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BENZO WITHDRAWAL REALITIES

Colin Downes-Grainger
July 23, 2008

Many thousands of patients were addicted to prescribed benzodiazepines for decades and many are still adding on the years because government refuses to control prescribing in the National Health Service they oversee. I was addicted to the stuff myself for thirty years without knowing it and without knowing that all my mental and physical ill health during those years was caused by the succession of different benzodiazepines and resultant anti-depressants I was prescribed. So what is it like to finally break free of the never-ending drug cycle of benzo effects and polypharmacy?

Well, it isn't the rosy picture the establishment says it believes in - real consciousness returns but there's often a price to pay. If you know anything about the background and nature of the drugs and most people don't, even after they've broken free of them - then an expectation of returning to health after maybe twenty or thirty years of neurotoxin ingestion and polypharmacy may be too much expectation.

So let's examine the price you can pay.

Much depends on the circumstances of your life when the drugs are gone. If you managed to stay in work during the long years of ingestion (which is often impossible) and manage to stay in work during the awful long months of withdrawal (again often impossible), then you may at least have economic security. This is not the reality for large numbers of former patients. Many spent years on state benefits, the providers of which, for political reasons, do not recognise the health and economic impact of benzos. If you have managed to retain a supportive partner (and many don't because benzos induce iatrogenic symptoms mimicking mental illness), then he/she may provide some form of security.

But what form of security would you have had if you hadn't become addicted to these drugs prescribed by doctors for the often temporary life problem you had years ago? This is one of the major things you have to live with after the return of an ability to think post benzos. Whether you were a millionaire, an accountant, an artist or a teacher like myself, you may well have lost it all when your doctor addicted you to benzodiazepines. The career you would have had, with its satisfactions, security and sense of personal worth, giving you a place in the world - disappeared.

After decades of addiction you may well, as I and others do, have to face the fact that you have no place in the world. So you have to try and create one, perhaps at the age of 50 or 60, which isn't at all easy.

For a start you have to try and learn to live with what you have lost, and some find that impossible and it tears at them in consequence. This realisation, that you may not be able to internalise and accept, is one of the legacies after benzo addiction.

And what may you have lost?

There are those who can't even remember the years during which they took benzodiazepines their memories have been wiped. Many former patients have thinking and memory deficits inflicted by years of ingestion and find this a serious handicap with permanent consequences.

But most people do not know the details of benzodiazepine drug harm and still do not make a connection afterward - with the drugs and their continuing ill health. In one way this could be seen as a blessing. To know what many doctors still do not know, and what the Department of Health for political reasons pretends not to know, can be a scarring realisation. But what a thing to have to say, that in order to live out the rest of a blighted life, it might be better not to know the details of how it has been blighted.

If aware, you will reach the inevitable and correct conclusion that the Department of Health and the regulatory agencies have done little and do little to protect benzodiazepine patients because of the past. Their priority is to protect doctors and their reputations from the consequences of past prescribing, and to protect the image of drug regulation as scientific and efficient. A second motive is to ensure that a class of drugs, which only in the bald mortality stakes, do less damage than their predecessors the barbiturates, remains in use as a sticking plaster for the life problems increasingly in evidence in modern society.

In a fairly successful attempt to achieve obfuscation, the Department of Health maintains a pretence that benzodiazepines were only ever prescribed for psychiatric reasons and any care in withdrawal (and there is almost none), should primarily be provided by psychiatrists because the original problem may recur. The biological fact that benzo addiction is entirely physical, and produces apparent mental illness, is strenuously and deliberately avoided by the DH. This sort of knowledge is hard to live with. It is harder too, to live with awareness that withdrawal assistance for an addiction far worse than heroin, is for political reasons of cost and for reasons of political cost, not provided.

The modern message pumped through the media and government is that the individual is entitled to choice. You may be left post benzos, with the knowledge that you had no meaningful life while addicted and you had no choices, even if you believed in your afflicted state that you did. Instead your life was diverted into a non-productive limbo, devoid of personal significance or worth. Your future in consequence is all too likely to offer no choice, no real improvement - merely continuing disadvantage, official dismissal and poor physical health.

But benzodiazepine addiction does not just affect the addict personally - it also affects the addict's family. Benzodiazepines abolish emotions and empathy and there is therefore no proper emotional relationship between family members. The addict is distant, unconnected and often irascible, with thought processes so affected, that normal logic and assessment of thought and actions does not operate. The addict feels inadequacy and guilt but for reasons unknown, can do nothing to avoid the causes and improve matters. This inevitably means that after prescribed addiction has ended, the history of familial relationships is so skewed that the addict with a freed mind is unlikely to ever reach a complete rapprochement. You can tell family members that it wasn't you - it was the drugs, but you are working against historical experience, and that is a book that cannot be rewritten.

The impact of benzodiazepines on thought, often also affected by antidepressants prescribed in ignorance to counter their effects, manifests itself in other ways. The years of benzo inadequacy can for example leave you in debt for many reasons. Because many cannot work due to the effects of the drugs and for a significant number, because of the effects of withdrawal from the drugs, these debts are unavoidably incurred. Many who would want to work after the return of thought cannot work because of the physical effects on their body. The Department of Health avoids this reality and never talks about it, except in discussions behind closed doors on avoidance policy of course.

What is the nature of post withdrawal ill health?

The biggest negative is the inability to sleep. It was known thirty years ago from sleep studies, that sleep induced by benzodiazepines, (and now drugs such as Zopiclone) was not proper sleep, and after use there would be a payback. The payback for those addicted for many years, and often the subjects of polypharmacy, may indeed be never-ending. Daily activity is therefore often conducted with swimming eyes and a feeling of exhaustion. Take the symptom to many doctors today, and if they don't believe in benzos they are likely to offer advice on how to prepare for sleep, completely missing the point. Far more likely they'll offer you a new sleeping pill - a Z drug, or bemusingly a benzodiazepine, the cause of the permanent insomnia.

In the normal person, sleep produces refreshment but not in the withdrawing addict and not in many of those who have withdrawn from long-term addiction - not a preparation for a day at work.

Is it any wonder that some will not use a doctor thereafter? Frankly, taking the chance that a doctor will be open to education, 45 years after Librium was introduced is more than such people can bear. Facing doctor denial of the effects, because they are not in data sheets, when you know the effects are down to the drugs, is more than any rational being can stand.

But drug insomnia and sleep that doesn't benefit is merely one of the health effects the former addict has to deal with. Benzodiazepines are muscle-relaxants, but after long-term use, in some unknown way, they have the opposite effect. You can lie in bed and be unable to move your feet, because to do so causes intense pain. You may be unable to pick up anything heavy, because the muscles in your arms are so tight, that the pain would lead you to drop the object. You can pull your muscles with the slightest movements. The tightness of the muscles in your neck leads to headaches, which can go on for days or weeks, with little let up. All muscles in the body, on a random basis, achieve this state of pain - daily prediction is impossible.

In fact this question of health prediction is a factor that can govern the life of the long-term ex-addict. How are you supposed to work, when you don't know from day to day how you will be feeling? How can you undertake anything with equanimity?

Symptoms are many and varied and random. Unlike most normal illness, you don't progress through the symptoms and recover. Numb teeth or gums can be replaced by intense joint pain or by burning sensations, or you may have a period of tinnitus (for some it is permanent) or neuralgia-like pain. You may have a patch of blurred vision, a painful spine or find difficulty with walking. Any length of sleep may cause violent headaches. Frequently on any given day there will be a collection of symptoms, which together are quite incapacitating. Merely living with this varied illness is difficult enough without any attempt to reintegrate into a life in a way that approximates to normality.

When the ingestion of pills is over, the effects of the ingestion aren't and many former prescribed addicts feel shame and guilt related to their addiction. Without the understanding of their families, they will never get over it.

The return of full consciousness is extremely disturbing, particularly if you find that the life you weren't able to assess previously turns out to be a life of insecurity. In many, this causes quite natural panic and a deep sense of unreality. Moreover long-term addicts who, because of the addiction, let personal responsibilities devolve to others, find they have to take personal responsibility again and that is not easy. Taking responsibility again can be very difficult after a decade or three of not doing it. The Department of Health and its experts like to see the resulting anxiety as a return of original symptoms, in spite of the fact that the majority of addicted patients did not have anxiety in the first place. Quite justified anxiety occurs, but it has nothing to do with a state of health prior to taking pills. For the DH, 'symptoms returning' is a convenient view to maintain, for benzodiazepine manufacturers it is not hard to find a motive.

What has happened with benzodiazepines is the clear essence of the politics in UK healthcare. The NHS in its use of psychotropic medication is a long way from the ideals of the welfare state. There will not be many doctors who realise that they are in fact acting as a political arm of the state. Matthew Parris had it right when he said in a television programme set in a deprived area of Newcastle that the NHS was drugging patients into submission. Charles Medawar had it right too when he said in Power and Dependence that the dangers of benzodiazepine addiction were always obvious and the providers of medicine readily let the damage happen.

Colin Downes-Grainger
July 23, 2008


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