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Author Topic: Afraid, doctor lowered my Xanax script and said nothing?  (Read 516 times)

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Offline insights

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #15 on: June 29, 2014, 09:03:12 AM »
I believe them to be the right thing for certain anxiety patients.

I don't believe you do. If you did you wouldn't be calling them "addictive" drugs without qualification. The only time you add a qualification about their use, as in the above, is when challenged, otherwise it is a lot of inflammatory statements, much of which have little to do with the great majority of anxiety patients. It is something I see often from the zealots. Again, the great majority of anxiety patients do not abuse benzodiazepines, don't escalate their dose, nor do they sell them on the street.

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But, you have never addressed my concerns about your statements.  Do you believe BZDs are safe for lets say a recovering alcoholic to take for their anxiety?

Probably, not, though that would be a case by case judgment. I don't know the history of everyone that comes here, and I'm no more going to interrogate them than you do. The appropriateness of BZDs is something that their doctors will have to decide, not me, and not you.

Quote
Anything that causes euphoria can and will be abused.  That's addiction 101.

What is also "addiction 101" is that addiction is about more than just the drug. It is a psychosocial phenomenon in addition to a chemical one. To quote from the ASAM definitions article I linked to earlier regarding opiates, "Addiction, unlike tolerance and physical dependence, is not a predictable drug effect, but represents an idiosyncratic adverse reaction in biologically and psychosocially vulnerable individuals....Addiction is a primary chronic disease and exposure to drugs is only one of the etiologic factors in its development." But your attention is just on the drug. You're like the guy with a hammer who loses sight of the big picture and only sees nails sticking up.

Most people taking BZDs for anxiety disorders do not experience euphoria and drugs that don't produce euphoria are also abused. Aspirin for example which can be truly addictive to the point that some will return to it time and again even though doing so damages their bodies and will ultimately cause their death.

You want me to attach warnings every time I mention BZDs? Well stiff cheese, sonny, it ain't going to happen, just as I don't list all the potential hazards of antidepressants or therapy whenever I write about them. That is something their doctors should be doing. Being the gatekeeper on the suitability of a med is the most fundamental part of their job.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline NeverAgain2

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #16 on: June 29, 2014, 09:13:17 AM »
I believe them to be the right thing for certain anxiety patients.

I don't believe you do. If you did you wouldn't be calling them "addictive" drugs without qualification. The only time you add a qualification about their use, as in the above, is when challenged, otherwise it is a lot of inflammatory statements, much of which have little to do with the great majority of anxiety patients. It is something I see often from the zealots. Again, the great majority of anxiety patients do not abuse benzodiazepines, don't escalate their dose, nor do they sell them on the street.

Quote
But, you have never addressed my concerns about your statements.  Do you believe BZDs are safe for lets say a recovering alcoholic to take for their anxiety?

Probably, not, though that would be a case by case judgment. I don't know the history of everyone that comes here, and I'm no more going to interrogate them than you do. The appropriateness of BZDs is something that their doctors will have to decide, not me, and not you.

Quote
Anything that causes euphoria can and will be abused.  That's addiction 101.

What is also "addiction 101" is that addiction is about more than just the drug. It is a psychosocial phenomenon in addition to a chemical one. To quote from the ASAM definitions article I linked to earlier regarding opiates, "Addiction, unlike tolerance and physical dependence, is not a predictable drug effect, but represents an idiosyncratic adverse reaction in biologically and psychosocially vulnerable individuals....Addiction is a primary chronic disease and exposure to drugs is only one of the etiologic factors in its development." But your attention is just on the drug. You're like the guy with a hammer who loses sight of the big picture and only sees nails sticking up.

Most people taking BZDs for anxiety disorders do not experience euphoria and drugs that don't produce euphoria are also abused. Aspirin for example which can be truly addictive to the point that some will return to it time and again even though doing so damages their bodies and will ultimately cause their death.

You want me to attach warnings every time I mention BZDs? Well stiff cheese, sonny, it ain't going to happen, just as I don't list all the potential hazards of antidepressants or therapy whenever I write about them. That is something their doctors should be doing. Being the gatekeeper on the suitability of a med is the most fundamental part of their job.

Ian

Hear, hear!

Fight "Med Madness". 
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Offline ShawnW

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #17 on: June 29, 2014, 10:43:52 AM »
I believe them to be the right thing for certain anxiety patients.

I don't believe you do. If you did you wouldn't be calling them "addictive" drugs without qualification. The only time you add a qualification about their use, as in the above, is when challenged, otherwise it is a lot of inflammatory statements, much of which have little to do with the great majority of anxiety patients. It is something I see often from the zealots. Again, the great majority of anxiety patients do not abuse benzodiazepines, don't escalate their dose, nor do they sell them on the street.

Quote
But, you have never addressed my concerns about your statements.  Do you believe BZDs are safe for lets say a recovering alcoholic to take for their anxiety?

Probably, not, though that would be a case by case judgment. I don't know the history of everyone that comes here, and I'm no more going to interrogate them than you do. The appropriateness of BZDs is something that their doctors will have to decide, not me, and not you.

Quote
Anything that causes euphoria can and will be abused.  That's addiction 101.

What is also "addiction 101" is that addiction is about more than just the drug. It is a psychosocial phenomenon in addition to a chemical one. To quote from the ASAM definitions article I linked to earlier regarding opiates, "Addiction, unlike tolerance and physical dependence, is not a predictable drug effect, but represents an idiosyncratic adverse reaction in biologically and psychosocially vulnerable individuals....Addiction is a primary chronic disease and exposure to drugs is only one of the etiologic factors in its development." But your attention is just on the drug. You're like the guy with a hammer who loses sight of the big picture and only sees nails sticking up.

Most people taking BZDs for anxiety disorders do not experience euphoria and drugs that don't produce euphoria are also abused. Aspirin for example which can be truly addictive to the point that some will return to it time and again even though doing so damages their bodies and will ultimately cause their death.

You want me to attach warnings every time I mention BZDs? Well stiff cheese, sonny, it ain't going to happen, just as I don't list all the potential hazards of antidepressants or therapy whenever I write about them. That is something their doctors should be doing. Being the gatekeeper on the suitability of a med is the most fundamental part of their job.

Ian

Ian,

I don't know how many words you put into my mouth, but I must admit you are determined to defocus the conversation.  I have been stating you must look at the history since the first time we discussed this topic.  You on the other hand have made no attempt to do so in any of your conversations with individuals on this board.  This is merely hocus pocus change the focus in order to preserve your stance.

You admit that BZDs are "probably" not safe for an alcoholic.  Great.  That's all I needed to see in print.  You are correct they are not safe in this population.  I could care less what you believe about my philosophy or medical knowledge.  We have gotten somewhere so this discussion wasn't a total waste of my time.

The only population I am concerned about are those with a predilection towards addiction.  Statistically, that is probably around 10% of the posters on this message board.  When you have been giving your medical advice to people on this board (totally unqualified to do so btw) I have not seen you once ask about a persons history of addiction.  So, the fact that you admit that these are probably not safe in those with tendencies towards addiction is a step in the right direction.
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My insight, thoughts, experiences or advice that may be posted in this forum are not meant as a substitution for the advice of your physician.

Want to know how to address your anxiety?
http://www.anxietyzone.com/index.php/topic,93402.msg521266.html#msg521266

Offline ShawnW

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #18 on: June 29, 2014, 10:46:55 AM »
PS- I passed my ASAM boards, have you?  Obviously, you don't have any idea about anything related to addiction.

Since we are discussing articles here is one for you...

http://www.samhsa.gov/data/2k11/WEB_TEDS_028/WEB_TEDS-028_BenzoAdmissions.htm

That is an even handed article that matches what I see in our treatment center.

Take home messages...

1) Benzo admissions tripled from 1998-2008
2) While benzos are usually taken with other drugs, 5% reported that being their only drug of choice.
3) 12.9% reported that BZDs were their primary drug of choice.
4) That physicians need to screen patients for those who are predisposed to addiction.
5) A significant portion of BZD admissions also have concurrent psychiatric diagnosis (which accounts for many on this board)

Everything fits what I am saying...use caution as these drugs are not without risk.  People do abuse BZDs alone AND with other drugs.  If you have a history of addiction or a strong family history these drugs propose a much higher risk for that population.  And just because you have a primary psych diagnosis doesn't mean addiction to these medications shouldn't be a concern.

Now, if you say that these conclusions are merely the brainwashing of doctors by "the man", then I don't think we have anything else to discuss.

I guess this SAMHSA report made a small crack to where you are teachable?  If not, I hope others at least learned something from the report.

BTW-How many people need to go to treatment for aspirin addiction?  That is such an odd argument.  How many people would sell themselves for aspirin?
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My insight, thoughts, experiences or advice that may be posted in this forum are not meant as a substitution for the advice of your physician.

Want to know how to address your anxiety?
http://www.anxietyzone.com/index.php/topic,93402.msg521266.html#msg521266

Offline NeverAgain2

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #19 on: June 29, 2014, 11:08:41 AM »
Shawn W....

If I missed it I'm sorry, but where in your bio is your mention and proof that you are a medical doctor?

And, are you on this forum to offer advice to people or to seek it yourself -- or both?

I am not trying to be confrontational here, but, as you know, anybody can come onto the internet and pose as anything.  I think you can see from some of my posts where I stand on the issue of Benzos, so I won't take up any truck with you about that.  But, really, who are you?  I know Ian is a layman, so his advice is taken into consideration from that perspective.  You are a doctor, so you say, and it would be helpful to know your pedigree, experience, reason for postings, and current practice, so as to lend credibility.

Thanks.
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Offline ShawnW

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #20 on: June 29, 2014, 01:46:34 PM »
Shawn W....

If I missed it I'm sorry, but where in your bio is your mention and proof that you are a medical doctor?

And, are you on this forum to offer advice to people or to seek it yourself -- or both?

I am not trying to be confrontational here, but, as you know, anybody can come onto the internet and pose as anything.  I think you can see from some of my posts where I stand on the issue of Benzos, so I won't take up any truck with you about that.  But, really, who are you?  I know Ian is a layman, so his advice is taken into consideration from that perspective.  You are a doctor, so you say, and it would be helpful to know your pedigree, experience, reason for postings, and current practice, so as to lend credibility.

Thanks.

I am a physician who was diagnosed with panic disorder and generalized anxiety disorder when I was in my early 20's.  I suffered from anxiety and addiction for many years.  I still struggle with anxiety, but have been in addiction recovery for nearly 7 years this August.  I'm here to help and for support.  As stated in a previous post, I am family practice trained, and now the medical director of a well known addiction treatment center.  Addiction is 90% of what I do.  These are things I have explained before.  But, as with everything on the internet take what someone says with a grain of salt.  If my advice helps, great.  If you think it's a bunch of nonsense, then toss it.  As with anything, I always recommend someone seek the advice of your personal physician.  But, hopefully some of the things I bring up will cause members to discuss with their physicians.
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My insight, thoughts, experiences or advice that may be posted in this forum are not meant as a substitution for the advice of your physician.

Want to know how to address your anxiety?
http://www.anxietyzone.com/index.php/topic,93402.msg521266.html#msg521266

Offline NeverAgain2

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #21 on: June 29, 2014, 07:13:53 PM »
Shawn W....

If I missed it I'm sorry, but where in your bio is your mention and proof that you are a medical doctor?

And, are you on this forum to offer advice to people or to seek it yourself -- or both?

I am not trying to be confrontational here, but, as you know, anybody can come onto the internet and pose as anything.  I think you can see from some of my posts where I stand on the issue of Benzos, so I won't take up any truck with you about that.  But, really, who are you?  I know Ian is a layman, so his advice is taken into consideration from that perspective.  You are a doctor, so you say, and it would be helpful to know your pedigree, experience, reason for postings, and current practice, so as to lend credibility.

Thanks.

I am a physician who was diagnosed with panic disorder and generalized anxiety disorder when I was in my early 20's.  I suffered from anxiety and addiction for many years.  I still struggle with anxiety, but have been in addiction recovery for nearly 7 years this August.  I'm here to help and for support.  As stated in a previous post, I am family practice trained, and now the medical director of a well known addiction treatment center.  Addiction is 90% of what I do.  These are things I have explained before.  But, as with everything on the internet take what someone says with a grain of salt.  If my advice helps, great.  If you think it's a bunch of nonsense, then toss it.  As with anything, I always recommend someone seek the advice of your personal physician.  But, hopefully some of the things I bring up will cause members to discuss with their physicians.

Thank you for your reply.  I know on some forums doctors and other professionals do identify with their names and occupations and specialities.
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Offline insights

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #22 on: June 29, 2014, 08:49:19 PM »
BTW-How many people need to go to treatment for aspirin addiction?  That is such an odd argument.  How many people would sell themselves for aspirin?

You are unaware that aspirin is a drug of abuse? That the problem is so serious that gastroenterologists are advised by their peak bodies around the world not to perform corrective surgery on aspirin (and other NSAIDs) abusers unless they are clean because so many will undo the work done by again abusing aspirin? I some countries, Thailand for example, NSAID abuse is almost an epidemic.

Take for example the study by Hirschowitz BI, 1998, who performed corrective surgery on a random sample of 30 patients suffering from aspirin induced peptic ulcers. Half the sample denied taking aspirin though blood tests proved they were. Only 3 of these patients were able to stop taking aspirin after surgery, 27 (i.e. 90%) went right back to it, with 16 subsequently requiring surgery a second time. Of that 16, 8 then required surgery a third time because of aspirin use, and one had surgery a fourth time. Of the original 30, 4 died during the period of the study as a direct result of aspirin abuse (about the expected death toll if they'd all played Russian Roulette). How many of your primary BZD patients would continue to abuse these drugs if they required major surgery to repair BZD induced physical damage? I suspect none, and certainly not 90% of them.

The only reason aspirin (and other NSAID) abusers don't sell themselves for aspirin is because they don't have to. They can buy it by the cart load from any supermarket for peanuts. But they would if they had to. As Hirschowitz demonstrates, some are prepared to die for it.

Given the choice of tightening BZD use or imposing restrictions on aspirin I'd make the latter, and other NSAIDs, a lot harder to get. I believe it is a bigger issue than BZD abuse. The fact that you, and afaics the ASAM, are blissfully unaware of the pitfalls of this med is, IMHO, very telling about the state of the specialty.

NOTE: for those spooked by the above, this is about the abuse of aspirin, no one is going to end up selling their bodies to Walmart for an aspirin fix if they use the drug to relieve the occasional headache/fever, or take small daily doses to prevent heart attacks (though this should be done only on medical advice IMHO). When used wisely aspirin is a beneficial drug that has saved countless lives. But as with every med, it is not without risk and used carelessly can bite hard so if you begin needing it often then consult your doctor asap.

Last point on this topic which is growing increasingly tedious. I believe BZDs are as legitimate and as valuable anti anxiety treatments as antidepressants and therapy. So does the American Psychiatric Association, see for example their practice guidelines for treating panic disorder. This doesn't mean I believe it is the universal 'cure,' or even a good treatment in every case. But I'm not about to warn people off them because a few run into difficulty. Every psyche drug has problems, some have far greater issues than those of BZDs (interestingly, some of them are now being increasing prescribed off-label for anxiety I suspect at least partly because of an unwillingness to prescribe benzodiazepines). Doing nothing carries even greater risks.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline ShawnW

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Re: Afraid, doctor lowered my Xanax script and said nothing?
« Reply #23 on: June 29, 2014, 09:26:56 PM »
Listen, I'm done going around with you.  You stated that those with an addiction history "probably" shouldn't take BZDs.  That's good enough for me.

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My insight, thoughts, experiences or advice that may be posted in this forum are not meant as a substitution for the advice of your physician.

Want to know how to address your anxiety?
http://www.anxietyzone.com/index.php/topic,93402.msg521266.html#msg521266

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