Over my years of practice, I have been aware of the intense suffering of many patients frequently caused by the overuse of benzodiazepine drugs, like alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin), to name the ones most commonly involved.  These drugs were designed for short term use, say 2-4 weeks at best.  Long-term use in some patients can cause physical dependence, tolerance to the effects of the drug and an interdose withdrawal syndrome, requiring higher doses or more frequent dosing to stay out of withdrawal.  Interdose withdrawal means that as the dose of the benzodiazepine is diminishing in the blood stream, and usually just before the next scheduled dose, withdrawal symptoms start to arise.  The withdrawal symptoms tend to mimic the symptoms for which the drug was intended to treat in the first place: heightened anxiety, an inability to relax, insomnia, to name the most common.  Often these withdrawal symptoms are more intense than what was there at the start.  What reduces the withdrawal symptoms is an increase in the blood level of benzodiazepine, aka the next dose.  A vicious cycle can occur then, taking more of the benzodiazepine to treat the impending withdrawal symptoms.  The roller coaster begins, using the drug, that once really helped but now doesn't really, just to treat the oncoming withdrawal symptoms, in essence, just to prevent a full-blown withdrawal.  Sometimes I meet people living this way, caught in the cycle, on this roller coaster.  They suffer a lot.  The worst part of the suffering is a conditioned belief that these intense withdrawal symptoms, which occur quite regularly in their lives, are really just further "proof" or confirmation of how messed up they really are, and how much they need medication help like benzos.  "You see, I am really just an anxious person, I will always be this way" the belief goes.  I meet some patients firmly stuck in that belief, and suffering greatly both physically from the edge of withdrawal and psychologically/spiritually from the self-punishing belief that tends to form.

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If this sounds like something you experience, and you want to explore ending this cycle, I may be able to help you here through slow, patient-centered benzodiazepine tapering care.  I make use of the concepts developed by Professor Heather Ashton in her manual Benzodiazepines: How They Work and How to Withdraw , Mark Horowitz's and David Taylor's excellent The Maudsley Deprescribing Guidelines, and the helpful information provided by the Benzodiazepine Information Coalition.  Relieving this medication-induced suffering, and especially challenging the belief that forms with it, is one of the most rewarding things I do.  I work best with those who are:

• ​conscious that this is indeed the problem and need help.

• highly motivated to address the problem through more than just a slow benzodiazepine taper.

• engaged with a therapist or counselor for the additional support that is needed.

• open to develop non-medication ways to settle the nervous system including regular exercise, healthy eating, and meditative practices.

• held by some kind of community of support during the taper.  You can't do this alone.