Are Benzodiazepines the Next Opiate?
Phillip Seymour Hoffman
Do you know what this list of celebrities has in common? Most people would say they all died of opiate overdose. However, each of them also had benzodiazepines in their toxicology. So, more accurately, they died of opiates and benzos combining to depress lung function and lead to their demise.
Most of us are familiar with the risks of opiates or narcotics. Unfortunately, many of us also know someone who has been affected by the opioid epidemic. The risks associated with prescription opioid painkillers include addiction, sedation, constipation, worsening pain, cognitive impairment, and of course death, to name just a few.
The benzodiazepine class of medications which includes commonly prescribed medications like Xanax, Ambien, Klonopin, and Valium. Even as a doctor trained and licensed to prescribe these medications I was surprised to learn recently from my friend and colleague Dr. Shawn Barnes, MD just how risky benzos are. They are extremely addictive, and patients on them quickly become dependent. They increase the risk of osteoporosis, reduce balance and increase incidence of falls and associated fractures. They often lead to less restful sleep so you wake more tired. In addition, they often make anxiety — the symptom they are prescribed to manage — worse! Most frightening to me benzos are linked to both death and the fate almost worse than death, dementia.
Tapering off Benzodiazepines
I have been helping patients reduce their dose and get off Xanax and Ambien for years because they felt ready and asked for my help. Now, I want to let every patient know the risks and work much harder to free all of my patients from them. This is why I have partnered with my favorite psychiatrist in North County. Dr. Barnes is not your typical psychiatrist. His goal is to prevent the unnecessary use of psychiatric medications, only use psych meds when there is a plan in place to get off of them, and support dependent patients as they safely wean off psychiatric medications.
Dr. Barnes’ role with my patients is to prescribe a taper and initiate a therapeutic program to target sleep and anxiety. Benzo tapers are both art and science. Tapering off long-standing benzo use can be a profoundly uncomfortable process. As patients reduce their dose and fully discontinue benzos there is a predictable withdrawal period. Many patients interpret poor sleep and an increase in anxiety as proof they need the medications. These are withdrawal symptoms. This is the proof a patient is addicted or dependent to a substance. Benzos and alcohol are the only drug withdrawals that can actually kill someone. The rate and dosage are different for everyone, and there is no one standard process. That is where the art comes in. Dr. Barnes has significant experience tapering benzodiazepines slowly and safely.
Dr. Barnes and I work closely together with patients to support them through this process. Dr. Barnes manages medication doses and prescriptions as well as providing valuable psychotherapy to get to the underlying issues that trigger anxiety and insomnia. Dr. Barnes and I share the goal of truly treating the cause!
I work with patients to individualize the biochemical and nutritional aspects of their mental health. I use dietary interventions, Dr. Bill Walsh’s protocol and NAD+ IVs. Together Dr. Barnes and I have created a unique collaboration to serve anyone struggling with anxiety, insomnia or dependence on risky benzos.
Written by: Dr. Heather Sandison, ND