Minor dependence comorbidity with Alcohol

[[em...]]

Hi,

 

Alcoholic suffering Post Acute Withdrawal.  Used Diazepam to take myself off of alcohol 4 or 5 times in the last year.  Relapse every time I taper off the benzo's.  As much as 15mg/day in the last year.  Last stint started 40 days ago at 10mg/day after relapsing; currently at 5mg/day.  Obviously I have excited GABA A whether that be before self medicating with 10-40oz of Vodka a day or as a result.  I know it sounds trivial but diazepam seems to be the only thing that has kept me sober off alcohol over the last 5 months (1 week lapse in that time).  I'm attempting again to cut it off again without relapsing to alcohol.  Currently taking Diazepam, Campral, Naltrexone and Mirtazapine.  I will be starting Baclofen (Gaba B agonist) in the slim time I'm going to be without benzo's or alcohol.  I'm curious how others have settled their anxieties post benzo's and/or alcohol.  I promise not to interfere with anyone.

[[be...]]

Hi  Welcome to BenzoBuddies!

 

I am so happy you found us today.

 

You might like to check out The Ashton Manual it is an authoritative source on what to expect in withdrawal and recovery.  Dr. Ashton is an expert in the field.  She describes and explains withdrawal symptoms.

 

Please feel free to post to any of the dedicated boards, we have a wonderful community of people here, who will give sound advice. Members have been through all aspects of benzodiazepine use and withdrawal and are more than willing to share their experiences.

 

Withdrawal Support During Your Taper

 

Please take the time to Create a Signature.  This will allow others to see where you are in the process so they can better support you.

 

Again Welcome! 

 

benzos-R-cruel

 

[[Te...]]

 

Hi, empyr3al,

Although I wasn't fully alcoholic, as I reached tolerance on klonopin,  I did drink excessively to deal with the stress and anxiety no longer quieted by the klonopin.

Last summer, before I knew what the benzos were doing to me, I got very sick and quit drinking cold turkey. Ironically, the klonopin probably kept me out of the hospital. Be aware that benzos and alcohol work on the sane receptors, and damage them.

I'm 7 months off alcohol. In the first three months, I had terrible cravings, even at odd hours when I never drank. It was all made worse by the taper from klonopin and then the gabapentin used to taper off the klonopin.

To deal with it all, I meditated. There are several good apps for that, as well as a free online program at palousemjndfulness.com (recommended by my cognitive behavioral therapist). My therapist also recommended a technique called urge surfing to deal with the cravings. You can search for it on YouTube.

It hasn't been easy. I do miss having an occasional drink. But I'm not consumed by it now. And I tell myself nothing good will come from drinking and it will only impede healing. And I keep telling myself that every day. I want to get better.

Hugs and healing.

TeeCee

 

Hi,

 

Alcoholic suffering Post Acute Withdrawal.  Used Diazepam to take myself off of alcohol 4 or 5 times in the last year.  Relapse every time I taper off the benzo's.  As much as 15mg/day in the last year.  Last stint started 40 days ago at 10mg/day after relapsing; currently at 5mg/day.  Obviously I have excited GABA A whether that be before self medicating with 10-40oz of Vodka a day or as a result.  I know it sounds trivial but diazepam seems to be the only thing that has kept me sober off alcohol over the last 5 months (1 week lapse in that time).  I'm attempting again to cut it off again without relapsing to alcohol.  Currently taking Diazepam, Campral, Naltrexone and Mirtazapine.  I will be starting Baclofen (Gaba B agonist) in the slim time I'm going to be without benzo's or alcohol.  I'm curious how others have settled their anxieties post benzo's and/or alcohol.  I promise not to interfere with anyone.

[[em...]]

Hi TeeCee, and everyone else.

 

I'll post this as further explaination of my introduction.  My sobriety is maintained by Diazepam currently but I am exploring some alternatives.  Risking sobriety but in a very safe place atm.  Safety nets all put in place.

 

I've been a full fledged physically dependent alcholic for 20 years with some periods of sobriety here and there.  Other times managed with a six pack of beer instead of a 40 of Vodka.  Known as AUD (Alcohol Use Disorder) by the DSM-V.

 

Being that I'm Canadian, we have some some subsidies for rehab, therapy and such.  Medications are covered generally through employers insurances; which i currently have.  Some of my meds are extremely expensive and I won't be able to sustain using them when my benefits run out.  I do meditate and practice mindfulness.  I've done 2 inpatient treatments one subsidized and one high end.  Both AA based.  I've done one outpatient day treatment more CBT based.  I have done biofeedback training with a psychologist. I've done in hospital anxiety groups.  I have attend non AA based talk therapy groups.  I have done hundreds of meetings (90 in 90, etc).  Experiences that are adjuncts to pharmacology in maintaining sobriety from alcohol.  I don't attend currently as using using benzo's is a no no in the culture of NA and AA.

 

Canada is not as forward thinking as we'd like to think of ourselves as in regards to addiction treatment.  Standard therapy from a GP or even in specialist care are Diazepam to detox short term and SSRI/SNRI's for anxiety and depression.  Only 2 medications which have 10% efficacy are approved therapies for AUD and are used for roughly maximum a years therapy post acute withdrawl.  They are rarely if ever mentioned or suggested by GPs or Rehabs.  Their prescription is AA and antidepressants.  Aud treatments are Naltrexone which blocks opiod receptors and simply lessens the enjoyment of drinking.  It is prescribed as a daily does of 50mg.  And Campral (acamprosate) a calcium salt which is not specifically understood in its mechanisms but seems to correllate to an ion channel which bypasses GABA to some degree.  Wiki it if you are curious about how misunderstood it is.  These medications without benefits cost over $400 together.  Neither specifically address anxiety and cravings. I've managed to get my GP to prescribe both concurrently although with some reluctance at first.

 

I am exploring some of the off label drugs such as Mirtazapine, Baclofen and Gabapentin which are insanely cheap by comparison and are showing higher efficacy rates than the approved medications.  In some studies Mirtazapine has been 44% more effective than placebo and Baclofen in high dose showing promise even higher. It is difficult to get prescriptions for these meds, but some how I've been effective at teaching and guiding my GP and some other specialists to explore their possibility as treatment.  They obviously come with down sides and up sides as can be seen on this forum and others.  In my case some side effects are worth the benefits.  I obviously cannot stay on diazepam indefinitely.

 

In regards to Naltrexone, some use off guidelines an hour or two before drinking to make the brain unlearn its habit of finding peace in a bottle.  Its known as the Dr. Sinclair method for those that don't know.  Its a way of retraining the brain using the extinction method where by the brain unlearns the habit.  Being abstinent this doesnt fit in my requirements but I plan to use what Naltrexone I have on demand in high risk scenarios after moving my meds around which i will explain.

 

In regards to SSRI/SNRI/Multimodal.  Desvenlafaxine(Pristiq), Venlafaxine(Effexor) are SSRI's that actually are shown to increase drinking behavior in those with AUD.  I know this first hand from experience as they blew my addiction sky high.  Trintellix which is a newer multimodal drug caused me insane emotional disregulation and borderline insanity.  By far the worst experience using an anti-depressant so far.  I'm 2 months cold turkey off that med.  I've had bad experiences also with Cipralex.  Trazadone was interesting and was used as way to make me sleep when a rehab forced me off of Valium and Clonazepam in the past.

 

In Canada diazepam is used to prevent seizure during withdrawal but is not intended for long term use.  Although the school of thought in Canada is that benzo's are less harmful than alcohol.  The approved methods leave very little to assist an addict post detox to maintain sanity. I have NO cravings for alcohol in this scenario using diazepam which has given me insight into what long term abuse of alcohol has done to my brain.  Gaba A specifically is down regulated and simply not functioning properly.  It is the root cause of relapse for me.

 

So where does this leave me...  3.5mg Diazepam (tapering).  Now at 20mg titrating Baclofen to 30mg.  30-45mg of Mirt at night. 3x666mg Campral. 50mg Naltrexone daily which I'm dropping to on demand in high risk situations.  I've been on diazepam for just about 40 days so I'm weaning off of it at a quite rapid pace.  At any sign of issue I will reverse course. Being that Baclofen is a GABA B agonist and has a minor influence over how GABA A is regulated I have some hope it can appease some of the issues.  Its certainly not a direct replacement by any means.  I'll be evaluating my "fight or flight" behaviours and stress tolerances as this occours.  Next GP appointment is mid April.  At which point I can evaluate which direction I need to go.

 

If you are curious why I'm trying Baclofen, take a look at Dr. Amanda Stafford's website www.baclofentreatment.com

 

Thanks for reading!

[[Te...]]

Your situation is more complicated than mine. Benzos, then alcohol, made me ill, and other than short term use of gabapentin to get off the klonopin, I've refused all other meds. For me, I believe they all impede healing. Again, you are in a different place with alcohol than I am. I wish you luck, and perhaps someone else on this forum with an experience similar to yours can offer you better advice.

Hugs

TeeCee