![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 168 to 192 of 251. Go back in thread:
Posted by queenb on April 19, 2001, at 12:26:46
In reply to Re: mood disorders/klonopin,depakote,neurontin etc...., posted by jimmygold70 on April 19, 2001, at 9:19:22
>I have been on klonopin for 2 days now and off xanax. i feel very not at ease. Very ancie, i guess you could say. Very nervouse feeling. Is this because i am switching medications??? Im not sure i like klonopin. I also feel very tired. My mind is racinf though. I am goin through spurts of extreme hyperness to restlessness throughout an 8 hour work day. what is up?
Queenb
Posted by jimmygold70 on April 19, 2001, at 13:30:52
In reply to Re: mood disorders/klonopin,depakote,neurontin etc...., posted by queenb on April 19, 2001, at 12:26:46
Maybe you're taking too little Klonopin. How much are you taking ? How much Xanax you used to take ?
> >I have been on klonopin for 2 days now and off xanax. i feel very not at ease. Very ancie, i guess you could say. Very nervouse feeling. Is this because i am switching medications??? Im not sure i like klonopin. I also feel very tired. My mind is racinf though. I am goin through spurts of extreme hyperness to restlessness throughout an 8 hour work day. what is up?
>
> Queenb
Posted by queenb on April 19, 2001, at 14:53:47
In reply to Re: mood disorders/klonopin,depakote,neurontin etc...., posted by jimmygold70 on April 19, 2001, at 13:30:52
> I was only taking 05mg of xanax a day. i am taking 1.0klonopin a day.
Posted by jimmygold70 on April 21, 2001, at 8:49:18
In reply to Re: mood disorders/klonopin,depakote,neurontin etc...., posted by queenb on April 19, 2001, at 14:53:47
So the Klonopin dose is allright.Some sources of mine state that 1mg Klonopin=1mg Xanax, some say that 2mg Klonopin=1mg Xanax, and some say the very opposite: 1mg Klonopin = 2mg Xanax (I tend to agree to the latter). Anyway, you're on the safe side.
> > I was only taking 05mg of xanax a day. i am taking 1.0klonopin a day.
Posted by Ryan on April 22, 2001, at 21:56:01
In reply to Re: mood disorders/klonopin,depakote,neurontin etc, posted by MrZest on December 10, 1998, at 10:26:21
I have social phobia, major depression, and ocd. I've used Effexor XR, Zoloft, Gabitril, Klonopin, Adderall, Paxil, Buspar and Celexa.
Effexor worked best and controlled more symptoms than anything else. I used 300mg. per day. My problem is that I am afraid to take any medication anymore. I read a study that stated that Prozac, Zoloft, Pondimin, and Meridia change the shape of seretonin receptors in the brains of rats after only 14 days of administration of extremely high doses. It isn't known if these changes are permanent or harmful. I'm angry that this study wasn't done BEFORE the drugs were released. I thought these studies were done before the drugs are cleared by the FDA. I'm now scared of taking ANYTHING because of this. If anyone knows of other research on this subject or other ways of treating my problems PLEASE post.
Posted by stjames on April 22, 2001, at 22:32:30
In reply to Longterm safety of SSRI's and other psych. drugs, posted by Ryan on April 22, 2001, at 21:56:01
> I have social phobia, major depression, and ocd. I've used Effexor XR, Zoloft, Gabitril, Klonopin, Adderall, Paxil, Buspar and Celexa.
> Effexor worked best and controlled more symptoms than anything else. I used 300mg. per day. My problem is that I am afraid to take any medication anymore. I read a study that stated that Prozac, Zoloft, Pondimin, and Meridia change the shape of seretonin receptors in the brains of rats after only 14 days of administration of extremely high doses. It isn't known if these changes are permanent or harmful. I'm angry that this study wasn't done BEFORE the drugs were released. I thought these studies were done before the drugs are cleared by the FDA. I'm now scared of taking ANYTHING because of this. If anyone knows of other research on this subject or other ways of treating my problems PLEASE post.James here....
How do you know these changes are harmful ? Why do you think they are ? Something has to change if a drug is to be effective. The changes you mention are at least 50 years from us understanding what they really mean. Do we follow
Chicken Littles logic, be scared of everything we don not understand. So we don't give people these drugs because of something that happens that we will not understand for 100 years. Even though people have been taking AD's for 50 yrs we pull them due to something happening at the micron level. We allow more people to suffer and die due to mental illness, no because of big issues like toxisity and mutations but worry to death about sometyhing at the micron level. STUPID.Please find something else to worry about. Running out of matter in this system/univiverce
or the balance of matter to expansion changing so
a big big bang or implosion and w are all gone has far more info on it than changes to seretonin receptors. Look up the "Theory of everything"When you can answer these questions you can start worring about seretonin receptors.
1) What do the they look like
2) What do they do
3 What does their structure look like through out their life
4) How does structure relate to function
5) Account for being able to function normaly with 90% loss of seretonin receptorsJames who is very tired of this thread coming up again. Worry about what you know and can prove. Don't worry about little facts that we are 50-100
yrs from beginning to understand. I also do not understand why you an angry, all kind of tests were done, tests where we understand what the results mean. Tests that give results that we are no where close the understaning proves nothing. There is no point is being afraid fo what we don't understand.James
Posted by kid47 on April 23, 2001, at 10:04:29
In reply to Longterm safety of SSRI's and other psych. drugs, posted by Ryan on April 22, 2001, at 21:56:01
> I have social phobia, major depression, and ocd. I've used Effexor XR, Zoloft, Gabitril, Klonopin, Adderall, Paxil, Buspar and Celexa.
> Effexor worked best and controlled more symptoms than anything else. I used 300mg. per day. My problem is that I am afraid to take any medication anymore. I read a study that stated that Prozac, Zoloft, Pondimin, and Meridia change the shape of seretonin receptors in the brains of rats after only 14 days of administration of extremely high doses. It isn't known if these changes are permanent or harmful. I'm angry that this study wasn't done BEFORE the drugs were released. I thought these studies were done before the drugs are cleared by the FDA. I'm now scared of taking ANYTHING because of this. If anyone knows of other research on this subject or other ways of treating my problems PLEASE post.
Hi Ryan. I understand your concern about taking meds. I also have taken lots of different mood altering drugs some legal some not. I am so much better off with these meds (the legal ones) & can enjoy a fairly "normal" existence which I could not have without them. I try not to look to far ahead & am most content just taking it "a day at a time".The first thing I check about drug studies is who is paying for it. When the sugar industry finances a study to determine if "Nutra sweet" sugar substitute causes cancer, I am going to be a little suspect of the results. Also comparing results of a rat given 5 times it's body weight daily of a certain drug & that of a human consuming a far more reasonable dose might prove tricky. I am glad testing continues & think continuing research is our best hope but I do take the results of these studies with a grain of salt.
If you feel you are better off with the meds than by all means continue taking them. Please don't let
sensational headlines & fishing expedition type studies scare you away from the very thing that can make life worth living. Take care
Posted by willow on April 23, 2001, at 10:13:29
In reply to Re: Longterm safety of SSRI's and other psych. drugs, posted by stjames on April 22, 2001, at 22:32:30
I too am having success with Effexor. My condition was controlling my life before this medication. I was severly limited. Now I am functioning; would I give this up for something can happen in the future? Probably not! For something that may or may not happen? NO WAY!
As we get older the quanity of life decreases, trying to preserve or maintain quality is more important in my opinion.
Regarding James thoughts on worrying about the expanding thing, I've actually had a spell where this caused me quite a bit of anxiety. : )
Willow
Posted by SLS on April 23, 2001, at 14:47:03
In reply to Longterm safety of SSRI's and other psych. drugs, posted by Ryan on April 22, 2001, at 21:56:01
Hi Ryan.
I am not sure what you read. I think the changes in neurotransmitter receptors you read about are those that are supposed to happen with these drugs. It is thought that it is exactly these changes, and changes like them, that are responsible for how antidepressants work. If you notice, these changes became apparant at 14 days, the same amount of time delay that is needed for antidepressants to begin working. Some doctors think that the change in the sensitivity or numbers of these receptors represents an adjustment made to a system that is not regulated properly. Scientists really don't know yet.
I hope this helps to allay your fears. People have been taking those antidepressant drugs that have changed receptor sensitivity for over 40 years. Some of them have been smiling for that long.
- Scott
> My problem is that I am afraid to take any medication anymore. I read a study that stated that Prozac, Zoloft, Pondimin, and Meridia change the shape of seretonin receptors in the brains of rats after only 14 days of administration of extremely high doses. It isn't known if these changes are permanent or harmful. I'm angry that this study wasn't done BEFORE the drugs were released. I thought these studies were done before the drugs are cleared by the FDA. I'm now scared of taking ANYTHING because of this. If anyone knows of other research on this subject or other ways of treating my problems PLEASE post.
Posted by Doo on April 23, 2001, at 21:04:58
In reply to Re: Longterm safety of SSRI's and other psych. drugs » Ryan, posted by SLS on April 23, 2001, at 14:47:03
Hello Ryan,
I too have this fear and I try to live with it. I tried a number of meds, and I take a small dose of zyprexa. I know that med can lead to certain problems. Some days I feel that taking it is wrong. Wrong for my organism. I don't have any answer for you, I can only share your fears and doubts. I find it hard to accept the fear, but I think it's better to act this way, rather than make myself believe that there's no danger at all.
For me, the better way to approach the question rationnaly is a question of risk vs benefits. If the benefits are higher, then let's continue. Of course, the risks are sometimes difficult to evaluate... Especially when you try to see long-term use. The benefits can hopefully be more palpable. But who says you have to take the meds for a long time? I take meds to help me, but I hope I'll one day be able to live without them.
Take care,
Doo.> My problem is that I am afraid to take any medication anymore. I read a study that stated that Prozac, Zoloft, Pondimin, and Meridia change the shape of seretonin receptors in the brains of rats after only 14 days of administration of extremely high doses. It isn't known if these changes are permanent or harmful. I'm angry that this study wasn't done BEFORE the drugs were released. I thought these studies were done before the drugs are cleared by the FDA. I'm now scared of taking ANYTHING because of this. If anyone knows of other research on this subject or other ways of treating my problems PLEASE post.
Posted by JCB on June 22, 2001, at 0:58:18
In reply to just advice, posted by Ellen on August 8, 1999, at 6:34:35
I recently was prescribed Klonopin to deal with the stresses of having a serious chronic illness recently diagnosed. I also am a professional mental health counselor who's been working with drug/alcohol addicted clients for over 5 years now. After reading all the opinions on what is or isn't addictive, I thought I might share my experience in treating my addicted clients. As far as the benzos (klonapin, xanax, valium, etc) withdrawal is serious if you've taken a high enough dose for a long enough time. I've had clients that were taking 6-10 pills a day if not more for years. They usually get detoxed in a hospital over a 2 week period and are given a comperable drug to help manage the withdrawal symptoms. Here is my point. I've had MANY clients VERY addicted to benzos and most of their addiction (after being detoxed of course) was purely psychological addiction. I'm not saying they didn't feel anxiety, I'm sure they were, but it wasn't withdrawal, but rather their perception of life's struggles w/out anti-anxiety medication to buffer normal day to day stress that we all otherwise learn to deal with w/out medication. I've had great success in treating these clients using a variety of cognative-behavioral therapies, mostly in conjunction with family or peer group support. To sum this up, I do believe it is possible to "get off" of any drug you feel you are addicted to. I have had clients who were addicted to EXTREMELY addictive substances such as methadone (more addictive than heroin if you can believe it!) get off the stuff. I suggest that if you're having trouble getting off a drug, you consider seeking treatment at a good chemical dependency program in your city. It would be worth the try if it works for you.
Posted by Annabelle on June 22, 2001, at 6:30:09
In reply to Addictive meds in general, posted by JCB on June 22, 2001, at 0:58:18
> I recently was prescribed Klonopin to deal with the stresses of having a serious chronic illness recently diagnosed.
Hi and THANK YOU for your words of wisdom. Finding this board was eye-opening for me as I didn't realize these drugs were used in such a wide capacity.
I have been taking Klonopin .5 once a day and more recently Neurontin 2 x 300 2xday for extreme muscle pain.
Klonopin has been working for years until lately. Now my neurologist is finally sending a referral to the Pain Clinic so that I will be able to have a Botox shot to control the spasms that have been driving me nutty for years.
Good luck to you in your search for relief. Please keep us posted.
Annie
Posted by gilbert on June 22, 2001, at 10:30:37
In reply to Re: Addictive meds in general » JCB, posted by Annabelle on June 22, 2001, at 6:30:09
JCB,
I have been sober for fifteen years and when I was using would snort eat or drink any mood altering chemical I could get my hands on. I also suffer from panic and anxiety. About 2 years ago I began trying meds. The only drugs that help without horrendous side effects are benzos. I have some guilt in using them however I have been on and off of xanax for the last year and have never had any problems starting or stopping the meds. I can taper down slowly and stop....no rebound anxiety none of the horror stories you hear about. I also have never wanted to take them to get high in fact I don't feel high at all from taking them...they just get rid of the panics and make me feel normal. The benzo phobes and the attitude toward benzos needs to change. They are very effective drugs. If medically supervised they are very very safe for long term use. Even though tolerance may appear after the initial dose most people can maintenace dose with the same amount year after year. I have had every ssri and tricylcic and nsri and remeron and serzone pushed at me due to the fact that they are not addictive. I will tell you all drugs cause dependence at some level. Your body becomes used to the drug and will react if you remove it from your system. Even blood pressure drug removal causes rebound. Addiction versus dependcy is the issue. Are diabetics addicted to insulin....no. Are diabetics dependent on insulin.....yes. Some of my AA friends feel I am jeopardizing my sobriety by use of these meds. I can honestly say I would be drunk if it were not for xanax. It has been a life saver. I can drive anywhere. I am a functional dad and husband. I had my best sales year and finished first in the company last year. There are some great articles and I would direct you to this explaination of benzos specifically xanax......
http://neuro-www.harvard.edu/forum/PanicDisordersF/Xanaxexpalinedagain >html.P.S. ssri dependency is also very prevelant and coming to the forefront now that users are having withdrawal problems. Again if they taper slowly no problem. But to think that you can just cold turkey stop any of these pyscho-active drugs just to prove they are not addictive is pie in the sky.
P.S. I have never thought wow why don't I take a bunch of xanax and go hang out downtown and party. They just don't feel or work that way. I have been able to take xanax and do things I was always afraid to do I.E. visit friends in hospitals, ride elevators, be a pallbeareer at funerals. I am taking my family on a summer trip to Mackinaw island. I could not do these things without my meds. Bill Wilson the founder of AA suffered from terrible depression throughout his sobriety. After many years sober he did LSD to try to alleviate his depression. So I think some of the addiction specialist need to know that even the man responsible for starting the greatest reovery program since time began still continued to suffer and had to search out pysch-active meds for a solution.
Gil
Posted by gdog on June 22, 2001, at 15:24:32
In reply to Re: Addictive meds in general, posted by gilbert on June 22, 2001, at 10:30:37
gil,
thanks very much for posting your thoughts on this. i am recovering alcoholic and addict, clean and sober 4.5 years. when i was prescibed ativan for my panic and anxiety, i went through a lot of issues with it. i stopped using it (even when i did use it, i dosed at a much lower dose than prescribed) for a couple of months. but my anxiety/panic got worse (partially due to the other meds i was/am on) and i had to resort to ativan just to stay in my own skin. however, i constanty second guess myself, do i need it, or am i just wanting to change the way i feel so i dont have to deal with things. its a real struggle, and definitely adds to my anxiety. plus, i usally wait until i'm way far into the anxiety/panic and have suffered for a couple of days before i take the ativan. which isnt the best thing for me mentally or emotionally. i appreciate that someone else out there has these issues and is willing to post them.
Posted by Sulpicia on June 22, 2001, at 17:04:48
In reply to Addictive meds in general, posted by JCB on June 22, 2001, at 0:58:18
Gil and Gdog -- ditto on this end. Over a decade in recovery myself.
Addiction is simply a common comorbid of many disorders and we can and do
recover to live healthy lives.JCB -- I don't know where you trained or what you're field is, and I totally
agree with you that a good chemical dependancy treatment program can help an
addict, this statement leaves me confused, especially coming from a mental
health professional who treats addicts:
"As far as the benzos (klonapin, xanax, valium, etc) withdrawal is serious if you've taken
a high enough dose for a long enough time. I've had clients that were taking 6-10 pills a day if not more for years.
They usually get detoxed in a hospital over a 2 week period and are given a comperable drug to help manage the
withdrawal symptoms. Here is my point. I've had MANY clients VERY addicted to benzos and most of their
addiction (after being detoxed of course) was purely psychological addiction. I'm not saying they didn't feel anxiety,
I'm sure they were, but it wasn't withdrawal, but rather their perception of life's struggles w/out anti-anxiety
medication to buffer normal day to day stress that we all otherwise learn to deal with w/out medication."
"Physical" addiction does NOT consist entirely of withdrawal nor is "psychological" addiction limited to self-medication and
coping skills. To reduce a complex problem like addiction into physical and psychological components is questionable, and
rather unusual in light of what we know about the brain.
Tho perhaps I'm misunderstanding you??? Entirely possible today!
S.
Posted by Daveman on June 22, 2001, at 22:09:37
In reply to Re: Addictive meds in general:Gdog, Gilbert JCB, posted by Sulpicia on June 22, 2001, at 17:04:48
Based on what I've read; discussions with my doc; and my own somewhat limited experience; I do think it is an oversimplification to state that dependency on benzos is psychological not physiological. It does seem clear that the main mechanism of action of the benzos is to bind to the GABA-A receptor sites in the brain and heighten the effect of GABA (Gamma-amino butyric acid); therefore it is also logical that, at high enough doses over long enough periods, the brain would adjust to the presence of the effectuating agent by reducing the amount of GABA naturally produced. Thus the logic of tapering slowly; so that the brain can adjust to the deprivation of the effectuating agent and begin producing more natural GABA. (This is a very rough understanding, feel free to correct me:))
I also would not necessarily discount the horror stories some people have about the benzos. Consider that there have been many millions of scripts written for these medications; it is a statistical inevitability that there will be some adverse reactions. I liken it to being killed in a plane crash; the statistical odds of this happening are astronomically small, but that makes you no less dead if you're the one killed in such a crash. Similarly, the likelihood is that if you take benzos under careful monitoring of a knowledgeable pdoc, the odds of a truly bad outcome are small, but the people in that group suffer no less because the odds were against it.
There are risks in any endeavor. Driving is a good example. Any medication entails some risk, the key is whether the patient is properly advised of the potential risks, and is properly monitored and follows their doctor's advice to reduce the odds of an adverse outcome even further.
Dave
Posted by JCB on June 22, 2001, at 22:24:27
In reply to Re: Addictive meds in general:Gdog, Gilbert JCB, posted by Sulpicia on June 22, 2001, at 17:04:48
Sulpicia, I'm afraid I was misunderstood, because I agree with your comments. Maybe this example will help clear up the point I was trying to make about addiction/dependency/physical/psychological and their relationship to each other. I often have clients who are addicted to pain killers. When they stop taking them, their body reacts with a compensatory response of hypersensitized physical pain. Pain from the injury they originally sought medication to treat AND new pain manafested in muscle crams, aches & pains, etc. This is purely Physical Withdrawal symptoms from a physical addiction. Too often, however, over the course of taking pain medication to, lets say alleviate back pain, they inadvertantly find out that the pain killers also kill emotional pain (i.e. the kids are less frustrating, mother-in-laws are more tolerable, you get the picture) During accute withdrawal, people experience their original pain hypersensitized as well as additional aches and pains. These usually become manageable throught other treatments (we refer our clients to pain management clinics if indicated). Just as the pain medication killed emotional pain, the post-accute withdrawal from pain medication is usually a difficulty coping with day to day life stresses. This is completely understandable. Its also the bodies compensatory response to the absence of the drug. Here is where people either go back to their drug or continue to recover. People need to be around other people who understand what they are going through, thats why 12-step programs are so very popular and effective. I also recommend individual counseling, if applicable, to address possible personal issues that may not be appropriate for group discussion (i.e. past abuse issues, childhood trauma, etc.) I chose this example because I believe it more clearly illustrates my philosophy in treating chemical addiction. However, these basic concepts are appropriately generalized to most other drugs, especially CNS depressants (benzos, alcohol, opioids, etc.) I've found when treating people with stimulant addictions, the dynamics are somewhat different. The treatment, however is quite similar. I hope this has been helpful. For the record, I'm a licenced mental health counselor and certified chemical dependency counselor with 5 years experience in working with chemically dependent adults and their families in a hospital outpatient setting.
Posted by gilbert on June 22, 2001, at 22:32:46
In reply to Re: Addictive meds in general:Gdog, Gilbert JCB, posted by Sulpicia on June 22, 2001, at 17:04:48
Sulpicia,
It is almost the chicken and the egg question.....as I am sure now that my primary illness is probably not alcoholism but that drinking was used to self medicate agoraphobia, panic and some depression. I never felt good sober like many people do in AA. They get sober and start normal lives etc. I got sober lost my medicine.....booze and almost immediatley began to have problems functioning in the outside world. I believe this is why so many relapse and drink again. They never get medicated or help for the underlying illnesses. I busted my butt at AA for 10 years. I would do open talks while panicking to the point of doing damage to my heart from elevated blood pressure from anxiety. I worked the steps over and over and over trying to find comfort all the while blaming myself for not getting well or not having enough faith to turn it over. I worked with new cummers endlessly at one time I was sponsoring 10 people. Everyone thought I was the perfect AA and I was dying inside. Five years ago upon my 10th AA birthday I was so dissapointed in my progress I actually contemplated suicide. I then went into therapy and tried that for 3 years and still go but yet still I was nonfunctional due to panic and agoraphobia. I finally have started trying meds. I am still trying to get the luvox to work but am doubtfull. I have tried everything under the sun to not take benzos. Xanax makes me functional yet I still have a tremendous amount of guilt over using it. My wife loves me on xanax I am a new person. She thinks I am nuts torturing myself with AD's so I can be accepted at AA. I had to see a cardiologist because of a heart murmur. He told my doc get this guy on something to calm his heart down he is doing damage. You would think this would alleviate the guilt. Still I feel guilty like I am betraying AA. I am stuck between feeling like I belong in AA versus being menatlly and physically healthy. I even tried a beta blocker for my heart but my pulse got to slow plus it made me impotent. So I will torture myself a little more with the luvox and then I am sure will just have to take the xanax because it works. This is why I get so defensive about benzos....sometimes they are all that works. The attitude towards some of these meds can really hurt peoples feelings and chances of getting well. I finally against the wishes of my sponsor told some people at a table last night that I was on benzos because nothing else worked. I got some support and I got the usual AA oldtimer advice about how I was going down the path to self destruction. Well I have been on that path for 1.5 years at 2 to 3 peach xanax a day. No progressive usage. No using to get high. No unusual behavior after taking xanax. No withdrawal..I can stop at random without side effects. It is time we enter the 21st century and realize some people can use this stuff responibly without going down the tubes......frankly the thought of trying to just work the steps without the help of some of these wonderfull drugs including the ssri's makes me want to suck vodka for breakfast again.
Thanks,
Gil
Posted by gilbert on June 22, 2001, at 22:59:41
In reply to Re: Staying Sober and taking meds, posted by gilbert on June 22, 2001, at 22:32:46
JCB,
I have been in the trenches since 1979 in and around 12 step groups and in and out of 3 inpatient rehabs plus 3 outpatient rehabs....have been sober 15 years and am still very active. I have personally taken about 100 drunks or addicts to hospitals for detox on 12 step calls. I have enrolled at leat half of those people in half way houses. I think AA is miraculous.....that being said. I think statistically it is a failure. About 1 out of 10 stay sober and of those who don't relapse probably only about 1 out of 15 stay sober permanantly. Of all the people I have tried to help some are dead, few are sober, most are missing. I believe 12 step groups to be a great assest but there is much dangerous advice and much dangerous misconceptions in and around AA. Many many people are advised not to take meds to just work the steps. I have a friend who in the early 80's was advised not to take lithium if he just worked the steps he would be fine. This almost cost him his life. I think with the new found spirituality and God like fervor that is felt when sharing with other suffering humans some feel that the hand of God will come down and fix their underlying mental illnesses. Or if they only do a good enough 4th step they will be free from this bondage of depression......you know all the slogans and cliches that sound so good but don't work for all.
I would dare say if all the depressives and all the anxiety sufferers were to be medicated and getting proper pychiatric help prior to using alcohol as medicine.....AA would be quite empty. There are very few pure alcohlics out there who simply do not suffer from some form of mental illness. I would remind all of my fellow recovery AA members who visit this board that Bill W. the founder of this program suffered from sever depression until his death. He also had much trouble in the fidelity area......One could say after alcohol was no longer his medicine....sex than became his new medicine. He finally resorted to dropping acid LSD to try and get some comfort. This does not sound like the kind of sober life I would wish to live. I think 12 step groups need to realize they need some input and need to be very openminded in pychiatric concepts. The meetings are shrinking in my area. They have gotten smaller and smaller. I don't think it is coincidence that after the invention of some tolerable effective medicines people no longer have to keep drinking to the point or level I did in order to stop. I think people are getting their underlying illnesses treated prior to getting in trouble because of all the advances in medicine and therefore the numbers at 12 step groups have dropped. I am gratefull to be sober and to have AA......I also realize without my meds I would be drunk or dead..........I use both to live my AA alone would not sustain me. I think many in the program pay painfull lessons and even lose their lives trying to 12 step something that can't be.Sincerely,
Gil
Posted by JCB on June 23, 2001, at 7:40:35
In reply to 12 step group effectiveness, posted by gilbert on June 22, 2001, at 22:59:41
Gilbert,
I understand that many of the people reading this who are in recovery are concerned about AA's acceptance, or rather lack there of, of psychiatric medication being taking while working AA's program of recovery. I can tell you that, in general, it has been my experience that AA has come a long way since it's beginnings and much less "militant," for lack of a better word, about not taking ANY medications. Its unfortunate that there are people out there that suffer more from going to AA (stopping all their medications) than getting the support they desparately need. I'd like to make just 2 points on the subject.
First of all, for those of you in recovery who feel guilty about taking psychiatric medication AS PRESCRIBED by your doctor, please DON'T. AA continues to hold to the disease model in their teachings of addiction, however, I've found that even AA is realizing that there are some people who, for whatever reason, will need to be on some kind of psychiatric medication, at least throughout therapy, if not perminantly. Here is where I'd like to distinguish between someone who, I believe to be "cheating," and someone who is honestly in need of psychiatric medications. All psychiatric medications are mood altering, otherwise, they wouldn't be psychiatric medication. However, not all psychiatric medications give a "buzz." We call these non-addictive mood altering drugs (i.e. lithium, depakote, prozac, wellbutrin, etc.). How many times have you heard of someone coming into a chemical dependency treatment center saying "hey, I've got a real prozac problem...last night I did hit after hit all night long"? I know this sounds rediculous, but it makes my point. For this reason, AA should have no problem with recovering people taking these kinds of drugs. They were designed to correct chemical imbalances in the brain, which they do very well.
Now, as far as recovering people who are taking classes of drugs that DO give you a "buzz" (maybe not in low doses, but if you take enough they will), (i.e. valium, xanax, klonopin, percodan, darvocet, basically all benzodiazapines and opioits). Here is my opinion on the subject. I have no flat rule/advice for people who are taking these drugs and working a program of recovery. I take each person, their personality, and lifestyle into consideration before giving them my opinion on whether they should try to get off these drugs or not. First of all, I'm not a doctor and would never advised a a client to go against their doctor's recommendations. I do, however, often work with clients who, in time, feel comfortable suggesting to their doctor that they be weaned off their medication (remember I'm strictly speaking of the mood altering addictive types). I'm a firm believer in the benefits of talk therapies, or else I wouldn't be one I guess! Sometimes, especially with clients who have extreme anxiety that appears to continue, even after a significant period of abstinance, I will recommend they seek anti-anxiety medication from a psychatrist, at least to help them calm down so they can focus and gain more benefit from our therapy sessions. Often the drugs that are prescribed are the ones I mentioned that people can abuse to "get high" (klonopin, valium, xanax, etc.) Here is my final point. If a person is taking these kind of medications, AS PRESCRIBED, AND honestly seeking behavioral change through 12-step and/or individual psychotherapy, I don't see anything wrong with it. In fact, I think its how I would prefer to work with my clients who suffer from chronic anxiety. If this is you, please don't feel guilty. However, if you are just using the anti-anxiety medication alone, without any kind of talk therapy, I would caution you against using these medications as a "crutch." I think you know what I mean. This could actually prevent your growth in recovery and either lead you back to your drug of choice, or develop a new addiction.
I know this was a very long message, but I hope it helps those of you who seem to be struggling with this idea of taking psychiatric medication while working a program of recovery that is based on abstinence.
PS- on a lighter note, I live about 3 blocks down from Dr. Bob's house in Akron, Ohio, where AA was founded. Neat, huh?
Posted by gilbert on June 23, 2001, at 17:23:21
In reply to Re: 12 step group effectiveness, posted by JCB on June 23, 2001, at 7:40:35
JCB,
Thank you for the kind words. Your message felt like a little bit of a double message though. Even at higher doses in the middle of a panic xanax never gave me a buzz for the sake of a better word. As far as talk therapy goes....I have spent the better part of my sober life in talk therapy. I find if you do have a chronic condition that talk therapy to be very ineffective for certain disorders. I do not believe as AA and some others espouse that if I take xanax and don't go to therapy I may well be drinking again because of the xanax use. There are some very reputable studies on ex-alcoholics and panic patients in regards to benzo use..... abuse of the meds is very very low and there is no indication that they fall back off the wagon because of the benzo use. Most street druggies don't get high on benzos they combo it with coke or eight balls or heroin. It is very rare to just find a purely xanax junkie that isn't mixing the drug or trying to use it to bridge time between highs. Threre are sober benzo users epileptics, or people with MVP who are on maintenance klonopin to relieve their symptoms. Are they to believe that without proper therapy they will be destined to drink again. There has always been and will always be the typical AA stereotype messages about doom and gloom and how you will come to your demise. Something that has always bothered me about AA is some would warn you about drinking again so often and for so many reasons it's as if the threat of drinking will somehow keep you coming to meetings. I think maybe being gratefull for what I have will keep me sober much longer than fear or drinking. You mentioned that people don't come to clinics saying they have a prozac problem. Well ask some of these people on this board what it is like to go off some of these ssris after long term use. The withrawal symptoms get so bad they run screeming for their ssris to avert the rebound effects. They make junkies look calm. The detox periods and side effects from these so called non-buzz agents make my vodka withdrawl look like a trip to Disney World. The societal low brow view of benzos is parallel with the advent of ssris. I have to tell you in my entire 22 years of meetings I have never met a benzo addict in either program or in the prisons I went into to for 12 step work or in the hospitals or rehab centers. The closest I can even think of is qualude users in the late 70"s.
When you distinguish mood altering drugs in two categories like you did antidepressants and benzos you automatically make the judgement that the benzos aren't O >K >. I think that the same could be said for ssris. I am on both classes of drugs and if I miss my luvox dose you better get out of my way but half the time I don't even know whether or not I took the xanax. I appreciate your message and don't want to be too critical but I still feel that AA and many of the therpists and centers affiliated with the program are in the dark ages when it comes to meds. I would be drunk if I had not been availed the use of xanax. The only time in my life I was not panicking was drunk. I have seen 4 therapists, gone to Recovery Inc, gone to AIM(agoraphobics in Motion) I have gone to church every morning to pray it away, I have worked the steps over and over and over,I have bought all the tapes and books, I have been desensitised and CBT'd to death and still I get panics. I even had one therapist tell me I must need them because I am hanging on to them. That was the best he could say. I would love to give them to him for a day or two. I have spent most of my life unable to go and do things most people do spontanouesly. I have busted my butt. I would put myself in scary situations just to pratice harnessing the fears or feeling the fears or wahtever the therapy du jour was. So please make sure when you run into someone like me the differnce between life and death may not be about drinking.....it may be about having the chance to be functional. I know without the meds I would surely not be here. My life was that unbearable. I find myself being pushed out of AA and feeling quite inferior due to the "medical condition" and mental illness. This from a guy who has been a very active 15 years and I dare say has done more 12 step work than most drunks could shake a stick at.Thanks for the spirited conversation,
Gil
Posted by JCB on June 23, 2001, at 21:58:26
In reply to JCB, posted by gilbert on June 23, 2001, at 17:23:21
Wow, Gil, sounds like you've really been through the wringer so to speak. I feel here, again, I'm being misunderstood with respects to benzos. I have no problem with my clients taking them (clients with or without alcohol/drug problems) when it is indicated by a psychiatrist. I also have had quite a few clients, although not a majority, who were strictly benzo addicts and were not using any other substances when they sought treatment. As far as AA being affiliated with counseling agencies, AA is very careful to remain NON-affiliated with any other organization, from its original design. You misunderstood my point with the Prozac example. I never said people would be exempt from negative mood changes if abruptly discontinued (although its mostly the return of a chemical imbalance and not a compensatory response of traditional withdrawal). I was simply saying that people do not take SSRI's to "get high." Many people, however, DO take benzos to get high. I also agree with you that if you have a serious anxiety disorder, benzos would probably not induce this kind of euphoria that others might get who were not suffering from similar anxiety. That makes sense. On a personal note, my main goal in treating chemically dependent clients is to IMPROVE THEIR QUALITY OF LIFE. Learning good coping skills without the use of mood altering drugs is a very basic premise, but NOT an iron clad rule in my book (despite what AA may or may not say on the subject). If a client is leading a more healthy, productive, satisfying life, while taking certain psychatric medications, then I would consider this to be a treatment success. Chemical dependency is a chronic relapsing disease, so occasional relapses are definately not treatment failures. The important thing is to keep trying, keep talking, and stay focused on what you want out of life. I hope this has cleared up any inconsistancies you've perceived in my previous postings. A little plug here for therapists/counselors/psychiatrists. There are good and bad ones in every profession. If you've had bad experiences with some, don't throw the baby out with the bath water. Finding a good therapist is like finding a good pair of shoes. Some of them are going to fit, some are not. For psychotherapy to REALLY work, you need to work with someone who is right for YOU.
Gil, I appreciate your insights, experiences, and wish you well in your continued recovery.
Posted by JCB on June 23, 2001, at 22:19:00
In reply to JCB, posted by gilbert on June 23, 2001, at 17:23:21
Gil,
I just wanted to say that I AGREE with you, after hearing your story in previous messages, that taking yourself off of your meds (SSRI & Benzos I think) would not only aggrivate your anxiety & depression, but quite possibly lead you back to drinking/druging in an attempt to self-medicate. I also believe that, in your case, the alcoholism/drug addiction was SECONDARY to your agoraphobia/anxiety/depression. You drank to function, right? This concept will certainly ruffle a few feathers in certain AA circles, BUT, I have to tell you, AA as a whole is becoming more and more liberal and understanding of the complexities of addiction and other co-morbid disorders. Maybe this is unique to my geographic location (Akron, Ohio), but I suspect that it isn't. I recall a client with similar guilt feelings about taking xanax who asked his AA sponser his opinion on the subject. His sponsor told him to take it like MEDICINE and there is nothing to feel guilt about. It does, however, sound to me like the meetings that you attend continue to adhere to very strict AA abstinence principles..."no excuses to use anything!!" This is unfortunate and could possibly be harming people in the long run. I'd suggest attending other meetings and bring up the subject in discussion meetings. I think you might be surprised at how many other people share you're concerns and frustrations on this subject. Good luck!
Posted by Sulpicia on June 23, 2001, at 22:36:36
In reply to Re: Staying Sober and taking meds, posted by gilbert on June 22, 2001, at 22:32:46
> Gilbert--
well said! I'm sorry that you found AA incompatible with appropriate medical treatment: it's nowhere in the literature, and tho I'm sure your sponsor meant well, it certainly isn't his business to dictate your medical treatment, even if he had vast experience with your symptoms -- about which he was no doubt clueless.
I've seen a lot of friction in certain groups about this issue and I think it needlessly harms people, especially chronic painers who *must* balance sobriety with legitimate opiate therapy. A difficult task indeed.
Like you, I self-medicated with alcohol, tho for depression. AD meds are fairly acceptable in the world of AA but it never occured to me to look to AA to tell me about my medical problems, nor interfere in somebody else's.
Many years later I learned that a significant part of my depression was due to attention deficit disorder -- so now in addition to AD med, I take adderall.
This is a huge issue for many adults in recovery who are diagnosed with ADHD. The psychiatric consensus, born out by several years of experience, is that NOT treating symptoms greatly increases the risk of relapse. It scared me too, but ulimately it was the correct choice for me.
I'm glad it worked for you too.
I just have a really low tolerance for glib statements about addiction and I'm hoping that I misunderstood the original post ...
Liz
Posted by Sulpicia on June 23, 2001, at 23:06:20
In reply to Re: Addictive meds in general:Gdog, Gilbert JCB, posted by JCB on June 22, 2001, at 22:24:27
> JCB --
sorry about the tone and I didn't mean to challenge your credentials. It's unfair to expect perfection about such a complicated issue as addiction.
Now, granted that I'm unfamiliar with your patient population, it seems like the face of addiction is becoming more complex. People with chronic pain have long been plagued with addiction but one cannot simply withdraw them from opiates and substitute nsaids or massage: as medicine advances [some might use another verb] one of the costs is that many people survive major problems but live with chronic pain. If the pain is not relieved, and in some cases only opiates will do so, they will surely relapse. Many conditions are part of the self-medication-to-addiction/abuse dynamic, and these conditions MUST be treated if the patient is to have any hope of recovery or quality of life.
I take your point about meds being used as a crutch but please remember there is not one shred of research that demonstrates talk therapy without effective pharmacology has any efficacy whatsoever on disorders such as chronic severe depression, biopolar disorder, or ADHD -- I could probably think of more too.
And you know the cormorbity statistics as well as I do -- it is statistically impossible that the majority of your clients do not have one or more of these disorders.
Much like those recovering from eating disorders who must constantly face the substance they abuse, addiction treatment *needs* to accomodate the realities of psychiatric illness, and treat the patient accordingly. I don't envy you the complexity of your job.
Thanks for an interesting discussion.
And just for the record, benzo withdrawal is done inpatient because of the risk of seizures, which can be fatal, right??
S.
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