Lorazepam

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When addiction language is used, it is assumed that a person has some level of control and some level of culpability for their condition and can therefore take action to remedy it.

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The term addiction was used by the veteran campaigners in the UK and some are still arguing in favour of it.  However, most of us now agree that dependence and addiction are different and dependence is the appropriate word.

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Psychiatric Drugs: Key Issues and Service User Perspectives

By Jim Read 2005

Page 79

 

https://books.google.com/books?id=RU5dAQAAQBAJ&pg=PA79&lpg=PA79&dq=drug+companies+like+the+word+dependence&source=bl&ots=Fq3sHjrLEX&sig=A8kgnXUp9ViXlgHjqCTtRzw3bgo&hl=en&sa=X&ved=0ahUKEwiL-P7hxKncAhVolFQKHRxTB_YQ6AEIqQEwEQ#v=onepage&q=drug%20companies%20like%20the%20word%20dependence&f=false

 

This paragraph aptly describes the two emerging views on "tranquillers" in Britain in the 80's and 90's (the dependence view favored by doctors and drug companies, by the way), and helps us understand why Behan chose to use the word "addiction" in his memorandum.

 

Quoting Read:

 

"In the 1980’s, doctors and drug companies had to admit that tranquillisers possessed similar characteristics to illegal drugs of addiction, although they preferred to use the word dependence.  Their justification for this distinction was that people were not getting hooked on them through recreational abuse.  The distinction could be dismissed as a euphemism designed to cover up the dangers of tranquillisers, but it is one that was welcomed by many of the people struggling to get off them and who didn’t want to be called addicts, a term they associated with illegal activities, degenerate lifestyles and and element of choice in having deliberately taken drugs known to be addictive.  Others, however, embraced the term “addict” as a way of drawing attention to the harm caused to them by the medical profession."

 

So there are two camps.  I'm with Behan circa 2004.

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Yes, that is the argument but what has happened in the UK is that addiction services were set up and no services for prescribed drug dependence (the term I prefer and now use).  On a personal level I do not identify with the word addict and I do not feel that I was ever addicted, the word to me describes something quite different.  I was referred to the Substance Misuse Service as the only place I could consult with a doctor who is knowledgeable about benzodiazepines, I am furious that I should have to attend such a service because I followed medical advice and consumed a prescribed drug.  We are campaigning in the UK on services for prescribed drug dependence  ... benzodiazepines are now a lesser problem with antidepressants being a much bigger problem.  There is huge resistance from psychiatry that antidepressants should be included in the current Govt review and they are very keen to talk about benzodiazepines being addictive so that they can portray antidepressants as being largely unproblematic and non-addictive.  I  believe it is really important to separate out prescribed drug dependence and illegal drug addiction and separate services must be provided.

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Fiona, re/ AD's and moving to page 80, start with Glenmullen (2005, p 23)...regarding Eli Lilly's successful efforts to create a new linguistic term.

 

https://books.google.com/books?id=RU5dAQAAQBAJ&pg=PA80&lpg=PA80&dq=eli+lilly+paid+them+to+write+eight+papers&source=bl&ots=Fq3tyilQvV&sig=SLYks6o7tnu1kqf-YF4txec1-Ns&hl=en&sa=X&ved=0ahUKEwim1Oaa_6vcAhWrv1QKHcs_DZwQ6AEIKTAA#v=onepage&q=eli%20lilly%20paid%20them%20to%20write%20eight%20papers&f=false

 

Then scroll forward from there and read the section about "Rat Parks."

 

Interesting book!

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Thanks, I think I have read that before but my memory isn't so good ... 

 

 

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Thanks, I think I have read that before but my memory isn't so good ...

 

As you know, I'm all about new linguistic terms.  And so are Eli Lilly and others, apparently.

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Anyway, it's a tale of shattered lives and shattered dreams and profound physical and mental disabilities no matter what sort of language is being used.

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A great deal of time is spent in activities necessary to obtain the substance, use of the substance, or recover from its effects.

 

Spoken like a true addict. But we ARE NOT addicts, PhotoSF. You may consider yourself an addict, but don't put the label on us.

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A great deal of time is spent in activities necessary to obtain the substance, use of the substance, or recover from its effects.

 

Spoken like a true addict. But we ARE NOT addicts, PhotoSF. You may consider yourself an addict, but don't put the label on us.

 

Thank you, Terry .

 

Just because someone has a harrowing taper or recovery doesn't makes them an addict. Benzos just quit working for some people, and it becomes a do or die, potentially life threatening situation, and there is no way out but slowly through. The ultimate toxic tolerance wall, aka the dreaded "relative withdrawal". No updose will ever help, no emergency or rescue doses will help, staying on the same dose doesn't help, and tapering down becomes nearly impossible, where every fraction of a milligram is a hard fought victory, all the while being conveniently shrugged off as and addict or mentally ill by acquaintances, friends and family and medical profession. This is not the way how it should be. People need to be able to taper and recover in peace without having to be labeled by others.

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A great deal of time is spent in activities necessary to obtain the substance, use of the substance, or recover from its effects.

 

Spoken like a true addict. But we ARE NOT addicts, PhotoSF. You may consider yourself an addict, but don't put the label on us.

 

Terry offers sentence from somewhere:  "A great deal of time is spent in activities necessary to obtain the substance, use of the substance, or recover from its effects."

 

And then Terry says:  "Spoken like a true addict."

 

A google search on the sentence leads me here, in which that sentence is used verbatim in the DSM-IV-TR (circa 2000) description of substance dependence.  Brought to us by the American Psychiatric Association.

 

https://www.ncbi.nlm.nih.gov/books/NBK92053/table/ch2.t5/

 

I'm not trying to be contentious.  I'm just confused.

 

As for label-slapping, that's not something I do.  You'll have to look over there, on the left, for that...they're really good at it.

 

And no, I'm don't consider myself an addict.  Not anymore, anyway.  But I most definitely was an addict, for twenty years.

 

 

 

 

 

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It is confusing.

 

What would someone call a person who ends up falling apart on 2mg day of Lorazepam, being unable to withdraw for the risk of losing functionality, and their job, family, everything? Suppose that the person gets to 4mg a day and can keep their family and work and everything and buy themselves 5 more years of functioning. But 5 years later, they collapse again...

 

Feels to me that a lot of these definitions come to play when the person stops being functional. We live in a society where functionality and productivity is at the very premium, and most companies and families and people around us couldn't care less on how much benzo we're on, as long as we are functioning and fulfilling social obligations.

 

Once the person falls from grace and stops functioning, nobody gives a damn if they collapsed on .5mg of Ativan or 2mg of Ativan or 8mg of Ativan. The social indictment is just the same, regardless of the dose/time. It has to do with the severity of symptoms, more or less.

 

Sadly, people take these drugs to be able to function, and unless a person is thoroughly acquainted with this drug class, it is hard to say what is a therapeutic effect and what is a toxic effect, or if it is one and the same thing. It's a murky world of definitions out there.

 

It is a murky world because many people choose to take benzos voluntarily, without really understanding them very well. And it's the psychiatry that writes definitions of substance use/abuse/dependence, so they are going to be self-selecting, without calling the drugs they prescribe 'chemicals' or 'substances'. That's always reserved for other drugs, as far as psychiatry is concerned.

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Thank you, Loraz. Well said.

 

PhotoBugSF, why did you consider yourself an addict for 20 years? Was it illicit buying of drugs off the Internet or on the street, was it taking loads of pills at one time, was it ODing on them, or were you just suffering from tolerance for a lot of those years and THOUGHT you were an addict because of that? I'm confused.

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It is confusing.

 

What would someone call a person who ends up falling apart on 2mg day of Lorazepam, being unable to withdraw for the risk of losing functionality, and their job, family, everything? Suppose that the person gets to 4mg a day and can keep their family and work and everything and buy themselves 5 more years of functioning. But 5 years later, they collapse again...

 

Feels to me that a lot of these definitions come to play when the person stops being functional. We live in a society where functionality and productivity is at the very premium, and most companies and families and people around us couldn't care less on how much benzo we're on, as long as we are functioning and fulfilling social obligations.

 

Once the person falls from grace and stops functioning, nobody gives a damn if they collapsed on .5mg of Ativan or 2mg of Ativan or 8mg of Ativan. The social indictment is just the same, regardless of the dose/time. It has to do with the severity of symptoms, more or less.

 

Sadly, people take these drugs to be able to function, and unless a person is thoroughly acquainted with this drug class, it is hard to say what is a therapeutic effect and what is a toxic effect, or if it is one and the same thing. It's a murky world of definitions out there.

 

It is a murky world because many people choose to take benzos voluntarily, without really understanding them very well. And it's the psychiatry that writes definitions of substance use/abuse/dependence, so they are going to be self-selecting, without calling the drugs they prescribe 'chemicals' or 'substances'. That's always reserved for other drugs, as far as psychiatry is concerned.

 

LF writes:  "And it's the psychiatry that writes definitions of substance use/abuse/dependence, so they are going to be self-selecting, without calling the drugs they prescribe 'chemicals' or 'substances'. That's always reserved for other drugs, as far as psychiatry is concerned."

 

Correct.  This is why all versions of the DSM are shams.  The first order of the American Psychiatric Association is to protect itself and its members.

 

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I agree with that statement. The DSM is a bit of a sham. Each new version is always debated by the various entities-the American Psychological Association/ American Psychiatric Association.

 

A lot of really good psych docs and therapists don’t even bother to use it anymore.

 

What I don’t agree with is this “addict label” for benzos. It’s a chemical dependency period.

 

Did you crave it Photobug? Did you give up your job, family, and your home to get it?

 

Did you buy it off the street from drug sellers? Did you get “high” from using it?

 

That’s pretty much the idea of addiction. You know; that reward type feeling.

 

Yeah, call yourself whatever you want, but I’m not an addict. I’ve known addicts. They are in my family. They steal, they rummage through the most benign medications looking for opiates, and whatever they can find. They don’t even try to hide it. And when you confront them, they are the best liars you’ll ever find. And I called the cops on my family member. He was shocked because no one else ever did it before. But I went after him until he begged me to stop. The idiot had a rap sheet a mile long. Actually, it was my brother in law.

 

We’re you like that? If so, you were an addict.

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Thank you, Loraz. Well said.

 

PhotoBugSF, why did you consider yourself an addict for 20 years? Was it illicit buying of drugs off the Internet or on the street, was it taking loads of pills at one time, was it ODing on them, or were you just suffering from tolerance for a lot of those years and THOUGHT you were an addict because of that? I'm confused.

 

Terry38 asks:  "PhotoBugSF, why did you consider yourself an addict for 20 years? Was it illicit buying of drugs off the Internet or on the street, was it taking loads of pills at one time, was it ODing on them, or were you just suffering from tolerance for a lot of those years and THOUGHT you were an addict because of that? I'm confused."

 

I'm so glad you asked this, Terry.  We're back into definitions.  There are lots of "definition" makers out there.  The authors of the ever-evolving, constantly-morphing DSM, various academics and medical experts, pharmaceutical companies working behind the scenes to soften the language to protect themselves (and sell more stuff), campaigners who wish to distinguish between people who obtained (and became hooked on) benzos on the street and "respectable" people who obtained (and became hooked) them from a doctor, and so on. 

 

We choose the definitions and the language that make us feel comfortable and safe.  This is why some people in the U.S. are democrats and some people are republicans, for example.

 

I'm a very basic, Occam's Razor sort of guy.  We've been through this many times in other threads, but I'll just bottom line it again for you.  Just as you have selected your definitions, I have selected mine:

 

1.  You have an addiction when you can't stop taking a substance or engaging in an activity.

 

2.  You have a dependency when you depend upon something to treat an illness or on someone to perform a service.

 

Getting into qualifiers doesn't serve much of a purpose.  For example, you might say "but PhotoBug, you didn't experience craving or exhibit seeking behavior, did you?"  And I will say (again) that in the presence of an easily refillable prescription at a local pharmacy, the phrases "craving and seeking behavior" have no relevance and no meaning, at least until the prescription runs out.  And the word "illicit."  Please, Terry.  "Illicit" is whatever the system decides is illicit.  Weed is no longer illicit because the system has now decided it isn't.  "But PhotoBug, did you have an OD?"  Of course not.  I took the medication as prescribed.

 

There was a video (I think it was a Vice piece) that was posted in this forum not long ago that revealed how Xanax was being peddled on the back streets of a British city.  The journalist was able to interview one of the street suppliers and many of the users who were crammed into a run-down flat, stoned nearly senseless and slurring their speech, carving crude tatoos into each others faces, etc.  This is the image that respectable benzo users (most of us here) want very badly not to be associated with.  "I'm not one of these," they tell themselves.  "Don't put me in a detox center with these disgusting people," they would say.  "I'm not one of these."

 

Well, think about it a little more.  Many of these "losers," rather than seeking "professional help," sought relief through finding friends in the wrong places.  Maybe they had no choice.  Maybe the NHS wasn't able to work them in.  Maybe their parents failed them.  In any case, they found comfort from their anxieties, depression and isolation...and they found their addictive meds...on the streets and in these groups.  The group members became their therapists, and the suppliers on the streets became their pharmacies.  If they had been funneled into the NHS system (or in the U.S., paid a visit to a member of the American Psychiatric Association) they would found roughly the same things, albeit dressed up significantly.  But, we're more likely to call these people addicts because we believe they seek and they crave...and because they are deplorable.

 

But you know, I no longer have a dog in this hunt.  I'm out of the trap.  Still limping, but out.  I'm older and not well at all, so there's that.  And my kids have been warned.  They've learned from my experience and they are safe from BOTH channels of benzodiazepine distribution. 

 

But for the future of western societies as a whole, I can see so clearly that the strategy of putting lipstick on this pig is going to fail and many, many more people will suffer because they didn't receive the right message.  The NBC snippet was a good start.  It contained the correct message, which was "hey folks, be careful, you can easily get addicted to this stuff and suffer like this lady suffered."  But without repetition, this too will be wiped out by the next news cycle.

 

That's too bad.

[[In...]]

Photobug,

 

Maybe you got mixed up here. Terry wasn’t asking that last post. It was me. You know, it’s me.

 

I’m Intend To Be Off. I’m not Terry.

 

Actually by now I could be Want to be Off or Plan to be Off. This is taking awhile and I’m tired of it.

 

But I haven’t changed my moniker so it’s me. Not Terry.

 

But I guess your answer was in that response to Terry. So whatever. Seems you’re totally convinced so no point in debating the issue.

 

Actually the BIC folks weren’t so happy with the addiction labeling. You need to read those posts or maybe you have.

 

Ok you were an addict. Guess you acted like one too. That’s my conclusion.

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Photobug,

 

Maybe you got mixed up here. Terry wasn’t asking that last post. It was me. You know, it’s me.

 

I’m Intend To Be Off. I’m not Terry.

 

Actually by now I could be Want to be Off or Plan to be Off. This is taking awhile and I’m tired of it.

 

But I haven’t changed my moniker so it’s me. Not Terry.

 

But I guess your answer was in that response to Terry. So whatever. Seems you’re totally convinced so no point in debating the issue.

 

Actually the BIC folks weren’t so happy with the addiction labeling. You need to read those posts or maybe you have.

 

Ok you were an addict. Guess you acted like one too. That’s my conclusion.

 

"But I guess your answer was in that response to Terry."

 

Correct.  I was responding to Terry's brief questions, as quoted.

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PB, anyone ?

 

What about this ?

 

I don´t depend on clonazepam to treat something.  They fucked me up. Agreed, dependence is an euphemism. But people associate addiction with craving and pleasure.

 

´ You have an addiction when you can't stop taking a substance or engaging in an activity.´ Well, you know I could. Just don´t ask what happens next ... I wouldn´t call that withdrawal ...

More like exposure of intense and physical harm. Anyone to keep the people away who would ´help´ me ? You know, with antipsychotics or clonazepam ....

 

It´s not the CT I could have experienced 5 years ago. And  no, these things quite often do not go ´by the book´.  The local village idiot ´GP´ really fucked me up. Couldn´t have happened in USA, Dutch system is horrible.

 

Addiction ? The question of local addiction services/care ´what goes though your mind when you take a pill´I can answer with ´so awful that I see myself forced to take that clonazepam because of what that horrible GP did´. I had expected to be off 4 years ago, latest. Long story, you can read bits and pieces on this forum.

 

 

 

 

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Liberty,

 

I think you’re saying the drug really messed you up, but you’re not an addict. I never thought you were. I know that healthcare there and the drug K totally damaged your health.

 

 

[[In...]]

Photobug,

 

Why not respond to me?

 

Curious. Lots of experience here with drug addicts.

 

Therapist here-me.

 

So addicts in the family, and plenty of clients who were in substance abuse treatment. None of them for benzos though. Alcohol, opiates, heroin, meth. No benzos.

 

Why not respond to me? Some odd reason perhaps?

[[In...]]

Photobug, I conclude you just don’t know what to say to me. So be it.

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Photobug,

 

Maybe you got mixed up here. Terry wasn’t asking that last post. It was me. You know, it’s me.

 

I’m Intend To Be Off. I’m not Terry.

 

Actually by now I could be Want to be Off or Plan to be Off. This is taking awhile and I’m tired of it.

 

But I haven’t changed my moniker so it’s me. Not Terry.

 

But I guess your answer was in that response to Terry. So whatever. Seems you’re totally convinced so no point in debating the issue.

 

Actually the BIC folks weren’t so happy with the addiction labeling. You need to read those posts or maybe you have.

 

Ok you were an addict. Guess you acted like one too. That’s my conclusion.

 

"Ok you were an addict. Guess you acted like one too. That’s my conclusion."

 

Thank you for rendering your conclusion.  I absolutely was addicted and was therefore an addict.  The word addict is derived from the word addicted.  But I did not exhibit the behavioral traits (such as seeking the drug) that are ascribed to an addict by those who favor the word dependent.  I didn't need to seek, I had a prescription.  I didn't risk an OD because I took the medication as prescribed.  But yes, I did feel what can be described as a "high" in the form of great relief from interdose withdrawals and the psychological assurance that I would not crash and burn, just as we all do (or did).  This is a very simple matter.  Although the purpose of the initial prescription was to treat a condition, it became more and more clear as the years went on that I was taking the drug simply because I was taking the drug.  This is addiction, not dependency.  As I said, we all embrace the definitions we like.

 

"Actually the BIC folks weren’t so happy with the addiction labeling. You need to read those posts or maybe you have."

 

Of course I read the posts.  But my views, and apparently the views of NBC in this case, are not influenced by whether or not they make other people happy.  If we're trying to see an important thing clearly, making people happy is the last thing to consider.

 

"Seems you’re totally convinced so no point in debating the issue."

 

Correct.  We've gone round and round on this in this forum for a long time.  But take heart, your views are in the clear majority.  In fact, in this forum I believe I'm the only outlier.  The dependency people are ruling the roost!

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Photobug, I conclude you just don’t know what to say to me. So be it.

 

Just saw this.  Please relax.  It's not like I'm continually chained to this thing and available at your beck and call.  Take a deep, healing breath...

 

[[In...]]

Well that interdose withdrawl is upsetting for sure. That happens often on Ativan and xanax, and it is a great relief to get that next dose. I totally understand that.

 

Plenty of people have that problem. I was unusual in that I did take xanax, but only once a day. Never felt the need to take more. Slept fine. No problems. But I had a rough cross to K, and now have plenty of difficulties. Just too much messing up by doctors, and switching of generic brands. I have a very good doctor now thank goodness.

 

I’ve just not had any interdose withdrawals ever. Doing ok with my K taper, but another switch coming up. All these generic K discontinuations have affected many people here.

 

When I said that the BIC folks were not so happy, my meaning is that they were totally dissatisfied with the way it was handled. As in handled badly. It is not about making anybody “happy.”

 

I do know I’m in the majority as far as this problem of benzos being a dependency. Most people here do think that. It’s not just their opinion. Most here come to this forum knowing very little about benzos if even anything. They learn as they go. And this is what they learn.

 

Personally, I never thought much about either way. I’ve just wanted off, and that’s it. But I’ve learned that “addiction language” tends to put one in a category that is not only inaccurate, but a place that most professionals healthcare folks want a person to go to a detox facility. I tend to think you did not want to do that yourself, and thus you didn’t do that.

 

Addicts can do very well in a detox setting. They simply have trouble with relapsing. The average relapse for alcoholics is @12 relapses before they truly work hard to get off and stay off.

 

So that’s the addiction picture. You weren’t like that at all from my understanding. So by my definition, you were not an addict. But you can call yourself whatever you want. It’s your right to do this.