor. Would I like to be clean of them? Sure. Would I like to go back to having no social life, never meeting my wife, never eventually owning my own home and just living with my mom? Absolutely not.



This loops back around to my top reply about recreational value. Can I abuse Klonopin? Sure. But I get nothing out of it. Really I'll just ruin my day with apathy, usually resulting in napping or excessive coffee drinking to try and snap out of it.

In fact I have always been transparent with my doctor. I've said "Honestly, I scale my dosage based on the situation. For example a road trip with friends will probably be 2.5mg for the car ride and then I'll coast on 1.5mg during activities (I'm only prescribed 0.5mg 2x daily, to which he said ignore the label and do PRN). A small dinner date maybe 1mg-1.5mg, it depends if I've been to the place and am familiar with the menu and setting."

All he had to say was "Taking 5 (pills not mg), how often are you doing that per month?" and I said "At most twice, sometime none, if there is no anxiety to fight it will just make me drowsy." His final reply was "Haha alright, just want to keep an eye on that-" "dependence" since I cut him off in mid sentence. He just gave me the "thats right" nod and a 'bingo' finger gesture. A symptom of my anxiety has always been a fear of medication and excessive studying of anything I'm even considering, so at this point it's sort of a joke and we both have a mutual respect for the drug and in some ways he's talking to a wall. I refused to be medicated for 23 years prior.

I do see the relief of anxiety as euphoric but anxiety has to be present to experience it. I can't be bored and get that effect, I have to be in crippling mental discomfort. But even then it is not true euphoria, it's an illusion, like taking a sharp rock out of your shoe.
So we both take Klonopin and react the same way. Yup, I'm not sure what the most I've ever taken at once is, probably something like 4mgs maybe once or twice, but all I get is tired.

Actually that IS the one problem I have with it is that I wasn't really prescribed it for sleep but my anxiety takes many forms and one of them is excessive worrying about different things in bed which keeps me from falling asleep so unfortunately I have fallen into the habit of taking my Klonopin ALMOST exclusively at night (well I take a small dose before work and bigger at night) when it used to be ONLY in the morning and of course the Klonopin puts me to sleep BOTH by stopping the anxiety that is keeping me up and making me tired, but then I don't sleep as well cause of its' effect on my sleep and I think it might not be so bad if I only took it in the morning but now I have a hard time falling asleep without it cause my body is used to it at that time.

I somehow have to retrain my brain that it does not need Klonopin to sleep, but I'm not sure how I'll do it. Any ideas?

The tiredness it causes me is the one reason I want to take less, take it only during the day, or IF ever possible, taper off to another drug that is also effective but which doesn't make me tired.

Some have suggested Gabapentin but I don't know much about it.

Not to nick pick, but are you sure you used "dependence" how you wanted to?

Cause it sounds more like you meant psychological addiction and I've had it drilled into my head now by a number of people that "dependence" = physical withdrawal only and "addiction" = psychological compulsion to take something.

Like, obviously after all this time my body is physically dependent on the Klonopin,but most likely the fact that I have trouble falling asleep with it is largely, or at least 50% psychological ADDICTION to THINKING I need Klonopin to fall asleep. It's become a habit so I'm convinced I can't fall asleep without it and then it of course becomes harder to cause I have anxiety and I'm thinking about it, and while it DOES make me tired, and some of it could be that cause I drink WAY too much coffee and so I need something to knock me out (I REALLY need to cut down...),probably at least half of it is psychological and maybe if I was given half the amount of Klonopin I usually take to sleep and the other half was placebo I'd fall asleep fine.

And yeah, the only time I can possibly ever experience Klonopin as euphoric is if the anxiety is really that bad that it is like a breath of fresh air when being suffocated.

Actually, there is one other unusual type of euphoria it can rarely cause if I take considerably more than I'd usually take before bed, like more than 2mgs, and if I happen to not sleep much and wake up and I'm still on it and I drink some coffee and have to do something, under certain unusual circumstances the Klonopin will sort of transform my sleep deprived state into a more comfortable one by making everything a bit "dreamy"....but this is VERY rare, probably happens about twice a year at most, and has to have certain conditions behind it and I've never tried, nor would I try, to create that state on purpose.

Do you think Xanax probably produces more of a recreational high for people than Klonopin like I've heard people say?

I don't even want to take even once to find out. Klonopin already had some side effects and I don't want to get interested in any kind of more "euphoric" benzo. I've got enough drug problems as it is.,
 

BzCurio

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I somehow have to retrain my brain that it does not need Klonopin to sleep, but I'm not sure how I'll do it. Any ideas?
I've always avoided Klonopin before bed because of this. I take it on the occasional bad night where I'd prefer some sleep to tossing and turning, but not routinely. Have you tried melatonin? I usually split a 3mg in half, it is most effective at .3-1mg, so I get close enough with 1.5mg I suppose.

The tiredness it causes me is the one reason I want to take less, take it only during the day, or IF ever possible, taper off to another drug that is also effective but which doesn't make me tired.

Some have suggested Gabapentin but I don't know much about it.
Have you tried counterbalancing it with caffeine? It doesn't really reverse the benzos but it feels like it gives me a clean energy underneath the anxiolytic effect.

I've tried pregabalin and I felt nothing at 300mg

Not to nick pick, but are you sure you used "dependence" how you wanted to?

Cause it sounds more like you meant psychological addiction and I've had it drilled into my head now by a number of people that "dependence" = physical withdrawal only and "addiction" = psychological compulsion to take something.

Like, obviously after all this time my body is physically dependent on the Klonopin,but most likely the fact that I have trouble falling asleep with it is largely, or at least 50% psychological ADDICTION to THINKING I need Klonopin to fall asleep. It's become a habit so I'm convinced I can't fall asleep without it and then it of course becomes harder to cause I have anxiety and I'm thinking about it, and while it DOES make me tired, and some of it could be that cause I drink WAY too much coffee and so I need something to knock me out (I REALLY need to cut down...),probably at least half of it is psychological and maybe if I was given half the amount of Klonopin I usually take to sleep and the other half was placebo I'd fall asleep fine.
No I mean I am without a doubt dependent on klonopin at this point, but it's a low dose. Even though it's PRN, Klonopin made me say "yes" to more opportunities in life that would normally shut me down out of anxiety. As a result I ended up taking it more frequently. On the other side of the coin, it exposed me to so much of certain activities (ie grocery shopping, which I used to have a hard time with due to anxiety) that I no longer need it to do those things.

Do you think Xanax probably produces more of a recreational high for people than Klonopin like I've heard people say?

I don't even want to take even once to find out. Klonopin already had some side effects and I don't want to get interested in any kind of more "euphoric" benzo. I've got enough drug problems as it is.,
Yes and I also wouldn't try it for the same reason. It's duration of effect is also 1-1.5 hours where Klonopin is 4-6 hours.
 
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Mr.Deeds

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Chronic alcohol use is almost always going to trump chronic therapeutic benzodiazepine use in terms of risks.
Short-acting benzos taken chronically are going to increase WD severity as opposed to long-acting benzos. @Mycophile I'm suprised that you were able to CT the clonazepam, you got very lucky! Even though it is a long-acting benzo, the WD can still induce seizures and kill you, as you know of course. I'm glad that you didnt experience these, and that doctor should be taken to court, but that's another topic.
The short duration of alcohol will cause rapid WD onset if doses are not taken regularly in a chronic drinker. With benzos, there is still a good 6-12hr window before severe WD kicks in, I can see the exception in a benzo user who is scripted 10-12mg a day though (I'm using alprazolam as the example here), but these dosages are rarely given out.
And setting aside withdrawal for a moment, a chronic drinker will slowly (or quickly depending on how much they drink) scar their liver. In turn the whole body will eventually succumb to the toxins that have built up from lack of hepatic metabolism. Benzos, at least not the ones that are scripted regularly, will not do this. The short duration of action and toxicity of alcohol outweigh the risks of a chronic benzo user IMO.
Following this, interesting thread OP.
 

Mycophile

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I've always avoided Klonopin before bed because of this. I take it on the occasional bad night where I'd prefer some sleep to tossing and turning, but not routinely. Have you tried melatonin? I usually split a 3mg in half, it is most effective at .3-1mg, so I get close enough with 1.5mg I suppose.


Have you tried counterbalancing it with caffeine? It doesn't really reverse the benzos but it feels like it gives me a clean energy underneath the anxiolytic effect.

I've tried pregabalin and I felt nothing at 300mg


No I mean I am without a doubt dependent on klonopin at this point, but it's a low dose. Even though it's PRN, Klonopin made me say "yes" to more opportunities in life that would normally shut me down out of anxiety. As a result I ended up taking it more frequently. On the other side of the coin, it exposed me to so much of certain activities (ie grocery shopping, which I used to have a hard time with due to anxiety) that I no longer need it to do those things.


Yes and I also wouldn't try it for the same reason. It's duration of effect is also 1-1.5 hours where Klonopin is 4-6 hours.

Yes, I used 3.75--4mgs of Melatonin every night but it's still not enough without the Klonopin to easily fall asleep (I mean I will EVENTUALLY), but how much of that is placebo and how much of it is needing the benzo to fall asleep is a question. I drink a lot of coffee and also I am about to quit Dexadrine this coming week and I'm serious about probably never doing it again, but that will make it hard to sleep too, so will other drugs I occassionally use like Kratom, and I also have VERY poor sleep hygiene that I need to work on like not going to bed or getting up the same time every day or using screens before bed, so all those things will make it harder to fall asleep and I need to change them and I know I sleep better when I don't do that stuff and would need less Klonopin at night, so I do think that some of the KLonopin I take to fall asleep is physically necessary based on counteracting these bad habits, but I think some of it is also probably placebo based on thinking I need it, particular a certain amount of Klonopin like 1.5mgs, to fall asleep.

Unfortunately, even during my relatively sober periods where I will sometimes go months without many drugs other than maybe drinking like twice a month, other than a little drinking here and there and my medications, caffeine is the only constant that is always in my system and I still drink too much of it, though I don't drink nearly as much as I used to.

So NO, counteracting the tiredness with caffeine is actually THE WORST thing for me to do, and my last psychiatrist would always tell me that I particularly because I have an anxiety disorder and I know that my anxiety personally is increased by the caffeine, that when I drink more than just like a little bit of coffee, like a cup or two max (which I always do...) that I am DIRECTLY COUNTERACTING the effects of the medication and that I should not drink too much coffee because I will need more Klonopin, and I need to get to the point where I don't drink so much coffee.

It just counteracts it both by increasing my anxiety and then needing more Klonopin AND making it harder to fall asleep at night and then needing more Klonopin for that reason, and I know that during periods where I have been able to drink less coffee I have needed less Klonopin BOTH for anxiety and falling asleep and not always needed to take Klonopin at night and fell asleep easier, so actually caffeine is the EXACT OPPOSITE of what I need LOL...

In fact, if I ever really want to commit to trying as hard as possible to get off or even taper down my Klonopin I know I'll need to either quit coffee or get down to like no more than a cup and a half a day or something. I DID have anxiety prior to drinking coffee as a kid, but all I can say is it got MUCH worse in college when I became a chronic coffee drinking.

Stimulants and anxiety, even coffee, just don't mix, especially for me, yet I have a really physical dependence and mental addiction to caffeine, and also addiction and dependency to Dexadrine which I am literally quitting within the next week and I will hopefully never take it again if possible.
 

Mr.Deeds

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@Mycophile I have recently switched over to decaf. I'm addicted to coffee, and the decaf gives me a placebo effect to some degree which truly helps me with the caffeine problem that I have. The first cup or two of the day always has to be caffeinated, but anything after that is always decaf and it curbs the coffee cravings.
 

Mycophile

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Chronic alcohol use is almost always going to trump chronic therapeutic benzodiazepine use in terms of risks.
Short-acting benzos taken chronically are going to increase WD severity as opposed to long-acting benzos. @Mycophile I'm suprised that you were able to CT the clonazepam, you got very lucky! Even though it is a long-acting benzo, the WD can still induce seizures and kill you, as you know of course. I'm glad that you didnt experience these, and that doctor should be taken to court, but that's another topic.
The short duration of alcohol will cause rapid WD onset if doses are not taken regularly in a chronic drinker. With benzos, there is still a good 6-12hr window before severe WD kicks in, I can see the exception in a benzo user who is scripted 10-12mg a day though (I'm using alprazolam as the example here), but these dosages are rarely given out.
And setting aside withdrawal for a moment, a chronic drinker will slowly (or quickly depending on how much they drink) scar their liver. In turn the whole body will eventually succumb to the toxins that have built up from lack of hepatic metabolism. Benzos, at least not the ones that are scripted regularly, will not do this. The short duration of action and toxicity of alcohol outweigh the risks of a chronic benzo user IMO.
Following this, interesting thread OP.
Yeah, I was very lucky, but one thing I do believe is that I wasn't at risk of DYING at 1.5mgs a day, and they told me I wasn't at the hospital and that that doesn't really become a danger till you are taking around 4mgs or more daily, but I DO believe I was a seizure risk, and even one person who worked there but who wasn't a doctor told me she thought I was when I told her how the doctor was recklessly taking me off it cold turkey, but she was not in a position of power to do anything about it really because she wasn't a doctor, just a shrink who worked at the hospital.

I was also told...and I think this is PROBABLY true, that contrary to popular belief, the dangers, as far as death or seizure, from benzo WD, are really not dependent at all on how long a person as been on a dose. I mean, they are increased if you take it daily vs like every 4 days cause your dependence is stronger, but according to a few doctors at the hospital, if you've been on a 1.5mgs every day for 10 years your risk of seizure and death from WD, and the overall intensity of your WD, is really no greater or less than someone who has been on that same dose every day for 6 months: either way, if you've been on it daily and are dependent then you are dependent on the same amount and how long you have been is not really a factor in the WD.

I'm not sure 100% if that is true, because these doctors also fucked up at withdrawing me so fast, but it was a different doctor at the hospital who said that that was the case, so I don't know if she was wrong or as bad a doctor as that guy was.

Also, WD doesn't kick in in 6-12 hours for a Klonopin user or user of long acting benzos...NOT EVEN CLOSE.

Maybe that could be true for Xanax....but Klonopin lasts in terms of acute effects for up to 12 hours and the half life is 60--70 hours and it takes 7 half lives to be out of your system, so I actually know from personal experience (well..MAYBE I react differently than most cause I didn't have WD when taken off but still...) that I can go a couple days without and not get WD.

Even if for the sake of argument I just react really weirdly and don't get benzo WD for some reason (which would seem to be impossible to be true ONE HUNDRED PERCENT OF THE TIME and I probably got lucky due to rare biochemical factors that one time I was taken off it....) nevertheless....I do not believe that Klonopin WD would being even for the most sensitive person before around 60-70 hours when they get close to the half life....or maybe it could happen before that, but I doubt it would happen within like the first 2 days or 48 hours or so without.

You also have to factor in that if the person has been taking such a long acting benzo daily for a long time that they have a real lot built up in their blood stream and that could make it take even longer for them to go into withdrawal.

I personally believe that even if I was super sensitive to Klonopin WD that due to my high doses and how long I have been taking it that even if I had zero access to it all of the sudden that I would not experience any WD within the first 2 days without and POSSIBLY not even within the first 4 days without it.

I think I would start to get anxious probably after a day or 2 without, but I'm not sure that would actually be WD or acute WD so much as the lack of the medication.

But short acting benzos like Xanax can produce WD much much faster.
 

Mycophile

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@Mycophile I have recently switched over to decaf. I'm addicted to coffee, and the decaf gives me a placebo effect to some degree which truly helps me with the caffeine problem that I have. The first cup or two of the day always has to be caffeinated, but anything after that is always decaf and it curbs the coffee cravings.
Yeah, that's a good idea and the placebo effect is real.

I have considered actually having the first 2 cups be real coffee and then having a separate bag of coffee that is just totally a mix of regular coffee and decaf and drinking that the rest of the day (obviously not in excess of a certain amount since some would be caffeinated and then it would be pointless) and because I kind of have a very weird compulsion to think I need a certain number of cups a day, that would fight the compulsion/addiction since I'd never really know what my number of caffeinated cups would be for the day or past the morning since those other cups would just be a random mix of caf and decaf.

I had the idea a while ago, but for some reason I just haven't been able to pull the trigger on it, but I should.

I actually did a caffeine detox for 1 week with a supplement I found online about 6 months ago (taking it daily without drinking coffee and 8 cups of water) and it REALLY worked and after the week was up just one cup felt like 3 cups and even though I went back to drinking coffee I was able to keep it to like 1-2 cups a day for the first 2 weeks, but then I escalated to around 3 and unfortunately now I am up to between 3 and 4 1/2 a day, but believe it or not before the caffeine detox I drank 6--8 1/2 cups a day which is just fucking stupid and insane and I'm glad at least I don't do that anymore.

I think I will probably do the same detox again in about a month and try to keep the caffeine to 1-1.5 cups a day going forward.

I mean, some people I told think me the supplement I used was a scam and that the only reason my tolerance went down was that I went one week without coffee and not taking the pills, but I disagree both cause I have gone longer than 7 days without coffee before when not doing this detox and my tolerance didn't go down, and also, the supplement made my caffeine WD symptoms COMPLETELY go away within about 3 days, which the advertisement said it would, whereas other times I've tried to quit coffee cold turkey without the supplements I was still in caffeine WD a week later.

I think coffee is actually a worse drug than some people do.

I know it ain't good for me to drink so much and that's why I'll do the detox again.
 

Mr.Deeds

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Yeah I was talking about short acting benzos like alprazolam when I said a 6-12hrs. But correct me if am mistaken, but taking really any benzo chronically s going to accumulate more and more of the drug in your body, and as dependence rises and you bump up another .5mg or so, it increases even more, thus leading to a more severe withdrawal than if a user only took the benzo for 6 months as opposed to 5+ years?
 

Mycophile

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Yeah I was talking about short acting benzos like alprazolam when I said a 6-12hrs. But correct me if am mistaken, but taking really any benzo chronically s going to accumulate more and more of the drug in your body, and as dependence rises and you bump up another .5mg or so, it increases even more, thus leading to a more severe withdrawal than if a user only took the benzo for 6 months as opposed to 5+ years?
Well, I don't increase my dosage and haven't in years.

Klonopin is one of the benzos known to still be effective at the same dose for many years and my tolerance really hasn't increased beyond my dosage of 1.5mgs, even though occassionally I will take a little more I never really need more than that for anxiety and sometimes less.

As far as more of it accumulating in your system, well of course more will, and it would seem like that would lead to worse WD, and this doctor could have been wrong, but according to her once you've been dependent for that long, lets say we make it 1 year vs 10 years, she was basically saying it's really the same difference and it's the dosage you are coming off of that determines the WD and not how long you've been taking it, but again, she could be wrong and I'd personally think that wouldn't be true as it's usually the case with most other drugs, but I don't know, I'm no doctor.
 

Mr.Deeds

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Well, I don't increase my dosage and haven't in years.

Klonopin is one of the benzos known to still be effective at the same dose for many years and my tolerance really hasn't increased beyond my dosage of 1.5mgs, even though occassionally I will take a little more I never really need more than that for anxiety and sometimes less.

As far as more of it accumulating in your system, well of course more will, and it would seem like that would lead to worse WD, and this doctor could have been wrong, but according to her once you've been dependent for that long, lets say we make it 1 year vs 10 years, she was basically saying it's really the same difference and it's the dosage you are coming off of that determines the WD and not how long you've been taking it, but again, she could be wrong and I'd personally think that wouldn't be true as it's usually the case with most other drugs, but I don't know, I'm no doctor.
Interesting. I'll do my best to find some info about this. It may very well be true.
 

BzCurio

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Yeah I was talking about short acting benzos like alprazolam when I said a 6-12hrs. But correct me if am mistaken, but taking really any benzo chronically s going to accumulate more and more of the drug in your body, and as dependence rises and you bump up another .5mg or so, it increases even more, thus leading to a more severe withdrawal than if a user only took the benzo for 6 months as opposed to 5+ years?
This is the case, but not at the timescale you are thinking of.

In pharmacokinetics, steady state is when a drug reaches blood peak, it takes about 4x Half lives to reach this. The 6 months vs 5 years example is irrelevant as blood peak due to metabolites for a long acting benzo such as Klonopin would be reached in (40h x4) 160 hours, which to round up is 7 days. Steady state does not mean dependence. Dependence onset would still be about 3 weeks of daily dosing. In reality someone using for 1.5m will be as depending as a 5 year user.

But you raise another point, IF the dose is raised then the severity of withdrawal will as well. That would be time independent though, as you could hit the ground running abusing 4mg of Klonopin and again I don't think anyone would disagree that 1.5 months of daily dosing 4mg will become a problem.

However:
as dependence rises
My original post brings evidence forward that for desired anxiolytic effects, tolerance is likely to never develop. It would appear GABA receptor up/down regulation either doesn't happen at all or is radically transient.

My hypothesis is the initial hypnotic/sedating effects of benzos (to which tolerance is quickly developed) are synergistic with the anxiolytic effects, so once they are gone the patient may be under impression it isn't working anymore. - The reality is they are just no longer dozing off in anxiety provoking scenarios.

In a chronic theraputic setting, a benzo dose should never be raised past the minimal amount that displays anxiolytic effect. There is no known evidence as of 2012 that they stop working: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321276/ and benzos are pretty old.


This further reinforces the speculated claim: When SSRI's were headed for the market benzos provided worthy competition, funding was then poured into research in an effort to discredit them as long term treatment. Benzos were and are the holy grail of anxiety treatment, their replacement of barbituates with no loss in efficacy and little risk of overdose pinned them as kings of the "panic disorder [69–72], generalized anxiety disorder [73], and social phobia [74–76]" market.
 
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BzCurio

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Klonopin is one of the benzos known to still be effective at the same dose for many years and my tolerance really hasn't increased beyond my dosage of 1.5mgs, even though occassionally I will take a little more I never really need more than that for anxiety and sometimes less.
Just want to throw in that this is true for all benzos in terms of anxiety fighting. I continue to feel 0.5mg even with my occasional jumps up to 2mg for certain occasions.

This is not true, however, for benzos that are being used solely for their euphoric properties. You will develop a tolerance to the mechanisms creating euphoria very rapidly. Some people falsely equate euphoria with anxiolytic action, and then take the false stance that benzos stop working.

Klonopin has one of (if not THE) least euphoric profile of all benzos, which is why it may seem like it is only true for Klonopin. Really no euphoria is being chased, so patients have no reason to expect anything more from it by raising the dose. Most will just get too sleepy to function.
 

Mycophile

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Just want to throw in that this is true for all benzos in terms of anxiety fighting. I continue to feel 0.5mg even with my occasional jumps up to 2mg for certain occasions.

This is not true, however, for benzos that are being used solely for their euphoric properties. You will develop a tolerance to the mechanisms creating euphoria very rapidly. Some people falsely equate euphoria with anxiolytic action, and then take the false stance that benzos stop working.

Klonopin has one of (if not THE) least euphoric profile of all benzos, which is why it may seem like it is only true for Klonopin. Really no euphoria is being chased, so patients have no reason to expect anything more from it by raising the dose. Most will just get too sleepy to function.
Yeah, I mean the only benzos I've ever used are Klonopin, Lorazapam just a few times (it felt pretty much like Klonopin to me) and only once before a surgery I was injected with Valium, and the Valium injection was the only one which gave me any euphoria, so I have kind of never understood how anyone gets euphoric from benzos.

I guess the Valium injection made me aware that it can possibly happen to me, but other than that it still seems kind of weird to me how people get so high off them when I don't, but I've never tried Xanax and that seems to be the main one that most people use for euphoria.

I guess maybe there's a massive difference between how Xanax and Klonopin feel. Either that or maybe I have unusual biochemistry and Xanax wouldn't get me high either, but I'm not going to go looking for it in order to find out.
 

BzCurio

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I was injected with Valium, and the Valium injection was the only one which gave me any euphoria, so I have kind of never understood how anyone gets euphoric from benzos.
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.
 
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