The Untold Story of Benzodiazepine Dependency | The Epoch Times

The Untold Story of Benzodiazepine Dependency

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"As a freshly minted physician’s assistant, Nicole Lamberson was nervous to start seeing patients, struggling with residual stress from her studies, anxiety, and a lack of confidence. A colleague prescribed her Xanax (alprazolam).

The pills worked like a charm for the first couple of weeks, but then they lost their power.

What started as a simple prescription spiraled into a medical nightmare that nearly claimed her life–and revealed a little-known truth about one of America’s most commonly prescribed classes of drugs.

Across the United States, over 30 million adults take benzodiazepines, medications like Xanax, Klonopin (clonazepam), and Ativan (lorazepam). Most believe, as Lamberson did, that following their doctor’s orders keeps them safe. 

Yet a growing body of evidence suggests these medications can create devastating physical dependence, even when taken exactly as prescribed, leaving patients trapped between the terror of continuing and the danger of stopping. In 2019, approximately 92 million prescriptions for benzodiazepines were dispensed to outpatients in the United States. About half of the patients took these medications for two months or more. Long-term use typically refers to taking them regularly for more than a few weeks.

11/18/2014

Benzodiazepine-related problems are often mistaken for addiction. However, dependence is neurological in nature and happens even when patients take the medication as prescribed.

It is critical to understand that “rebound symptoms, such as insomnia and anxiety, can occur after stopping benzodiazepines after using them for just 2 weeks,” according to a 2022 review published in Medical Clinics of North America. “Dependence develops in about half of patients who use benzodiazepines daily for more than 1 month.”

Many people who experience benzodiazepine withdrawal say they had no idea what was happening to them.

Benzodiazepines are sold under various brand names, including Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam), Klonopin (clonazepam), and Doral (quazepam). Short-acting benzodiazepines include Prosom (estazolam), Dalmane (flurazepam), Restoril (temazepam), Halcion (triazolam), and Versed (midazolam). View a complete list of benzodiazepine drugs here. While benzodiazepines have been prescribed for decades, many people have a misconception that these medications are safe for long-term use. High doses of benzodiazepines can result in respiratory depression. When combined with alcohol or opioids, benzodiazepines can lead to respiratory failure.

Director and producer Holly Hardman experienced this firsthand. In the mid-1990s, her gynecologist prescribed her 0.5 to 1 milligram of Klonopin (clonazepam), which she took a few times a week for more than 15 years. She stopped once while preparing for a documentary film festival.

Holly Hardman, director and producer of "As Prescribed." Courtesy of Holly Hardman

“On the fourth day after stopping, I started experiencing frightening symptoms. I felt like I should go to an emergency room,” Hardman said in an interview with The Epoch Times.

A quick Google search led her to a Wikipedia page alerting readers to the dangers of benzodiazepines.

“I rushed to my bathroom cabinet and took a 1 mg Klonopin tablet, then continued a deep dive into a shocking world of suffering, medical ignorance, and big pharma malfeasance,” she added.

After almost two years of tapering, she successfully stopped the medication and decided to create “As Prescribed,” a documentary about benzodiazepine dependency. The film follows several people dealing with benzodiazepine-induced neurological struggles and features the continuous fight to bring legislative changes. Patients cannot simply quit benzodiazepines cold turkey because of the body’s physical reaction to the drugs, said Dr. Josef Witt-Doerring, a board-certified psychiatrist and founder of TaperClinic, the largest psychiatric drug tapering program in the United States. He recalled a patient who attempted to stop abruptly, only to experience severe withdrawal that led to a suicide attempt. The patient was eventually stabilized by restarting the medication and later successfully tapered off under medical supervision.

“Benzodiazepines act on the GABA-A receptors in the brain. Gamma-aminobutyric acid is a chemical messenger that helps reduce feelings of anxiety and stress. The binding to these sites depresses and slows down our nervous system. In return, our brain signals to counteract the drug and produces less GABA on its own,” Witt-Doerring said.

Nicole Cain, naturopathic doctor and author. Courtesy of Nicole Cain

Nicole Cain, a clinical psychologist and naturopathic doctor specializing in benzodiazepine withdrawal, describes this process of receptor desensitization in detail in her book “Panic Proof.” She emphasizes that dependence “can occur in as little as two weeks of benzo use.” “Benzo belly” refers to gastrointestinal symptoms many people experience during benzodiazepine withdrawal, including abdominal pain, nausea, appetite changes, and diarrhea or constipation. Good nutrition plays a key role in the taper process.

Cain says that increased intake of probiotics, fiber, and appropriate herbal and natural supplements can alleviate the symptoms. She knows this after conquering her own crisis.

Running a private practice, and treating patients with anxiety, Cain found herself “caught in a panic-anxiety loop,” she told The Epoch Times in an email.

“At my lowest point, I had lost significant weight, my menstrual cycle stopped, I couldn’t sleep, and I experienced involuntary muscle movements,” Cain added. She tried numerous alternative treatments, but after all those failed, she turned to prescription medication. Diazepam provided the most relief. However, her medical training pushed her to find a deeper solution.

Cain successfully tapered off benzodiazepines over 18 months–10 years ago. Since then, she has supported thousands of patients, emphasizing the importance of treating not just the symptoms but also the underlying cause of anxiety. Interdose withdrawal—withdrawal symptoms that occur between doses—and the loss of drug effectiveness often lead to misdiagnosis and additional prescriptions. Patients find themselves on cocktails of drugs, as was the case with Lamberson, whose side effects—insomnia, irritability, and increased anxiety—were mistaken for mental health issues.

Cain recalls a patient who was prescribed one benzodiazepine (Zoloft) by her primary care physician and another (Lexapro) by her psychiatrist. “This combination is contraindicated and can potentially lead to serious issues such as serotonin syndrome,” she said, emphasizing the importance of collaboration and clear communication across specialties to ensure patient safety.

A 2024 study published in Annals of Medicine examined polypharmacy in nursing home patients. Of these older adults, nearly half exhibited polypharmacy and another quarter, hyperpolypharmacy. Scientists monitored 226 patients’ benzodiazepine intake and found that when these medications were used inappropriately, the risks of drug-related harm were unacceptably high.

In total, nearly 56 percent of the nursing home patients used benzodiazepines, with 28 percent in amounts higher than recommended for geriatric populations. Overall, 75 percent took benzodiazepines long-term. Problems surrounding benzodiazepine use are an ethical dilemma, Cain said. The main problem is in the current medical system, which is not designed to “consistently prioritize patient safety and well-being,” she told The Epoch Times. “Should we limit access to these medications, which can be life-saving in some cases (like mine), because doctors may lack adequate knowledge to manage the associated risks?”

Many medical professionals graduate from top programs without training in benzodiazepine tapering, she noted. Cain calls for enhanced education, increased resources, and the development of “comprehensive protocols for prescribing and tapering” for medical professionals and patients. Practitioners should know the difference between short-acting and longer-acting benzodiazepines and their effects, she added.

Witt-Doerring agrees that patient-centered care is lacking.

Dr. Josef Witt-Doerring, a board-certified psychiatrist and co-founder of the TaperClinic. Courtesy of Dr. Witt-Doerring

“I noticed that there was a problem of how we prescribed psychiatric care medications when the treatment of patients started looking like a conveyer-belt,” Witt-Doerring said in a phone interview with The Epoch Times.

In 2020, he co-founded the TaperClinic, which now operates in seven states and focuses on helping patients safely discontinue psychiatric medications.

Witt-Doerring sees a positive shift in the declining numbers of new benzodiazepine prescriptions nationally since 2019.

“However, that doesn’t help the fact that hundreds of thousands of patients have taken them for decades and that there is no official guidance on how to get these people off these medications.” A “patient-guided” taper refers to a process in which a physician closely monitors a patient’s symptoms and gradually decreases the medication in small increments. This tapering process can take months or even years.

However, this poses another problem for physicians and patients—some benzodiazepines only come in pill form and cannot be broken into small enough pieces to regulate an appropriate taper.

“We often taper patients with liquid formulations. Tablets don’t allow people to safely come off the medication,” Witt-Doerring said. However, compounding pharmacies are rare, and custom preparations can be costly.

Patients often struggle with withdrawal symptoms, navigating the medical system, and financial challenges. That is why tapping into a network of experienced professionals who provide guidance can be helpful.

Additional Resources

• ASAM Guidelines: The American Society of Addiction Medicine’s Benzodiazepine Tapering Guidelines provide evidence-based tapering protocols that patients can share with their health care providers.
• Benzodiazepine Information Coalition (BIC): Highlights the importance of peer support and offers a comprehensive list of national and international support services, including social media support groups and tapering coaches.
• The Alliance for Benzodiazepine Best Practices: An Oregon-based nonprofit that provides educational resources for both providers and patients.
• The Inner Compass Initiative: Explores psychiatric medications, including benzodiazepines, and founded “The Withdrawal Project,“ which amplifies personal experiences and shares practical strategies for coping with withdrawal symptoms.
• The Ashton Manual: Published by Newcastle University in the UK, this comprehensive guide explains how benzodiazepines work and how to withdraw safely. A PDF version of the manual is available through BIC.

Today, Lamberson is a taper coach and the medical director of the Benzodiazepine Information Coalition, a Florida-based advocacy group for people dependent on benzodiazepines. Fourteen years after stopping the medication, she still suffers from symptoms of ongoing nerve damage.

Nicole Lamberson, medical director of the Benzodiazepine Information Coalition. Courtesy of Nicole Lamberson

It took Holly Hardman 22 months to free herself from what she calls the “Benzo Beast.” She still manages lingering effects but sees light at the end of the tunnel. “Good things are happening. More doctors are listening to updated information about benzodiazepines,” said Hardman, adding that “As Prescribed” is now supported by clinicians researching benzodiazepine withdrawal and what many refer to as Benzodiazepine-Induced Neurological Dysfunction (BIND).

Cain advises patients to find a health care provider who views anxiety as more than a condition to be managed indefinitely.

“Remember, hope is a key part of the healing process. Don’t let anyone, institution or individual, take that away from you.”

The Untold Story of Benzodiazepine Dependency | The Epoch Times