Benzodiazepines in Canada: Is a withdrawal crisis looming?

[[Ka...]]

sharing this link

credit X Mark Horowitz

https://madincanada.org/2024/02/benzodiazepines-in-canada-is-a-withdrawal-crisis-looming/

Edited February 20 by [Ka...]

[[La...]]

Thanks very much for sharing this article, Katrina. I'm looking forward to reading it carefully a bit later on today when I have time. I just wanted to thank you, though. I haven't seen much written on this issue here in Canada lately -- other than discussion of benzo-laced opioids everywhere.

[[Re...]]

 

Thank you @[Ka...] for the article! 
I like Nicole's opinion about the interview, it grabbed my attention very quickly :
"...As often happens with editing and time constraints when making a documentary, that testimony wound up on the cutting room floor."

When I watched the interviews the length of recovery did come through , however. Of course I know the process and I know what to look for... The direct connection between failing to deprescribe correctly and the lengthy process was less obvious. 
To be honest, someone asked me a few months ago what is going on several months, years later I would have thought,  that it is a psychological issue. Why would I think anything else as an Editor?... Years later, " that can't be a thing". 
I think our highly motivated fellow Buddies, like @[Nu...]have a good chance to make change, understanding the process through lived experience. 

 

Edited February 20 by [Re...]
Typo, and correction

[[Li...]]

Major hat tip for finding and sharing this piece with us, @[Ka...]!

I hope all members and guests will read it.  

Nicole Lamberson’s comments about what was edited out of the Prescription Nightmare documentary is both telling and chilling.  She made it a priority to make two points during filming.  First, patients who are already physically dependent on benzodiazepines should never be forced against their will to withdraw. Second, conflating the terms ‘addiction’/’addictive’ with ‘dependence’/’physical dependence’ will result in harm.  Both of these important points ended up on the cutting room floor during editing.

Per usual, Mark Horowitz hit the proverbial nail on the head with his comments (excerpts below), especially those related to older adults. He’s also given us a great analogy to use re: the harm caused by stopping benzodiazepines too quickly.  

“In the wake of increased public awareness of the dangers of benzodiazepines there can sometimes be unintended negative consequence of further harm. When doctors are made aware of the harms of benzodiazepines, the pendulum can swing to the other side, and prescribers can react in knee-jerk fashion by compelling their patients to stop benzodiazepines too quickly. It is often difficult to hold these two competing ideas in mind: that it can be both bad to be on a medication, and even worse to stop it too quickly. I often use the (visceral) analogy of an arrow: it is bad to have an arrow in your chest (equivalent to being on a drug that causes multiple harms) but it can be even worse to rip that arrow out of your chest (the harm that comes from severe withdrawal effects after quickly stopping). 

The only way to steer between these two poles is to stop these drugs carefully – if people are willing to do so. Given how difficult the process can be for some people it may be the lesser of two harms is to stay on the drugs, especially for older people who have been on the drugs for decades. If people do decide that they wish to come off benzodiazepines then they should do so gradually.”

[[Re...]]

 

7 minutes ago, [[L...] said:

I often use the (visceral) analogy of an arrow: it is bad to have an arrow in your chest (equivalent to being on a drug that causes multiple harms) but it can be even worse to rip that arrow out of your chest (the harm that comes from severe withdrawal effects after quickly stopping)

In an interview Dr. Horowitz used decompression sickness as an analogy for stopping cold turkey and rapid taper. I loved that analogy as well. 

11 minutes ago, [[L...] said:

especially for older people who have been on the drugs for decades

I wonder what percentage of the elderly, who may be institutionalized or are diagnosed with dementia are actually going through benzodiazepine withdrawal or tolerance, or other psychiatric drug withdrawal and are widely misdiagnosed... 

We have great people to do great things in this community. I really think so. It is high time.

[[Li...]]

1 minute ago, [[R...] said:

I wonder what percentage of the elderly, who may be institutionalized or are diagnosed with dementia are actually going through benzodiazepine withdrawal or tolerance, or other psychiatric drug withdrawal and are widely misdiagnosed.

Whatever the percentage … it’s too high.  

Older adults in general (not just those who are ‘institutionalized’) are at risk for both misdiagnosis and what I have dubbed PID — Potentially Inappropriate Deprescribing.  (PID is a play on PIM — Potentially Inappropriate Medication.)

[[Nu...]]

Thank you, @[Re...], for the kind shout out.

From a healthcare provider perspective, I know of patients admitted into the hospital who had their benzo "stopped on discharge". The patient would then begin with these horrible symptoms that are often treated with powerful meds like haldol. In essence, benzo withdrawals treated with powerful IV push antipsychotics, which, after not working, can place the patient at risk of physical restraints.

One particular case I know of followed this sequence after the patient became aggressive with muscle twitching and an array of physical symptoms. The physician was considering physical restraints but, after advocating for the reinstatement of the benzo, which the physician reluctantly agreed to, the patient became the kindest, sweetest elderly lady you can imagine.

Benzos being held on discharge is common in many hospitals. It's hard to know the damage that is being caused. As @[Li...] said, any percentage is too high. If, as healthcare providers, we hurt even one person, that's too high in my book.

Hoping and praying for change. Hope benzos in the news and other current efforts will at least begin the conversations that can instigate meaningful change and protect others.

[[Ka...]]

47 minutes ago, [[L...] said:

Whatever the percentage … it’s too high.  

Older adults in general (not just those who are ‘institutionalized’) are at risk for both misdiagnosis and what I have dubbed  PID — Potentially Inappropriate Deprescribing.  (PID is a play on PIM — Potentially Inappropriate Medication.)

Older adults are often on other medication too & from what I have witnessed giving benzos, z drugs etc comes with additional risk. 

Edited February 20 by [Ka...]

[[Ka...]]

27 minutes ago, [[N...] said:

Thank you, @[Re...], for the kind shout out.

From a healthcare provider perspective, I know of patients admitted into the hospital who had their benzo "stopped on discharge". The patient would then begin with these horrible symptoms that are often treated with powerful meds like haldol. In essence, benzo withdrawals treated with powerful IV push antipsychotics, which, after not working, can place the patient at risk of physical restraints.

One particular case I know of followed this sequence after the patient became aggressive with muscle twitching and an array of physical symptoms. The physician was considering physical restraints but, after advocating for the reinstatement of the benzo, which the physician reluctantly agreed to, the patient became the kindest, sweetest elderly lady you can imagine.

Benzos being held on discharge is common in many hospitals. It's hard to know the damage that is being caused. As @[Li...] said, any percentage is too high. If, as healthcare providers, we hurt even one person, that's too high in my book.

Hoping and praying for change. Hope benzos in the news and other current efforts will at least begin the conversations that can instigate meaningful change and protect others.

‘Stopped on discharge’ has to be the worst scenario. 
This happened to a loved one, frail & with dementia on transfer to a nursing home. 

Edited February 20 by [Ka...]

[[jo...]]

6 hours ago, [[K...] said:

sharing this link

credit X Mark Horowitz

https://madincanada.org/2024/02/benzodiazepines-in-canada-is-a-withdrawal-crisis-looming/

What little faith I had left in the Medical Industrial Complex has completely evaporated.  It is a cult like any other, but with oversized power and influence.  Google is now safer to me than any mainstream credentialed 'doctor'.

[[Ka...]]

@[jo...] I’m in UK & I’m staggered where we are in 2024. 
 

Edited February 20 by [Ka...]

[[jo...]]

3 minutes ago, [[K...] said:

@[jo...] I’m in UK & I staggered where we are in 2024. 
 

There was a documentary in the UK in the 80s (two separate documentaries I think) that clearly demonstrated what devastation benzos were doing to people and communities all over the UK, yet I had to learn that the hard way after a college educated 'doctor' threw these pills at me without a word of warning.  He didn't even tell me they were benzos or what the possible side effects were.  I specifically went to a doctor and not a psychiatrist because I naively thought only psychiatrists could prescribe the potent head meds.  I just needed some temporary relief from stress induced insomnia.  Little did I know that stopping these meds after 4 weeks (no more than 1/2 the prescribed dose every day) would lead to an level of insomnia that I did not know was possible or could be survived. 

I have not returned to that doctor because he would likely gaslight me and I would have to seriously restrain myself from doing something rash.  It's his job to know this stuff.  I paid him good money for services and got a chemical lobotomy for my trouble.  These clowns haven't a clue.  Just glorified sales reps with zero conscience.  I know 'doctor bashing' is frowned on in here, but sometimes you just have to call a spade a spade.  Is anyone going to contact him and warn him against 'patient bashing'?  I didn't think so. 

[[Re...]]

I see why you are upset. The problem is, however, deeper and - I am sure you aware - very complex.

The average doctor does not know about this, it is a deeply faulty system when it comes to benzodiazepine withdrawal. It is not their fault.

It is rooted in the education doctors receive, the financial model in medical education and research and the patriarchy in the medical education system contributes to this anomaly, too. Moreover, drug safety is itself financed by drug companies, which is madness... 

Doctors just don't know about it, because, on paper - see the DSM - there is hardly anything to know about... 

Edited February 20 by [Re...]
Added "too"

[[jo...]]

3 minutes ago, [[R...] said:

I see why you are upset. The problem is, however, deeper and - I am sure you aware - very complex.

The average doctor does not know about this, it is a deeply faulty system when it comes to benzodiazepine withdrawal. It is not their fault.

It is rooted in the education doctors receive, the financial model in medical education and research and the patriarchy in the medical education system contributes to this anomaly. Moreover, drug safety is itself financed by drug companies, which is madness... 

Doctors just don't know about it, because, on paper - see the DSM - there is hardly anything to know about... 

You would have to be blind to see your patients regularly getting worse and more distressed as time goes by and blame it on a mysterious illness that is just getting worse out of the blue, and not attribute it to the bucketful of pills you keep throwing at them.  But hey, a patient that used to come in once or twice a year, is now banging your door down twice a month for refills, and asking for expensive tests for all these mysterious new disorders they are complaining about.  What a cash cow eh?.  That new model Porsche sure would look nice in the driveway, and don't blame them, they are 'just following the guidelines'.

There's naivety which I could accept from new doctors, and then there is 'voluntary naivety' which is what I suspect is behind a lot of this.  These meds turn one off patients into a lucrative subscription service. 

[[Ka...]]

I am indebted to a private doctor who warned me…actually he said “for heavens sake get off benzos” So I did. 
a lone good doctor who works in an integrated holistic practice that medics don’t really rate!
 

[[or...]]

34 minutes ago, [[j...] said:

What little faith I had left in the Medical Industrial Complex has completely evaporated.  It is a cult like any other, but with oversized power and influence.  Google is now safer to me than any mainstream credentialed 'doctor'.

I have to agree with you for the most part, I do know doctors are needed to fix broken bones and other things we can't heal on our own.  I don't know though, there may be ways to even do that on our own

[[jo...]]

Just now, [[o...] said:

I have to agree with you for the most part, I do know doctors are needed to fix broken bones and other things we can't heal on our own.  I don't know though, there may be ways to even do that on our own

They should have a 6 month med school for junior docs who can stitch up wounds and set broken bones.  I'll take my chances with that doc, a keto / sugar free diet, and a personal trainer. 

[[or...]]

This Doctor Bret Scher is interviewing, I would go to in a hot minute, any day!  They are out there, and I keep hoping more and more will show up very soon:

Dr. Unwin, UK, interviewed by Bret Scher of "Diet Doctor" Channel

[[jo...]]

Just now, [[o...] said:

This Doctor Bret Scher is interviewing, I would go to in a hot minute, any day!  They are out there, and I keep hoping more and more will show up very soon:

Dr. Unwin, UK, interviewed by Bret Scher of "Diet Doctor" Channel

I was strict keto for the last 5 years.  Fell off with the benzo withdrawal (not too bad, but started having bread with breakfast and potatoes with dinner).  As of tomorrow I will be a week off all carbs again.  Looking forward to getting fully keto adapted again. 

[[or...]]

3 minutes ago, [[j...] said:

They should have a 6 month med school for junior docs who can stitch up wounds and set broken bones.  I'll take my chances with that doc, a keto / sugar free diet, and a personal trainer. 

I think opening their minds, at least looking at the evidence, still being teachable (not reached the God-Standing yet) would go a long way with "some" in the medical profession

[[jo...]]

Just now, [[o...] said:

I think opening their minds, at least looking at the evidence, still being teachable (not reached the God-Standing yet) would go a long way with "some" in the medical profession

Agreed.  But they should have come out of med school that way ... instead they came out as glorified pharmaceutical sales reps. 

[[Ka...]]

A GP appointment is usually 10 mins (20 mins double) hardly time to make informed choices. I’ve come home to think it thru & then been told next time not to dither! The system seems to be that we need or expect meds when often we just don’t. 
 

[[Nu...]]

2 hours ago, [[K...] said:

‘Stopped on discharge’ has to be the worst scenario. 
This happened to a loved one, frail & with dementia on transfer to a nursing home. 

Another big topic (sad topic) in this area is the overuse of AD/APs to basically sedate nursing home residents. Fits in with polypharmacy and the current psychiatrist trend in regards to these. It's quite a sad topic.

[[jo...]]

Just now, [[K...] said:

A GP appointment is usually 10 mins (20 mins double) hardly time to make informed choices. I’ve come home to think it thru & then been told next time not to dither! The system seems to be that we need or expect meds when often we just don’t. 
 

I knew the system was corrupt, but I had no idea just to what level.  Yes ... these meds have appropriate use cases and help many people in emergencies, but that's not what's in question here. 

I have come to realize that every single institution that we used to take for granted has been corrupted.  We are all lab rats for the elite overlords.  They simply change the laws to shield themselves from accountability which gives them a license to steal and maim.  Look at the family that owns Purdue.  They engineered the opioid epidemic through predatory marketing and deceit, yet they still got to walk away with billions. 

There is no morality in the system, just profit seeking.  Many medical practitioners get into the field from a deep desire to help people, but after a couple years of bureaucracy, increasing overhead, and ridiculous work loads, who can blame them for becoming cynical and prescribing quick fixes for common problems?

[[Ka...]]

2 hours ago, [[N...] said:

Another big topic (sad topic) in this area is the overuse of AD/APs to basically sedate nursing home residents. Fits in with polypharmacy and the current psychiatrist trend in regards to these. It's quite a sad topic.

@[Nu...] this subject is close to my heart 

Edited February 20 by [Ka...]