Getting through benzodiazepine withdrawal: INTERVIEW with Dr. Jennifer Leigh, Psy.D.
Jennifer Leigh holds a doctorate – a PsyD – in psychology and is an award-winning author and spiritual growth coach for people in recovery from alcoholism, addiction or psych med withdrawal. Today, we speak to Dr. Leigh, Psy.D. about benzodiazepine medication(s) withdrawal and invite you to share your thoughts and questions on this topic in the comments section below.
ADDICTION BLOG: Let’s begin with these two burning questions: “Why are benzodiazepines such a widely prescribed class of drug (mostly to women and the elderly)?” and “Why does treatment with benzos tend to last a lot longer than the recommended few days or weeks?”
DR. JENNIFER LEIGH: Those are two questions that we who have been harmed by these drugs ask, too.
It is hard to come up with an answer that defends the current prescribing practices, as it has been widely known for 40 years that benzodiazepines are addictive and cause brain damage. The problem is that benzos work to reduce anxiety, pain, insomnia, etc. so they do have short-term efficacy. Long term that is not the case, but doctors don’t seem to take that into consideration.
One of the reasons treatment may last so long is that when a patient attempts to reduce their current dose, they feel withdrawal symptoms, which the doctor diagnoses as either the return of the original complaint or a new “illness” or disorder that needs medicating. Stopping a benzo can be so intolerable, that many stay on the drugs, even though they drugs are making them sick, literally.
ADDICTION BLOG: Tolerance is quickly formed after taking a benzo med every day for several weeks, and then, the effects subside. Why do doctors keep upping doses and continue prescribing to patients?
DR. JENNIFER LEIGH: When you hit what is called tolerance withdrawal, your brain needs more of the medication to continue to feel any effects from it. What happens is the drug remodels the brain. The current theory is that GABA receptors that they drug interacts with in the brain, are either absorbed into the neuronal axon or they become detached.
No one really knows.
All we know is the drug changes the brain and there are less viable working GABA receptors. That means that the patient will experience anxiety, panic, paranoia, intrusive thoughts, and a host of body symptoms, unless the dose is increased. At some point, however, even with increased dosages, withdrawal symptoms will not be kept at bay. The patient will be sick both mentally and physically from the damage done by the drug.
ADDICTION BLOG: What would you recommend is the best method to withdraw or detox from a benzo drug?
DR. JENNIFER LEIGH: I’m not a medical doctor so I can’t practice medicine without a license so cannot say anything here that would infer that I am.
But I can voice my opinion and say that Dr. Heather Ashton, the world’s leading benzodiazepine expert recommends a very slow taper off of the drug. She has a manual called the Ashton Manual that is the “Bible” of most benzo users who want to get off of their medication.
The worst way to get off a benzo is to go to a detox or rehab. Most are uneducated about withdrawal and will remove the drug far too quickly, or they give other medications to help with benzo withdrawal and the medications actually get in the way of the brain’s healing. A cold turkey withdrawal from the drug, or too rapid of a taper can be fatal.
What most doctors and detox or rehabs don’t understand is that once the drug is removed, recovery can take years. The suffering a person experiences in withdrawal is intolerable. A percentage take their own lives to end the suffering. It is important to get off of the drug slowly, so the withdrawal symptoms are lessened.
ADDICTION BLOG: How do you advise families to work together and help a loved one that’s become benzodiazepine dependent and is going through withdrawal?
DR. JENNIFER LEIGH: That is a wonderful question and I am so pleased that you asked it.
First, it is important that family members educate themselves as to the extreme suffering benzo withdrawal can cause. The suffering is mental, physical, emotional and spiritual. It affects every aspect of a human being-s existence. It is important to be aware that suicide is a very real risk in withdrawal. It is also important to reassure your loved one that they will heal. Reassurance will be needed many, many times throughout a day, for a very long time.
Also, it is important to understand that most doctors are ignorant about benzo withdrawal, so it is best to avoid insisting that your loved one visit a doctor for help, or to tell them that “the doctor knows best.” Usually, the doctor doesn’t know best, and the treatments offered to people in benzo withdrawal are actually harmful. Listen to your loved one, have compassion and above all, tell them they will recover, because they will. Don-t think that their symptoms are “all in their head.” They are not. They are very real, and very horrible.
ADDICTION BLOG: Are there things friends, family and loved ones should avoid doing when a person is withdrawing from benzodiazepines?
DR. JENNIFER LEIGH: Yes, family members should avoid insisting that their loved one do anything that is beyond their capabilities in withdrawal. We are truly very sick in withdrawal so the suggestion that we go to the gym, or suck it up and go on vacation, etc., really is hurtful and harmful.
Please avoid drama, and overly stimulating conversations, or activities. Benzos stay in the system for a long time and the central nervous system of a person in benzo withdrawal is quite fragile. We need calm and quiet. Please don’t tell a person in withdrawal to stop talking about their symptoms. Preoccupation with benzo withdrawal is a benzo withdrawal symptom. It will fade away like the other symptoms will.
ADDICTION BLOG: Long-term benzodiazepine use can have damaging effects on many organs is the human body, including the brain. You, yourself have experienced benzo dependence and withdrawal. Would you like to share your the details of your recovery process?
DR. JENNIFER LEIGH: (Laughing) No, it was too horrific. But of course, I’ll share the highlights.
I had panic attacks in my mid thirties. I was put on Clonazepam. I was kept on the drug for 18 years. I never abused it, and took it only as prescribed. Nine years into taking it, I started having strange health issues; my bladder, stomach, heart, bones, muscles I didn’t feel well a lot of the time.
Not one doctor ever told me I was in tolerance withdrawal, even though I clearly stated that I was on a benzo and had been for many years. In 2010 I was having a lot of tolerance withdrawal symptoms and made the decision to taper off. My doctor (who is one of the “best” in the area”) gave me very bad advice which I followed.
I tapered for 8 months. I became bedridden and unable to sleep during the night. Another doctor gave me Phenobarbital and sent me home to cold turkey on my own. I ended up in the hospital, deathly ill and out of my mind with terror, the hallmark benzo withdrawal symptom. I had almost every symptom that one can have in withdrawal. I was lucky I never had a seizure though.
The 18 month off of the drug was exceedingly cruel. I prayed for death every day. I had intrusive thoughts, looping thoughts, severe anxiety, terror, panic, paranoia, depression, hopelessness, and an inability to feel joy or comfort. I developed bizarre fears and phobias.
My body was a mess too. I had horrific pain in my bones, joints, muscles and eyes and ears. The fatigue was crushing. I also had severe cognition problems. I couldn’t use a computer for awhile as I forgot how. I lost things, and forgot things. I went days without showering as I had developed POTS, postural orthostatic hypotension. Standing was almost impossible some days. I used a walker or a cane for awhile. I was unable to work, and unable to participate in normal life. I felt removed from everything and the only emotion my brain could create was fear or shame.
It took three years for the mental symptoms to go away, and I-ll be four years free this June, and my body still is healing from the damage. I have blogged honestly about my journey so as to give hope and comfort to others who are suffering in benzo withdrawal. It is an almost unbearable suffering. It is primal suffering. And the sad thing is is that doctors are doing this to people, all over the world.
ADDICTION BLOG: Benzodiazepines tend to produce the same withdrawal effects that they are prescribed to treat. Usually, when people stop taking a benzo they do not realize that symptoms can be part of the withdrawal effect. What, in your opinion, needs to be done to better educate people who are receiving benzodiazepine therapy?
DR. JENNIFER LEIGH: First, it would be best to avoid taking a benzo for any reason other than a one time dose pre-surgery or to stop an uncontrollable seizure in an emergency situation. Other than that, there shouldn’t be a market for them, unless you are in the market for brain damage.
I’m not sure who would be better to educate, the general public or doctors. But if one is currently on a benzo, please know that your brain and body will function better if you slowly get off of the medication and allow your brain to return to its normal state. It’s important to know that not everyone taking a benzo will suffer horrible withdrawal symptoms. We don’t know what causes some people to be able to take the drug with little harm, while others are decimated by it. Don’t avoid tapering off because you are fearful of withdrawal. Long-term use of the drug may cause dementia. It certainly can cause cognition problems and memory loss, along with the terrible benzo withdrawal symptoms.
Know that your doctor may not be educated about benzo use, tolerance and withdrawal. Please educate yourself. There are many blogs, websites, Facebook groups and an online forum where you can get information about benzos and withdrawal. Once you are armed with the facts, stand your ground when you talk to your doctor.
ADDICTION BLOG: When other successful anxiety and insomnia treatments become available, do you think that benzodiazepines will still be as widely needed? Also, are there currently successful treatments out there?
DR. JENNIFER LEIGH: There are many ways one can deal with anxiety. A good therapist can help, as can yoga, meditation, prayer and exercise. Benzos are not “needed” per se as anxiety is a normal human emotion. It isn’t pathological. Knowing that benzos can restructure the brain and cause anxiety/panic/terror/paranoia, it doesn’t make sense to treat someone with something that can cause the same, if not worse, feelings and thoughts.
I am hopeful for two things.
- As we learn more about the brain and how it functions, better medications can be invented to help those who have brains that cause mental/emotional problems.
- In time, I hope that the public becomes educated about all psych meds and they learn the inherent dangers in each and every one of them. There are no “safe” psych meds. Yet we all believe that if we are anxious or depressed, a quick trip to our doctors and a pill will solve those feelings. We’ve been brainwashed into thinking that pills are the answer and they are safe. Neither is really true.
ADDICTION BLOG: What would you recommend needs to be done to change the benzo prescribing practices of clinicians and healthcare professionals?
DR. JENNIFER LEIGH: I am hopeful that here in the U.S. that the FDA will step in an laws will be created and enforced so that these drugs can not be prescribed long term. The manufacturers of benzos say 2-4 weeks is the maximum they should be prescribed. (Even that is too long for some people. Addiction has been recorded in 10 days. )
Legal battles have been waging for decades in the U.K. over these drugs, with very little headway made. It is discouraging that profits are more important that people.
Education about the side effects, tolerance withdrawal, interdose withdrawal and the withdrawal syndrome that occurs upon lowering or ceasing the medication needs to be available to every doctor. The dangers with benzos needs to be taught in med school.
There is so much information now on the web from people who have survived benzo withdrawal, it is a shame that the powers that be discredit it, or don’t read it.
ADDICTION BLOG: Finally, is there something we missed that you’d like to add and share with our readers?
DR. JENNIFER LEIGH: I want the public to know that these drugs are very dangerous. Not everyone will be so grossly affected by them, but many, many will be. The health issues that arise while taking them can be debilitating. And doctors are unaware that the source of the problem is the benzo. You can go for years with sub-optimal health, while you are one them, and not know why you are so sick.
I’d like your readers to know that there are very, very few doctors here in the U.S. who are educated and truly understand the damage that a benzo can cause, and how very long, frightening and debilitating the recovery can be. Even doctors, who claim they understand, don’t, and they prescribe more drugs or supplements and vitamins that are actually harmful to us in withdrawal. It really is a health crisis.
I encourage anyone who is on a benzo to educate himself or herself by learning from those who have been in the trenches. They know the truth. They have more good advice than 99% of the doctors. (It’s not that doctors are bad, they just haven’t been exposed to the truth.) People who have been through withdrawal know about kindling, a very real complication that can occur, as well as what foods, beverages, vitamins, supplements, medications etc. must be avoided so the central nervous system isn’t more compromised than it already is. They understand why traditional talk therapy is counter productive in benzo withdrawal. They know what works and what doesn’t work.
It’s a shame, really, that there is such an enormous health crisis in our country, caused by doctors, ignored by doctors, and the only help is from fellow sufferers who have been through it. Hopefully one day, the medical community will wake up, get the message and stop damaging people with these drugs.
Please remember that there is no safe amount of a benzo to take. Just because your doctor prescribed it and you take it only has directed, doesn’t mean that you are not being harmed or becoming dependent on the drug.
Photo credit: David Goehring