Benzos-- On My Soapbox

I hate benzodiazepines. HATE them. This class of drugs (what we know as Ativan, Xanax, Klonipin, Librium, and Valium and various others) was introduced in 1961 and sold to the medical community as "safe." Doctors then naturally begin writing prescriptions left and right and we are now learning that benzos are NOT safe. I speak from my own personal experience in working with addicts as well as from scientific research and statistics. I see people almost daily who are struggling to overcome addictions from various substances but cannot overcome the final hurdle of benzos addiction because doctors continue to hand these drugs out like candy.

Let's just lay out the facts. First of all, the manufacturers of benzos do not suggest that this drug be used longer than two weeks. Second of all, we know that long term use leads to increased tolerance (requiring more of the drug to feel any benefit), physical dependence, and dangerous, potentially life-threatening withdrawal symptoms when one tries to stop taking the drug. We also have statistics that support the fact that most people abusing benzos are typically combining their benzo with another substance, usually alcohol or opiates. This is a deadly combination.

Here are some important statistics. In 2006 the Center for Disease Control reported " Poisoning {drug overdose} is the second leading cause of injury death overall, and the leading cause of injury death for people aged 35-54 years, surpassing both firearm-related and motor vehicle-related deaths in this age group." Of these "accidental" deaths, 17% of those were related to the misuse of benzos. In 2009 in Washington state alone, benzos were indicated in 20% of accidental deaths, higher than alcohol (17%), cocaine (15%), meth (5%), and heroin (2%). Even in 1986 the well-respected National Center for Biotechnology Information (NCBI) completed research that indicated those who were depedent on benzos alone had a mortality rate 3 times higher than a control group being treated for similar mental health issues without a co-occurring benzo addiction. When the benzo addiction included the use of alcohol or other addictive drugs, the mortality rate jumped to 6 times higher than the control group.

I sat with a seventeen year-old girl this week who was begging me for benzos. She understandably wants relief from anxiety and has learned from our culture that the most efficient way to do that is to pop a pill. It breaks my heart. I also work with various other adults who struggle with enduring the withdrawal symptoms of benzos and most of them require multiple inpatient hospital stays throughout the year. Long-term benzo use has been shown to lead to an INCREASE in depression and anxiety. The abuse of this class of drugs has become a social problem, a menace to society, a bomb dropped on families, and ultimately kills.

This anger has been stewing in me for many years and the recent death of Whitney Houston really sent me into a tailspin. We do not yet know the autopsy results for this artist, but we do know both alcohol and three different kinds of benzos were found in her room. It doesn't take large volumes of these two combined drugs to cause significant depression of the central nervous system and cessation of breathing.

I believe Whitney Houston was clean from illict drugs and, thus, convinced herself she was "sober," because she was "just taking" the various benzos being prescribed to her. How do we expect people to stay clean when they are having addictive substances prescribed to them by the very people who are supposed to be helping them remain healthy? NO ONE with any history of addiction should take benzos... period. Whitney Houston should never have been given those medications. She believed she was sober and well. Our culture is ignorant to the dangers of benzos and I believe this prohibited the loving friends and family around her from knowing that the path she was on was a deadly one.

If you are taking benzos or know someone who is, these are the signs of benzo dependence (from myaddiction.com):

1. Tolerance to the medication, to the extent that the patient needs to take more to achieve the same effect; more marked when used as sleep aids, less common when used intermittently for anxiety.

2. Withdrawal begins when the medication is discontinued – may lead to taking other drugs to relieve symptoms.

3. Taking a higher dose or a more frequent dose outside of a physician’s advice. This includes taking the medications for problems other than they are prescribed for.

4. An inability to stop or excessive anxiety when considering stopping.

5.Preoccupation with acquiring more medication or another prescription – usually to meet increased need because of self-administering a higher dose.

6. A drastic change in habit or lifestyle, such as skipping social engagements or ignoring responsibilities because of the medication or the effects of the medication – embarrassment and lying may be associated with this.

I believe we should lovingly confront those we love who we know are abusing or misusing their medications. Had someone done this for Whitney Houston, we might still have her today. Please know that tapering from benzos should be done under the guidance of a doctor, due to the potential severity of symptoms. Let's wise up about this very dangerous class of drugs and spread the word that it is not acceptable to take benzos for months or years on end. We have to become intolerant of doctors who have become legal drug pushers and push for tighter regulation of this class of drugs.

Bottom Line Behaviors: The Gentle Path

Here's a question asked by many sex and love addicts-- how do I know what my bottom line behavior is? For an alcoholic, it's a little more simple, they stop drinking. For a sex and love addict, it could be a whole host of behaviors that are creating emotional drunkenness, and what these behaviors are for one love addict can be different from the next love addict. A bottom line behavior is a behavior that, when engaged in, leads to loss of self. Engaging in this behavior can prevent the addict from experiencing valid and necessary feelings of anger, grief, or even intimacy. The bottom line behavior is sometimes used as a smoke screen to avoid the uncomfortable feelings of anger, grief, or intimacy. Engaging in the bottom line behavior tends to bring an immediate relief, an ah-h-h-h feeling, at least in the early stages of addiction. As addiction progresses, an addict often has to engage in more of this behavior or more intense forms of it to achieve the "high."

When a sex and love addict is ready to get clean, he/she must decide what their bottom line behaviors are and make the conscious decision to avoid those behaviors. Most commonly, these behaviors might be ceasing excessive masturbation, ceasing extra-marital affairs, or ceasing the use of pornography, etc. If you are an addict trying to define your bottom line behaviors, ask yourself these questions, "What is the behavior that, if I stop doing it, I'm going to feel like I'm going crazy? What behavior, at the thought of no longer doing it, makes me almost panic? What behavior, when I stop doing it, is immediately going to send me into emotional withdrawal symptoms?" Whatever you answer to these questions-- that's your bottom line behavior.

Here are a few important things to remember before launching yourself into withdrawal and ceasing your newly identified bottom line behavior:

1. Have a solid support system in place. Be prepared to attend your 12 step meetings as often as possible while going through withdrawal. Have the phone numbers of several recovery friends who can provide support and be very kind to yourself during this difficult time. Seek your Higher Power daily. Do not attempt to go through withdrawal alone and on your own will power-- that's just cruel.

2. Know it is OK to modify and add behaviors to your bottom line list as your progress through recovery. You are not expected by your Higher Power to know all of your bottom line behaviors in the early phases of recovery, maybe not in your entire lifetime! As you gradually survive varying phases of withdrawal from one behavior after another, you will most likely recognize other behaviors that also create emotional crazies. For example, after 3 months of successfully ending an abusive relationship, you recognize that having fantasies of that person also has deep emotional effects on you. Continuing to engage in fantasies of that person is like drinking a poison and you feel sick or out of sorts the remainder of the day. You have just learned that fantasizing about this past partner is a new bottom line behavior that should be avoided to maintain emotional sobriety.

Recognizing your bottom line behaviors and maintaining sobriety from them may sound like a complicated and daunting task. Yes, it can feel very overwhelming at times, causing an addict to just want to throw in the towel. Always remember the practices of gentleness and kindness toward yourself in recovery. You can be firm and discipline yourself in love and humility, not out of punitive shame. Identify the bottom line behaviors and know that abstaining from them is leading you down the path toward your true self. Ceasing bottom line behaviors is an act of love toward yourself not a punishment. You do this because not doing it could mean death or loss of sanity. You do it because today you want to hold onto your serenity. Knowing your bottom line behaviors and respecting their destructive power is a life preserver in recovery.

Photo above found at:
http://browse.deviantart.com/?q=gentle path&order=9&offset=24#/d2qvad7

Surviving Withdrawal

It seems that one of the biggest predictors for achieving sobriety (from any type of addiction-- drug, alcohol, love, gambling, etc.) is the person's ability to endure withdrawal. Certainly there are people who endure the pain of withdrawal and, in a matter of days or weeks, return to the drug. There are even those who have survived withdrawal multiple times. I think the largest group, however, are those who never enter withdrawal EVER.

I have come to believe that enduring withdrawal is nearly impossible when attempted alone. It's just too hard and an addict needs accountability, someone there holding them to the sober line. Addicts turn to the drug/activity of choice to avoid emotional pain of some sort. The use of addictive relationships and substances helps stave off pain from the past that, at the time, we did not have the tools to experience. A neglected or abused child with no parental support is not equipped to emotionally cope. The pain of this remains frozen and forever delayed through addictions. When this person, at age 35, decides to stop the addictions, the pain of that event, and perhaps many other events, shows up presenting a bill. Withdrawal pain includes experiencing delayed hurts... thus, why so many people fear they cannot endure it.

If someone feels they are ready to endure the darkness and pain of withdrawal, then I encourage you to surround yourself with loving and supportive people beforehand. Cut back on other responsibilities and be prepared to show immense kindness and compassion to yourself. Be prepared to cry, rage, and talk, talk, talk. You may want to write about what you are feeling. You may want to exercise or read about what you are going through. Reading about the process is a helpful reminder that the pain of withdrawal is productive and useful. Be patient with the process and know this is only a season of hurt and will yield great rewards when endured.

You have essentially been dropped into the ocean with oxygen, a flashlight, and a compass and told where to go. If you freak out and continually come to the surface, you will never be able to complete this mission. At some point you have to accept that you have all the tools you need to get where you are going. Stay calm, stay in the water, use your tools, and keep swimming.

Photo above found here:
http://conh.deviantart.com/art/A-Snapshot-of-Life-14918632

Sex and Love Addiction, Part 2

Sex and Love Addiction-- the withdrawal and recovery phases. I am assuming and hoping that any addict at this phase is fed up with their own addiction. At this point, an addict is willing to endure whatever withdrawal pain that comes and willing to sacrifice and let go of whatever and whomever in order to shake this addiction. By now the addict realizes that to continue on in the unhealthy behaviors and patterns of sex and love addiction can mean only certain death or irreversible loss of sanity. It is this realistic and healthy fear that drives an addict into recovery.

Withdrawal is tough. Like an addiction to a substance, withdrawal from sex and love addiction involves emotional, psychological, and physical suffering. The addictive process is occurring in the brain, thus, sex and love addiction is just as neurological and chemical as an addiction to heroin or alcohol. Withdrawing from these neurological and dopamine highs can create physical symptoms of sweats, chills, headaches, stomach aches, fatigue and/or listlessness. There are the unavoidable emotional symptoms of fear, panic, anxiety, intense sadness or depression, anger, the sense of "going crazy," and many other possible feelings. The withdrawal process is different for every person both in symptoms and duration.

Withdrawal is the process of ceasing all harmful behaviors and patterns related to your own sex and love addiction. This may mean refraining from compulsive masturbation, no longer incessantly phoning an ex-lover or driving by their home, ending frequent sex with strangers, or leaving an abusive relationship. Define your "bottom-line" behaviors-- those behaviors that you must presently stop in order to begin withdrawal and recovery. Know that ceasing these patterns and enduring the pain of withdrawal will require support from others. This is a difficult process that will be made only more difficult if you attempt it alone. Find a support group, a therapist, and a nonjudgmental and supportive friend. Get yourself into a 12 step group for sex addiction or sex and love addiction (Sex Addicts Anonymous or Sex and Love Addicts Anonymous). If you cannot find one in your area then consider a group for recovering codependents or an Al-anon group. These are sound 12 step groups that will provide you emotional support and a foundation of 12 step work to get you started. Read and learn about your addiction. Take care of yourself emotionally and physically during this very difficult and trying time. This process can take anywhere from 1-6 months depending on the severity of the addiction and your consistency in refraining from bottom-line behaviors.

During the withdrawal phase of recovery, all of your poison and junk from the past will begin to bubble to the surface. Acting out and mood-altering with unhealthy partners and in unhealthy behaviors have kept these feelings at bay for many years. Now that you are no longer engaging in the love addiction, these feelings are allowed to come out. You may feel compelled to begin overeating, drinking, or completely isolating yourself from the world as a means to cope with withdrawal. As much as you can try not to pick up other addictions! As much as you can try not to go to the opposite extreme of sex and love addiction and become a sexual anorexic, mistaking that for recovery. Recovery from sex and love addiction does not mean you will never be in a relationship ever again, it means you are beginning a relationship with yourself for the first time ever.

If you endure, you will find one beautiful morning, you wake up with this strange feeling. You will feel quiet on the inside and open to the universe and a Higher Power. You will feel clean and free. It will likely scare the hell out of you, but pat yourself on the back. You are experiencing the peace of recovery and this is a marker that some painful emotional wounds have healed and you have begun a trusting relationship with self. Surviving withdrawal is an accomplishment to be grateful for and one that opens the door to deeper recovery... to be discussed in Part 3.