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“Am I Going Crazy?!”

Post-Acute Withdrawal Syndrome (PAWS) is something that perhaps unfortunately, we haven’t discussed much in SMART Recovery®. It is a not yet widely known problematic syndrome (syndrome is a medical term which describes a grouping of varying symptoms) of addiction recovery. The following scenario can illustrate it:

You’ve been through detox and all of the withdrawal symptoms and you are doing pretty well for perhaps a month or two. Suddenly, you start to realize that you’re feeling edgy and antsy. You are experiencing mood swings that range from being on a pink cloud to feeling down in the dumps. You find that you can’t concentrate. You are having trouble sleeping, you’re sleeping too much, or you’re having very vivid dreams. “What’s going on?” you wonder. “Am I going crazy?!”

No, you’re not going crazy. You are suffering from what is known as PAWS (Post-Acute Withdrawal Syndrome). Unfortunately, as noted above, we don’t often hear much about it in the recovery community even though it is an extremely common experience.

We know that recovery progresses in stages. After the initial acute withdrawal, one can enter a second phase of withdrawal symptoms. Weeks to months into recovery, a variety of symptoms can occur such as described above. Here we will discuss PAWS in some detail because understanding it can aid in successful recovery.

In a recent study of a large number of patients it was discovered that between 70% and 90% of people experience symptoms of PAWS. The number affected depended upon what the substance of abuse was: about 70% of former alcohol users and as high as 90% for former opiate users. These numbers are very high!

Mind you, usually the symptoms of PAWS are mild and not too troublesome. However, in some people the symptoms can be extremely bothersome, to the point of people thinking that they are losing it. Intense urges are a big part of PAWS and some consider this to be the number one cause of relapse within the first year.

PAWS can last for varying periods of time and be of varying intensity with the duration usually being measured in months – occasionally over a year. The good news however is that, barring relapse, the symptoms will go away. Like urges, they decrease in frequency and intensity with time.

The list of the various symptoms of PAWS is quite long! It includes 20 symptoms. The following list presents some of the most prominent:

      • Sleep disturbances – insomnia, hypersomnia (too much sleep) or vivid dreams
        • Mood swings – from depression to euphoria
          • Anhedonia – technical term for the inability to feel pleasure
            • Anxiety and even panic
              • Irritability or edginess
              • Fine motor coordination problems

            Symptoms are not always present — they occur intermittently.

            Symptoms are made worse by stress or other triggers and may arise at unexpected times and for no apparent reason. They may last for a short period of time or for a long time. Any of the following situations may trigger a temporary return to, or worsening of, the symptoms of post-acute withdrawal syndrome:

                • Stressful and/or frustrating situations
                  • Feelings of anxiety, fearfulness or anger
                  • Unrealistic expectations of oneself

                There is little in the way of specific therapy for PAWS. That said, if the symptoms are prominent, it is wise to consult one’s physician because certain medications may be helpful. If you’re consulting with your regular physician you might mention that you believe you are experiencing PAWS. Perhaps like you, your physician might not be aware of the syndrome’s existence.

                Mindful Awareness Practice is likely to be helpful as well. Also, SMART tools such as urge-surfing are always there for you.

                The science in SMART Recovery tells of something called neuroplasticity. In review, neuroplasticity is the phenomenon whereby during the development of a new maladaptive behavior, such as the repeated use of a mind-altering substance, the repeated and habitual use of the substance leads to changes in the brain. Neuroplasticity also aids in the reverse process, which is good news. Once you have become abstinent from the mind-altering substance via your new behaviors, thoughts and feelings, the brain will rewire itself back to, or nearly to, your pre-addicted state. Thus, it is likely that PAWS is due to that very rewiring of the neural circuitry. Remember, neurons that fire together wire together.

                Although there’s no easy remedy for getting through PAWS, it is often a great help to know that you’re not going crazy. PAWS is just a temporary set of symptoms, which you can accept, knowing that it is merely evidence that your brain is healing.

                PAWS helps you recover.

                Bill Abbott and Suzy W. are SMART volunteers who, along with other SMART volunteer activities, both facilitate weekly SMART meetings in the Boston area.

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                237 Comments

                Thankyou VERY much for taking the time to write this article.
                Especially to look at the possible solutions to the situation and end on a positive note
                Early recovery is a raging pain in the butt, which has some very quick early payoffs and leads to the much fuller, engaged life of later recovery.
                Like all pain, it becomes a distant memory, and “recovered” becomes my normal life.
                Articles like yours give me a better opportunity to acknowledge, accept, and stay the course.

                HUGHK – How are you doing now, almost 5 years after posting? I am 5 months and 9 days sober. PAWS started for me 2 months 10 days. Symptoms are now not as intense and different symptoms come and go however, I am far from happy and have a constant underlying sunkeness feeling inside me of depression, ground hog day, everyday the same. Recovery from this is at snails pace. Was interested to know how long it lasted for you, I fear this is the new sober me

                I am so glad I read this and all these post I dealt with this I was on humera and perkacets for 15 years for RA without running out of them taking 10 5/325 I quite cold turkey cold turkey without help i have to say i am happy that did but I should of golden help instead I put my body through a rough withdraw and ending up with fribomylahia one month later
                I never new or heard if anyone getting fibromyalgia from stining opioids cold turkey like that but it did happen to me so my suggestion is get help to taper off never ever go cold turkey

                You have to hit the gym brother, it will help tremendously. I had to learn the hard way that exercise is the key to a happy life it really is man

                I am still in PAWS almost 2yrs after cold turkey withdrawel from xanax(Dr.did this) Depressed,hopless,helpless.sad.Now after reading about PAWS I have hope of getting better. THANK YOU.

                I’m 1 month 3 days sober today. I had a physical for a new job . which I think went well .Most of the morning and day was Sluggish.I woke up achy feeling .I had a stressful morning got a little Aggitated only because i was being rushed to leave the house..I don’t like being rushed .I like going at my own pace .Rushing brings me stress.I decided to look up why I’m feeling like this today

                Thank goodness you wrote this post. It has been like 8 years since I’ve been sober and it’s happening to me very intensely. The more upset I get about it, the worse it gets. I really thought I was going crazy. THANK YOU!

                I quit 54 days ago.I am still having crazy all night vidid dreams. This causes me to be irritable, angry,anxious and a little depressed. I haven’t read of anyone having this go on so long.I wish I knew if this will end

                I am 2 weeks into tapering off and I feel I am losing my mind and I’m in pain every day. I don’t feel my doc understands the gravity of this situation. I’m sad and angry.
                This is killing me!

                Hello everyone,
                So I got into marijuana at around age 14-15, I also started drinking around 13-14 years of age. I’m happily sober from alcohol for 3 years now and had quit marijuana that same day but I couldn’t let go of marijuana because I ended relapsing a little more than a year ago. I recently had a panic attack about a week ago, ever since that event, I quit again but this time I didn’t feel the same after the panic attack. I feel like I’m going crazy everyday since that event and get really depressed at work; anxious at moments. It can be overwhelming. I feel like going to the hospital at times but I know it’s all in my head but for some reason I can’t handle it sometimes. I’ve never felt like this before. I get waves in the mornings that feel really cloudy and I feel super sensitive to everything, I even feel like crying at times. My stomach has been feeling upset as well and no appetite for anything with a lot of nausea. My lips feel dry even though I’m drinking plenty of water. Insomnia, loss of appetite, nausea, sadness, racing thoughts of my past and more withdrawal symptoms that come with quitting cold turkey. I’m doing this as my mind is elsewhere and I know there’s more symptoms but I can’t think straight at the moment. Hands and feet always sweaty. I feel like I’m in a nightmare, reading this gives me hope. Thank you very much for this.

                Hey you are not alone. I’ve been clean bar one relapse for 3 years and like now I’m having a hard time staying clean. I have multiple severe mental health disorders too that don’t help. But I hope that knowing you aren’t along in your feelings helps in some small way xx

                Thanks for putting out this info. It helps me put how I feel in perspective.

                I usually find it difficult to find useful and educational advice- that is real and true. Thank you for making this available to a world of addicts where information like this is accessible, available, and reliable and very much needed.

                I have lately become a sort of expert in withdrawal articles. This article is the best by far at describing the possibilities associated with PAWS.

                I had never even heard of this syndrome. Now I might have an explanation for some things I have been asked about. Or at least a place to start learning.

                This sounds like an enourmously difficult diagnosis to make. For me the most important part is the reassurance that you aren’t nuts.

                Hi.my name is Leslie. I used oxycodone and oxycontin for over 10 years.i went in patient last November. I have not used since but this ANXIETY still remains and I have struggled every day.I feel this is not normal.I Have been on gabapentin which helps but I want to experience one day of a CLEAR HEAD.my life has not improved. I feel like it was actually better on pills,I had more energy and enjoyed life.i feel like I was a better mom even cause I was not always in bed like I find myself now.if anyone could help me or give me some sense of hope for this better life off pills please do.

                I feel the same way but can’t stand the idea of the up and down mess with opioids again. Proper sleep nutrition exercise may be the key. I’m going to try it.

                Leslie ! Hi my name is John. I read you comment and wanted to reach out to you! First off, I know exactly the way you feel! I was a heroin addict for many year. I’m 35 now and clean for the first time in a long time. Try to remember what it was like before you were ever prescribed oxycodone, can you recall those days when your enegery levels were up and you didn’t need anything but a good night’s sleep to feel great. Maybe you were a teen then maybe that was your 20s . But there was a time when you did have a clear head without any intoxicants. And I promise you can get back there. Your in the thick of it right now. Those feelings of depression, aniety, lack of motivation, tiredness and hopelessness WILL GET BETTER. I know you probably feel like your life is unfulfilled right now and it’s easy to think things were better on drugs. But that’s because you don’t remember all those years before they were part of your life. I promise you will get better but you must, YOU MUST try your hardest to slowly but surely begin excercising. Change your eating habits if you haven’t already. Take htp-5 supplement , melatonin supplements and anything else that will increase your body’s natural seratonin and dopamine output. Because it’s those “feel good” chemicals within your body that need to be rejuvenated naturally after so many years of being stimulated by oxy, your body will need time to readjust. But your over the worst part I promise you ! Add these things to your daily regime if you haven’t already and I promise you’ll see results immediately. Good luck Leslie. Feel free to write me if you ever want to talk! Cheers!

                Hey. First , I want to say you are doing great. Every single day is a victory..It is NOT easy but I can assure you it is better. Opiates do all of the above to our bodies and brains. Every single thing. It disturbs our sleep, it makes is depressed,it numbs you, and so on. It is NOT a better life on pills. That is just the opiates calling to you. Recovery is so hard but find things to help you cope. Magnesium chelate (no additives just 100% earth grade magnesium) has helped me so much. My mood, energy etc. I also highly recommend CBD I take 500-1000mg CBD. Vitamins (zinc,b12,vitamin C and magnesium ) those are the main ones. Eat healthy. Even if you have to force yourself. Drink lots of water and find a stress outlet. Mediation, kickboxing, running etc. Anything to give your.body a physical and mental release. It does get better. I know tons of people who have made it through and their lives are so much better. Our brains are an amazing thing and addiction is like knocking down a wall , cutting every wire and then trying to put them back together without remembering where they went. That is how our brains feel while recovering.. It’s just us trying to become us again. You can do this and I assure you a lazy/tired mom is SO much better than a mom who is ruled by drugs and addiction. You can do it. You are already so much stronger because of it.

                Leslie,
                I’m Sam, I’ve been in recovery for 5 years this November, and somedays I feel the same way. Somedays I feel like I miss being on cloud nine, I could conquer the world, I could juggle all of my motherly tasks, work tasks, etc., but then I remind myself that while I was doing the job and getting it done- that’s all I was doing, I had no real emotional attachment to anyone, and to be brutally honest that includes my kids.
                On the flip side- I only feel that way somedays, the other days- I’m high on life- my entire world changed for the better in year 2, I changed, my relationships changed, my career path changed, my “friends” changed, my hobbies even changed. My advice to you is to find some hobbies to occupy your time and to keep your hands busy. I’ve built a very therapeutic life, I moved to the country, rented a little house on a lot of land, we have ducks, chickens, pigs, stray cats- all raised from babies by us…. Every morning when I step outside and these animals surround me- I’m grateful for my life, I’m grateful for another day, for the air in my lungs, I’m grateful that I’ve built a life of peace.
                I’ve also discovered that I’m right crafty, I enjoy making things, painting things, cooking things, and slow dancing by myself in my own kitchen- things I couldn’t do or enjoy before….. Do I feel nuts…. Somedays- but other days (again with that, because recovery is a roller coaster) I realize that I have an appreciation for life that most ‘normal people’ will never understand- so, who is really nuts….
                Recently, I’ve also found a doctor that I can really trust, I’ve explained my addiction to her- and her alone, she has taken me under her wing and is helping me to mentally and physically deal with some of my challenges.
                For instance, did you know that opiates do more damage than they do good…. The chronic pain that I thought I was in- pales in comparison to the chronic pain associated with being in recovery from opiates.
                What do I do…. Well, I had a lot of vitamin deficiencies bc I didn’t take care of myself for so many years, I’m on supplements and have changed my diet, she also put me on Gabapentin as well- as this helps with the pain and the cravings- but this is just another “crutch” I can not stay on this medication for the rest of my life, and in some states this medication has been deemed a controlled substance as well because in high enough doses- it’s mood altering.
                Whatever you do, please take care of you- first- you are your #1 priority.
                Find hobbies, find peace, find you’re tribe.
                And most importantly- stay clean, and stay in this fight with us.

                I don’t have anything if is your first time quitting might be easier , this is my second time has been 10 day I am kinda out my mind
                hope something works for you .

                HI I’m Cesar I’ve been 7 days clean now. Been taking subs for the first 3 days and now I just take em when I feel down. I was a heroin user for almost 3 years. I know some people have it worse but I can’t help but to feel like my life isn’t worth anything now. It’s like I have nothing to look forward too. I just feel super depressed. I’m not sure what I’m doing but I don’t want to go back to heroin although at the same time I do because I felt my life was so much better then. Your not alone Leslie just keep going everyday is a win. Thank you for writing helps me not want to call and use again.

                Hi Leslie, my name is. Kim and I was using all sorts of pills but uppers and downers in mass quantities for about 16 years. I have been clean for about 5 years and at the beginning I felt grateful and loved life and just felt like a new me. I was in a relationship and doing thinfs that normal people do. All of a sudden almost a year ago I got side tracked in my mind and felt down all the time. Anxiety got bad. I never wanted to do anything I think cuz I relalized I had no friends and really no life. I worked, went to meetings, came home and went to bed. Everyday the same thing. Well Inquit my job, my boyfriend ended our relationship after a lot of years. Now I always feel in a rut. I have anxiety super bad. I can’t find a job cuz I have 3 felonies and life just feels meaningless. I sleep all the time like you. I just never feel happy. If I do it’s for a quick minute and then it’s back to the same old depressed me. I felt like when I was using I was getting things done, was more active, had grimness or I guess I thought they were friends. Basically I felt alive . But I cannot let these feelings get me back to using. My doctor did put me on Celexa and Buspar cuz my anxiety was making my blood pressure borderline stroke/heart attack about to happen. I just want to be happy. My dad never used amd my mom has been sober for almost 7 months but they have been divorced since I was three. Anyway, I’m forty years old, single, live with my dad, no job. Bit in recovery. I feel like a shell of a person that could be so much better even though I’m in recovery I feel bad more then I feel good. I need to remind myself of what an ass I was when I was using. I was in and out of jail and I never want to be like that again. Just keep telling yourself and I will to that these bad feelings will pass. They always do. Lately I have been having nightmares and I did when I was using too. They are so bad that I woke up the other day crying. I mean I was crying while I was asleep. How f***** up is that? For the past 6 years I’m scared to go to bed. I’m dead serious cuz
                My nightmares are that bad. But I tell myself all the time things will get better. Keep telling yourself that

                I went through PAWS for about 6 months but I didn’t abuse OxyContin as long as you (I abused the hell out of them for about 3 years). Acute withdrawals were hell but I thought everything would be fine after they got out of my system, boy was I wrong. PAWS is even worse because you’re trying to work, play, have a relationship with your wife and kids, but you feel like doing ABSOLUTELY NOTHING! I hated the thoughts of hopelessness and especially the fatigue… the good news is that you will get back to normal one day. The best things I found to do were:

                1. Keep telling yourself that it’s going to get better and that it’s all in your mind. Your dopamine’s simply not working on it’s on yet but it will!

                2. Eat HEALTHY! You have no idea how good a healthy diet is for you!

                3. Take vitamins and supplements!

                4. Learn to meditate

                5. The most important of them all is to EXERCISE YOUR ASS OFF! When you get the blood pumping, your dopamine will start pumping too.

                If you do all the above as much as possible, you WILL return to normal. It’s just gonna take a while for your brain to heal because you were on them for an entire decade! I hope this helps!

                I agree with you cause I’m in detox now cold turkey from being on opioids Because of fibromyalgia and not just a bit either!! Trued stopping once before and stated in bed git back on and I had a sense of a life. But our bodies grow tolerance and then we need more. I was at 365 pills a month at 5’1 and 108 pounds of Percocets and 20 mg oxy’s and I went cold turkey this time at home. I’ve tapered before then tried Suboxone since it was my tolerance that was the problem and I needed something for pain and doc didn’t tell me much but it gave ne adrenal fatigue after stopping them and thyroid issues as well as now knowing that one pill can make us feel how we used to. But what if some brains are unbalanced just like people on antidepressants, Because this don’t work on me , but everyone is different and chemistry is as well ,so we take the pill and it balances us out like others on antidepressants? That’s what my doc thought after a while because as soon as I went bck on them I was as good as new again!! But my liver won’t be able to take such amounts so I stopped cold turkey this time ,no Suboxone, methadone,nothing to see and started loading with L- Thyrosine non amino acids and it promotes dopamine naturally which will help you get back to being happier, motivated,etc.. look up Matt Fitch on you tube. He knows his stuff ..good luck everyone

                It is not easy, but I am only doing this once. Fifty days clean.

                omg thank all of you. I quit cold turkey after being on these since i was 18. I am 36.So i did it 1 yr and a half and still stuggling with paws. I feel my old self like i am 18 again, no denying that the feeling of being normal is amazing but i always feel like i was taken apart and put together wrong. Still fighting this because I like not needing a pill to function but has all these symptoms and feel lost and confused at times.

                I know how you are feeling Leslie. I quit cold turkey November 2019 because I knew I needed too. I knew that person I had become wasn’t who I was. So I quit. I still get the sweats sometimes. It does feel good not being on a search, or worrying about running out and getting sick. But some days I wish I had the energy I once did. I know most of us have to keep pushing forward and not let the demon catch up to us regardless of how bad we may feel some days.

                My psychiatrist put me on Xanax twice a day and I saw her for 6 years! She left the office in May and gave me refills up until early June. I haven’t found a new psychiatrist – so no new prescription.

                I feel very naive that I had no idea about needing help to actually taper down my medication or that it was addictive. I went down to one pill per day for two weeks, but that was only because my prescription was running out. I just went cold turkey the rest of this month.

                I feel like I should have been aware of some of the symptoms, but since I didn’t, I was very worried and made an appointment with my new primary care doctor. I’ve lost 60 lbs in 5 weeks and I have no appetite. I’ve been forcing myself to eat at least once a day. I want to do is sleep, so I’m having a lot of problems concentrating.

                I started to look into Xanax and all of my symptoms were included in the list of withdrawal problems. I have no idea how long they will last.

                This article really helped! Because my doctor prescribed the Xanax, I followed her instructions. I’ve asked multiple times about my prescriptions to make sure they weren’t causing any reactions or issues. My primary care doctor, pharmacist, and the psychiatrist all said my prescriptions were okay and not causing any reactions.

                At this point I don’t know if I should wait until I get a new psychiatrist or try to find a rehab center to get help. I’m actually peeved about this because I specifically ask for nonaddictive medicine. I have no idea how I missed this one! Where to go now.

                Thanks for reaching out.

                SMART Recovery’s online mutual support meetings are searchable through our website https://www.smartrecovery.org/community/calendar.php

                Our local meetings are searchable here: https://www.smartrecoverytest.org/local/ Some of those meetings are in-person, others are temporarily meeting online.

                Hi, how are you now? I’m curious to know if you have overcome the sleepiness. I’ve experienced this myself at times but I find that pushing myself to get up and do anything helps. As hard as it may seem.

                Leslie my name is Timothy. I am in recovery now going on four and a half months. This is what I can tell you and what I’ve been through. I never went to inpatient however I had to end up in a clinic on a daily basis. When I was stabilized I started dropping my mg per week. It took me almost three years to come off. To this day I have diarrhea, the legs shaking, the hot sweats at night, pure misery, and then at times I actually have a peaceful night. Your body is resetting itself. Stay in the fight and stay strong. I know it can be done. Hang in there.

                Are u still off pills? Are u getting better?

                Hello,
                I weaned myself off medication approximately 5 months ago w/ my doctor’s help. After all these months, I still wake up shaking and feeling weak as if I’m going to faint. More feelings that I can’t explain. Is this normal? What, if anything, can I do?

                I know this post is from years ago but your story hit me. I’m almost two months off drugs after literally 10 years of never going through withdrawal. Now I wake up exhausted achy, irritable, and anxious. Some days are better than others, but I struggle to get out of bed. It’s like half the day my kids are on electronics because I’m struggling to get out of bed. I’m hoping I made it through. It isn’t worth going back. Praying my brain just needs the rewriting.

                Hi. I feel the same about PAWS. I drank for over 50 years 15 – 65. Throughout my adult life I drank most days. About 1 year ago I decided to quit, because I had started to binge drink in the solitary life I had adopted. I gave up for 1 year and didn’t really suffer withdrawal and had no desire to drink. I remained on a very low dose of medicine, which I have been using for a couple of years to control my anxiety. On 1 September I suffered at the hands of yet another narcissist and went on a binge. This time I felt awful as I discovered the horror of PAWS. I have not drank since and never will so as to prevent a further experience of PAWS. Thank goodness I found about PAWS and can prevent a further relapse. My heart goes out to anyone out there experiencing it for the first time.

                Any program or method will work if we put the work in and we are all worth it. Wishing you all courage to change the things we can and sending much love, light, laughter and happiness. God bless.

                Thanks for bringing this to more attention. I have relapsed due to PAWS as I was not aware of the condition and thought the feelings were my new normal and I struggled living with that. Currently I am a poster child for PAWS as I am 6 weeks off of RX opioids and still feel pretty lowsy. I had acute withdrawals for much longer than most but now have daily symptoms to those you described above. Some days are better than others but mornings seem to be the worst. I do wish there was more attention given in researching and understanding PAWS as this seems like the hardest part as it seems like there is no near term end in sight. Thanks again

                Thanks for the response. Keep up the great work! If you haven’t already, find a local SMART Recovery meeting to support your efforts. Or, you can also check out our online community for 24×7 support.

                Hi this is very interesting, I have 10yrs sober as of May. Is it possible to still have PAWS? I started drinking around 14/15 so I have definitely rewired my brain, drank for 20+ years. Thankyou for any information.

                Do you ever get extremely itchy? I have been off opiates for 32 days now and feel pretty good. The only thing is some days I get EXTREMELY itchy as if I was doing opiates. Lotion doesn’t seem to help at all. Thanks in advance.

                Hi James. I just made my 32 day mark today off methadone and I get intensely itchy as if bugs are crawling through my skin in various parts of my body. The more you think about it the worse. I usually put cold water or take Claritin. I sometimes even get little hives in random places. Also, I get an intense tingliy sensation to the point it tickles as if someone where about to touch me. Do you experience that?

                I am on day 20 of Norco withdrawal. I also had my last cigarette the same day, and I cut valium dose from 2 5mg per day to only 1 at night. I have chronic Lyme Fibromyalgia a deformed back…been sick most my life it seems. I’m just trying to live as pain free as possible. Refused opiates for years until I couldnt stand the pain anymore…about 6 years ago. I used Kratom to withdrawl cold turkey….still having horrid symptoms after 3 weeks and it sounds like I will for a while to come. No life left either way. I’m 64 and alone. Can’t exercise. But medication makes me sick and Drs don’t believe it. I’m between such a rock and a hard place. I can’t live with ’em or without ’em so to speak. I know this….I couldn’t keep trying to function ON the Norco. If I can’t function without it then without it…it is! God I just want to feel better.

                Yes that’s al I want is to feel better and end this incredible anxiety and insomnia!! If of suboxone 37 days and still horrifying! I can stand it much longer!! I don’t want to use!! When will it ever end!! It’s hard to b alone I’m 60 and alone too hope things get better soon for u and for me!

                Thanks for this. Thought I was going crazy. Thought I was doing good. Been on pain pills on and off my whole life. Low dose. 10 days off. Also on Xanax. My anxiety is way out there. Was wanting to get off Xanax but guess I need to wait. I have heart failure and it is really messing with my heart. Tried antidepressant. I am so scared and alone.

                Off of heroine 15 days without sleep my body is shutting down, how long will this last? Please help

                For those having issues with PAWS… It is quite difficult going through this phase of recovery. I have been through short as well as long term PAWS. Again, it isn’t easy but very well worth going through. There is a rainbow at the end of this phase of recovery. To anyone suffering this condition…. HANG IN THERE! ITS WORTH IT!!

                Thank you! I’m hanging in there as crazy, painful as it is.

                Pat. Did you suffer any anxiety mental symptoms and recover from them?

                To those struggling, don’t be afraid to try MAT (medication assisted treatment) to cope with your symptoms. Methadone clinics get an unfair bad rep but they do some great work and patients who quit using MAT have a greater chance of not relapsing and not experiencing PAWS, or at least a lesser version of it. I dont know weekday I would’ve done without it. I still had cravings for a few months, but our wad to a degree I could handle, but mostly I felt relief and less stressed. I was able to work again and 4 years later I have not relapsed. I still try to keep myself informed on new research in hopes of better understanding addiction because it is a nationwide epidemic but I have high hopes. Hang in there. There is a light at the end and it is soo worth it!

                What if it lasts 18 months and then, like me, you give up? If at 18 months I’m still having insanely painful wds, I just can’t do it.

                My brain has permanently changed. How come no one EVER MENTIONS CHEMICAL CHANGES IN THE BRAIN?

                I hope you were able to hang on and keep yourself clean. I’m pulling for you.

                I’m on day 20 cold turkey (had no choice-but it was hell) and I have no energy. I have to push myself to get things done. I’m still in pain and have trouble eating but I fight through it. I have been forcing myself and I find the more I make myself move the easier it gets. I cant sleep during the day or i wont sleep at night. I go until I’m dead tired and then I lay down and can get some sleep. It will get better. You gotta get your head right and you gotta push yourself. I know it’s hard, but the worst is over! Stay strong! It’s not worth going through it again!

                Tom you can do it 15 days off opiates is amazing and you are PAST the worst I promise you. I am 25 days off and I had a period of 6 yrs clean prior. I’m telling you there is hope take a sleep aid like melatonin or get a prescription from your doctor and drink lots of water and force yourself to take hot showers go for walks and pray! I prayed every night for just the tiniest amount of peace and sleep and with the help of prescription sleep aids. It’s been the best thing I ever did for myself. Good luck! NA meetings also help, writing, reading, meditation, deep breathing…. good luck!

                I am in a very bad state of PAWS when I try to ween off my medication, which is now Xanax and Merthadone, I feel like I wanna die. I shake like crazy, have fears to even be around people is close to impossible because my anxiety is so high I lose my breath and ability to talk to people and feel like people l can see through it even though I try to play it off as hard as I can but I just want to run. I just feel for everyone going through this and wouldn’t wish this on my worst enemy. I just want all of us to get over this epidemic. It is the toughest thing, aside of cancer, to live through. Wishing you the very best. Please hang in there.

                Love,Light, & Blessings,
                Gina

                Hey Gina maybe try one at a time. I am currently 5 months of hydrocodone. I still don’t feel how I hope. I mean don’t get me wrong, I feel sooo much better! But a lot of anxiety and isolation still. I still take Xanax and I’m wondering if that is not affecting my mind – moods, motivation, anxiety, etc. My goal is now to wean down off of the Xanax. I did hydros cold turkey. And it’s literally one day at a time.

                How are you doing Gina?

                Thank you for taking the time to shed light on this subject. I’m experiencing several of these, at times feel down right miserable. 3 and a half months clean from 10 year addiction to opioids.

                I am now 7 months going on 8 sober from ice, and since I quite the first couple months I’ve had panic attacks almost daily, felt feelings I’ve never felt before and always, always have this pounding heart, and I’ve been to the cardiologist and they told me theres no damage or any blockage so now I am certain it is PAWS and I cannot wait for it to go away, i am so grateful for finding this page, it makes it easier knowing that it is common, I thought I was going crazy for a while there, always freaking out, for no good reason and obsessing over things that I shouldn’t. Btw don’t ever do meth, not like anyone should ever have to tell anyone that but the PAWS symptoms suck.

                Yo what did you feel like shoulder pain and palpitations?

                I have to quit soon and im not sure what to expect, except for, before when ive gone days without it i was beyond tired literally DRAINED. sleeping all day and so much hunger. Is there anything that can help with the tiredness? Anything that can boost my energy? Coffee etc? I have no choice but to go cold turkey and i cannot make anything obvious

                You can take Kratom…only by at good nutrition supplement store. Do not buy at gas station or tobacco shop EVER. It helps tremendously with paun and energy. I quit 6 yrs of Norco with it 3 weeks ago. I stopped Kratom 3 days ago as well.. It kept me out of the hospital as I’m older and sick…stay hydrated and goid luck!

                I’m on day 8 off opiates after 11+ years! The physical symptoms are pretty much gone (except for not being able to sleep). All I think about is how much better I would feel if I could get some Dilaudid! I’m alone in this and could really use some support. Thank you for this information

                Im on day 9 and also alone in this. Keep ur head up u goy this.

                I am 26 days clean, after 15 years of heavy opioid use. I, too, am all alone out here. But, I am certain that this too will pass.
                I actually slept for almost four hours last night.
                PAWS sucks. Besides not sleeping, I am easy to anger and really want to hit something.

                I am about 30 days off of 25 years of heavy oxy . I broke my spine and the pain is unbearable but opiates were screwing up my brain . I am also in PAWS and cant sleep much and have zero strength in my legs and energy .Its a worry and often I wonder if I should just go back on the oxy? I wont but I cant keep up my large property and live alone. Its a worry for sure Stay strong brother

                I’m 4 months clean from cocaine and this explains a lot of what I’m feeling. Anxiety, heart racing, panic attacks. Paws explains so much.

                Thanks for this. Thought I was going crazy. Thought I was doing good. Been on pain pills on and off my whole life. Low dose. 10 days off. Also on Xanax. My anxiety is way out there. Was wanting to get off Xanax but guess I need to wait. I have heart failure and it is really messing with my heart. Tried antidepressant. I am so scared and alone.

                Hello. March 15 was my last day in detox coming off opioids (again) from 12 years of using. This was the first time in 12 years I went to a supervised detox facility. I wish I went sooner. Totally skips the 1st week of hell! I went right to a addiction recovery center by me. On the 25th of March I still tested positive for methodone which was used for detoxing. It is staying in my body longer than usual. Not sure why. I am experiencing all levels of PAWS except suicidal thoughts. The recovery center I’m in offered suboxone or Clonidine. I went with Clonidine since suboxone is 50% opioid. I felt like I’d be going backwards if I went that route. Now still feeling crappy and always snapping at family members and having trouble going to my meetings every morning and then work and 5 kids to deal with I’m considering switching to suboxone. Is it cheating or going backwards if I switched to suboxone. Thanks for reading.

                I detoxed from Roxy’s and methadone 5 and a half months ago. Methadone takes at least 30 days to detox from because it goes deep into your core, even into your bone marrow. Clonidine was my best friend detoxing from methadone, but then I learned it was my enemy. You gain a physical dependency on that as well, if taken longer than 2 weeks. It took me another 30 days to wean myself off of that. And those withdrawal symptoms are like no other because it increases your blood pressure. Many times, mine sky-rocketed till I was almost in hypertension. I wanted off clonidine so bad because IT causes sleeplessness, anxiety, and appetite/stomach issues. After detoxing for over 60 days total, I lost nearly 20 lbs, but quickly gained it back once my stomach returned to some normalcy. Now, I feel anxiety the same time everyday, feeling depressed over my weight gain, but have no motivation or will to do anything. My energy is completely drained. I now think its PAWS

                The tiredness and no energy is killing me. I’m only a couple of weeks off opioid addiction for 5 years. I’m thinking I should’ve tried weening myself off as I am miserable now. Will I ever want to work and do stuff again.

                Not necessarily “cheating”, but please note, methadone itself has a VERY (almost as intense as heroin) strong and VERY long lasting (about 1 month roughly, or more for some of acute. Then at least 6 months to a year of paws) withdrawal. Similarly, suboxone, while having a much less intense withdrawal, lasts a long time and has a withdrawal of it’s own. This is currently where I’m at. I was given suboxone at very high doses by a doctor who was an idiot, so I just weaned myself down. I would ask her to lower dose and shed send in the same max dosage, so I had roughly 2 years worth of them saved up at the low dose I was at. I ended up leaving the clinic abruptly and entered a med mj program, which did help, but made some symptoms worse occasionally. Fast forward, I weaned myself down to .25 mg every other day, but was so afraid of the sickness, I did not want to take the plunge. However, I had begun feeling withdrawal symptoms even while taking the suboxone long, long before that, so it was either let my body recover, or face the prospect of almost daily withdrawal symptoms on a substance that was supposed to eliminate them. My point is, suboxone is very helpful… SHORT TERM. I cant stress th is enough. Any longer than maybe a month or two and your body just becomes addicted to that instead. You can use it for a few weeks just tot get you through while lowering the dose, then just jump off. That’s the best route. Do not become complacent and stay on it just because it seems to help. It has long term consequences, and I found it killed my sex drive and made the world seem less bright and vivid. While you wont necessarily feel paws while on it, it definately kills any pleasure you may feel in life. While paws sucks, it is temporary. This is all temporary. Keep telling yourself that. And going back just for a small relief is only setting yourself back. I learned this the hard way!

                Also, the methadone is not staying longer than usual. It has an extremely long half life of I believe 2 or 3 days and therefore can take 5x that to exit the body completely. You would have to look it up and do the math. It is considered by many to be the most risky and worse of the two maintenance meds to start and get stuck on.

                I understand the stigma of using suboxone, but it SAVED MY LIFE! Using hydros for almost 20 years, coming back to being “me” was dang near impossible. The withdrawals & emotional aspect was intolerable. Suboxone put me back to me. I do recommend it. I’ve been on suboxone for almost 2 years and am down to 1/2 a strip per day. I never thought I’d have the feeling of being proud of myself, but I am. I wish you the best & hope you are well.

                Hi Catherine,
                I was wondering when you were finished cutting down on suboxone, how did you feel?
                I also cut down, even slower than my doctor prescribed, and I still went through horrible withdrawals. Wondering what your experience was.

                Thank you for your honesty. You used the sentence “ feel like ME again “ that’s all I kept saying to my GP 1 year after he put me on medicine, that I didn’t feel like “me” any more and he didn’t understand what I was trying to say. Although I was pain free, and as a mother of 4 that was helpful, but upstairs in the brain I wasn’t Lesley anymore. After doing much research I decided I wanted off them. Never before had I used any drug or hardly even drank. My work and family were my life, All I wanted was to feel the way I felt before taking drugs, even if it means being in pain. 5 years later and I went cold turkey after years of trying to explain to my GP that this medication was killing me inside. He was not helpful, so I decided to find some withdrawal help groups and they made me understand I wasn’t crazy. I am now 5 months patch free. But all of a sudden the last 7 or 8 weeks I have certainly felt the PAWS symptoms so badly I actually felt suicidal. I am now seeing a psychiatrist. My only wish is I had done the research before hand but I can’t kept torturing myself with it. It is what it is. I understand now in time my brain will rewire itself but it needs me to help it and it is at a slow pace. I just keep telling myself that one day I will wake up again and feel normal, feel ME again and that’s worth the wait. I now understand that any withdrawal is a brain disease and we must fight it. Fight it so hard that we can live again. It’s never too late and websites like this are gold dust. Good luck everyone. xx ❤️

                Don’t ever be afraid to get a little extra help, it definitely is NOT cheating and it will help you stay on track and deal with the symptoms. It works differently than other opiates and it will help you get your life back. Hell, do it FOR your family, they will thank you in the end. Medication assisted treatment is nothing to be ashamed about. Hang in there!

                Hi Carlo, I was wondering what you ended up doing? I detoxed cold turkey off of suboxone in Feb/March this year. I was hoping you are doing well.

                Thank you so much for posting this article! I was on prescription opioids for only about 8 months, but, at times in the hospital was on dilaudid every 4 hours, Percocet every 4 hours, and a fentanyl patch. I weaned off of the pain meds (or so I thought) after lowering the dose to four 7.5’s a day. I discontinued use about 2 months ago, and felt fine until about a week ago. I returned to work, and I am having the worst time concentrating, and tasks that were once routine now give me extreme anxiety. I talk on the phone (customer service) for a living, but I’ll constantly go into a different status to avoid getting a call while trying to complete a specific task, as I’m horribly worried that I won’t remember what I was doing, or won’t be able to concentrate on the current call. This article actually explains, almost to a T, what I’m feeling. Thank you again!

                I captain doing benzos for 27 years. I quit them in November I also quit doing oxycodone last May I switched to methadone I thought I was through. When I stopped taking benzos Klonopin I weaned it down from 1 mg to 1/2 mg and I quit, as soon as I quit my total life went to hell and no what was coming or going I honestly thought I was going crazy! I didn’t know what I was having to me no one could tell me the truth I went to the emergency room three times I was mean to everyone, yelling and screaming I was so upset they couldn’t tell me what was wrong no one told me about p a w s! I then realize I have to get help, I went on Suboxone I’ve been doing it for about 6 weeks, and I’m feeling a little better but not much. I never knew it would be so detrimental to my health my mental health. I always kept it together until now I suffer from every symptom and then some. It’s been over a year, let’s just hang on breathe remember to breathe I keep saying there’s a light at the end of the tunnel!!

                I’m on day 12. So agitated with everything and antsy. Just can’t relax. Didn’t expect to feel this way now. Really hope this will pass. I keep thinking a drink will relax me, but I know my brain is trying to trick me. Good to know it’s the brain rewiring itself.

                Now i am running paws of 2 months with anxiety, fear , panic, etc,. How long it will take to symotoms to fade….

                I was prescribed Norco for back pain for well over 10 years. I went from 7.5 mg (4-5x a day) down to half a pill 4x a day for a month then to 5.mg 4x a day for a week then just stopped taking it. Acute withdrawal symptoms lasted about 5 days. My dr. prescribed Catapres patch and tizanidine. Catapres helped but the tizanidine only made me more lethargic. I had some lyrica which also helped but that put 10 pounds on me. I stopped both the tizanidine and the lyrica a week ago.
                It is a month that I’m completely off the Norco. I thought I’d be ‘normal’ by now, but I’ve never felt so terrible. I can’t get out of bed. I’m so tired, I just want to sleep, but can’t. I have no desire to do the things that I need to do. I’m forcing myself to get up and go to work ( I have a demanding full time job ) and act as normal as possible but it is a real struggle. I have a terrible cough and feeling of drowning. I’ve started taking Zertec to dry my head up. I’ve also just started Imodium for loose stools.
                I have no desire to go back to Norco. I just want to be my eager and energetic self. If this is PAWS and PAWS can last for months, (years) I’m not sure I can continue. I’m 70 years old and have zero health issues, EXCEPT for this awful side experience to my opiate dependence.
                Could my PAWS be due to not weaning off the Norco at a slower pace? Maybe I should start over? Wean off the Norco more slowly? Would that be going backward? I need to have my life back, as this is no life.

                No man don’t go back it gets better!!
                I’m at day 86 off Of oxycodone pills for 5 years!
                I’m dealing with PAWS but life is much better then the first month!!
                You got this! Tell yourself you’re a damn warrior!

                Hi Dane. Thank you for your encouragement. Today is my 207th day off Norco. Can’t believe I’m still experiencing symptoms of PAWS. Some days are better than others, but I’m still nowhere near what I remember as normal.
                My dr. put me on Catapres patch for a a few months. I’ve been off that for a month now and anxiety is back almost daily. Mood swings are common and energy levels vary from “ok I can get through the day,” to OMG, how do I get out of bed today.
                Blood pressure is up without the Catapres too. Heart rate jumped 15 bpm on average too ( I wear a Fitbit). Sleep is better, maybe 5 or 6 hours a night, but wake up several times during night and am having vivid dreams and that’s odd for me as I rarely remembered dreams in the past.
                My digestive system has good days and bad days too. Still have persistent and annoying post nasal drip and cough but it’s better than it was.
                Still, I’m hanging in there. I won’t go back to opioids, ever.
                Even though I am better than I was a few months ago, I’m wondering if it will be years of this. I sure hope not!
                Hope this didn’t discourage anyone else out there struggling with PAWS. I am better and keep reading that the brain will rewire and dopamine will eventually go back to where it needs to be.
                Here’s hoping. Good luck to all of us in the same boat. One day at a time.

                Hi there – I just had my 10 months sober, after 10 years of trying to get sober and clean – I was a narcotics user for nearly 20 years. Recovery has been less than good – I have absolutely no desire to have a drink or drug and I am grateful for this. I am HIV positive – however I have been working on major projects for work which have almost come to a halt and I may have to give them up and deal with the shame and guilt. I feel myself withdrawing into seclusion and depression and to the point I can’t eat, make a decision and feel very hopeless and extremely sad. I have an incredible sponsor who is so supportive. Money and work are major triggers and I run my own business – its been my life and is my world and now the thought of losing another project for over 2 years is crippling me and I can hardly feed function. As I said, I have no desire to drink or drug, however I know I am slipping into major depression. I eat very little but I exercise everyday because it is the only thing that keeps me going. Is there anything you recommend?

                This is the first place I have seen which addresses symptoms of opiate withdrawals months after the initial detox. I was feeling discouraged about feeling bad 22 days into my recovery. I do NOT want this to be my “new normal”! Maybe I was not addicted to opiates but I was dependent for sure. After moving from Oregon to Sacramento, CA I was unable to find a doctor to refill my prescription. So I started to taper down and after 4 days of “terrible symptoms,“ checked into a detox center for 6 days. I am just now beginning to get my appetite back and not need Imodium. I am feeling numb and lethargic and anxious. It is difficult to be at home alone all day trying so hard to feel better. The hours pass like days. Time seems to be standing still. My back and neck pain have been severe now from spinal stenosis and arthritis but I am not craving pain meds. I just want to feel good enough to go somewhere and clean my little house. It is wonderful knowing that I am not the only one going through this and the encouragement to stick it out is very uplifting! Thank you, everyone, for your understanding and encouragement here.
                I have gotten through this with comfort from God’s promise that He will rid mankind of all pain and suffering very soon. Rev. 21:3-4. He has the power and the desire to fix everything and return mankind to his original purpose, a worldwide paradise with no death, pain or suffering! That keeps me going when my world feels bleak.

                I have been addicted to opiates for twelve years and am on my fourth day clean from yet another stent of using …. I was clean for four months before I relapsed and that was eight months ago but if it wasn’t for the experience I had when I was sober with feeling the depression lift and feeling so good … I would be freaking out right now. But the unfortunate truth is I had been taking adderall for fifteen years and am two months sober from that and my Xanax so this kind of is the first time I have really gotten sober without having some other crutch. Plus I never had an alcohol problem but I quickly saw myself swapping addictions. This is the first time I’m going for complete cold turkey holistic detox and the physical stuff sucks a lot yes. But the mental stuff sucks more because not only does the foggy memories of your behavior while using come flooding back to you like a brick in the face but you have so much guilt to address at the same time. I’m use to having the aderall which took the mondanity out of getting sober but I knew as long as I was still on that I was not truly clean. So this is uncharted territory for me. All I know is when I was about 30 days clean last year I felt the fog lift and at 60 even better. But the PAWS crept up I got cocky and I relapsed. It only takes one pill and poof…. right back down the rabbit hole. Good luck to all of you and keep up the faith…. because no matter how hard it gets it’s still better than being a slave to addiction ….

                Lindsay, how are you doing now? I’m going through the same thing–painful PAWS after having taken adderall daily for 10 years. I am 5 months sober…fatigue and weight gain have been horrible.

                76 days off norco, still feeling badly!
                Constant loose stools, maximum 4.5 house sleep at night ( with the help of ambien), still have persistent cough and post nasal drip. . But the worst symptom is the lack of motivation. It
                Takes a huge effort to just get out of bed and get to work. Everything needs a push. Joy seems to be a distant memory. I’m taking vitamins, supplements, eating protein. Have catapres patch. Better on and off but still miserable.
                I posted here before. This post is an update for anyone looking for a time line answer, as I am.
                Bottom line, 2 and a half month in and still nowhere near normal.
                I keep telling myself that if I give in and take a pill for some relief, I will just undo whatever physical advances my brain has made so far.
                Lack of natural dopamine and serotonin is devastating.
                The medical community ( pain management doctors) really need to get an understanding about the mess pain meds create.
                And oh yes, still have back pain. Taking Tylenol for that.

                I read your post. I’ve been off opiates for some time now and what I can tell you is it will get better. The things your feeling is your brain rewiring itself. I helped my paws with a cold shower at the end of my hot shower. Try to stay under cold water for 30 seconds. I know it sounds strange but it actually helps. Do this every day for 10 days. Also eat healthy as you can. One other thought. Your sleep will get better. I did not sleep for 20 days after quitting. You have to embrace the suck. In the end you will feel normal again. It took me 4 months before I felt about 80 %good. 20 %paws. In one year you will be the happiest you have ever been. Hang in there u can do this.

                Thanks for the breakdown Morgan… Hit the nail on the head, can’t wait for those brighter days!! On day 84.

                Hi Morgan
                I just wrote a very long and detailed update but don’t see it so I must have done something wrong. Bottom line it’s day 207 and PAWS still with me!
                Some days better than others but I’m afraid my recovery will take LI her than most. Sure hope not but I will never go back to opiates.
                Best of luck and hang in there for everyone struggling.

                Diane – did your post nasal eventually go away? I’m at 161 days and still have major post nasal issues. Allergy meds aren’t helping at all most days. It’s really fun to have a random need to clear my throat or cough during a pandemic!!

                It will get better

                Im 1 month clean (again) off Heroin from an addiction over 3 years… smoked snorted and injected. Ive stayed clean for a lol over 6 months before and relaspe. Ive never gone into treatment nor detox. Just used susuboxone and winged myself. NOW im feeling a really odd symptom i would only feel during the first “72 hour” withdrawals. What im feeling is heat coming from the back of my neck! Im so uncomfortable in my own skin. I KNOW im through the withdrawals from h & suboxone. I understand
                My body needs to readjust. This time i feel like something is off and not right. Should i see a doctor.. does this sound familiar to anyone? When will it stop is there something i can take?

                I have that same feeling! I keep my house really cold because if I’m not cold..I have this horrible heat sensation like a fever all over my body. I get claustrophobic feeling and anxiety. I’ll purposely do things that I know will make me get really cold (cold bath, or shower) just because like my body can’t regulate my temperature or something. I’m glad I read this because I’m reading everyone’s comments and no one had said anything about this yet…and it’s weird, it starts at the back of your neck and turns into a fever like feeling.
                I’m on day 7 of cold turkey quitting off of heroin use for 3 years…
                I still feel like crap but I see the light at the end of the tunnel.
                Good luck!

                does this go for weed as well?

                I was on pain killers for about 8 years on and off but the 4 years mostly everyday. I stopped on my own cold turkey, it’s been almost two months. I was starting to a little better around one month in but now I’m feeling stressed and I panic about small things. I don’t have much strength, I’m not sleeping good. I also was laid off last year and my health insurance is going to end in a few more months. This has stressed me out, my options are state insurance programs which I can make a certain of money a year. I’m a 62 year old and it’s been difficult finding work. I just want to feel normal again. I was drinking red wine or occasionally beer or a little smoke to ease the withdrawals but now it’s making me feel worse.

                I’m sorry you’re feeling not yourself. It took me a while to feel normal and “in my own skin” after getting sober. But alcohol is a different withdrawal from what you’re dealing with. I actually slept better, had less panic and more strength. But like you, I also lost a job and stressed about it. But I realized I was in danger of slipping so I just channeled my energy into new projects and chasing job possibilities. (I succeeded after a while; and we’re only a few years apart. Just keep pushing forward; avoid the easy temptation to fall back – even if its a beer or wine or smoke here and there. Funny how those “little habits” turn big before we know it. And then that’s just another problem we don’t need. I’m thinking of you…

                Im glad I found this article. After nearly 29 years of alcohol and cocaine abuse off and on I am finally at 90 days clean. I have quit for 30 days or so off and on in the past and now realize why I kept going back..the tremendous panic and anxiety are like a prison at times. Found out I damaged my Autonomic CNS and Vestibular system which adds to it. I know with my long time abuse I was going to deal w this bit it’s so disabling..seems driving is my worst anxiety trigger as the hyperarousal of busy places etc are hard at this time. Very isolating. I refuse to ever go back to my old lifestyle and am working hard on my recovery and just trying to be patient. I hate seeing everyone else deal w PAWS but I am grateful to know I am not alone…and not going crazy.!

                I feel your pain. Describe your anxiety mental symptoms to me please

                Well it’s been about 3 years now since I have touched a opiate pill. I took Norco 1mg three times a day for 19 months. I quit cold Turkey. I get mad real fast with anything. I am brutally honest with people and also will yell at a stranger if someone does something to make me mad. I road rage. I don’t want to be here anymore because of how I treat others. I feel like everyone hates me and are out to get me. I didn’t ask for this… I hurt myself and went to the ER. I missed out on almost two years of my life. Again it’s been 3 years . I can’t handle this anymore.

                Hello! Fellow ‘jerk’ here as well! (Having dealt with exact mirror symptoms of what your going through) trust me I know how this can be, and this is why I felt compelled to respond to you in particular. Your NOT a jerk….a jerk is someone who practically enjoys being that way. We didn’t choose this. My major dysfunction ended up being the underlying mental issues that came to the surface once I was clean from the opiates. For many of us this can be a direct effect of how the opiate use has rewired our brains. It takes time yes, for myself YEARS and the benefit of certain psychiatric medications to re stabilize our brains from this disorder. I would have been better sooner if I had started the trial and error process of finding a beneficially acting medication, and I wanted you to know this so you don’t go through what I did. The meds I’m on now aren’t controlled substances and they are easy to obtain, you just have to find a doctor willing to listen. The depression, the irrational angry feelings, anxiety and irritability can be crippling for many people going through this, long after they have quit using opiates. I wish I was someone who could have suffered through a short period of time and been fine, but this type of thing is extremely common. The lack of opiates actually caused a depressive/anxiety disorder that was not present before me starting. Now I simply manage this by taking psychiatric medications once daily that work for me extremely well. We are ALL very different so finding the right one/combo can be a challenge but don’t get discouraged. This is NOT our fault. We have gone through an ‘event’ that has been life changing and scary for our psychological state, just by simply refusing our bodies what it has grown accustomed to in order to survive. Unlike food we will not die from depriving our bodies the opiates, but our bodies required it to feel normal. Again, we didn’t make this decision consciously so don’t be hard on yourself. I urge you not to be resistant to the idea of working with a doctor to get through this. I am just being honest, but I had to commit myself to a hospital for a few days in order to work close enough with a team of doctors to get through it. It’s all ancient history now, but let me tell you I was NUTS! I made the decision my life was more important than simply the ‘idea’ of being off ALL substances completely. What I am taking is not addictive like the opiates in a sense, but naturally I may need it for the rest of my life and I’m FINE with that. I have my life back, I enjoy the precious moments again, and I cope with the crappy moments a LOT better than I did when I was simply not taking opiates anymore. There may be a lot more to this recovery process for some people. I was a hot mess, and if I made it through so can you my friend. You’re an amazing person for making it this long, please I strongly advise you to talk to a doctor ASAP. Your not alone and never will be. I wish someone had told me this sooner. It would have shortened my length of suffering by miles…I wish the best for you in every way.

                My friend maybe you’re Bi Polar like myself
                I’m on day 86 off of OxyContin
                Talk to your doctor
                Bi Polar meds saved my life

                After about 10 years of heroin addiction I went to rehab in FL.on Feb 19. Spent there 45 days, went through withdrawals cold turkey, didn’t sleep a night, left rehab, came home, and relapsed, now, third day without heroin or sleep, going crazy. Heard from some people that sleeplessness can last up to 6 months. So hard not to relapse.

                I’m on day 86 coming off of 60-80mg OxyContin everyday for 5 years. My doctor was fired for prescribing too many pills so I had to hit the streets for them spending $600 a week. I had to stop!! I went to detox for 5 days and thought the hard times were over. Ya right! I’m going through PAWS now. Physically I’m ok except for extreme exhaustion. Mentally still a big struggle. The last 3 days have been ok, today I woke up in a viscous mood and left work after 3 hours. On the way home I had massive road rage which I never do.
                I’m lucky though! I own a family business and have been able to miss work with the support of my family and friends! But this has been a nightmare journey to this day!! Nothing will stop me from completing it!! The good days when you feel so proud of yourself and happy to get a life back out way the bad days and make this worth it!!
                Warrior Style on this journey my friends

                I’m so glad I found this so i can encourage you all. I have been off opiates for exactly 2 years this month. I was prescribed pain killers in February of 2006 due to a ruptured disc in my neck. Didn’t have surgery until June of 06. So I was addicted to the PKs before I even had surgery. Because I have a really degenerative spine both neck and lower back I was able to get Drs to keep prescribing. I would go through the rx fast and then straight into w/d’s for 10 to 14 days. I did this for 10 yrs. Well over 100 w/d’s, I know that makes me a complete and total idiot but it just goes to show how addictive those bastards are. I finally went cold turkey. Then relapsed a few times but like I said I’ve been clean for 2 whole years. I am just now starting to feel normal. But, that might be because I have a predisposition to depression and anxiety. Not everyone will experience PAWs for that long. Everyone is different. But PLEASE REMEMBER THAT YOU WILL GET BACK TO NORMAL. It’s been a hell of a time, mostly the fatigue. It has been crippling BUT I am coming out of it and you all will too! Life is beautiful again. Even if you don’t believe in God/Jesus, pray to Him. What will it cost you? Test Him. He will do amazing things. He doesn’t want any of us to suffer from this or be a slave to it. He will see you through it. Keep up the good fight. You will be blessed by preserving. God bless all of you. And be proud of yourself no matter how many days you are clean. See everyday you go without as a victory. Just stay clean or you will be doing a disservice to yourself, like I did for so long. I never thought I’d be healthy again. It’s a slow process but well worth it. I know the “suck” believe me. And because I went through it and am now on the other side, I have sympathy for all who are addicted and trying to get out from under it. I can now encourage you. You can do it.

                I was using heroin for 5 months. Stopped cold turkey an it was hell. I made it 5 days then gave in. Just went and sniffed about a half a gram. I need some advice on how to keep the withdrawals to a minimal. I know i can beat this if i just did 5 days clean. I was weak an exhausted but i could’ve made it. I dont know wtf i was thinking. The urge just took me down. Any advice on a home remedy for withdrawal..

                I just got out of my second detox this year and I also went straight to the Dope man on day 5-6. I did that about once a week for a couple weeks bc I just wanted to get up and shower and wash my clothes and clean the house and then go right back to withdrawing. It helped me get to this point. Not saying it’s what anyone should do but I felt like that was the path I needed to get clean this time. I’m out of the pain and suffering of the beginning of detoxing but I just have no energy or any motivation to get out of bed. It’s getting better though so just know that this too shall pass. I lost my husband to an overdose in 2014 and thought I’d never do this to myself again but it happens to the best of us. It’s ok. I’m so grateful that I came to this page today bc I don’t feel so alone now. We are strong mf’s in my opinion, this dependency is just so freaking powerful. We can do this.

                Sigh. I never thought in a million years I would be writing on a message board like this. A little background…. Opiate user for 14 years due to a back injury. Multiple surgeries and complications over those 14 years. On and off opiate use for the first 4 years, then doctors prescribed them for me steadily since then. I moved out of the country and now can’t get them prescribed for me. Big shocker? Most countries aren’t handing them out like the USA does. So, here I am. Weaning myself off of them. 4/day week 1 — 3/day week 2 — 2.5/day week 3 — 2/day week 4 — 1.5/day week 5 ….and that’s where I am. I thought weaning myself this way would work, WRONG! I feel like complete crap. Crying, depressed, heart racing, anxiety and the pain…..Whoa! The Pain!! All I want to do is grab an entire pill to make this go away. Please someone help me. My husband knows what is going on. It’s just him and I. I’m trying not to lash out at him, but he has noooooo idea how hard this is. I feel so weak. Help!

                Anna the weaning did not help? I’m in the same boat and was planning on doing the same thinking it would work.

                Hi.. I am on day 16 of being oxycodone free!! But I still have chills and sweat alot. Is this normal? It’s freaking me out! Any help would be appreciated. Thank you

                Yes this is very normal. Sweats and anhedonia have been my biggest issues during early withdrawal. Every body is different but my sweats have lasted usually a couple weeks during previous attempts to get clean. I’m currently on day 4 as I relapsed again so I’m speaking from previous attempts. I don’t give advice because I’m obviously still struggling but I can offer some insight due to my previous experience. Best of luck and reach out if you like.

                I have been off oxys for about 3 weeks but have been having problems this whole time never had any break head head pressure blurry vision chills goosebumps I kinda did detox off subutex briefly. I still feel weird confused heart palpatations can’t sleep more then maybe 4 hours a night and that’s a good night sometimes 2-3 I feel hopeless I almost wanna do a oxy to see if my problems will go away if that’s the problem I been to the hospital and doctors office so many times they stopped seeing me am I going crazy or is this how it is for awhile I’m literally going insane feeling this way I wanna make it all go away sometimes it’s truly driving me crazy andyone can tell me if they had any feelings or symptoms of this I was using about 10 30s a day for the last 2 years I know that sounds crazy but I was

                Hey jace c
                I was doing Oxys for 1.5 years
                2 weeks clean and I have the same problems I have head pressure/headaches I’m tired most of the time and have bad anxiety hopefully it gets better soon

                Hi Kendra, how is it going with withdrawal? I am doing well since stopping Oct 8 2019. Was tough for 4 and half months but all good now.

                Hi Scott,
                I just wanted to say thank you for being such a positive support in the posts. I just found this site recently and I can see your encouraging words throughout. I really appreciate your presence and dedication. Also, thank you for your updates. I think they are probably giving others something to work towards. More than ever, acts of kindness are needed.

                Day 25 off oxycodone (10mg x 5 day x 3 years). My thoughts are much clearer. I am really proud of myself for quitting since the damn things really weren’t working and I was miserable on them anyway. Life was terrible on oxy. I can’t go back. Around day 16 I felt physically better, since then just plugging on. Worst was the no appetite (but hungry) it’s hard to get healthy not eating right. I’m good at work, but at home NO ENERGY, no motivation. This is scary, four weekends gone doing nothing…… I’m getting very tired of myself! Haha Hopefully this weekend I’ll be able to wash a car or something. UGH!

                How is it going Theresa? Hope all is well.

                I have headpressure/headaches, fatigue, anxiety
                Did oxys for 1.5 years
                I’ve been off oxys for 3 weeks now, is this normal?

                Hey Jordan, I did Oxy for 2 years.. 80mg a day sometimes more.

                I have been off for a month. I still have bad anxiety, pressure headaches, and constant heart palpitations. The anxiety is so intense I thought of using again. But I really can’t go back. I know it sounds cliche but the last three days I exercised lightly.. and it helps with the anxiety.
                From what I have read it is normal.for us to feel this way.
                Anything I try and eat goes right through me.

                Overall it is getting more manageable.

                The first time I quit I wasn’t aware of PAWS and thought I was losing it!

                We are not.. our brain and bodies are resetting and that takes time.

                OH! I also found the breathing balloon helps with the anxiety.

                Hey Shelly, thanks for the advice.
                My pressure headaches are worse in the morning and get better throughout the day. My anxiety is horrible and now am experiencing health anxiety and I keep thinking the worse like I have a tumour or ms things crazy like that. I am now 32 days clean hoping this wears off soon.

                Have not really wrapped my head around normal. For the last 12 years I have used Hydrocodone, Xanax, Valium, Klonopin, Oxycontin, Oxycodone, Adderall and finally .. the unmentionable H. The last one led me to cold turkey. White knuckle if you will. 40 days ago.

                I’ve enjoyed looking in the mirror but am sick of sitting at home doing nothing. I like walking the dogs and watching Youtube while attempting to work but all of this is strange territory. While I know it hurts those around me, I felt more in control when I had that substance to look forward to.

                It led me down quite a few paths. I hate to imply that I was a successful drug addict so I will not. The reality is that all of the good I felt I was achieving came at a cost. It has taken a few weeks to realize that and righteous I am not.

                My best is yet to come. The problem is achieving it without help. I have gone to a few meetings and met with a set of ears who probably does more good than not. I also had a brain scan and one session of tranquil music interrupted by an annoying beeping sound every 20 seconds in order to, over time, rewire my thoughts. None of this seems to cut the mustard.

                Similarly to the mindset that brought me into the throws of substance abuse, i’m looking for a silver bullet. How long does it take to find normal? What is normal? If my late youth was interrupted by stimulants, opiates and benzos, what does 33 feel like clean? How do we know who we are when so many years have gone by without discovering?

                Maybe it’s a positive. An embryonic state. A clean slate, fresh start and all that. I will try to find hope in that notion. Until that happens, how do we do this without someone to say whether or not we’re making progress? Is there an end in sight?

                I would love to have some answers. I’d also like to use but then I’ll wake up tomorrow and not only feel like crap for using but the only thing i’ve done for myself over the last month will be thrown away and the clock will reset.

                This is my first foray into Smart Recovery and I really don’t know where this message will go but if someone out there sees this bottled up tidbit, please know that I have hope for myself and would really appreciate knowing how others out there feel.

                I feel all of your pain. I am also very proud of all of you who are fighting like hell to get well. More needs to be done about getting the facts out regarding PAWS. I am going thru it now. It is a major chore to push myself to do anything. But push myself is what I am doing. I believe fully in “This too shall pass”.It will and we shall all get to that place we long to be. So grateful to all of you for posting and for this article. Thank you! Thank you! Thank you! Today I will push myself forward. I will not retreat. You have all inspired me. I will return to this page every time I need to read your words. Today I shall rewire it a tiny bit more. That tiny bit gained daily will surely add up to good things. My addiction lasted 20+ years. I want to get well and indeed I shall, we shall. God bless all of you, all of us.

                How You Can Help Someone Stop Ativan

                Have you heard of Ativan (generic name lorazepam), and of the risks of benzodiazepines drugs in older adults? Is an older person you care for taking prescription medication for sleep, anxiety, or “nerves”?

                Would you like an easy, practical tool to help someone stop a drug whose risks often outweigh the benefits?

                If so, I have good news: a wonderful new patient education tool has been created by a well-respected expert in geriatrics, Dr. Cara Tannenbaum. Best of all, her recently published study proved that this tool works.

                As in, 62% older adults who received this tool — a brochure with a quiz followed by key information — discussed stopping the medication with a doctor or pharmacist, and 27% were successful in discontinuing their benzodiazepine. The brochure includes a handy illustrated guide on slowly and safely weaning a person off these habit-forming drugs.

                This is big news because although experts widely agree that long-term benzodiazepine use should be avoided in older adults, getting doctors and patients to work together to stop has been tough. It is, after all, generally easier to start a tranquilizer than to stop it!

                But through a patient education brochure, Dr. Tannenbaum’s team was able to make this tricky process much more doable for older adults, their families, and their doctors.

                The must-read information brochure on Ativan and older adults

                If your older relative is taking Ativan (generic name lorazepam), I highly recommend you read Dr. Tannenbaum’s brochure. It provides really good information about these drugs, and includes practical tips on how to address sleep and anxiety issues without using drugs.

                You can get a copy of the brochure — which includes a sample taper schedule — here: You May Be At Risk: You are Taking a Sedative-Hypnotic.

                Note: It can be dangerous — as well as physically very uncomfortable — to suddenly stop benzodiazepines. Discontinuing benzodiazepines should involve a gradual lowering of the dose. This process should always be done with the supervision and support of a healthcare professional.

                Other sedatives to consider stopping

                The brochure above covers Ativan along with other benzodiazepines, such as Valium, Xanax, Klonopin, and Restoril (generic names diazepam, alprazolam, clonazepam, and temazepam, respectively). It also covers commonly-used sleeping pills such as zolpidem (brand name Ambien)

                Why it’s important to try to stop benzodiazepines

                Benzodiazepines are a commonly used type of tranquilizing medication. These drugs are usually prescribed for sleep, anxiety, or agitation.

                However, benzodiazepines are much riskier than many older adults realize. For instance, research has found these drugs:

                • Worsen balance and thinking;
                • Increase the risk of falls, and of fractures;
                • Can make dementia symptoms worse;
                • Are linked to a higher risk of dying within a few years.

                Because of these problems, in 2013 the American Geriatrics Society’s Choosing Wisely list included benzodiazepines as one of the “5 Things Physicians and Patients Should Question,” when it comes to healthcare for older adults.

                But unfortunately, benzodiazepines are easily habit-forming, meaning that the body becomes dependent on them quite quickly. (And occasionally, some patients develop problematic abuse of these drugs.)

                So it’s important to offer an older adult the right approach, and a lot of support, when it comes to getting off these drugs.

                I especially recommend avoiding benzodiazepines in people with memory concerns or a dementia such as Alzheimer’s disease. Benzodiazepines act on the same brain receptors as alcohol, and they almost always keep people with dementia from thinking at their best level.

                Is it ever okay for an older adult to take benzodiazepines?

                Benzodiazepines, like all drugs and medical interventions, need to be considered by balancing their likely benefits with their burdens and harms.

                There are some older patients — often with severe chronic anxiety — who seem to overall benefit from a low dose of these drugs.

                Ideally, benzodiazepines should be used as a last resort, after making a serious attempt to treat insomnia and anxiety with non-drug approaches. These can include techniques such as cognitive-behavioral therapy, regular exercise, and stress-reduction techniques. For people with dementia, providing caregivers with coaching on managing difficult behaviors can also help.

                I do have some older patients who are on benzodiazepines. I don’t like it, but usually we’ve tried other things, discussed the risks with the family, and concluded that this balance of benefits versus risks is acceptable. We also usually work to find the lowest possible dose.

                Tips for caregivers

                If your older loved one is taking a benzodiazepine:

                • Do make sure you and the older person are properly informed about the side-effects, risks, and alternative options for treating insomnia or anxiety. Dr. Tannenbaum’s brochure is a terrific resource for this.
                • Do talk to the doctors about attempting a taper off the drug. It’s usually worthwhile in the long-run. Even a reduction in dose can help reduce side-effects and risks.
                • Don’t try to suddenly stop the benzodiazepines. Reducing these medications should be done gradually, and under medical supervision.

                If your older loved one complains of insomnia or anxiety:

                • Do question things if the doctor proposes a benzodiazepine or other tranquilizer as a solution. Ask for help with lifestyle changes and cognitive therapy instead. Remember that these drugs are much easier to start than they are to stop!

                Questions about benzodiazepines in older adults? Please post in the comments below!

                Update October 2015: I just came across an important study report. In a randomized trial to help older adults taper off benzodiazepines for insomnia, 76 older adults were assigned to one of three 10-week interventions: supervised benzodiazepine taper, cognitive-behavioral therapy for insomnia, or a combination of the two. All three groups were able to decrease their benzodiazepine use, and 63% of participants were drug-free at 7 weeks. In other words, it IS possible to learn to sleep without these medications, even if you’ve been taking them for years.

                Update June 2017: Here are two additional resources to help if you want to learn more about tapering benzodiazepines:

                • The “Ashton Manual” is a detailed online resource, created an English psychopharmacology professor who is an expert on benzodiazepines. Find it here: Benzodiazepines: How they work and how to withdraw.
                • This article describes a journalist’s experience trying to taper off benzodiazepines, and her frustrations with medical professionals who seemed to underestimate the risks of using these drugs: I Tried to Get Off Ativan.

                Comments

                I cared for a lovely little old lady [ think she was 96] who just loved getting her blue pill at night time. She gave a beautiful smile as she took it, and would hold my hand and say “thank you dear, now I get to have wonderful dreams and forget this life”
                So it does have its place, for the right person .
                Agree with all stated in the blog tho for those who haven’t had 96 candles on their birthday cake

                Leslie Kernisan, MD MPH says

                Thanks for sharing this sweet story. I, too, have found that many older adults love their benzodiazepine. (Heck, I’ve met people of all ages who are fond of this line of medication; almost everyone appreciates a little relaxation.)

                As I say in the post, I think the key is to realize that these medications do come with risks and side-effects, so it’s important to be informed and consider alternatives.

                But it’s certainly possible to weigh the benefits and risks, and then decide to continue the medication.

                Leslie Kernisan, MD MPH says

                Unfortunately, it’s not possible to provide much help online, beyond providing useful resources and perhaps suggesting some questions to ask your usual doctors. If you are concerned about benzodiazepine use, I recommend printing a copy of Dr. Tannenbaum’s brochure and discussing it with your usual health provider. Good luck!

                (And of course, in case of emergency or severe symptoms, go to the nearest emergency room or call 911.)

                Sandra Rossetti says

                Thank you, but the ER’s won’t do a thing

                Sandra Rossetti says

                Risks. I have been on a living hell of a life I’m finding out now from being on 3 different kinds of “benzo” through the years. I had a specific problem about 30 years ago, doctor gave me Xanax, then Klonopin, now Ativan the worse. Thru the years I could not breathe, gave me different anti depressants which I am now thinking the benzo were the reason. I am now so sick wonder everyday if Im going to die. When I go to bed at bad times I leave notes good bye notes for my kids. I broke down in my doctor’s office today – he would not give me anything more. Finally he said I could take Zoloft which has terrible side effects for me – I’ve tried it many times. He would not take me off the Ativan and in there I was so upset I forgot to pursue it. Scared…..

                Leslie Kernisan, MD MPH says

                Sorry to hear of this, it does indeed sound difficult. If you think you would benefit from being on less or no benzos, please keep trying to bring this up with your health providers. Sometimes it helps to bring in a trusted family member or friend to help you advocate for working on this. Good luck!

                Thank you for this article. No one around here seems to know how to help. Now the dr has me taking 23 ml of Viseral, I’m so sick and can’t seem to relax. Taking very small am’ts of Ativan. Don’t know where else I can go for help. Do you. Can you help. Is it possible to go to a rehab or ? Will I ever be okay. Drowsy, dizzy, sick to my stomach.

                Leslie Kernisan, MD MPH says

                Sorry but I can’t help. You will need to find local providers to assist you. You could also try contacting a community hospital or community clinic; they are sometimes more aware of local options for rehab or tapering addictive substances. You may also want to ask a family member or trusted friend to help you research your local options. Good luck!

                Ativan is one of the worst to quit. I got 37 years never missing a day…… never missing a 8-hour block. Got off methadone in 60 days. Methadone withdrawal is a cup cake party compared to benzos and most say methadone is for life. Not true. The half life is the magic secret-and same goes for benzos. It’s all over the web so I won’t elaborate.

                Furthermore do NOT read or buy into the horror stories you see online. Many of those fools couldn’t climb out of a paper bag and proof is me and methadone. According to most addicts you will go to hell and back,, lol it’s 100% BS. That is unless you buy the story. Don’t buy it- you are different. Unique. You don’t know these folks background. Perhaps they have underlying mental issues? No success in life whatsoever (I know one of these). Or are just plain weak souls.
                I’m going on Valium and I expect to do it using positive mindset. Refocus that withdrawal energy into something positive…. the lower the low the higher the high once clean. I’ve been having interdosal withdraws now for 2 years & never recognized it. Now I do.
                Also-ask for a beta blocker for pounding chest and head tension. I take atenolol when I’m quitting. Be ready to die (metaphorically speaking). Do anything and everything necessary. Prolly have to take leave of absence for 30-60 days.
                My point is: make it priority! I’m relaying all I know from Methadone detox and intend to blow thru Ativan detox ASAP. Bring on the pain. Embrace it and you will become a new person. Fight it, complain, self loathe and sure….. you too will be going to hell and back. You not need to I promise. CBD oil is beneficial and easy to get albeit pricey. I know I’m in Colorado. Pure cbd doesn’t show on drug tests. Again- done 3 fine and one I failed. Now I do a pre test at home before giving my UA to a facility. KNOW what your going to pee B4 ever giving a UA. DG sells tests for $1/ea.
                Best of luck to all battling this. Sincerely MB. Boulder,CO

                Ann Balthaser says

                Hi Sandra
                My daughter (52) is going thru this. Says she feels like she’s out of her body and in a dream. It’s a living hell and I feel so helpless.

                Sandra Rossetti says

                Thank you but be careful of Methadone. My son got addicted to opiates and has gained tons of weight. He doesn’t look like the same person and now he’s got diabetes all because her was treated and retreated for back pain.

                JoMarie Indovina says

                It is a living hell.

                Leslie Kernisan, MD MPH says

                Dizziness can be caused by many things. I would recommend being evaluated by a medical professional.

                I am so impressed with the information you are providing. I am 60 yrs old & have been taking lorazepam for over 13 years. My doctor has me take hydroxyzine as well. It is for sleep. My memory has been impaired and I am eager to get off both medications to stop the harm to my brain. Thank you Dr Kernisan for addressing this problem.
                PS I must admit it was a relief to have something to ensure I would sleep but the memory loss is motivating me to try and get off the sleep cocktail. Thank you.

                Leslie Kernisan, MD MPH says

                Thank you for sharing your story! I’m glad the information is helpful, and great that you’ve decided to work on this issue.

                Your situation unfortunately is not uncommon. People often start medications for sleep when they are going through a stressful period in mid-life, and then their doctors never quite get around to revisiting the issue. However if you tell your doctors of your concerns and ask for help in stopping or at least minimizing these medications, they should be able to assist you.

                Also, I’m sorry to say there are usually no easy and fast ways to learn to sleep without these medications. That said, with enough coaching and help many people do learn to sleep without medications. Often therapy helps — such as cognitive behavioral therapy — as well as incorporating relaxation techniques and exercise. (Note that exercise may mainly help sleep only after one has stuck with it for a few months.)

                For more ideas on how to handle insomnia without drugs, try reading something like The Insomnia Workbook (you might find it at your public library). It’s written by a sleep medicine psychologist and has lots of good ideas.

                Good luck! Getting off sleep medication takes time and persistence, but for most people it’s good for health in the long run.

                I take two of the benzo’s for sleep; one for restless leg syndrome and one for insomnia per a sleep specialist that gives me the prescriptions. I’ve noticed the Temazepam seems to cause memory loss and I’m concerned…very concerned. I’ve been on these two drugs for a long time (4 years at least). Thanks for the schedule to discontinue them. I’m in my early 70’s and don’t want to take them anymore. I will talk to the sleep doctor too and tell her of my desire to quit them. I also use the lowest dose of the hormone patch and now I’m concerned about that too.

                Leslie Kernisan, MD MPH says

                Great that you are being proactive about this. If you are concerned about your memory then I would definitely encourage you to discuss your concerns with your doctors. It is often possible to taper off benzodiazepines, but this should only be done under medical supervision. Good luck!

                My father was on these for years and years .He never had to up his dose , didn’t suffer side effects and his doctor was more than happy for him to continue .My mum took nothing at all and died horribly of vascular dementia.My dad had a good death at 86 , my mother , dreadful at 90.

                I think it really depends on the individual, the effects of these drugs .It was of a massive help to my father who was on 3 mg a day,and was perfectly with it ,mentally , when he passed away .

                Leslie Kernisan, MD MPH says

                Sorry to hear of your mother’s difficult death. Agree that it does depend on the individual. However initially as clinicians — and even as patients — we can’t tell how an individual will respond over the long term, so we should start by working with what we know from observing groups.

                (For instance, we all know people who smoked regularly and lived to their 90s, but they are exceptional. If someone is 40 and smoking, we cannot tell if they will be among the exceptional ones or not, although better analysis of genes and cellular activity might enable this soon.)

                For benzodiazepines, my experience has been that most patients and families have been told very little about the downsides, and they haven’t been encouraged to consider alternatives. Ideally, people would be better informed before proceeding, or continuing on these drugs.

                I will say that in some cases, the benefits seem to outweigh the risks. So I don’t want to say it’s *never* reasonable for older adults to take benzodiazepines. But given that they increase fall risk and worsen thinking, it’s worth thinking carefully before continuing with them long-term.

                My elderly mother has been on ativan for years. We are her caretakers. She has an colostomy and has constant pain and bloating. Last time we took her in to the hospital they said she must get off her ativan and ambien for sleep. They weened her off of it and it was rough but worth it. She came home a new person that was happy and ate well and was in great spirits. 1 month later he put her back on the meds because he said it was unfair to take her off of them she is now back right whete she started, sad and when no appetite and has continual cramping and bloating.

                Leslie Kernisan, MD MPH says

                Hm, this sounds odd. Sounds like someone (a doctor I presume) put your mother back on her Ativan and Ambien? Was there a reason other than “it’s unfair to take her off?” And does your mother make medical decisions for herself?

                I can’t tell what happened in this particular situation, but unfortunately, it is common for doctors to push ahead without adequately discussing things with patients, unless families and patients push back and insist on further discussion before proceeding with a medication change. This is tiring and uncomfortable for patients, but right now it’s often necessary.

                If you think your mother really was better off her medications, you should bring it up with the doctor or consider a second opinion. You can also ask whether a slower taper might be possible; this might be less “rough” than the first one was. Good luck!

                My wife (73) was started on antidepressants and clonazepam 13 years ago. Ever since, she was unable to get rid of the clonazepam habit although different doctors tried to reduce/wean her away. Particularly in the past 3 years she has been suffering immensely and virtually unable/unwilling to even get out of bed. The maximum dosage that she was given at any time in the past was 1.5 mg in three divided doses. Currently we are trying 0.75mg per day but it is making her condition/suffering worse.
                I have a simple question: Is it possible to reduce her suffering by increasing the dose to say, 2 or 3 mg and continue same for the rest of her life or increase it even a little more, say 4 mg after a few years? I have only one objective and that is to reduce her suffering. Kindly give your advice/comments.

                Leslie Kernisan, MD MPH says

                Sorry to hear of your wife’s difficulties. Unfortunately, it’s impossible for any doctor to answer your “simple question” online, you will need to work with someone in person. In particular, to answer your question a clinican would first have to review your wife’s medical history and especially understand what are the current causes of her suffering and other health difficulties. Only then would it be possible to advise regarding the dosage of her clonazepam and your other options for improving her well-being.

                Now, you can probably get much better help by finding the right type of clinician. Many doctors do not have the right expertise provide your wife with the kind of help that’s likely to be a good fit.

                Given the situation you describe, I would recommend you consider a consultation with a palliative-care specialist. Palliative care is a medical specialty that focuses on relieving suffering and difficult symptoms, and also emphasizes a comprehensive approach to help patients reach their most important goals.

                Last but not least, you mention your objective for her but of course it’s vital to consider HER objectives for her health and wellbeing.

                I hope you will be able to find a suitable clinician to help you. You can learn more about palliative care here: Get Palliative Care.

                Thank you so much for your detailed reply and advice. I will follow up on consulting a palliative care specialist here in Hyderabad, India.

                I have been taking Lorazepam since 1982, at night or in the morning if I feel edgy .25 mg as I bite the .5 in half. I never take .5 mg in a 24 hour span. It seems to take the edge off or allow me to sleep fine. My doctor has retired and I have been forced to look elsewhere. The doctors I have encountered say I must get off it asap as it is so bad for you (I have friends that take 16 times a day what I take). I have cut down to .12 mg every second or third day. The edginess has returned along with mild headaches and if I wake up after 3 hours sleep and am up till the next night, so needless to say I am frustrated being 59 years old, being sent for random blood samples to test for drug abuse which they say is now mandatory in Canada for Ativan use. I was fine on this drug 35 years, is it really that harmful

                Leslie Kernisan, MD MPH says

                At 59 years old most people aren’t yet having difficulties with their memory or balance. But these issues become a concern for many older people, and it will only get harder to taper off your benzodiazepine as you get older. So although you are not taking a very big dose, it’s probably still worthwhile for you to find a way to stop using it, especially since your doctors are encouraging you to do so.

                Did you read the brochure on tapering off these types of medications? (See here.) The brochure recommends a very slow taper that takes 16 weeks. You may want to ask your doctors for help implementing a similar taper.

                I would also encourage you to ask your doctor for help implementing other approaches to help you with insomnia and edginess. Cognitive behavioral therapy for insomnia has an excellent track record, and is even available online through Sleepio and SHUTi. We have more information on treating insomnia here: 5 Top Causes of Sleep Problems in Seniors, & Proven Ways to Treat Insomnia.

                Sandra Rossetti says

                My drugs did turn on me after taking them for years. I kept telling my doctors and they didn’t say a thing making me be a mind reader meaning it was the pills but it wasn’t and they change you.

                Hi Leslie. I was prescribed Xanax about 12 years ago because I was having severe panic attacks when my son was serving overseas. I never upped my dose but eventually they stopped working as I felt worse with each day & finally traced it to the fact that I had hit tolerance on them. That is the 1st time that I researched these horrible drugs & I was shocked at what I found out, to say the least. I tried to talk to my Dr about this & she just thinks I’m being ridiculous. Anyways, for whatever reason, my last appointment with her, she informed me that she will no longer prescribe Xanax to her patients & she gave me a script for Lorazepam. I began my 1st cut at that time because she didn’t realize that they are not equivalent meds & she gave me the same amount of pills. I am desperate & determined to get off of this medication because it is greatly affecting my quality of life! It has gotten to the point that I will not do anything unless it is absolutely pressing. My relationships are suffering (except for the ones with my kids & grandkids because they are pressing) my hygiene, my job, my diet, my housekeeping (& I had OCD before this started & my house was always immaculate) my cognitive ability is awful, my memory is getting worse, my libido is nonexistent, I don’t seem to care about much, my emotions are blunted AND I experience a myriad of physical & mental symptoms from one minute to the next. Ugh. Sorry to rant on but I can’t seem to discuss this without my frustration getting the best of me. Anyway, I stumbled across your article & have a question about your taper schedule. I guess that I really don’t understand it. I see that it starts with a half dose on Monday, full dose on Tuesday, etc. I am currently at .5 milligrams 3 x a day. So when you are saying half dose, does that mean to only take .75 on the half days? I keep reading to reduce by .10 or .15 at a time. Any advice that you can give me would be greatly appreciated! Thanks…

                Leslie Kernisan, MD MPH says

                Sorry to hear you are concerned about your benzodiazepine use, but glad to see you are being proactive about addressing this.

                First and foremost: I do not recommend that you or any other benzo user attempt to taper on their own. The handout is meant to provide some sensible starting guidance to an older person and their clinical team. The described taper should be suitable for most people, but it’s important to review it with someone who is in a position to consider your particular health history, and adjust the plan if necessary. Some patients do need additional psychological support or other additional clinical assistance, to keep their symptoms manageable while they taper benzodiazepines.

                Now, admittedly some doctors may not have the latest knowledge of how to help patients taper their benzodiazepines. If your doctor doesn’t seem willing or able to help you address this issue, you may want to find another provider to assist you.

                Regarding the taper schedule in the handout, it’s probably easiest to use when people have been taking the same dose of benzodiazepine, once a day. A clinician could help you figure out how to apply it to your situation.

                Usually, benzodiazepine tapers are meant to reduce the total weekly dose by 15-25%, every 2 weeks. (This is what the taper in the handout shows.) Your current dose is 0.5 x 3 x 7 = 10.5 mg per week. So a reduction of 15% would mean taking about 9mg/week, and then in 2 weeks, your clinician would probably recommend a further reduction of 15-25%.

                Some people do experience benzodiazepine withdrawal symptoms when reducing by 15-25% every 1-2 weeks. In this case, the solution is to attempt an even slower taper (i.e. reducing by a smaller percentage every 2 weeks). You can find good information and slower taper schedules in the “Ashton Manual” online: Benzodiazepines: How they work and how to withdraw.

                Again, I would strongly urge you to get help from your doctor or another clinician. You can bring the handout to the visit, as it often helps clinicians to see the recommended taper schedule. Good luck!

                My mother was diagnosed with cancer and put onto Diazepam at a low dose to start with. She was starting to act a bit odd after a few weeks on the diazepam she seemed to be delusional and unable to recall things from her short term memory, then she started to recall things none of the family were aware of. Mum was given a terminal diagnosed some weeks later and slowly but surely her meds increased. She was then on Oxynorm too. Mum’s behaviour was scary and we were told it was not the diazepam because that was for relaxation and she could have as much as she like as and when she liked. It was thought that it may have been the oxynorm and that because on occasion she took up to 70mg of that throughout the day/night in total, she may have been overdosing. The oxynorm was stopped dramatically but the diazepam carried on and was up to 50mg at some points, wavering around the 30mg most days but some were 40mg and some 50mg. My started to get angry and delusional about things her family were doing and not trusting us. She was accusing us of things that were not true but the medical people told us it was just the drugs adjusting. We were so frightened and scared but it all seemed to be the norm. Suddenly we were told that mum didn’t want to take diazepam any longer and as such after taking it for a good couple of months or more she was suddenly stopped it. She grew more and more agitated and angry but then occasionally she was given the odd 5 mg or 10mg to calm her down but then she would have nothing for days on end and would grow more and more delusional. Convinced we had been trying to kill her. Is it possibly that all that could be down to the diazepam? Mum had over her life time suffered depression and each time she went to the Doctor with depression the doctor gave her either valium or atavan or zanax, clonozopine or sanex and similar and every time she took them, after a few days of mixing them with her whisky she would end up trying to kill herself and delusional and even psychotic. I know she was being given alcohol with the diazepam and Oxynorm/oramorph during her terminal phase so wondered if she could have been experiencing a heightened effect of the drug when on them with alcohol and then massive withdrawal when she suddenly stopped. Thank you for taking the time to read this

                Leslie Kernisan, MD MPH says

                Thank you for sharing your story. It sounds like your family went through a lot of difficult and frightening times when your mother was taking these medications. (Depression in a parent is difficult, too.)

                Benzodiazepines such as diazepam and lorazepam do relax many people, but they can also paradoxically agitate or confuse others, especially older adults. So I think it’s quite possible that your mother’s worsening was related to her benzodiazepines.

                And then yes, even if they were making her worse, the body does become dependent on them. So suddenly stopping or reducing them usually causes significant withdrawal symptoms. In someone whose mind has been weakened, I would not be surprised if withdrawal made a person’s delusions or confusion worse. (Benzodiazepine withdrawal can also sometimes cause life-threatening stress to the heart and other organs, so these drugs should always be tapered down.)

                An opiate such as morphine (in oramorph) or oxycodone (in oxynorm) does sometimes cause confusion in older adults, so it’s possible that this was contributing at times.

                Honestly, it sounds like your mother had some underlying changes to the brain which made her vulnerable and prone to developing confusion and delusions. In such people, they can get mentally worse when they take mind-altering drugs, when they suddenly stop mind-altering drugs, and when they are experiencing uncontrolled pain or some other trigger for delirium.

                I’m sorry you had to go through such a hard time with her. I can’t tell from your comment whether she is still alive or not. If she is, I hope the doctors have found a way to keep her feeling better. If she’s no longer with you, I wish you the best in grieving her and recovering from this experience.

                I have been taking Lorazepam for a couple of months, on and off. just 1 mg. No more than that per day, and some days none at all….but now I want off of them because of all the bad stuff I have been reading. I went to the mental clinic and talked to a therapist before I started taking these pill…I was supposed to see the Dr. at the clinic..but it takes weeks to see him. So I really don’t have a prescription for them, but a friend gave me a whole bottle of hers. I never finished the bottle and now I don’t want to. I take them for anxiety and sleep problems, and they helped..but I think I can do something different to address these problems. I am 63 years old, and I am going to see the Dr. at the clinic in a couple of days… I have stopped taking them cold turkey, and having high anxiety and cannot sleep..what should I do. I have considered taking one just to get some sleep. Do you think the Dr. will help me…even though I never got a perscription for them??

                Leslie Kernisan, MD MPH says

                Most people find lorazepam to be very effective in reducing insomnia or anxiety symptoms in the short-term, so I’m not surprised that you found they helped. But yes, it’s generally not a good idea to rely on this type of drug, because it’s habit-forming, and creates risks and problems in the longer-term. So I think it’s good that you’ll be seeing a doctor and asking for help.

                Quitting cold turkey is often uncomfortable and can potentially be dangerous. Don’t delay in going to urgent care or the emergency room if you are feeling really unwell.

                You should certainly request medical help in reducing/stopping your lorazepam use and in finding better ways to manage your symptoms. Doctors are often reluctant to prescribe a controlled substance to someone who got them without a prescription, but hopefully someone will be willing to help you with this issue.

                For what it’s worth, I consider 1mg to be a pretty large dose. Many older adults experience symptoms relief with 0.5mg or even 0.25mg. However when the body gets used to 1mg doses, smaller doses may provide noticeably less relief.

                Good luck getting help with this medication!

                Mom (87 yo) has been on 2 mg of lorazepam (L) for many years (?15). For the past 4 months, everyday she wakes up different, with some new strangeness. She was acting so bizarre, but they told me it was a UTI. I thought it was due to a tolerance on the L. The PA told me to reduce her dose by 1/2 mg every third day which I did. She developed aspiration pneumonia and I asked the hospital staff to stop her L since it was time on the given schedule. None of the behavior got better, it just remained bizarre, but she stopped sleeping. So we thought if we put her back on her full dose we could stabilize her and then slowly…slowly ween her off. But back on her full dose, she has now developed partial seizures. Her pcp wants to put her on antipsychotic drugs which I said no to. I am in a small town where I am already seeing the “best doctor”. I am so scared I am poisoning her by giving her L everyday! Please advise! Or just list the options you see available to me. I am desperate for help.

                Leslie Kernisan, MD MPH says

                This does sound like a difficult situation. A few thoughts:
                – for someone who has been on 2mg, going down by 1/2 mg every third day is a lot. Many people will experience significant withdrawal symptoms. I would recommend looking at the brochure this article links to. A slow taper over 3-4 months is more likely to be successful, the slower the better.

                – If a person is having difficulty sleeping or other problems related to a decrease in lorazepam dose, it might be better to increase the dose a little bit, rather than jump back to the original dose.

                – The seizure issue sounds a bit odd to me. Benzodiazepines are actually effective anti-seizure medications, although that’s only rarely the main reason they would be prescribed. Are the doctors quite sure she is having seizures and not some other problem? If she is indeed having seizure medication, then it would be appropriate to consider prescribing something specifically to control the seizures. This is usually managed by neurologists, preferably those with experience managing seizures.

                At age 87, my guess is that some of your mother’s strange behavior may be due to developing some form of dementia. If you can slowly taper down her benzodiazepine, that might help her think a little better. But realize that she might experience irritability and withdrawal symptoms in the short term.

                Don’t worry too much about poisoning her. It’s not ideal that she’s on this drug, but it’s not something that usually can be changed quickly.

                You may also find it helpful to read the section on weighing benefits and burdens, in this article about anticipating an older parent’s decline: How to Plan for Decline in Alzheimer’s Dementia:A 5-Step Approach to Navigating Difficult Decisions & Crises with Less Stress. Even if your mother doesn’t have Alzheimer’s or dementia, the general principles on figuring out what to do will apply.

                I have been taking ativan (lorazapam) 3mg per day for about two years and I really want to get off of them. Do you have any advise for me. I am 67 years old and pretty healthy guy. Did physical labor my whole life. Depression runs in my family. My father and some of my brothers and a sister have had some troubles as well. Not my Mother. Thank you.

                Leslie Kernisan, MD MPH says

                Congratulations on deciding to address your lorazepam use. For many older adults, the effort it takes to taper off benzodiazepines is worthwhile, since a drug like lorazepam slows brain function and increases fall risk.

                I would recommend printing Dr. Tannenbaum’s brochure and then bringing it to your usual health providers. It can be difficult and even dangerous to attempt to decrease or stop lorazepam on one’s own, so you should definitely find a clincian to assist you. Here is the brochure:
                You May Be At Risk: You Are Taking a Sedative-Hypnotic

                As you’ll see in the brochure, experts recommend that clinicians consider a slow taper over 18 weeks. Some people need to take it even slower.

                Regarding your depression, I would strongly recommend you discuss this with your health providers as well. Depending on your symptoms and the rest of your medical situation, they might recommend you start an anti-depressant or a certain type of therapy. (Therapy can help treat anxiety or insomnia as well, which might crop up as your body adjusts to being on a lower dose of the tranquilizer lorazepam.)

                You are really smart to address this now, because in my experience, the older people are, the harder it can be for them to taper off daily benzodiazepines. Good luck!

                George Post says

                Thanks very much for your advise.

                Mike Miller says

                It was about 8 years ago when I started to have acute problems with confusion and long/short term memory loss. I was in my late 50’s. My wife had to quit work to help me with self care. I was on a blend of clonazepam, adderal, and the maximum dose of zyrem (a powerful hypnotic). I complained repeatedly to my prescribing doctor. He would become angry and told me that I would have to be on these medications “the rest of your life”. He even tried to force me to have electro shock therapy. My cognitive testing showed me to be very impaired. My MRI showed reduced brain volume, enlarged cerebral ventricles and small vessel disease (hyperintensities). Still the neurologist said that it was depression and that I should continue taking the same drugs. (He is a friend of my prescribing doctor) Just 7 weeks ago, a new doctor looked at the same findings on a new MRI and diagnosed me as having “vascular dementia”. She refused to discuss my drug history. Question! What is the relationship of these various drugs to vascular dementia? Who is doing research on this problem? Thanks so much for being a advocate.

                Leslie Kernisan, MD MPH says

                I don’t know that these drugs have been studied in relation to vascular dementia per se.

                Cerebral small vessel disease is associated with depression and with cognitive impairment. However, I am surprised that the doctor would diagnose you with a form of dementia without considering your medication use, because dementia is in part a diagnosis of exclusion and we are supposed to exclude other medical, medication, or mental health problems that could be causing cognitive impairment.

                Also, as it sounds like your symptoms started early, I would recommend getting evaluated by a specialized memory clinic, or by someone else with very specific expertise in evaluating early-onset cognitive problems. Good luck!

                Roberto Albino says

                Hello I was diagnosed with diabetes in October of 2013 at the age of 17 years old. I had my first panic attack in the e.r as they were trying to lower my blood sugar. I didn’t know what anxiety/panic attack were at that time so my doctor put me on Alprazolam *Can’t recall dosage. Was on it for two years, then I ran out of it & had to go to the emergency room to get a refill. They didn’t give me a refill because they said my doctor had to approve & it was a weekend, so they gave me one in the e.r until I saw my doctor. Well the one they gave me in the e.r looked different then the one I usually took & later that day I started having bad panic attacks, bad thoughts. So when I went to my doctor the next day I told them & they switched me to Lorazopam 0.5 mg. I’ve been on Lorazepam for about 2 years, going into 3. They have been helping me and what not, but since last year December they stoped working. I take 0.5 mg and it calms the anxiety but I’ve developed depression, and seems like it does no effect the body anymore, it doesn’t let me feel relaxed like I use to. I would like to get off this medication I am now 21 & turn 22 on April 21st. What do you recommend? I’ve seen a handful of people on YouTube who have over come it, but also a ton of people who say they tried it and failed. A man who goes to my church was on lorazepam 0.5 mg for sleep for 8 years & he is now 5 years sober & he said it was hell, but I’ve seen others say that if you tapper slow 2-3 years you will not feel anything. Please help, I am willing to pay any sort of money for someone to lead me in the right direction. I guess my plan is to get off it & once I’m completely off it, if my anxiety is still there over one panic attack I can try herbal teas. Because i never had anxiety and now that I’ve been on this medication seems like I’ve developed it. Sorry for all the questions, God bless.

                Leslie Kernisan, MD MPH says

                Sorry to hear you’ve had all these health challenges, and early in life, too.

                It sounds like you’ve developed some tolerance to your lorazepam, so it’s not offering you as much relief as before. I’m glad you are thinking of how to safely taper off this medication, rather than asking for more.

                You absolutely will need to work with health professionals to do this. Dr. Tannenbaum’s brochure outlines a sample tapering schedule that takes 16-18 weeks, but many people need to decrease their dosage even more slowly. You should also ask your health providers to help you find other ways to manage your anxiety and also your depression. Certain kinds of therapies can be very effective, and you might also benefit from treatment with an antidepressant as well.

                One problem people sometimes run into is that therapy is hard to find or not covered by insurance. Also most doctors visits (you will need to see a clinician who can prescribe your tapering doses of lorazepam) are often quite rushed.

                If you are willing and able to pay money, you might be able to pay a psychiatrist or therapist out of pocket, to get the extra support that will make your effort more likely to succeed. A psychiatrist who is also willing and able to do cognitive-behavioral therapy or other forms of therapy would be good. (Psychotherapists usually can’t prescribe medications.)

                Good luck and don’t give up! This is an important thing you are doing for your health. It will take time and probably be hard, but in the long run it will be worthwhile.

                The thing that worries me about anti depressants, is how about if I get addicted/defendant on it as well? Are they called ssri? Because I heard those were even harder to get off? I’ve seen the Ashton method, tapper off from Lorazopam 0.5 mg and switch to Valium that has a longer half life then tapper from that? I’m just really scared.

                Leslie Kernisan, MD MPH says

                Anti-depressants are not habit-forming in the same way as benzodiazepines, and are much less risky to one’s health. They can also be safely tapered off in many people, especially if it’s done in a thoughtful way over an adequate period of time. Yes, I have occasionally encountered some people who have had great difficulty getting off SSRIs, but often these are people who have been on them for years and years, often due to persisting depressive symptoms.

                It’s also often possible to treat depression and anxiety symptoms without medication, and you should be sure to discuss these options with your doctors.

                I am familiar with the Ashton manual. You will need to work closely with a clinician to determine whether using a longer-acting benzo such as Valium is a good idea for your situation. Good luck!

                Rosella Rhine says

                I have been on low doses of Lorazapam for many years (I am 86) and would love to get off this medication but am finding it very, very difficult. How do I get Dr. Tannebaum’s brochure?

                Leslie Kernisan, MD MPH says

                Kudos to you for trying to address this. It is indeed difficult, but doable. I have linked to the brochure in the article, where it says “You May Be At Risk: You Are Taking a Sedative-Hypnotic.” Here is the URL for the brochure:
                http://www.criugm.qc.ca/fichier/pdf/BENZOeng.pdf

                If you are finding it difficult to taper off the lorazepam, talk to your health provider about making the taper even slower. It is sometimes helpful to switch to a liquid formulation of lorazepam, as this can make it easier to whittle down the dose.

                You should also be sure to talk to your health provider about other ways to manage any insomnia, anxiety or other issues that might be related to your lorazepam use (or taper). Good luck!

                Dear Doc, I have been on Ativan 1mg 3 times daily and 1 mg clonazepam at night for sleep. I’m trying to wean to a half tablet of Ativan during the day, not sure about a sleep replacement (don’t want costipation). What makes this process easier?

                Leslie Kernisan, MD MPH says

                Kudos to you for trying to address your benzodiazepine use.

                I would highly recommend you read Dr. Tannenbaum’s brochure and then discuss it with your usual doctor.

                Generally, what makes this process is easier is:
                – reducing the dose of daily benzodiazepine SLOWLY, by 15-25% every 2 weeks or so
                – getting help addressing insomnia or anxiety or whatever problem the benzodiazepine has been helping to control

                Please do not attempt to taper on your own, it can be dangerous. Whichever clinician has been prescribing your benzos should be willing to work with you on a suitable taper. Good luck!

                Hi thanks for this fourm. I was first perscribed Ativan 35 years ago when I was 22, I was suffering from anxiety attacks, my doctor wrote a prescription for 1mg 3 to 4. Times a day, I took them as perscribed and I found that I didn’t have many anxiety or panic attacks anymore and when I did experience one it was much less severe. I thought my prayers were answered. That was 35 years ago,for.the past 35 years I’ve been taking the Ativan faithfully every day, I never took more than the dose perscribed by my doctor. I knew nothing about Ativan when I started taking it, when I asked my doctor about it ,he wasn’t concerned and just kept writing me more perscriptions. In the past year or so I’ve read about Ativan and tried to taper off it, I felt terrible and the anxiety started to return. My doctor is retiring in 4 months,and I want to get off Ativan, I live in an area where there is a doctor’s shortage very difficult to find a doc if you don’t have one. The emergency rooms at the local hospitals and clinics won’t write a perscription for anything like Ativan. Not sure what to do,I’m 56 now and Ativan has helped me most of my life with panic and anxiety. Now its going to be more difficult for me to get and I understand there are long term side affects. Hope you can help.

                Leslie Kernisan, MD MPH says

                Well, I think it’s great that you are interested in revisiting this, but after 35 years taking Ativan, you will definitely need help from a clinician. Generally the slower the taper, the more tolerable and the more likely it is to be successful. Please do look at Dr. Tannenbaum’s brochure and you may also want to look at the Ashton Manual, which also has sample taper schedules, many of which are quite slow.

                Probably the most urgent thing for you to do right now is: ask your doctor to help you find a new doctor. Many providers are leery of prescribing Ativan to patients they don’t know well. It could be very helpful for your current doctor to contact your new one and relay his/her experience prescribing Ativan to you (presumably you have been “good” and have not given your doctor cause to worry that you were abusing or selling your pills. If there is a shortage of docs taking new patients, perhaps your current doc can intercede and help you get in with someone. Or perhaps you can get on the waitlist for someone’s practice.

                Your concerns are probably well-founded; if you don’t have a regular doctor who knows and trusts you, you might have a difficult time obtaining your Ativan, much less getting the necessary support to manage a taper.

                I suppose if you can’t find a new primary care provider, another possibility would be to look into options for substance-abuse treatment. Please understand, I’m not saying you are an abuser as it really does not sound like you are. However such clinics are experienced in helping people manage a substance dependency (you are dependent right now) and might be willing to help by providing a controlled substance and working with you on a taper…they will surely find you much easier to deal with than those patients who do have a history of abusing and overusing controlled substances. Good luck!

                Been tapering Ativan for five weeks started on 5 mg one half years ago prior to that was in Xanax quit Xanax and got terrible stomach and chest pain now Ativan .5 then to 1 mg then to 1.5 mg wanted to stop lots of stomach issues and chest pain have had a lot of antibiotics last three years for h phylori and c diff now been weaning five weeks down to .25 Ativan horrible stomach chest and back pain daily troubles with food what to do keep weaning or quit

                Leslie Kernisan, MD MPH says

                I hope you are doing this taper under the supervision of a medical professional. As per Dr. Tannebaum’s brochure, tapers should be slooowwwww. If intolerable symptoms emerge, it’s often not a good idea to continue the taper and instead, it might be necessary to stay at a given dose for a while.

                I would definitely recommend talking to your health provider about your stomach and back pains. Especially if they are severe, you should not delay. They may be related to your taper but they also could be due to a variety of other serious conditions. Your provider will also be able to advise you on what to do about your tapering, given your symptoms. Good luck!

                I’ve been on benzodiazepines since 1967 when I suffered from virtual non-stop panic attacks and extreme anxiety. Without them I never could have earned a living nor had a near normal life. I started with Valium but after 15 or so years my then retiring psychiatrist had read the “news” that Valium was addictive and he didn’t want any of his patients addicted to a drug after he retired. I was at that time (1983) taking 10mg of Valium 4x a day). He gave me a pamphlet (my god, I wished I had kept it) about a newer ‘improved’ benzodiazepine called Ativan’ that was ‘not addictive” like Valium….(sigh)…..what did I know…I trusted my doctor and believed him…..I started on 2mg 3 x a day…..and never needed any increase. I never felt ‘high’ or any other side effects. Now, at age 70…on generic lorazepam I freaking out (can you tell I’m from the 1960’s?, lol) over two things…..my local Costco has changed manufacturers of the lorazepam they sell from Watson to Leading Pharma (which online forums regard as pretty poor)…..but in researching this I’ve come across so many really negative and scary reviews about the difficulty of either obtaining or getting off lorazepam. At 70 years old, I really don’t wish to start a decade long fight to get off a prescription med that may affect my memory or balance but would definitely change my life from focusing on living and caring (I’m a care giver to my wife with severe post polio syndrome…I do all the cooking, cleaning, shopping, wash, etc and still working to a limited degree) to a life of worrying where my next pill will be coming from. I’d like to just live out my life taking the meds I’ve never abused but never asked to be taking in the first place…but content to just maintain my anxiety and focus on living my remaining years. Getting old has enough issues without additional worries about a condition that has ruled my life getting so much worse without a drug that helped make it tolerable. I’ve always looked at it as a diabetic taking metaformin. Any encouragement whatsoever or am I doomed to spend the rest of my life to start trying to get off an addicted drug?

                Leslie Kernisan, MD MPH says

                Thanks for sharing your story. Well, I can certainly see why you are reluctant to rock the boat or change something that has been working for you, especially since you are putting a lot of energy into caring for your wife. It’s not necessarily unreasonable for you to want to continue as you are, but there are some downsides for you to consider.

                First, you very well may have difficulty finding a provider who is willing to continue prescribing your lorazepam. 6mg per day is not a small daily dose, either.

                Second, as you get older, you’ll likely become more vulnerable to experiencing benzo side effects…or if you have a fall or some memory concerns, you may become more interested in avoiding benzo-related side-effects.

                So, although I can see why you’d prefer to not contemplate a taper or discontinuation, I would still encourage you to consider it. If nothing else, your health provider may feel better continuing to prescribe your lorazepam if you start by making a good faith effort to at least reduce your dose somewhat.

                This approach might help your clinician feel better about prescribing your benzo long-term, because if ever they are called upon to justify “how could you keep prescribing that benzo to that older person” they can say “well I did recommend taper and discontinuation and we tried it carefully but then the patient experienced too many difficulties and we concluded that the burdens of continuing to attempt the taper outweighed the potential benefits.”

                Presumably a lower daily dose would be less risky for you, if you found your symptoms could be managed with a lower dose. We generally try to use the minimum dose necessary when it comes to medication.

                You could absolutely ask for the reduction to be done extremely slowly, given your concerns.

                I certainly am sorry that you were put on these medications years ago, it is unfair that this has become your problem to deal with, but there it is. Good luck!

                Getting off of Benzos destroyed my life for 4 years. I switched to Valium because it is key that you taper with a benzo with a long half life. I tapered but 1 year and it took me another 3 years to return to a passibly normal state. Constant fear, full body ticks, days on end in bed, my brain bouncing around in my skull. It was just day after day, week after week, year after year. I got divorced, had to send my daughter to live with her Dad during the worst parts. I am forver grateful fot holfimh It all started when I had a panic attack after returning from Indonesia. My doctor actually told me that drugs he gave me were not addictive. Im finally free. I never waivard even once.
                Whatever you do, stay away from Benzos and Z drugs: they are not worth it.

                Leslie Kernisan, MD MPH says

                Thanks for sharing your story. Yes, these drugs are often much harder to discontinue than people realize, in part because health providers often don’t discuss this issue before starting people on these medications. I’m glad you were able to persist and finally get off the benzos.

                I am 84 years old and have been on ativan for approx. 15 years.. The dosage I am on is 0.5 mg only at bedtime.. In the past couple of years I have noticed several changes eg: memory loss, confusion, irritability, muscle weakness etc etc and I desperately want to get off of this drug. I want to reduce the dosage but because the pill is so small, I have difficulty in cutting it into a smaller dosage. I would appreciate any suggestion that you may have for me.. Thank you

                Leslie Kernisan, MD MPH says

                Lorazepam (brand name Ativan) does exist in liquid form. This can be easier to work with, when tapering down to small doses. I would recommend discussing your desire to taper your lorazepam with your prescribing clinician, so that they can assist you and prescribe a liquid form if appropriate.

                If you’re concerned about your memory or other changes, I would also recommend bringing this up with your usual doctors so that they can do an appropriate evaluation. You should not assume all of this is due to lorazepam, as there are many reasons that someone your age might develop such symptoms.

                I describe the most common causes of changes to memory or thinking in this article:
                Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check.

                Last year I realized a 75 year old family member was addicted to Ativan and kept it secret. What a terrible revelation. Falls…sleeping every day past noon…balance issues…dizziness…I am grateful they never had a car accident. I had NO IDEA what was really going on. At least if someone is a drinker there are well-known signs.

                Why in the world are doctors so willing to write scrips for these dangerous drugs? Why isnt every patient given a detailed explanation of the risks? It is unethical in my opinion.

                I wonder how big drug companies are not forced to be more TRANSPARENT. I think these drugs are just as destructive as opioids. They lead to a very poor quality of life and wreak chaos on unwitting family members.

                Your thoughts would be appreciated.

                Leslie Kernisan, MD MPH says

                Sorry to hear about your family member. You’re right, it’s unfortunate that for a long time doctors were quite willing to prescribe these medications and there wasn’t enough transparency about the risks.

                Honestly, I think most doctors who were prescribing benzodiazepines to older adults simply had no idea that it could be so risky or problematic. It seems that doctors create their prescribing and medical practice habits fairly on during their training, and then those can be hard to change. We are very lucky to have lots of pharmacological options but at the same time, pharma is a business and they are more interested in getting doctors to prescribe than to talk about the risks and maybe prescribe less.

                So, it’s important for older adults and families to be informed and ask lots of questions. I do believe that most health providers are well-intentioned, but they are busy and no one has more of a stake in getting things right than do patients and families. Hope things work out with your older relative’s Ativan use.

                Steve Perez says

                Hello,
                My 89 year old mother has been taking 2MG (Mylan) Lorazepam 4X/ day for over 30 years. Mylan is discontinuing the drug and she has to switch manufacturers. She just tried a 2MG (Leading) Lorazepam and experienced enhanced side effects of stomach upset, “woozieness” and nasal congestion (?). She has degeneration in her spine and knees, but has more recently been experiencing more “minor” falls. Her muscle degeneration along with long-term Lorazepam use could be making this worse. She lives alone and this worries me. Her doctor was out today, but I think they may consider lowering her dose to 1MG with this “new” manufacturer to see if she gets lessened side effects.

                I’m not sure what to do next. She is really dependent on this drug and is literally freaking out that she can no longer get the particular brand of generic that her body is used to. Any suggestions? – Thank you

                Leslie Kernisan, MD MPH says

                Hm. Honestly, I don’t know much about the difference between different generic lorazepam formulations.

                8mg of lorazepam per day is a lot for someone who is 89 and it certainly might reduce her fall risk if she can taper down or off. But going from a 2mg dose to a 1mg dose is a big drop, I would expect a person to experience a lot of discomfort due to that drop and that might be contributing to her “freaking out.”

                I would recommend talking to her doctors about a smaller reduction, at least for now, and then your mother could consider working with her health professionals on a slow taper.

                It is safer for people her age to not be on benzos, but this safety benefit has to be weighed against the work and quality of life impact of reducing the drug. Good luck!

                Hello Doctor:
                Thanks you very much for giving hope to many people to come out of this addiction. I am on 2 medications Ativan 2 mg and lonazep 0.5 mg . The first one for about 12 years and the second about 6 years . I am 62 yrs old with a history of diabetes, heart disease and hypertension with hypothyroidism . I would like to come out of this anxiety drugs and not sure which one to address first . Ativan or lonazep ? Can you please give some idea to wean away from these drugs ? I am single and don’t have much support from family or friends. I don’t have a clue how to proceed . Could you please help. I am desperately seeking guidance and help.
                Thanks and regards
                Mahendra

                Leslie Kernisan, MD MPH says

                I had to look up lonazep, looks like it is clonazepam, which has the brand name Klonopin in the US. Clonazepam is longer acting than lorazepam (brand name Ativan).

                By far the best way to explore and manage a taper is to do so under the supervision of a health professional. They would be able to talk with you and help determine which is better to taper first. In some cases, the shorter-acting benzo (lorazepam for you) is first converted to a roughly equivalent dose of longer-acting benzodiazepine, and then the longer-acting benzodiazepine is very slowly tapered down. The “Ashton Manual” describes some slow benzo tapers (including the substitution to longer-acting benzos) here: SLOW WITHDRAWAL SCHEDULES.

                While doing this, it’s also very important to work on non-drug ways to manage any anxiety, insomnia, or other problem that was being controlled by the benzo.

                The more slowly your benzo dose is reduced, the more likely it is that the withdrawal will feel tolerable. Do try to find professional help. good luck!

                CATHERINE PETROCELLI says

                I’m interested in getting a copy of Dr. Cara Tannenbaum’s Patient Education Tool. I couldn’t find a link to order it or download a copy. Can you please provide information on how to go about getting a copy of it. Thank you so much.

                Leslie Kernisan, MD MPH says

                There is a link in the article, but perhaps it’s not very obvious. The actual URL for the brochure is http://www.criugm.qc.ca/fichier/pdf/BENZOeng.pdf.

                First, thankyou for taking the time to reply to so many questions! You obviously care about people very much.
                I am a retired nurse going back to school to be a high-school art teacher. I have always battled cognitive impairment that I think originated with learning disabilities caused from a horse accident when i was fifteen (sub-dural hematoma that was delayed brain surgery, and little to no extra help in school afterrwards )
                I have fought my whole life to remain functional. I finally gave in to medication a few years ago when I developed chronic pain in all my joints, but mainly my hips in the girdle area. I have taken Norco 7.5mg, 3-4x/day for about 4 yrs, then added 1mg Lorazepam @ hs about 3 yrs ago for restless leg and insomnia (never had insomnia of any degree before the onset of pain), then I tried Cymbalta for pain, getting up to 90mg with positive results and even being able to reduce norco to 1-2x/day. After about a year on Cymbalta I realized I was increasing the norco again and decided to quit taking it. It has been 3 months and weaning down to 15mg, but I still cannot stop it due to the tingling in my face and lips along with severe vertigo, and now I feel like I have severe dementia some days. I feel like I became “old” overnight and although it seemed natural to take “medicine” for all these new symptoms, I am feeling now that it was a huge mistake! I feel very trapped by these medicines and want to get off of them. My question is, should I start making a plan with my doctor to stop the Lorazepam now, or after the Cymbalta?(even though Im having severe withdrawal difficulty from it) Or after I am out of college ? (this is difficult enough at 45yrs old) I love my doctor but I also know she is too busy to really understand these drugs. It takes extra effort but I really believe in a natural healthy lifestyle now, rather than drugs. I was very unaware of the end result. Thankyou for taking the time to hear my story.

                Leslie Kernisan, MD MPH says

                Thanks for sharing your story. Well, sounds like you have a particularly complicated situation at hand. Chronic pain can be a challenge to manage in the long-term. Sorry but I don’t have much personal experience discontinuing Cymbalta on its own, much less in combo with lorazepam.

                Unfortunately, most doctors tend to have much more experience starting medications than discontinuing them. As a general rule, you want to taper slowly if you are experiencing side-effects or withdrawal. It’s also probably a good idea to look into some kind of multimodal non-drug pain management program, such as this one: Chronic Pain Self-Management Program.

                There are also “functional medicine” practitioners who take a more detailed and holistic approach to healthcare. Not sure their services will be covered by your insurance, but if this is very important and you can’t find a usual doctor to help you with this, it might be worth paying out of pocket. Good luck!

                I take it for a tic thing. It is like a tourettes person and I was so relieved when I started taking this along with blood presure medication. My doctor wants to discuss it. Also I am chemically sensitive to everyday products so it also helps with coping. Really stressed now they say I have osteoporisis and that medication sounds horrible. I am so careful not to use anything except these medications. I don’t want to twitch myself into a fracture. I was already so stressed about the bone density but now feels like I can’t plan anything. Thanks.

                Leslie Kernisan, MD MPH says

                Well, for every medication one needs to consider the likely benefits and risks, and also what are the available alternatives. There are often viable and safer alternatives for managing insomnia and anxiety, but that may be less true for your condition. If your twitching is problematic and there aren’t reasonable alternatives, then it might be reasonable to conclude that the benefits outweigh the risks.

                I think it sounds like a good idea to discuss with your doctor. Especially if you look into other ways to manage anxiety, perhaps you and your doctor will find it’s possible to reduce your dose of benzos somewhat.

                Dialogue, considering alternatives, and trying a potentially better approach are what is most important. Good luck!

                Hi little info needed please I’ve been taking lorazapam after having insomnia after taking antihistamine . Yes I’m very sensitive to medication. . I took .5 mg for 3 weeks then doc gave me escitipram 5 mg which then upset my sleep again so at 3 weeks I went on 1 mg lorazapam 4 weeks after this doc gave me 10 mg escitilipram which was very hard to get on side effects were awful but did that . So after 7 weeks I wanted of lorazapam doc said drop 10% evey other days which I’ve done over 9 days and felt awful ?. Since found out the drop is to much been told should be 10% a week I’m now on .8 mg so should I drop 4 then leave 3-4 days gap then drop another 4 . Thank you Kate xxx

                Leslie Kernisan, MD MPH says

                Congrats on your efforts to get off this medication. Yes, it’s generally best to taper slowly, and if you are struggling or having side effects, talk to your doctor about making the taper even slower. Using a liquid form of lorazepam can make it easier to manage the small dose reductions.

                I can’t comment on just what your dose should be. I would recommend bringing Dr. Tannenbaum’s pamphlet to your doctor, reviewing the suggested taper together, and then asking for help making the taper as slow as possible. Good luck!

                Oh in reply to the liquid form is it the same ingredient as doc never suggested this to me

                Leslie Kernisan, MD MPH says

                yes, it should be the same ingredient. Talk to your doctor or ask the pharmacist.

                I’m 40 and have been on a single nightly 0.5mg dose of ativan for roughly a year.

                I consider this a small dose. Can I go cold turkey without too many side effects?

                Leslie Kernisan, MD MPH says

                Lorazepam 0.5 mg is not a very big dose, but it’s not trivial either. I think it’s unlikely that you’d provoke life-threatening withdrawal symptoms by quitting cold-turkey, but I think you probably WILL experience some withdrawal symptoms, such as rebound insomnia, anxiety, and/or irritability.

                I would recommend discussing your interest in stopping with your prescribing doctor. Ask for help figuring out a reasonable taper schedule. Good luck!

                I’ve now got to .72 last 2 weeks

                Anyone else razor and weigh the meds

                I’ve now started prickly itching skin arms legs chest and head could this be related

                Leslie Kernisan, MD MPH says

                Not sure, seems to me it’s possible that such symptoms could be related to a benzo taper, but there are also other things that can cause itching. I would recommend seeing your health provider about these symptoms.

                Thank you so much for your reply itching seems to have calmed thankgod was awful . I’ve now dropped to .69 mg next drop in 6 days I’m planning to go .65 mg does this sound sensible . As I get lower should I stay at 5-10% weekly my doc seems to think I can jump of at .5 mg I really don’t think this is the case . Does it get easier or harder the lower you get . I’ve been given escitipram to help with reduction x thankyou Kate ?

                Leslie Kernisan, MD MPH says

                Generally the slower the taper, the more manageable it feels to the body. If your doctor suggests a larger step down, you can perhaps discuss your preference to taper more slowly if at all possible.

                You might also find it helpful to find an online community of people working on benzo tapers, that would be a good source of moral support. good luck!

                My elderly grandmother, 93, was placed on hospice 2 months ago. 2 weeks ago, she started having difficult sleeping and while lucid during the day, became confused throughout the night. She is bedridden but would attempt to get out of bed, remove her diaper and not know where she was in the middle of the night. The hospice nurse suggested starting her on .5mg to 1mg of lorazepam at bedtime. Twice I gave her 1mg, as the .5 didn’t seem effective, but got nervous about the dosage and resumed the .5. As I said, I’ve been giving her L for only 2 weeks, but she has started sleeping more throughout the day and seeking more confused. She was awake throughout the night last night be disoriented with the same behavior mentioned above after having been given .5mg. I am not sure what to do and an wondering if I need to step her down even after only 2 weeks of use. Thank you for your guidance

                Leslie Kernisan, MD MPH says

                Sorry to hear of these challenges. Lorazepam is often used in hospice patients of all ages, but as I explain in this article on medications in hospice, there’s not really a good evidence base for this, and it’s not at all clear that it’s advisable to use lorazepam in elderly hospice patients.

                Initially, it would’ve been good for the hospice team to investigate what symptoms or distress or underlying issue were causing her nighttime symptoms. Could it have been pain or shortness of breath or something else?

                Now that she has been on lorazepam for a few weeks, it’s possible that she might experience some withdrawal or rebound insomnia if you stop or reduce it.

                You could talk to the hospice team about trying to taper down the lorazepam. That said, it may or may not be realistic to hope that she can be managed without any confusion or difficulty whatsoever. Really it depends on what is her hospice diagnosis and her other conditions affecting her health, but declining and dying often do affect the brain, even in people much younger than 93.

                Good luck and hang in there. Remember that even if her experience doesn’t seem perfect or as good as you want it to be, she is very lucky to have you there accompanying her on this journey. What is most important is that she feels you are there for her, which I’m sure she does.

                Hi I was on 3mg Ativan for over a year taking at bedtime I was also on Ritalin and reglan I began having extreme anxiety and shaking and confusion as I cut Down on reglan an had stopped the Ritalin. Doctor said it was caused by Ativan so switched me to klonopin. I got vertigo bad after starting klonopin so after 2 months was switched to Valium. I have been on Valium for almost 2 months only 2.5 mg at bed along with trazadone And remeron and melatonin. Still can’t sleep and wake with bad shaking and anxiety. Seems only thing that helps is Ativan again. I tried a .5 dose and it calmed me down. Now doctor wants to know if I want to go back to Ativan. Should I stick with Valium or go back to Ativan? It been 4 months since I got off Ativan and withdrawals were bad from both Ativan and klonopin. Should I just take more Valium. I have advanced cancer and Mets to liver so I’m afraid of Valium effect on liver with all the other meds I take also. Would it take time again to get tolerance to Ativan or will it work at small dose as if starting over again?

                Leslie Kernisan, MD MPH says

                Your situation sounds exceptionally complicated, both because of the many medications you have taken and are taking, and also because you have advanced cancer and metastases to the liver.

                I would recommend you consult with a palliative care specialist. Palliative care is a discipline focused on helping people manage difficult symptoms and helping people cope with serious illness. (They are also experts in end-of-life care and hospice, but that’s not necessarily what you need right now.) Learn more about palliative care here: Get Palliative Care.

                Among other things, they should be able to discuss the big picture of your health and the likely benefits versus burdens of trying to taper off benzodiazepines at this time. Good luck!

                Jill Smith says

                My 82 year old mother has been taking 4 mg of Ativan every night for at least a year or two. The doctor was prescribing 3 mg every night however she called and asked if she could take an extra 1 mg. He said ok to do so every now and then. Apparently she was doing 4 mg every night. He then decided that 4 was too much and dropped her to 3mg. She immediately started having serious withdrawal symptoms and panic attacks. The doctor put her back to 4 mg Ativan and added Clonazepam 5mg. She was feeling very zombie like ( of course she was !) so he told her to cut back on the Clonzepam by 12.5 mg 2 nights a week. She is feeling withdrawal again. I have no idea where to turn, this Dr has over medicated her for years and now the withdrawal symptoms seem to be too much for her to take. Any advice would be greatly appreciated. I think she needs an inpatient detox type of treatment.

                Leslie Kernisan, MD MPH says

                Yikes. Sounds like she has been on pretty substantial doses of benzodiazepines, for a person of her age. I cannot make specific recommendations but in general, the more slowly the dose is reduced, the better. So reducing the weekly dose by 10% is usually more tolerable than decreasing by 25%. It’s also often more tolerable to reduce a longer-acting benzodiazepine (clonazepam is longer-acting than lorazepam).

                Regarding inpatient detox, it’s not clear to me that this is generally available for chronic benzodiazepine use. Tapering off benzodiazepines can take 3-6 months, that would be a long time to remain as an inpatient. So I’m not sure you’ll be able to find that. But perhaps you can find a health provider who is willing to work carefully with your mom and your family on slowly tapering her benzos? Alternatively, have you discussed your benzo concerns with your mother’s doctor, and would that provider be willing to take a different approach?

                You may also find it helpful to connect with other people concerned about aging parents. There is an active online caregiver forum at AgingCare.com. This is a way to get moral support and encouragement as you explore your options. Good luck!

                Hi I’m now down to .55 lorazepam is it normal to notice effects of reduction 7 days after last drop it seems worse when I am in the middle of my period thank you x

                Leslie Kernisan, MD MPH says

                I cannot advise as it has been a very long time since I took care of women who were still getting their periods. Would recommend addressing this query to your treating clinician. Good luck!

                My mom is 91yrs old and takes .5 Ativan, one in the morning and 2 at night. She has been taking Ativan for 20+ yrs. When the first FDA tapering came about her doctor was going to stop her cold turkey by not prescribing her anymore. So had to find another doctor who would work with her on tapering. Even after finding a new doc they didn’t help to taper. I had to find something online and began tapering her down. I got her down to the dose I mentioned at the beginning. Now there was a new FDA tapering in October and the office nurse treats my mom as if she’s a drug addict off the street. No compassion whatsoever. I have to call every month to get a new script for my mom, and this month they are giving me a hard time. They sent the script out but it can’t be filled until Friday, which means my mom has to go 2 days without any Ativan. Been arguing with office nurse, but she told me deal with it. You’re lucky you got the script. How can medical professions be so cruel? Thought they took an oath to protect and save. I’m beside myself on what to do.

                Leslie Kernisan, MD MPH says

                Well, it’s probably good that you are helping your mother taper her Ativan, but it’s really unfortunate that the health providers haven’t been more supportive of you and her. They are probably overworked and under a lot of stress, but still.

                For the future, you could see if the prescribing clinician would be willing to prescribe liquid lorazepam. This can be easier to taper down slowly. Good luck, your mother is very fortunate to have you looking out for her.

                Swapnali Bhosale says

                My mom took Depranil plus 5mg a diazpam tab for 28yrs continuously now she is taking ativan 2mg from past 3 months instead of Depranil plus, her sleep is good but Dr. Recommended she can stop taking Ativan too completely but I’m sceptical about this cause of her dependency on diazpam for so many years. What should I do should I give her half a tablet instead of full in such tapering down or can I abruptly stop it?

                Leslie Kernisan, MD MPH says

                I’m not familiar with depranil; seems it’s a version of imipramine, which is a tricyclic antidepressant. These are usually sedating. They are also anticholinergic and can interfere with memory and thinking somewhat.

                It’s not really clear to me whether she is now taking both diazepam and lorazepam, or just the lorazepam. Regardless, it is never a good idea to abruptly stop a benzodiazepine. People almost always get distressing withdrawal symptoms (e.g. insomnia, anxiety, irritability), and especially when it comes to higher doses of benzos, they can also experience life-threatening withdrawal reactions.

                I would recommend bringing Dr. Tannenbaum’s brochure to your mother’s health providers, and asking about a slow careful taper.

                My mom has been prescribed .5 mg Ativan by her GP for the past two years to help her fall asleep. During this time, my dad and I have witnessed major differences in her personality, most noticeably rage and irritability have emerged in a person who has never exhibited such behavior.

                It has been particularly challenging as we can’t seem to discuss what we perceive to be a major issue without her becoming enraged. I’ve spoken to my therapist about this, because I wanted to be sure that I was approaching her in a way that was non-confrontational — nonetheless, her recommendations have proven ineffective.

                I’m at a loss on what to do anymore. I want to call her doctor, but I also don’t want my mom to see it as a personal attack.

                Leslie Kernisan, MD MPH says

                Sorry to hear of your mother’s personality changes. This is a tough situation, especially when you feel that soliciting help from doctors will upset your parent.

                Honestly I would not expect Ativan to cause these major changes in personality. Benzos can certainly disinhibit someone, which can lead to certain sides of their personality becoming more visible, but a significant change in underlying personality would not be expected.

                So, I would recommend your mother get further medical evaluation for her personality changes, as these can be the signs of the brain changing or of another underlying medical condition.

                If she gets upset when you mention evaluation: this is really common, and also really challenging to deal with. It can be helpful to get advice from a professional who specifically has experience in constructively communicating with people who may be cognitively impaired (your current therapist may not have this experience). Otherwise, you will need to decide whether to communicate your concerns to her doctor. This is allowable from a privacy law perspective, but does often upset the older parent if they find out about it. Many doctors are willing and able to be discreet, when family calls/writes to express concerns, and hence don’t tell the patient that family has called to relay concerns. (Although, what you communicate will probably end up in your mother’s medical record, and if she ever requests the records, she can find out about your communication in that way.)

                For more on what should be assessed as part of an evaluation, see this article:
                Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check

                You may want to hold off on trying to address the Ativan use until her personality changes have been further evaluated…in these situations, it’s important to “pick your battles” and generally it’s impossible to push people to address more than one thing at a time.
                Good luck!

                Linda Gail Hargraves says

                My doctor put me on .5 Lorazepam three times a day four years ago because I was having severe panic attacks. He didn’t explain the side effects or tell me how difficult it is to come of this medication. Now I want to come off it. I tried to taper slowly by cutting one dose daily in half, but I experienced heightened anxiety and loud ringing in my ears. My doctor really does not seem interested in helping me come off this med. I am 74 years old, have heart disease and high blood pressure. What can I do? Is it best that I remain on this medication for the rest of my life if it is controlling my anxiety?

                Leslie Kernisan, MD MPH says

                Cutting a dose in half is still a big step down for the body. I would recommend printing out Dr. Tannenbaum’s brochure and bringing it to your doctors. Let them know you are interested in reducing your lorazepam but you need their help figuring out a very slow taper. You should also discuss other ways to manage anxiety or other symptoms that are currently being treated by lorazepam. For instance, some people benefit from special therapy programs to help manage their anxiety.

                It’s certainly possible that you and your doctors may conclude that it’s better for you to remain on lorazepam. But it’s often a good idea to at least explore alternatives before coming to that conclusion. Good luck!

                I’m 67 years old and my primary stopped my Ativan cold turkey on the 18th of January. A few days later I went to see a nurse practictioner because of my anxiety levels increasing and suicidal thinking. She referred me to see a Psychiatrist. Made an appointment, went and he called primary told her to get me off of Ativan. So no more Ativan. Which I don’t mind. BUT since last thrusday I have been going thru withdrawal. I called primary today and she said that withdrawal should have happened around the 18th. The literature I have read say that withdrawal could happen anytime. So she put me on Buspar, asked why the Psychatrist wasn’t taking care of this, and I said he wants the primary to are care of this. Benzo’s and the elderly is one big circle. Doctors including psychiatrists are so book learned nowadays that taking care of patients isn’t a priority. No wonder there is much Medicare fraud. I was placed on disability about 10 years ago due my memory loss. Every time I see someone they say the things I am supposed to do but I can’t remember things. I was a chemo nurse so I knew I couldn’t do it anymore. I have a neuropsychiatrist in a week. So putting me on Ativan which I didn’t remember was addictive was a big Nono what does a neuropsychiatrist do.

                Leslie Kernisan, MD MPH says

                Yikes, I am sorry to hear that a provider would stop a benzodiazepine cold turkey, that is not considered optimal practice as most people experience distressing withdrawal symptoms. (People on higher doses of benzos can also experience life-threatening physical withdrawal symptoms.) It sounds like you need to have health providers working closely and compassionately with you at this time, I hope you will be able to connect with someone suitable soon.

                Neuropsychiatry is a somewhat newer subspecialty, it is also sometimes called behavioral neurology, and basically draws from both psychiatry and neurology. You can learn more here:
                Neuropsychiatry: Where Are We And Where Do We Go From Here?

                Hmm , most of these stories are tales of woe .I have only had a positive experience of being on this drug for over 30 years .I haven’t had to up the dose , don’t get highs or tremors or memory loss . An article in the paper about this drug brought out positive reviews from doctors ,about patients who have benefited from this drug .Most of the studies are observational and not longitudinal .In later life , the harmful effects of withdrawal seem to me to defeat the object .As long as it keeps working for me ,I’ll take it .

                Leslie Kernisan, MD MPH says

                Yes, many people find benzodiazepines helpful for their symptoms at least in the short-term, and many people have been taking them for years without experiencing obvious issues.

                And, an individual person is not able to determine whether long-term use of a medication increases their risk for certain problems, such as falls.

                It is certainly reasonable for an individual to conclude that the burdens of attempting withdrawal outweigh the likely benefits. We mostly want people to have the information they need to make an informed choice.

                Doctors are not practicing Drs today. Quite frankly they are afraid of the federal government so what happened to this person is happening everywhere I have been on a combination of many drugs large part of my lifetime starting last year I was put on Adderall low dosage my choice of 5 to 10 mg per day I had a tooth crack the first night and it was said it wasn’t possible to be the Adderall also put on alprazolam for long-term insomnia and atenolol for migraines 1year later my whole mouth has cracked miss placed teeth I have some form of neuropathy gas coming up from my stomach that is so acidic it burns holes in my tongue mouth and lastly was taken off alprazolam cold turkey because of fear of repercussions from government I am very familiar with medications my mother was a senior RN on 3 words of a major cancer hospital in New York and was also the victim of doctors doing the same to her I don’t put much faith in doctors anymore they don’t practice for the good of the patient they practice to follow laws so here I sit with unanswered questions because my doctor does not wish to have anything to do with me anymore even though he’s the one who prescribed the drugs that’s how scared he is Meanwell I due to the combination of these drugs as I said have a terrible mouth I can’t even talk anymore let alone eat horrid nightmares that force me to go back onto the alprazolam half a milligram at night and I don’t know if that’s helping atenolol makes me bald and fatigued I want to how you would approach all this I’m at a loss at this point

                Leslie Kernisan, MD MPH says

                I’m sorry to hear of all your difficulties and especially sorry to hear you are having trouble finding a health provider to help you with this.

                Yes, doctors don’t always provide optimal care when it comes to prescribing or addressing the consequences of their prescriptions. (This is partly due to the system making it hard for them to do so.)

                Unfortunately, given the situation you describe, I don’t see how you can address these issues without seeing a health professional. You would either have to continue negotiating with your current clinician to get more help, or you will have to find someone else. It’s possible that if you phrase your request for help in a different way, your health provider may be better able or willing to help. Good luck!

                Hi my husband became ill in India and was put on Lorezepam .5 mg x3 per day he’s only been on them for about 3 weeks but we’ve decided that he should come off them. Does he still have to do this tapering or will cold turkey be ok. he is 86 years old thankyou

                Leslie Kernisan, MD MPH says

                Yes, at this point it would be best to do a taper. I would recommend discussing this with his health provider; it’s not wise to attempt this on one’s own. Good luck!

                I am taking 2 mg ativan for sleep and anti depression medication from 3 years I want stop it can u help me thanks

                Leslie Kernisan, MD MPH says

                Sorry but it’s not possible for me to help individuals, I can only provide education and sometimes point to useful resources online. I recommend finding a health provider to assist you in tapering. good luck!

                So I am turning 46 and take clonazepam for seizures, I have been on it approximately 15 years. 3 years ago my seizures worsened after 11 years controlled. With that I was not taking clonazepam daily until this time. Now I still cant get my static seizures controlled, often sending me to the ER. I recently had brain surgery to try and stop the seizures. It is worse now in some ways. So I asked my neurologist to prescribe Ativan for the days the static seizures come on. In the last week I have been to the ER 2 times. She told me she can give me only 5 a month as she would lose her license if she gives me more. I dont see how if I have to have both to stop the seizures how it can be illegal to prescribe them both to me. As I read your article, I understand that their are issues with long term benzo use, but death from static seizures seems a good enough reason to need them. Before two doses of Ativan, after I had had 1 mg of clonazepam at my regular morning dose, my pulse would not drop below 130 and was as high as 142. I do not recall how high my blood pressure was except they were very worried, especially as I am only a month out of brain surgery. Is it bad to have both medications being used if the possibility of dying from a static seizure not stopping. I’m just confused as to why both are used in the ER anytime I am brought in but being allowed to use them at home under my own supervision is illegal.

                Leslie Kernisan, MD MPH says

                Sorry to hear of your situation. The optimal or reasonable use of benzodiazepines for seizure control is beyond the scope of my own practice and this article. That said, I’m not aware of there being any particular prohibition against dispensing a certain number of benzodiazepine tablets in a month. If you have a good medical indication for the benzodiazepine and your clinician documents this, I don’t see why she’d be “putting her license at risk.” Frankly, I think she is at more risk if she is denying you needed treatment based on this. So, I would encourage you to ask her more questions. You may also want to ask her why she won’t be in trouble if she doesn’t prescribe the treatment you need to treat the seizures.
                Alternatively, you could try to find another health provider, ideally one with experience prescribing seizure treatment (I think this would be a neurologist specialized in epilepsy). Good luck!

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