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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by torachan on October 28, 2007, at 19:31:51
I recently went to a new doctor due to a move, briefly informed him of my history with anxiety and having been treated for it with clonazepam for about 15 years intermixed with SSRI'S, and he suggested promptly I have a drug problem. Does he have any legitimate case for making this claim? He also stated continued use of benzo treatment would worsen the anxiety and cause shaking.
This is not the only doctor who has branded benzo's as a poor long term treatment for anxiety. Why is it when I was on Effexor 150mg, while almost dropping the benzo entirely, I didn't have a drug problem, yet simply taking the benzo constitutes a drug problem? Don't other anxiety meds have similar long term usage risks as benzo's?
What is the deal with doctors refusing to acknowledge the reality of mental illness and branding prescription drug users as drug abusers?
Posted by Phillipa on October 28, 2007, at 20:03:41
In reply to Benzo treatment for anxiety=drug problem?, posted by torachan on October 28, 2007, at 19:31:51
Been on benzos over 30years and never had a pdoc suggest me coming off them. Has your dose escalated? That would be the only reason a doc might make a statement like them. Find a pdoc who is not benzo phobic. They are all over out there ask first if the doc believes in using them first. And good luck to you. Phillipa
Posted by Racer on October 28, 2007, at 20:52:48
In reply to Benzo treatment for anxiety=drug problem?, posted by torachan on October 28, 2007, at 19:31:51
Yes, you have a drug problem, just not the one this doctor has in mind. The drug problem I see is that you've been treated for a decade and a half with a class of drug many doctors are reluctant to prescribe. Fortunately, there is a good chance of improvement in this sort of drug problem, although you will possibly have to consult another doctor...
Seriously, the first question I'd ask is how your dosage has changed over the time you've taken the drugs? I assume you've increased your usage in times of acute stress, and probably gone back down again when things were more stable? If that's the case, or if you've never really increased the dose once you found one which worked, then I think you're probably in a good position to assess whether you have a drug problem.
The biggest problem with benzos is that they're the sort of short acting drug which can be taken for fun and then cause tolerance. There are a lot of people out there who enjoy them a bit too much, too, which also makes it harder for doctors to assess who is drug seeking, and who isn't. The good news is that the doctor you saw was probably genuinely trying to help, however clumsily. The bad news, of course, is that that wasn't helpful to you.
So, what do you think? Do you have a drug problem? Or are benzos an effective treatment for what ails you?
Posted by sunnydays on October 28, 2007, at 22:33:24
In reply to Benzo treatment for anxiety=drug problem?, posted by torachan on October 28, 2007, at 19:31:51
It's not the prescription part of it. It's the fact that SSRI's haven't been shown to have quite the addictive qualities that benzos have. Benzos are basically legal narcotics as I understand it, and so are highly addictive, although only if taken regularly - I wouldn't think taking them intermittently would cause addiction. The question becomes what happens if you stop using the benzos? And would you be willing to try other anxiety treatments?
sunnydays
Posted by yxibow on October 28, 2007, at 23:17:31
In reply to Re: Benzo treatment for anxiety=drug problem? » torachan, posted by sunnydays on October 28, 2007, at 22:33:24
Oh this is a sticky wicket. Some doctors are absolute "benzophobes" -- particularly in the UK from what I have seen.
Yes, benzodiazepines, while among the safest psychiatric drugs in terms of side effects to date when used as directed generally shouldn't be used more than 4 weeks in a row give or take.
Addiction at least I feel is the purposeless or street use of a prescription drug while habituation is something that can occur during prescribing.
Of course both can occur at the same time. And everyone is different, as some people have been on Valium since 1963.
Does the Valium I have taken long term contribute exclusively to short term memory issues -- probably not. There are psychological issues, depression and decompensation easily contribute to this phenomenon as well.
Neuroplasticity may also have an impact in mind/body rewiring of the brain.
Posted by torachan on October 29, 2007, at 2:27:10
In reply to Re: Benzo treatment for anxiety=drug problem?, posted by yxibow on October 28, 2007, at 23:17:31
Generally I haven't increased the dosage anymore than my occasional readjustments with the levels of intake of my varied ssri treatments. The problem with the ssri's is they don't seem to tackle anxiety as well as benzo's. And I just don't understand how two different classes of drugs which have biochemicl effects can have different perceptions in terms of their addictive properties.
I did have a history of drug abuse as an adolescent which to me only strengthens the case that I have a psychiatric/emotional disturbance resulting in me requiring legitimate pharmocological treatment, not continued drug abuse. When I take clonazepam I experience relief from anxiety, not a mental high.
As for the dangers of benzo treatment mentioned by this doctor such as increased anxiety and shaking, is this a credible claim with supporting evidence. And would long term treatment with an ssri not lead to similar problems.
Do docs really believe anxiety has no permanent physiological basis which requires long term treatment, or do they think I have poor coping skills that requires a 'drug problem' to deal with?
Posted by Cecilia on October 29, 2007, at 5:49:17
In reply to Re: Benzo treatment for anxiety=drug problem? » torachan, posted by Phillipa on October 28, 2007, at 20:03:41
Effexor is every bit as "addictive" as benzos-witness the many people who write in to psychobabble with terrible problems from withdrawing from it. Cecilia
Posted by tecknohed on October 29, 2007, at 7:42:44
In reply to Benzo treatment for anxiety=drug problem?, posted by torachan on October 28, 2007, at 19:31:51
I've been taking clonazepam for over a year now. I've NEVER found it 'more-ish'. And I am a recovering alcoholic & drug addict.
I recently doubled my clon from 1.5mg to 3mg/day, NOT because it lost its efficacy but to see if the higher dose would work better for my (social) anxiety. And guess what - I feel MUCH better for it! Hopefully I can stabilize at this dose without needing to increase.
Posted by Racer on October 29, 2007, at 10:46:48
In reply to Re: Benzo treatment for anxiety=drug problem?, posted by torachan on October 29, 2007, at 2:27:10
>
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> Do docs really believe anxiety has no permanent physiological basis which requires long term treatment, or do they think I have poor coping skills that requires a 'drug problem' to deal with?There's no way to generalize across doctors -- some do believe it, some don't. Just the same way some non-doctors believe that taking drugs is a crutch, some doctors believe it, too. Not a good thing for us, of course, if we happen to come across the more rigid, old-fashioned doctors. (I have, and it was quite damaging.) I grew up in one of those families that saw taking medication as "weakness" and "bad character," which makes sense since depression is really just "laziness" and "selfishness" and "bad character." And guess what? One of my cousins is a doctor...
As for coping skills, I'm a big believer in psychotherapy to teach better coping skills. Which doesn't mean that you wouldn't still need medications. It only means that it might help to attack the problem on both ends.
Good luck.
Posted by Phillipa on October 29, 2007, at 19:44:59
In reply to Re: Benzo treatment for anxiety=drug problem?, posted by Cecilia on October 29, 2007, at 5:49:17
Cecelia have read horrible stories from people withdrawing from all the antidepressants. I've cut down and gone off benzos without a problem many times before my thyroid went at which time the internist said I would have to play with dose of benzos as said may need more or less. Phillipa
This is the end of the thread.
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