The benzodiazepine crisis

The opioid crisis ravages families and communities worldwide; however, another class of widely-prescribed drugs rivals that destruction: benzodiazepines, potent anxiolytics coming in various forms and durations of action.¹ These medications have affected my life in a way unparalleled by any other substance; I am still to this day dealing with an intricate aftermath resulting from years of usage. Benzodiazepines, called benzos for short, are utilized by doctors to treat a host of afflictions: generalized anxiety, post-traumatic stress, depression, epilepsy, fear of public speaking/socializing, and likely much more. They act in a similar manner to alcohol—they sedate and sooth, taking away all of one’s felt problems for a time, making you feel good even if your life is inherently painful. Common benzodiazepines include, listed in order from longest half-life to shortest: diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), alprazolam (Xanax), and triazolam (Halcion).²

Neurologically speaking, benzodiazepines work to increase the synaptic transmission of GABA, the fundamental inhibitory neurotransmitter in the brain, and to decrease that of glutamate, the excitatory neurotransmitter. GABA soothes while glutamate arouses; in a healthy sober brain there is a harmonized interplay between these two messengers. While under the influence of alcohol or benzodiazepines, however, the action of GABA far outweighs that of glutamate, until they wear off, at which point glutamate function compensates and may create a felt state that is overwhelming and unbearable.³ Benzos are highly addictive, physiologically speaking but especially so from a psychological standpoint, as they provide the user with a genuine break from whatever is unfolding in their lives, be it desolate or mundane. Nothing really matters when you’ve taken them; the world around you fades into a silenced hue of somewhat-bearable. Some consume them sporadically, in the cases of a panic attack or a speech, for example, but others less fortunate fall into the trap of regular ingestion, quickly leading to complete chemical dependence and horrible withdrawal symptoms if and when stopped.

My story with benzodiazepines is comprised of harrowing misery and ultimate triumph. Of all the psychoactive drugs which have enslaved me, decidedly, benzos are the one I truly wish I never touched. After years of abusing them and stopping, only to abuse them again, stuck in a notoriously vicious cycle, my brain health is noticeably and significantly below its healthy normal. My first encounter was in my early 20s, a time when a negligent doctor would hurl scripts at me in an apathetic effort to absolve me of a terrible and constant corroding pain I lived with, residing around my liver, an evident result of my then excessive alcohol intake. I recall vividly the love affair that promptly began, my first exposure being to clonazepam, a relatively long-acting benzo that is often the first approach when this treatment route is decided on. Upon consumption, the incessant noise I was so accustomed to would dampen, a serenely blissful sense of quiet bestowed on me, akin to a massive weight being removed from my chest. It is no surprise this type of drug is so sinisterly addictive; in a culture brimming with chaos and pain, anything to reduce the effect that external stimuli has on our fragile psyches is welcomed. In the case of benzodiazepines, one finds themselves with a tiny, legal and easily-obtained pill that within minutes causes its client to drift out from the jagged edges of reality into a cloud-like state of tranquility. They offer an almost unfair advantage—there are no internal concerns under the hazy guise of benzo influence, until the drug has worn off, at which point one can reach back into the big-pharma-approved cookie-jar to induce yet another day of artificial inner safety.

I used and abused benzos periodically for a few years before getting serious with them; a prescription was always within hands-reach, unquestioningly gifted by my dealer-esque treatment provider of the time, and I absolutely loved how they made me feel. Oftentimes I would swallow them to abide a hangover, or whilst drinking to amplify the intoxication, but only after my father left this world, nearly five years ago at the time of writing this, did my usage become parasitic and my body dependent. In the months succeeding his abrupt and rather gruesome demise, I was popping pills like a child does candy, my consumption totally unhinged and unlimited. A major issue for users of sedatives, of pretty well any drug, is that of tolerance. The human body, particularly the brain, swiftly becomes habituated to the internal presence of an otherwise foreign chemical and eventually begs for higher volumes in order to reach the same status as before, which is clearly problematic. My own tolerance would later get so extreme that the amounts I had to take for one enjoyable dosage would likely kill someone else totally naïve to the drug; I am talking staggering amounts.⁴

Nine months had passed since saying goodbye to our family’s patriarch when I was assaulted by someone I had considered a friend, a person I trusted deeply in a vulnerable space, during a dark time of my life where many who had once been closest to me had become sparse and distant. Having battled through intense grief and addictions that year, returning from the edge of hell, my world was yet again ripped away from me, largely due to the dangerous decisions of another man. Beyond that juncture, benzos were no longer casual—I became addicted within days, not by some hedonic choice but out of necessity for my very survival. I did not possess the capacity to deal with that incident without a chemical buffer and at that time, thankfully, was abstaining from alcohol completely. This desperate fling lasted slightly over a month, after which I forced myself to detox, alone in a big empty house, constantly replaying that wholly traumatic event over and over and over until I became convinced that I was still living within its haunting framework.

The withdrawal from benzodiazepines is unlike any other experience known to man. It is inescapable and utterly terrible—symptoms include extreme and exaggerated anxiety, totally irrational paranoia, awful shakes and tremors, brain zaps, sharply gnawing muscle and joint pain, completely dysregulated stomach, hallucination, weeks-long insomnia, irritability, agitation, derealization, a constant sense of rapidly impending doom, and worst of all, suicidal ideation, planning, and potentially, success.⁵ Apart from all of that, the sudden cessation of benzos can easily kill you, with cause of death ranging from heart attacks and stroke to seizure and blunt-force head trauma. Despite my knowledge of that, even years prior to my first time coming off of them, I managed to put myself through at least four serious bouts of withdrawal in only four years. In some of these instances, the detox was conducted in a slow and precise manner under the supervision of a trained professional; in others, such as the first, I stopped abruptly, inducing a chaotic hell-scape that in itself is and was scarring. For example, in 2020 after quitting “cold-turkey” over the preceding Christmas, I fought long and hard with a new doctor to sustain the autonomy he had granted me, in regards to medication and how I used them, being triumphant until suddenly not. Overnight, I ended up addicted yet again to a high dose of clonazepam, along with amphetamines and clonidine, until months later yet another prescriber transferred me to diazepam to then spend nearly a year tapering down my dosage, each cut offering a renewed flavor of endured withdrawal.⁶

Looking retrospectively, I have various mental and emotional baselines obtained prior to my years of benzo trials that elucidate the detriment they induce, comparatively using the way that I feel in the present, totally clean from them. The journey has been long and painful and my brain will undoubtedly take many years to recover fully, if it ever does. This raises blatant questions regarding the ethics and morality involved in prescribing and supplying such drugs. They are clearly useful for certain occurrences, such as panic attacks, due to their innate ability to completely eradicate psychic turmoil in a matter of minutes. However, taken continually even for a short duration can result in dependency and the need to enter the agonizing detox phase; taken for a long period of time can result in atrophy of the brain, leading to debilitating conditions such as Alzheimer’s disease.⁷

In my experience, physicians who prescribe benzodiazepines rarely inform you, to an appropriate degree, of the nightmare you are willfully creating for yourself.⁸ With my original prescriber—not even a mention, only a half-hearted murmur, they will help your anxiety. Oftentimes I wonder just how many denizens of our culture walk around and interact under the influence of benzos. On low doses it is near-impossible to tell—intoxication only becomes outwardly visible after doubling or tripling the recommended intake. For all those who are, and I was once one of them, just how many knew at that moment of vial transference, from pharmacist to their eager fingers, that they were fated for an incredibly hellish and life-threatening ordeal should they ever want to go about living without? Beyond the obvious issues of dependency and withdrawal, benzodiazepine usage is problematic in that it promotes social engagement without the natural sensations of caution, fear and suspicion.⁹ This is a dangerous thing in a sick world. Not only does it make people susceptible to manipulation and poor choices, it provides an easy-out to perceived existence, something supremely desirable for those who struggle with the mundane and obscene aspects of society. People want a magic pill that makes them feel okay, and benzos provide just that, but at a cost that is unfathomable until the debt is actually collected. The pharmacological tax-man looms at every step in the life of the benzo-dependent, just waiting for that moment of awakening, the decision to peel off the chemical dressing and truly feel again what humans are meant to. These drugs do not only block out negative affect; they erode positive feelings as well, such as joy, curiosity and wonder. Spend a few weeks numbed out on Valium and you will have forgotten that happiness even exists. Their effects on the brain’s emotional system are frightening and I speak from firsthand experience; still I relish in even the tiniest fleeting signs of authentic felt emotion.

Opioids are murdering many, no doubt; however, our focus as a unified society need not fall in that regard in order to address the emerging crisis that is benzodiazepine usage. Perhaps the impact of the former is more visible—we see people on our streets strung-out and frozen in ungodly positions, and overdose statistics are on the rise, but imagine all the poor souls trapped behind the infernal gates of benzo-hell, muted and deaf to the world, empty, begging for a way out but naturally unwilling to stomach the insufferable withdraw phase which must be faced to do so, all because some doctor chose to apply a pharmaceutical band-aid to a holistic problem, to treat environmentally-induced symptoms with a powerful poison rather than ask: why these symptoms?

If you or a loved one are caught in this seemingly endless and hopeless spiral, you are not alone. There is light on the other side—I can attest to that—I thought myself irredeemable countless times in regards to benzos, as they repeatedly reeled me back in with their cold, blank, steely allure. It requires time, determination and dedication, as does any worthy endeavor, but to once again feel all that God intended us to is one of the most enriching and gratifying rewards one could ever attain.¹⁰ If you have not yet experimented with benzodiazepines, I sincerely hope you will heed my warnings and refrain from doing so; the inevitable misery to follow is exponentially more profound than any functional or sensational benefits that you may gain from using them. Our society, in an act of heightened compassion, should thoroughly update its attitudes and standards around benzodiazepines; for example, by:

1. fostering far more awareness and outreach around the perils of their usage, especially geared towards the youth population,

2. offering enhanced and compulsory doctor training on appropriate prescribing criteria and supervised withdrawal, and

3. prohibiting corporate incentivization—for physicians to pad their pockets through pushing these awful drugs on vulnerable and unknowing patients should be an offence punishable by law.

1. The term “anxiolytic” means that they work to reduce anxiety and fear.

2. The half-life of a drug or medication refers to the amount of time past point of ingestion after which there will be half the amount taken still active in one’s body.

3. Note that I am not well-versed in neuroscience—my rudimentary knowledge comes mostly, at this point, from a book I recently read titled Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs by Dr. Marc Lewis (Anchor Canada 2012), which is a fascinating account of the basic neurological happenings around drug use and addiction. All neuroscientific concepts mentioned in this section are paraphrased from this book (see pp. 23-24), other than the point about glutamate compensation, which I attribute largely to reading posts on reddit where a phenomenon termed “glutamate storm” is often discussed, referring to the neurological state of benzo withdrawal.

4. For example, 100-200mg of diazepam, where a normal dosage is 5mg.

5. Paradoxically, sustained benzo usage also has been shown to result in the development of suicidal tendencies.

6. Diazepam is a beast of its own, different from other benzodiazepines in that it also contains an active component that works as a muscle relaxant.

7. There is also a horrible post-acute stage of cessation, where only another benzo can take away the grinding horrors of waking existence, which just restarts the cycle all over again. This is a commonality in all drug withdrawal, something clinically referred to as post-acute withdrawal syndrome (PAWS). However, I would reckon with some certainty that in benzodiazepine withdrawal this stage is far more pronounced than with other substances.

8. I have also gotten this sense in general from the anecdotes of countless others. It seems to be a gap in prescribing ethics; doctors rarely offer up the appropriate level of warning when handing out benzos, perhaps due to monetary incentives given to them by massive pharmaceutical companies such as Purdue, who is linked directly to the opioid crisis and has been taken to court for such by activist groups. A great documentary was made about this titled All the Beauty and the Bloodshed which I highly recommend to anyone wanting to learn more about this rather insidious type of corporate behavior.

9. When I finally came off of benzodiazepines for good, I quite literally had to relearn how to walk, talk, and act in our world, and still months later this is an ongoing process I deal with.

10. To get off of benzodiazepines, I (and any competent professional) would recommend setting up a drawn out taper using diazepam or another long-acting benzodiazepine. There is a protocol set out in the Ashton Manual that is obviously not perfect (for example some elements of the equivalency table are debatable) but offers insight and a practical solution to being free from benzos. I also would point people to a group on Reddit called r/benzorecovery, a support group for those suffering from the negative impact of benzodiazepine usage. Information there should be taken with a hint of skepticism but overall it serves as a strong community of people going through similar things. Lastly, I urge anyone struggling with these drugs to contact me directly if it may be of use to you. Benzo withdrawal is no joke—please do not treat it as such.

Creator credit for Unsplash photos, from top to bottom: James Yarema, Kyle Cleveland, Sander Sammy, and Rosie Kerr.