Comment by arealperson | Hacker News Reader

Comment by arealperson | Hacker News Reader

Parent Full thread

I made this account specifically to reply to this comment.

I take Klonopin. It is the ONLY thing that works for me. I have tried nearly everything. Every form of therapy you can think of, basically every class of drug to treat anxiety...

But Klonopin (benzos) are the only things that allow me to function enough to work and provide for myself. If I didn't have Klonopin, I would be without a job and would be homeless. I would literally be unable to function outside of the house (by function, I mean interact with people, work, go to the grocery store...), until I were forcibly removed because I haven't paid rent in months.

So if this attitude you and others share continues to embed itself into the minds of doctors, then people like me will be left without proper care. And what that means is that people like me will be unable to work, and unable to slog through the process of acquiring disability (and trust me, it's hard as hell), so we will be homeless or forced to burden our families with our care. It's not some abstract issue, one that can be handwaved away, one that you can distance yourself from by saying "the drug is bad so it should not be used with regularity; those who need it with regularity can instead be treated in other ways". There are zero other ways, in my case, and I am sure in many others' cases too.

Sorry if I seem accusatory, but people's insistence that these drugs be given only for short periods of time is in effect an insistence that I be left without any options after that short period of time expires.

We have to look at both benefits and harms. Benxodiazepines have caused absolutely immense harm, because they have a cluster of very nasty properties.

Tolerance and physical dependence develop rapidly. For most patients, the actual effect of the drug disappears within a few weeks unless the dose is increased. The most common withdrawal symptom is rebound anxiety, so you'll feel worse after stopping the drug than before you started. Benzodiazepines are respiratory depressants and tolerance of this effect develops more slowly; higher doses present a substantial risk of overdose, particularly when combined with alcohol. Paradoxical effects are remarkably common, with a significant proportion of patients developing impulsivity, aggression and mania.

I accept that long-term prescription of benzodiazepines may be a reasonable option for some treatment-resistant patients as a last resort, but America is grossly over-prescribing benzodiazepines with disastrous consequences. Here in the UK, benxodiazepines are some of the most strictly controlled prescription drugs and new prescriptions for more than 14 days are rare.

Thanks for your comment. I was appalled that the article didn't mention the implications of being prescribed benzodiazepines (both culturally, behaviorally, and physically). I wish in America these consequences were taken more seriously AND that people were more educated about it, but it almost seems like a long-running joke from the 50s -- "Oh, just take a valium! You'll be fine!" and etc. I really wonder how long until that is not socially acceptable...

I actually have the exact opposite experience. I was on klonopin a long time, and it does get addictive. My doctor thought it was the best way for me to function with anxiety. After a couple years, I got a new doctor, who was far more cautious with medication. I got off it, which was incredibly hard. In fact I don't think I could have done it if the resulting agoraphobia hadn't prevented me from leaving the apartment to try to get more.

It took a very long time in what was the psychological equivalent of someone going through physical therapy to learn how to walk again, but I was able to identify and work through the underlying causes of my anxiety. I'm doing better now without the medication.

To be clear, I am NOT saying medication is bad or unnecessary. Some people do need these medications long term. But benzos really need to be prescribed with the same responsibility as opioids, because the risk of addiction and withdrawl is very real.

As with everything there are exceptions to the general rule and it appears that you are one of those exceptions.

My point was more that prescribing a strong benzo like Xanax is done too easily. There are people, like yourself, who need such medicine long term but with doctors handing them out to almost anyone who has a little bit of anxiety opens them up to abuse which then makes it harder for people like you to get medicine they really need.

They're both benzos, but xanax ain't klonopin. It has a half-life around 12 hours while klonopin is about 30 hours. You can get interdose withdrawal with xanax, while it's less likely with klonopin.

You should try meditating a few hours a day.

Do you meditate a few hours a day?

Reply on news.ycombinator.com