On 14 Dec 2005 20:59:02 -0800, Sbharris[atsign]ix.netcom.com wrote:

Adie wrote:

Hi, I have a friend who it turns out has been taking xanax for quite some
time; around 3-4 years. They'd like to kick and keep trying cold turkey but
with no avail - only last 3 days max.

I've been doing a little reading and it turns out that it's a fairly nasty
drug to kick, and that 3 years is a considerable amount of time to be
using.

This person has access to pretty much any medical resources available and
would recieve a high level of care - although they tried a recovery clinic
and didn't like so left deciding to go it alone.

Does anyone have any experiences with kicking this drug? What's the best
approach? How long does it usually take? Is it dangerous (as in life
threatening) to stop suddenly? Etc...

COMMENT:

The drug is a bit like stopping smoking or drinking, and for some of
the same reasons. Nothing really replaces Xanax but the same stuff.
Tapering off is a bit like tapering off cigarettes or alcohol. It's
been done but is difficult.

In theory, cold turkey from large doses can causes seizures, but in
practice it isn't nearly as dangerous as cold turkey from alcohol or
barbiturates, and is benzo cold turkey is frequently done in detox and
jails (you might get a dose of Ativan if your heart rate gets too
high). Symptoms are some kind of combination of anxiety/panic, PMS,
depression, and the flu. It's worse on people with higher intelligence,
because in the heightened state of anxiety induced by withdrawal, all
possible threats are amplified (including unreal ones). Imagination is
the enemy here. I've seen benzo addicts in full-on hysterical
hypochrondriasis when they withdraw quickly. Not only do they develop
every medical symptom you can think of, but they're convinced that all
of them are life-threatening. In such a state, if a doctor won't give
his patients Valium, he'd better take it himself (to quote a wise
clinician). People who are less high-strung to begin with have a better
chance of making it through, and may cold-turkey with merely the
feeling of being generally ill in a world which is completely bleak and
hopeless. This lasts about a week, and by two weeks, is mostly over
with.

The worst of the mental effects of benzodiazepine withdrawal last only
a fraction of the time that a severe bout of grief or depression does.
As with both greif and depression, wtih most addiction-withdrawal
symdromes, it's helpful for the sufferer to be reminded that it doesn't
last forever. (Of course, usually the sufferer during this time feels
like Job talking to his "comforters".)

The slightly longer-acting benzodiazepines like Valium and Clonepin can
partly replace Xanax, and have been used by an occasional addict as a
sort of "Xanax methadone." That may be helpful for the person who
can't be locked up, yet who becomes hysterical when cold-turkeyed. The
ideal dose of these drugs is one that makes the Xanax addict feel
crumby and dissatisfied, but without the worst of the panic. One cannot
really tell how well this method is going to work, until it is tried.
Or indeed whether it will be needed at all.

In theory, a couple of months of treatment with an SSRI antidepressant
drug may help to control the panic that accompanies benzodiazepine
tapering in some. But that's a theory which hasn't (to my knowledge)
ever been put to the clinical test. Some clinicians believe that Buspar
may help with benzodiazepine withdrawal, but I have to tell you that
most think it's about as helpful as giving Tylenol or Darvon for Heroin
withdrawal.

Ultimately, as with smoking and drinking, there is no "best way" to
quit. As in many tasks in life, every successful person tends to think
his own method must be God's method. In reality, there are as many
paths out of a given substance-abuse problem, as there is into it.
They're very individualized. If I can offer a generalization off the
top of the head, it might be that they all require a certain amount of
stength of will; and that people who normally feel in control of their
lives (or that God is) tend to do better than people who seem
themselves as victims of the storms of life and the malice of others.
Xanax and alcohol are both very bad drugs for "victims," for in
withdrawal these people see themselves as super-victims. This is so bad
for self-insight that shrinks often don't even bother to treat these
people for anything *except* addiction, and sometimes not even that.
"Call me when you're sober, since until then, you're wasting both our
time," is fequently heard said to the drinker. But it applies about
equally well to the person who is used to some dose of Xanax, and who
isn't getting it.

Thank you for the insight. The person in question has gone back into
hospital and is beginning to get the idea that they're an addict.

I'll
speak to them regarding what you've said they should expect over the coming
few days/weeks. It doesn't sound like fun, but one hopes the light at the
end of the tunnel will be bright enough for them to keep plodding on...
Thank you and much appreciated.