This post is the second in the series on benzodiazipines, that is, all your calming and sleeping tablets as described in the first post, The bad side of benzos. As I eluded to at the end, I am benzo dependent, partly due to my persistent bipolar symptoms but also because that is what happens if you use them for too long.
There are two sides to the coin of persistent use. The “I am dependent on them” side and the “I am resistant to them” side. Most long time benzo users see both sides at once. Let us start off with the dependency side. How do you tell if you are dependent on your “chill pill” of choice? Here is a list of indicators:
- A strong desire/compulsion to take them,
- struggling to stop using them or only taking what is prescribed (I won’t say needed, because there is a difference between the perceived need according to the prescribing doctor and the patient),
- Physiological withdrawal symptoms when you stop taking them or reduce the dose,
- Building up a tolerance for them, meaning you need to take more to get the same effect as what you did when you started taking them (other side of the coin we will discuss later),
- Slow loss of interest in previously pleasurable activities like hobbies,
- And finally, the worst one: persistent use, despite the evident harmful consequences.
Big eyes? Mouth wide open? Freaked out? Or still in denial?
Do not despair there is hope, I myself have tapered my use down from a freakishly high amount to very little, all in good time… But let us look into why benzo’s are (yes let us be brave and use the A word) addictive.
Why do we get addicted to benzo’s? Here is one explanation: “The pharmacological mechanisms underlying benzodiazepine tolerance and withdrawal are complex and still not clear. Present knowledge has recently been reviewed in detail. Tolerance to chronic benzodiazepine administration appears to result from neuroadaptive processes involving both desensitization of inhibitory g-aminobutyric acid (GABA) receptors and sensitization of excitatory glutaminergic receptors. Both these systems include multiple receptor subtypes. Changes in GABA receptors may include conformational alterations towards a low affinity state for GABA and uncoupling of benzodiazepine receptors from their sites on certain GABAA receptors, followed by internalization and perhaps long-term effects on intraneural gene transcription. Changes in the glutaminergic system may include sensitization of N-methylD-aspartate (NMDA) and possibly other receptor. These adaptations could occur on different time scales depending on the receptor subtype and brain region involved, thus accounting for the differing rates of development of tolerance to various benzodiazepine actions.” – H Ashton, “The diagnosis and management of benzodiazepine dependence” http://www.benzo.org.uk/amisc/ashdiag.pdf
Okay for us normal people here, you are dependent once you can only function normally (although that is relative) when you’ve taken the benzo. The neurons in your brain have changed due to prolonged exposure to the drug, but the science people don’t really know why yet. (yay for us, NOT!)
This explanation for why we become dependent on them also helps us understand why we become resistant to them. Benzo’s have a lot in common with other “drugs of dependence” like caffeine and alcohol. What are the consequences of such a dependence? Well it’s not a pretty picture to say the least. You could end up with memory and other cognitive problems, become depressed and excessively sedated, which brings its own set of dangers. To top it off, you can experience the resurgence of the symptoms it was intended to treat in the first place.
Like I have stated before and will keep on reminding you of, there is hope, this is not how it ends for you. Look out for the next post in this series where we will talk about withdrawal, from what it looks like to how to survive it and walk away with all your parts intact.
We would love to hear your stories and experiences with benzos, we would even like to feature some of the stories you tell us so please get in contact with us, through the comment section or message us.