Benzos and grief, diet, and distension. Benzos and pets, laughter, and levity. Benzos and indecision and lack of memory. Benzos and research, internet, and advocacy. So many topics, so much to discuss. In today’s episode, we dive into our mailbag again to hear from you. D shares some comments, answers some questions, and even reads some critical feedback. Join us for a few insights and friendly discussion. Video ID: BFP126 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 INTRODUCTION 02:25 The Gift of Caregiving 04:13 Our New Puppy 05:48 The Social Benefit of Dogs 07:50 Recent Blog Posts at EA 09:41 1,000 YouTube Subscribers 11:53 Graham, Jimmy, & Robin 17:07 Lightening the Load 21:45 A.I. and Being Genuine 24:20 MAILBAG 24:33 Indecision and Control 28:11 Five Stages of Grief 29:25 No One Path 31:11 Connection So Important 32:45 Benzo Belly 35:58 What Is a Healthy Diet? 38:00 Way Too Much About Me 39:04 Angie at Burning Man 42:00 Internet for Awareness 43:38 Research Is Important 45:19 Internet Limitations 46:09 Content Vying for Coverage 47:27 Has My Memory Improved? 50:51 Thanks for the Comments 52:12 MOMENT OF PEACE Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. INTRODUCTION — Easing Anxiety Blog Posts: https://www.easinganxiety.com/posts/categories/blog — Our New Puppy Blog Post: https://www.easinganxiety.com/post/meet-murphy-our-new-mascot MAILBAG — Indecision — https://www.easinganxiety.com/post/anxiety-and-indecision-6-tips-to-help-you-decide — 5 Stages of Grief — https://www.easinganxiety.com/post/benzos-bind-and-the-5-stages-of-grief — Who Am I Now? — https://www.easinganxiety.com/post/who-am-i-now-confidence-and-self-esteem-in-benzo-withdrawal-bind-bfp122 — Benzo Belly (Take 2) — https://www.easinganxiety.com/post/benzo-belly-our-gut-in-withdrawal-take-2-bfp060 — Lazy Morning on the Patio — https://www.easinganxiety.com/post/lazy-morning-on-the-patio-updates-community-compassion-and-coaching — Angela Peacock — https://apeacockconsulting.com — BIND Roundtable — https://www.easinganxiety.com/post/the-bind-roundtable-benzodiazepine-survey-research-team — Benzo Brain — https://www.easinganxiety.com/post/benzo-brain-cognitive-symptoms-in-withdrawal-bfp073 The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITS Music provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

Welcome back to the Easing Anxiety blog series, "What We Learned from the Benzo Survey." In our 2nd post, we continue with the key demographics from the Benzodiazepine Survey of 2018/2019. Our first post from August 17 explored age groups. Today, we wrap up the key demographics with gender and country. Scroll to the end of this post for details about the survey and research team. GENDER The benzodiazepine survey reported that 71.3% of all survey respondents were female, 25.7% were male, with 2.0% either "other gender identity" or "prefer not to say." Considering that 98% of all respondents identified themselves as male or female, we will focus there for now. To simplify the above numbers, one could say that almost three times more women took the survey, than men. Which then begs the question, are women prescribed benzodiazepines more often than men? According to a 2021 JAMA Open cohort study based on data from one of the largest commercial health insurance databases in the U.S., women are prescribed benzodiazepines at a rate almost double that of men. The records of 17,255,033 adults (51.3% female) were analyzed, and for March 2020 females were prescribed benzodiazepines at a rate of 4.91% and males at 2.66%. One side note from this research — a bit of good news — is that for both women and men the prescribing rate has decreased since 2018 (females 5.61%, males 3.03%). But, this still leaves us with the biggest question of all. Why are more women prescribed benzodiazepines as compared to men? I will admit, I spent some time researching this topic for this post. Unfortunately, the answers were not nearly as definitive as I had hooped. Doctor visit frequency, requests for medication, prescriber/patient biases, mental health support, and social media use were just a few of the proposed causes in a long list of possibilities. It quickly became clear to me that this discussion is well beyond the scope of this blog post here. So, I determined it was wise to move on. If this discussion is of interest to you, please let us know and we will tackle it in a future article. Question (n=1,207): Would you please give your gender? It may be important to know. COUNTRY Over 3/4 of the respondents to the survey were from the United States (76.6%). Canada followed with 8.8%, the United Kingdom at 3.8%, and Australia at 1.9%. The remainder of the countries contributed less than 1% each of the respondents to the survey. Those who selected the "Other [country]" option below (5.6%) were asked by the survey to select there specific country. Those results are not reported here in this post. Why are most of the respondents to the survey from the U.S.? We don't have data to accurately identify the reason, but there are some logical speculations. Access to the survey was promoted mostly via U.S. based support groups and other websites. Also, advocacy for those dealing with benzodiazepine withdrawal and BIND is more active in the U.S. than other countries, thus those populations are more likely to attribute their symptoms to this class of drugs. The survey was also an English-based survey, so language barriers may have existed for non-English respondents. The country question does not appear to provide unique insight into the BIND experience, but instead is more a bellwether highlighting limitations of the survey and the state of benzodiazepine awareness and advocacy in each country. Question (n=1,207): What country do you live in? References Milani SA, Raji MA, Chen L, Kuo Y. Trends in the Use of Benzodiazepines, Z-Hypnotics, and Serotonergic Drugs Among US Women and Men Before and During the COVID-19 Pandemic. JAMA Netw Open. 2021;4(10):e2131012. doi:10.1001/jamanetworkopen.2021.31012. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785392. Faust DT, Lin LA, Blow, FC. Benzodiazepine Use and Misuse Among Adults in the United States. Psychiatric Services. 17 Dec 2018. Accessed September 1, 2023. https://doi.org/10.1176/appi.ps.201800321. Survey papers are listed below. About the Benzodiazepine Survey About the Research The largest survey of its kind, "The Benzodiazepine Survey of 2018/2019" was created and administered by Jane Macoubrie, PhD and Christy Huff, MD. Over 1,600 individuals took the survey, resulting in 1,207 qualified respondents. The survey constituted 20 questions, including demographic inquires. Some of these questions had multiple sub-questions and/or allowed multiple answers. The survey generated three published research papers in scientific journals (as noted below) between April 25, 2022 and June 29, 2023. The research team is still together working on new benzodiazepine-related research projects. Special thanks to the Alliance for Benzodiazepine Best Practices for sponsoring and organizing this research. Published Papers PAPER 1 — April 25, 2022 Reid Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. PAPER 2 — February 6, 2023 Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. PAPER 3 — June 29, 2023 Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, et al. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Research Team Research Team / Authors (alphabetical) A. J. Reid Finlayson, MD, MMHC — Vanderbilt University Medical Center D E Foster — Benzodiazepine Action Work Group Christy Huff, MD — Benzodiazepine Information Coalition Peter R. Martin, MD, MSc — Vanderbilt University Medical Center Alexis Ritvo, MD, MPH — University of Colorado Anschutz Medical Campus Bernard Silvernail — The Alliance for Benzodiazepine Best Practices Acknowledgements The Alliance for Benzodiazepine Best Practices — Sponsoring Organization Jane Macoubrie, Ph.D. — Survey originator Jo Ann LeQuang — Medical Writer Limitations SOURCE: Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey This study has several limitations. The study reported on ‘suicidal thoughts’, which can range from fleeting notions of self-harm to passive desperation, preparatory planning, and disinhibition. Suicidal thoughts may be underreported, even in an anonymous online survey, as respondents might hesitate or be embarrassed to report self-destructive thoughts. There was no control group. Much of the survey dealt with symptoms presented in multiple-choice lists, and it is possible that patients may have been suggestible to the list presented, may not have correctly remembered past symptoms, or may incorrectly attribute certain symptoms or feelings to benzodiazepines. We did not account for a nocebo effect. The large number of write-in comments suggests that many respondents felt the survey did not allow them to fully describe the extent of their experiences and emotions. Another limitation of our survey is that it recruited respondents from social media and online sources that deal with benzodiazepine use and withdrawal. Respondents were self-selected, forming a convenience sample that may not represent the population of benzodiazepine users as a whole because visitors may have sought sites such as these specifically because they have experienced problems. Moreover, those who use the Internet for health information tend to be younger, and those who join online support groups for medical conditions tend to be in generally worse health. Our results thus may not be generalizable to the population of all people taking benzodiazepines. Data Analysis A medical statistician produced the initial results of this survey utilizing SAS Software. Subsequent data analysis was performed in greater detail by an experienced data scientist who imported the survey data into a custom SQL Server data model. Customized queries were employed to obtain correlations among the data. In particular, this analysis examined conditions for which benzodiazepines were prescribed and compared them to symptoms and adverse life effects reported by patients who were tapering or had discontinued benzodiazepine use. All analyses were delivered via a structured reporting process and validated against the original SAS reports. The survey was made available online through websites and internet benzodiazepine support groups and general health and wellness groups. The data scientist mentioned above is D E Foster, who is also the author of this blog series and the founder of Easing Anxiety. D has been a member of the Benzodiazepine Survey Research Team since 2019, providing general benzodiazepine knowledge and lived-experience in addition to formal data analysis and reporting. Prior to his withdrawal from benzodiazepines, D worked as a database developer and data scientist for over 25 years. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

Sometimes you just have to write about something happy. This is especially true, and necessary, when most of one's work focuses on hardship — as does mine. Which brings me to the topic of today's post. This is a story about two dogs. My Buddy, Bear For those of you who have followed Benzo Free and Easing Anxiety for longer than a couple of years, you may remember a fuzzy fella named "Bear." Bear was an Aussie Shepherd mix and was my best buddy for over 12 years, including the hardest days dealing with severe benzo withdrawal and BIND. Without him by my side, I don't know that I would have made it. But I did, and he helped me every step of the way. Two years ago this month, we had to say goodbye to Bear. He was 15 years old and his body was failing him. This is the third dog Shana and I have had to say goodbye to since we've been married, and it definitely does not get any easier. Little did I know at the time that this was only the beginning of another incredibly difficult period of my life. A period that rivaled my early years off Klonopin. Over the next 18 months, I cared for and lost my mother and father to dementia, and also lost two close cousins to COVID. I truly wish I had my buddy next to me during these times. But alas, he had moved on. It's been two hard years, but we're doing better. And, it's finally time to move on. So, we started looking. Meet Murphy About 11 days ago, my wife showed me a picture of a puppy at a foster home in Denver. We had been searching for a shelter dog for a couple of months, but the process was very lengthy and the dog we were interested in was usually gone by the time the paperwork was done. This time, though, things were different. On Friday morning, my wife showed me a picture and description of a dog, and by Saturday afternoon we had a puppy. Meet Murphy, a six month old Great Pyrenees / Border Collie mix. At least we think he is. We take him to the vet this afternoon and will run a DNA test just out of curiosity. He's about 50 pounds now, and will probably top out close to100 pounds full grown. We've had a Pyrenees before, so we are used to the size. We love all dogs, but have always had a particular fondness for the ones with really big hearts. My wife has been recovering from surgery and Murphy has been an amazing therapy dog for her. He's still a puppy and we still need a lot of training, but he's an amazing dog and perfect for us. Now, with Murphy added to the clan, our home feels right again. We don't have kids — at least not the human kind. We have dogs — and they make us very happy. Sharing Joy Why am I telling you this? To share the joy. To share the joy we feel as we welcome a new family member to the Foster clan. And, to include you, our friends, in that experience. This is pure joy. And sharing joy is perhaps one of the most powerful weapons against fear, pain, and hopelessness. But, there's another lesson here also. I lost five loved ones in a little over a year, in the middle of COVID, and all while dealing with long COVID and benzo symptoms myself. And yet, life moves on. Life gets better. There are sunrises and sunsets, friends and laughter, successes and achievements, s'mores and snickerdoodles, and yes, puppies, in all of our futures. This I know is true. I will sneak in a story about Murphy now and then to keep you updated. I hope each and everyone of you has a joyful thought or event in your life right now that can bring a smile to your face as Murphy is doing for us. With Love, D

It's 8:30pm Sunday Night. I have every intention of keeping this short — and this time I just might succeed. Nine Years Benzo-Free August 20th, 2014 — On this date, I took my last dose of clonazepam (Klonopin). I've been benzo-free now for nine years. Yay! Yes, I still have symptoms. This I must admit. But I can also admit — quite honestly — that I am happy. My life is good, and I have so much to be grateful for. It gets better. I can't say it any simpler than that. It gets better. The Book and Websites August 20th, 2018 — Five years ago today, I published my book "Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal." We also launched the Benzo Free Website on the same day. This was the beginning of what we do here today, and a few people started to pay attention. February 20th, 2019 — Six months later, we launched the first five episodes of the Benzo Free Podcast. Earlier this month, we published episode 125. A few more individuals took notice. October 2020 — The Benzo Free website became Easing Anxiety, adding general anxiety content to our channel. March 2023 — The new, and current version of the Easing Anxiety website was published — and it is growing each and every day. Thank You! From the very beginning, the one cornerstone of Benzo Free and Easing Anxiety has been you. The listeners of the podcast, the visitors to the website, the terrified individuals desperately seeking information, validation, and connection. You are the heart and soul of what we do here. Without you — none of this would have ever existed. Thank You! More to Come... And, there is much, much more to come. So, stay tuned. With love and appreciation, D :)

What’s new at Easing Anxiety? What’s new in the benzo community? What’s new in the world of BIND? And what should someone new to benzos do if they’re just getting started? Join D for an off-script conversation this lazy Sunday morning. In today’s episode, D records the podcast live on his back patio enjoying the sights and sounds of nature. He discusses the EA Community, a new team member, lingering symptoms, coaching, training, surviving, and a few tips for those just getting started. Video ID: BFP125 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 Introduction 02:41 Sunday on the Porch 05:05 Replying to Your Emails 08:41 EA Community Update 09:56 Welcome Doryn Chervin 11:41 How to Be Notified 12:37 Podcast Update 13:59 My Health Status 15:39 9 Years Benzo Free 16:21 Managing the Crazy 17:26 Starting Out Afraid 18:48 Why I Still Have Symptoms 21:40 More Benzo Support Today 24:19 Advice for Beginners 25:37 Amazing Benzo Support Orgs 30:55 You Got This 31:38 Love Doing the Podcast 33:23 Blog, Subscribe, and Log In 35:08 Coaching and Training 40:46 We Heal 41:30 BIND and BIND Coverage 43:54 Our Approach at EA 46:20 Compassionate Responsibility 51:03 D Unscripted 52:04 Wish You Were Here 55:58 Thank You 57:03 Closing Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. — Easing Anxiety — https://easinganxiety.com — Benzodiazepine Information Coalition (BIC) — https://benzoinfo.com — The Alliance for Benzodiazepine Best Practices — https://benzoreform.org — Benzo Action Work Group — https://benzoaction.org — Benzo Peer Training — https://benzopeertraining.org — Baylissa Frederick — https://mccare.org — Jennifer Leigh — https://benzowithdrawalhelp.com — Benzo Warrior — https://benzowarrior.com — Geraldine Burns — https://podcasts.apple.com/us/podcast/benzodiazepine-awareness-with-geraldine-burns/id1358022441 — Angela Peacock — https://apeacockconsulting.com The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITS Music provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

A paper published in the journal Neuropsychopharmacology presented evidence that ketamine treatments may help reduce depression during benzodiazepine withdrawal. The study evaluated 22 patients with severe unipolar or bipolar TRD (treatment resistant depression) undergoing discontinuation from long-term (>6 months) benzodiazepine use. The patients in the study received ketamine infusions over a period of four weeks. ARTICLE: Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report PUBLICATION: Neuropsychopharmacology AUTHORS: Nicolas Garel, Kyle T. Greenway, Lê-Anh L. Dinh-Williams, Julien Thibault-Levesque, Didier Jutras-Aswad, Gustavo Turecki, Soham Rej & Stephane Richard-Devantoy DATE: August 2, 2023 Situation Depression is a common symptom of withdrawal from BZDRs (benzodiazepines/Z-drugs). In addition, patients with depression are far more likely to be prescribed BZDRs than others. Approximately 30–50% of patients with depression are prescribed benzodiazepines and/or Z-drugs at some point during their illness. Although international depression guidelines generally recommend only short-term BZDR use, chronic use eventually arises in 10–15% of patients with depression – particularly those with treatment resistant depression (TRD). — Garel 2023 Since BZDR use is linked closely to depression for a number of reasons, and depression can have severe detrimental effects on a person's health, including suicide, finding an effective treatment for depression associated with discontinuation is a top priority. Study Findings The study evaluated 22 individuals, of which 91% "successfully discontinued all BZDRs [benzodiazepines/Z-drugs] by the end of the 4-week intervention." During follow-ups 3-24 months later, 64% remained off BZDRs. According to the article, "These preliminary results suggest that ketamine infusions for TRD may facilitate the deprescription of BZDRs, even in patients with active depressive symptoms and significant comorbidity." Only a minority (≤25%) of participants experienced clinically significant deterioration in depression, anxiety, sleep, or suicidality at any timepoint during the treatment process by PCC analysis. These results contrast with typical rates of BZDR withdrawal symptoms occurring in 40–100% of discontinuers, even with gradual tapering, most commonly in the days-weeks following the last quarter of the original dose. — Garel 2023 In closing, the authors summarized "we present the first quantitative and qualitative evidence that ketamine may facilitate discontinuation of chronic BZDRs," and they suggested that further research is warranted. Analysis New studies that provide hope for treatment of benzodiazepine withdrawal and/or BIND always grab our attention. We endlessly wish for the day when a treatment or protocol or medicine comes along a makes it all go away. Unfortunately, medicine, and life, are rarely that easy. This study does provide some hope, but it also has its limitations. The sample size was small, so a much larger study would be warranted. In addition, all of the patients had severe unipolar or bipolar TRD, so this is not a general sample and is limited to individuals with diagnosed TRD. The authors also stated other limiting factors such as "lack of a control group, varying length of follow-up, inability to examine the impact of sex on outcomes of interest, and, most importantly, the lack of standardized scales of BZDRs withdrawal." And then there is homeostasis. Homeostasis is a common topic in the benzo community. It is also a common theory of recovery — which at is core is about the "rebalancing" of the neurotransmitters glutamate (excitatory) and GABA (inhibitory), and how they are received by their respective receptors. The goal of this "rebalance" is to allow the body to return to normal functioning, without medication interfering with that process anymore. This definitely over simplifies the theory, and there are many other processes in the body affected by BZDR exposure, but for now I'm going to focus on the one that gets most of the attention. According to a 2020 study in Frontiers in Psychiatry, "Converging evidence suggests that ketamine elicits antidepressant effects via enhanced neuroplasticity precipitated by a surge of glutamate and modulation of GABA." Ketamine has also been found to directly affect cortical glutamate levels (Stone 2012). While it may be possible that a medication or treatment may assist in the "rebalance" we all seek, it is also possible that these treatments may hinder the natural healing process that is already taking place. I must admit that I am very skeptical about treating BIND with additional medication, but I also realize that for some individuals it is worth the risk. BIND can be distressing and debilitating for some people, and may also increase the risk of suicidality. In these cases, it is important for the patient to work closely with his/her doctor to determine the best course of action. I also want to state that I am not a medical professional and my analysis here is definitely that of a lay person. Still, sometimes common sense provides wisdom in these situations. When it comes to healing from benzodiazepine use, I will rely on the natural approach for now. We were told that benzos were completely safe time and time again by the medical establishment. That didn't turn out so well. Should it be a surprise, then, that we are now cautious of additional medication? I will remain open, and continue to analyze research on new treatments — and do so with a touch of caution and hope. Ketamine very well may help treat depression for individuals discontinuing benzodiazepines. But, as with many mediations, it may also hinder the healing process in the long-run, or even worse, cause its own added complications. We truly don't know. References Garel, N., Greenway, K.T., Dinh-Williams, LA.L. et al. Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report. Neuropsychopharmacol. (2023). https://doi.org/10.1038/s41386-023-01689-y. Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, et al. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Silberbauer LR, Spurny B, Handschuh P, Klöbl M, Bednarik P, Reiter B, Ritter V, Trost P, Konadu ME, Windpassinger M, Stimpfl T, Bogner W, Lanzenberger R, Spies M. Effect of Ketamine on Limbic GABA and Glutamate: A Human In Vivo Multivoxel Magnetic Resonance Spectroscopy Study. Front Psychiatry. 2020 Sep 8;11:549903. doi: 10.3389/fpsyt.2020.549903. PMID: 33101078; PMCID: PMC7507577. https://pubmed.ncbi.nlm.nih.gov/33101078/. Stone JM, Dietrich C, Edden R, Mehta MA, De Simoni S, Reed LJ, Krystal JH, Nutt D, Barker GJ. Ketamine effects on brain GABA and glutamate levels with 1H-MRS: relationship to ketamine-induced psychopathology. Mol Psychiatry. 2012 Jul;17(7):664-5. doi: 10.1038/mp.2011.171. Epub 2012 Jan 3. PMID: 22212598; PMCID: PMC3883303. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883303/. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

COMMENTARY Periodically, I post blogs based on articles written about anxiety and/ or anxiety medication (benzodiazepines / Z-drugs). My primary goal is to shine a light on new information about these topics and to better understand the problems that face us. As part of this process, I have a Google alert set up for topics related to benzodiazepines, anxiety, and a few other topics. This is how I find many of the issues that I write about on this site. Last week, that algorithm alerted me to an article about a person named "D" who was addicted to "Xanax." As you might expect, I took notice. ARTICLE: Brain chemistry: four stories of drug use and mental health in Aotearoa PUBLICATION: The Spinoff AUTHOR: Naomii Seah DATE: May 25, 2023 In this article, the writer shares the stories of four individuals: James, D, Thomas, and Sam. Three of these stories focused on cannabis use, mostly recreational. But one, the one about "D," was about benzodiazepines. The names were changed to protect privacy, so perhaps the name "D" was invented by the author and there is no coincidence — I really don't know. But, that is not the reason for my commentary... so I'll move on. Let's take a look at some quotes from the article. Brain Chemistry Brain chemistry: four stories of drug use and mental health in Aotearoa This first thing that grabbed my attention were the first two words of the article's title: "Brain Chemistry." The concept that mental health disorders are a result of a chemical imbalance in the brain is a controversial topic that, in my opinion, has lead to the overprescribing of psychiatric medication. While it is true that brain chemistry affects our moods and mental stability, diagnosing every unique behavioral trait as a disorder — one which has a chemical fix in the form of psychiatric medication — has lead to an epidemic of overprescribing, dependence, and protracted symptoms similar to the opioid crisis. In 2017, a national emergency was declared by the White House regarding the opioid crisis. Now, six years later, it appears that benzodiazepine overprescribing is following in its footsteps. “The real illness is that the model of care that we have is inadequate to meet the need...” said Dr. John Krystal in an article in Yale Medicine. “The symptom is benzodiazepine over-prescription.” Please note, that while I use the term "overprescribing," I do not support a ban on psychiatric medication, nor do I believe they do not have their place in specific treatment protocols. I am not a psychiatrist or medical professional of any sort, and nothing I say in my blogs should ever be considered medical advice. But, I have worked with individuals dependent on benzodiazepines for almost ten years now, and I might have learned a few things along the way. Prescription and Its Effects “I was prescribed Xanax by my doctor. I f***ing loved it. It made all my anxieties go away… I wanted that feeling all the time.” If benzodiazepines weren't effective in the short-term, we wouldn't have the problem that we have and I would not be writing this blog today. Unfortunately, they do work — at least for a little while. But eventually, with far too many individuals, dependence sets in and long-term complications plague that person's life. So, I'm not surprised by D's initial reaction to the drug. The part of this excerpt that really got my attention, was that D's Xanax was prescribed by a doctor. This was not street use; and the patient did not acquire the medication recreationally, even though the rest of the article steered in that direction. Which brings me to the fact that in the article, "dependence" was not mentioned once. The fact that D was prescribed Xanax by his/her doctor, should have been a red flag in my opinion — but it wasn't. Benzos and Rehab Even after D was sent to rehab, he didn’t believe he had an issue with drugs. It took a month until that realisation hit. “That’s how much denial I was in – I just thought what I was doing was normal,” he says. “To me, it wasn’t bad.” Now, I realize that it is possible that "D" had a substance use disorder (SUD) in relation to his alprazolam (Xanax) use. Still, there was nothing in the article that lead me to believe that. I think there is a much more likely scenario. "D" took Xanax as prescribed by a doctor for years, and became "reliant on drug use." This sounds like dependence and tolerance to me. I must admit, my heart goes out to D here. D was convinced by doctors and/or rehab counselors that it was addiction, and that it's necessary to "talk the talk" and "walk the walk" of someone dealing with substance use disorder (SUD). This frightens me. Not because there is anything wrong with SUD treatment protocols, but because they just aren't appropriate, or effective, for most individuals dealing with benzodiazepine dependence, withdrawal, or BIND. These protocols are often far too rapid, use addiction-specific language and practices, and do not recognize the complications created by dependence. An article by Nicole Lamberson, PA from the Benzodiazepine Information Coalition (BIC) lays out "Why Prescribed Benzo Patients Shouldn't Go to Detox or Rehab." In this article, Lamberson concludes that "...detox/rehab facilities are inappropriate and substandard for physically dependent benzodiazepine patients." Unfortunately, rehab is rarely a productive solution for individuals dealing with benzodiazepine dependence. This is something I see consistently with the people I work with through the podcast. Most of these programs focus on 30 - 90 day treatment protocols, which are far too rapid for this class of drugs. Also, they commonly focus on behavioral modifications to deal with cravings and other SUD related issues which are not relevant, and can even be detrimental, to someone dealing with benzo withdrawal and/or BIND. At the end of the article, the author shares that "D has now managed to stay away from his addiction for six years now," and D states that his mental health is now "the best it's ever been." I am so pleased that D is now doing well and that he is doing much better. Perhaps rehab actually helped D. I can't say for sure. Or, perhaps, he healed from his dependence and his symptoms have now eased on their own. I don't really know. All I can say is that I have yet to work with an individual going through benzodiazepine withdrawal who shared with me that rehab was a good choice. Usually, it's the exact opposite. I want to emphasize in the end here, that I am not against rehab facilities, or the protocols and languages used to treat people suffering with SUD. This is not my area of knowledge, so I would not assume to know how they should be run. But, I do know something about benzodiazepines, especially when taken as prescribed. For these individuals, in my experience, rehab has yet to shown itself to be a productive solution. References Chen, Jennifer. Are Benzodiazepines the New Opioids? Yale Medicine. December 11, 2019. Accessed August 2, 2023. https://www.yalemedicine.org/news/benzodiazepine-epidemic. Lamberson, Nicole. Why Prescribed Benzo Patients Shouldn't Go To Detox Or Rehab. Benzodiazepine Information Coalition. April 20, 2018. Accessed August 2, 2023. https://www.benzoinfo.com/2018/04/20/why-prescribed-benzo-patients-shouldnt-go-to-detox-or-rehab/. Seah, Naomii. Brain chemistry: four stories of drug use and mental health in Aotearoa. The Spinoff. July 25, 2023. Accessed July 26, 2023. https://thespinoff.co.nz/partner/25-07-2023/brain-chemistry-four-stories-of-drug-use-and-mental-health-in-aotearoa. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

The Z-drugs: Ambien. Lunesta. Sonata. What are these? Are they benzos? Hypnotics? When did they hit the market? Can they cause dependence? Withdrawal? BIND? These questions and more will be discussed in our feature today. In today’s episode, we focus on nonbenzodiazepines, or Z-drugs. How are they like benzodiazepines, and how are they different? We also answer some questions about dosage, duration, and rebounding and we hear a story of struggle from Tulsa, Oklahoma. Video ID: BFP111 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 INTRODUCTION 02:09 My Podcast Voice 05:33 Progress on Website 06:33 Peer Support Training Update 09:10 Struggles, Symptoms, and the Podcast 14:47 A reason why, or just coincidence? 18:16 MAILBAG 18:58 Does dosage or duration matter? 21:24 Rebound from medical procedures? 24:31 BENZO STORY 32:28 FEATURE: Z-drugs 34:38 What are Z-drugs? 36:00 When did Z-drugs hit the market? 36:36 Do Z-drugs act like BZDs on the body? 37:54 Z-drugs often partnered with BZDs 39:46 What are Z-drugs prescribed for? 40:07 The Quest for the Magic Pill 42:04 Are Z-drugs less likely to cause symptoms? 45:06 What are the Z-drug side effects? 47:02 Are Z-drug symptoms different? 48:20 How to taper from Z-drugs? 49:05 BZD and Z-drug Terminology 51:48 MOMENT OF PEACE Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. FEATURE: Z-drugs Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. https://easinganxiety.com/ashton Brandt J, Leong C. Benzodiazepines and Z-Drugs: An Updated Review of Major Adverse Outcomes Reported on in Epidemiologic Research. Drugs R D. 2017 Dec;17(4):493-507. doi: 10.1007/s40268-017-0207-7. PMID: 28865038; PMCID: PMC5694420. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694420/. Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, CO: Denim Mountain Press, 2018. https://easinganxiety.com/book Kay, Abigail L. et al. Drug Abuse, Dependency, and Withdrawal. Therapy in Sleep Medicine. 2012. https://doi.org/10.1016/C2009-0-40426-4. Schifano F, Chiappini S, Corkery JM, Guirguis A. An Insight into Z-Drug Abuse and Dependence: An Examination of Reports to the European Medicines Agency Database of Suspected Adverse Drug Reactions. Int J Neuropsychopharmacol. 2019 Apr 1;22(4):270-277. doi: 10.1093/ijnp/pyz007. PMID: 30722037; PMCID: PMC6441128. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441128/. U.S. Food & Drug Administration. Taking Z-drugs for Insomnia? Know the Risks. Last Updated April 30, 2019. Accessed November 30, 2022. https://www.fda.gov/consumers/consumer-updates/taking-z-drugs-insomnia-know-risks. Waller, Derek G., Anthony P. Sampson. Anxiety, obsessive-compulsive disorder and insomnia. Medical Pharmacology and Therapeutics. Fifth Edition. 2018. https://www.sciencedirect.com/science/article/pii/B9780702071676000208. Wikipedia. Nonbenzodiazepine. Accessed November 30, 2022. https://en.wikipedia.org/wiki/Nonbenzodiazepine. Z-Drug. ScienceDirect. 2022. Accessed November 30, 2022. https://www.sciencedirect.com/topics/neuroscience/z-drug. The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITS Music provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2022 Denim Mountain Press – All Rights Reserved

In the benzo community, some observations have almost become clichés. These include "every one is different," "it's dependence not addiction," or even "we do heal, in time." Then there are the ones about certain doctors and pharmaceutical companies — but I think it's better not to repeat those here. That being said, there are also a few other observations I have seen which are a bit more complex, and perhaps not as frequently discussed around the water cooler, or whatever the virtual version of that is today. I've noticed one observation stand out over the past couple of years; one which appears to be relatively consistent with many individuals I've worked with. While many of us — yours truly included — talk about "acceptance" in our blogs and videos and support groups, rarely do we discuss the source of that concept. "Acceptance" is actually the fifth and final stage of a process that many individuals experience when something traumatic has happened in their life. But, what about the other four stages? These too are quite common in benzo withdrawal and BIND, and I think it is wise to take a few minutes here to understand them better. The Five Stages of Grief were originally introduced in the book, "On Death & Dying" by Elisabeth Kübler-Ross, MD, published over 50 years ago. She lists the five stages as Denial, Anger, Bargaining, Depression, and Acceptance. This book was not only a massive best-seller, but it became a standard text book in classrooms across the nation. It even inspired entire courses which adopted the book's name. How do I know this? Well, I actually took a class titled "On Death and Dying," based on Kübler-Ross' work, back in high school. Yes, in case you were wondering, we had books back then. Benzos and the 5 Stages What does a book on death and dying have to do with benzodiazepines? Great question. I'm glad I asked it. A terminal illness, or the death of a loved one, are two of the most significant events in a person's life, and often the most traumatic. But, death is not the only cause of this type of trauma. Other life events like disaster, loss of career, and non-terminal illnesses can also trigger a similar reaction. And that is where BIND comes in. Today, I want to take a look at the fives stages as Dr. Kübler-Ross originally defined them, and discuss how they present themselves for those of us who have experienced benzodiazepine dependence, withdrawal, and BIND. And as we step through them, it is important to keep in mind that this is not necessarily a linear process. Some individuals start with anger, some with depression, some even skip stages altogether or double-back more than once. While the road map presented here may be the more common progression, it is definitely not the only one. Let's move on to the first one... 1) Denial Among the over 200 patients interviewed for her book, Dr. Kübler-Ross noted that "most reacted to the awareness of a terminal illness at first with the statement, 'No, not me, it cannot be true.'" As human beings, we have a natural predisposition of avoiding difficult news. It's a protection mechanism. Denial, at least partial denial, is used by almost all patients, not only during the first stages of illness or following confrontation, but also later on from time to time. — Elisabeth Kübler-Ross, "On Death and Dying" Does any of this sound familiar? Most individuals I have worked with in the benzo community resisted the thought that they might be dependent on a long-term medication. It's not a comfortable position to be in. When I learned that the clonazepam (Klonopin) my doctors prescribed me for over12 years may have seriously altered my body and mind, I freaked out. I had an all out panic attack, didn't sleep for days, and thought that my world had collapsed around me. I wanted nothing more than to get this drug out of me immediately. Thankfully, I did not quit cold turkey, but instead educated myself and found the support I needed. But, the panic attack was not my only reaction. Most of all, I wanted a way out. I wanted for this not have happened. I wanted to wake from this nightmare. But, that wasn't possible. It wasn't a nightmare. I wasn't sleeping. This was real. We sometimes avoid knowing things, as a way of coping. Denying it happened is a protection mechanism. It's a way for our minds to say, "wait a minute, this is more than I can handle at this time." Rather than face what could be life-altering news all at once, we can block our understanding temporarily, and ease into it. But eventually, it does sink in, and then we quite often... get mad. 2) Anger I think we all know this one. When it comes to benzodiazepine dependence, anger is very common. We're mad at God. We're mad at ourselves. And most often, we're mad at the doctors who prescribed the drugs and the pharmaceutical companies who made them. The experiences that so many have faced in doctor's offices border on horrendous at times. Individuals ignored, distrusted, and even forced to quit their drugs cold turkey. All while the pharmaceutical companies — who made billions from these same drugs — ignore the patients' stories and pretend their medications are perfectly safe. The search for a "benzo-wise" doctor is a common one. In fact, the most common request I receive through the Benzo Free Podcast is, "how do I find a doctor who can help me?" I provide these individuals some references, such as BIC's Cooperative Doctors List — but in all honesty, we don't have a very good solution. Still, I wouldn't have to answer this question so often if more doctors were educated on proper prescribing and deprescribing protocols for benzodiazepines. Unfortunately, that is not the case. When the first stage of denial cannot be maintained any longer, it is replaced by feelings of anger, rage, envy, and resentment. The next logical question becomes: "Why me?" — Elisabeth Kübler-Ross, "On Death and Dying" Anger is a normal and expected emotion during this time. It is also a difficult stage to move past. So many of us in the benzo community are still trapped in this stage. We get mired in the frustration and the blame and the rage and find it difficult to leave those emotions behind. We might even tell ourselves that "we are justified in our anger," so why would we want to let it go. There is one key reason why letting go of the anger is important. Because, it is not a friend to healing. As long as we hang on to the blame and the hate, healing can't move in. There's just not enough room. At some point, most of us realize that we need to move on. But, even if we move past the anger, we still may not be ready yet to accept what has happened. And, we might be looking for another way out. 3) Bargaining If denial and anger don't work, it's time to make a deal. It's time to bargain. It's time to ask God, or someone else with enough power, to take this away from us. It's time to beg for this not to be. At least, that's what our minds tell us. ...maybe we can succeed in entering into some sort of an agreement which may postpone the inevitable happening... — Elisabeth Kübler-Ross, "On Death and Dying" In BIND, bargaining takes a variety of forms. Here are just a few examples: "Please God, Doctor, or whatever powerful entity you wish to bargain with, I'll do anything if..." "...I'm not dependent on this drug." "...my taper goes smoothly." "...these symptoms would just stop." "...I could have one good night's sleep." "...I could just think straight for one minute." Or, perhaps the most common... "...this was all over tomorrow." For so many of us, this is a desperate time. We'll do anything to stop the anxiety, the akathisia, the tremors, the burning, the muscle pain, the tinnitus, or whatever your most severe symptoms are — we'll do anything to stop them. And thus, we are willing to make a deal. Sometimes this is just a request, "please do this for me." Sometimes it includes a bargaining chip, "I'll donate to charity," or "I'll spend more time with my family," or "I'll eat right, exercise, and take better care of myself." It doesn't matter the bargain, it's about us being at the end of our rope and willing to do anything to make this go away. But, it's usually a futile ask. And then, we hit the next stage... 4) Depression Depression is perhaps the one stage that makes the most sense, considering what we are going through. For those of us dealing with severe withdrawal or BIND, our lives have changed for the worse. There's no skirting around that fact. Life is going to be harder for a while. Perhaps a long while. And this can be a very depressing fact. When the [patient] can no longer deny his illness, when he is forced to undergo more surgery or hospitalization, when he begins to have more symptoms or becomes weaker and thinner, he cannot smile it off anymore. — Elisabeth Kübler-Ross, "On Death and Dying" In the three research papers we published from the Benzodiazepine Survey of 2018-2019, we reported not only on the common symptoms of withdrawal and BIND, but also on the adverse life effects. These include the negative effects on relationships, loss of job, loss of house, loss of a business, violent thoughts, and perhaps one of the most common, financial struggles. In Kübler-Ross' book, she spoke about the financial strain that terminal illness can place on a family, and this is equally as relevant to BIND. Financial burdens "have forced many patients to sell the only possessions they had; they were unable to keep a house which they built for their old age, unable to send a child through college, and unable perhaps to make many dreams come true." When you combine the symptoms common in BIND, sometimes severe, the duration that these symptoms may last, sometimes years, and the strain this can place on the individuals and the people around them, sometimes unseen and often unsupported, it is no surprise that depression is a common result. And this rarely effects only the individual, but instead the entire family unit and/or support team. During this time, suicidality is also a serious concern. Suicidal ideation and threats of suicide should never be taken lightly, especially when benzodiazepine dependence is involved. If you, or someone you know, is experiencing thoughts of suicide, please get professional help immediately. We have a list of suicide prevention resources on our website for your reference. 5) Acceptance Finally, we get to the somewhat mystical stage, of acceptance. Acceptance is spoken of quite regularly in the benzo community; and in my opinion, for good reason. If a patient has had enough time and has been given some help in working through the previously described stages, he will reach a stage during which he is neither depressed nor angry about his "fate." Dr. Kübler-Ross defines acceptance as a stage of accepting the inevitable fate, which, considering the target audience of her book, is often death. Benzos are different. Benzodiazepine dependence and BIND is not a death sentence — although for some of us it seems like that. It's a hardship. A severe hardship, for some, but a hardship none-the-less. And all hardships can be overcome. And "acceptance" is where this takes place. I have spoken about acceptance on my site and podcast many, many times. In my book, "Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal," I wrote a whole chapter on "Managing the Fear of Benzo Withdrawal." I also dedicated episodes 3, 4, & 5 of the Benzo Free Podcast to the same topic. In both of these, I share the five areas where we can improve to help manage our fear. These include responsibility, positivity, mental and physical activity, kindness, and finally, acceptance. Acceptance was a cornerstone of healing from benzos over four years ago when I published my book, and it still is today. Finding acceptance is about moving past the anger, the frustration, even the depression, and accepting that this happened to you. It's no longer about avoiding it, it's no longer about bargaining your way out of it, it's not even about blaming others for it — it's about accepting it. This has happened to you. There is nothing you can do to change that. Now you must decide how you are going to handle it. Finding acceptance for me was about healing: That's all that benzo withdrawal really is; it's your body healing. And healing is a good thing. In fact, it's an amazing thing. Our bodies heal even from some of the most horrendous injuries. It's an incredible piece of biochemical engineering. And the best thing I could do was let it do its job. — D E Foster, Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Summary Why did I write this article? Well, the primary reason was so that we can recognize the stages some of us may go through during benzo withdrawal and BIND. When we can recognize these stages, we can have a better understanding of them, and ultimately, learn how do deal with their effects in a healthy manner. BIND is a mental game. Sure, many of us experience a series of physical symptoms ranging from mild nuisances to debilitating effects, but the area where we can make the most positive change, is in our mind. It's all about "mindset." Learning about what happened to us, finding acceptance for what happened to us, and ultimately, rising above and making the most out of what happened to us; that's where we can make the most gains. Well, that should wrap things up. I hope this helped. And thank you again, for allowing me to be part of your healing journey. References Kübler-Ross, Elisabeth. "On Death & Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, & Their Own Families." New York: Scribner 1969. Foster, D. E. "Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal." Erie, Colorado: Denim Mountain Press 2018. https://easinganxiety.com/book. Foster, D E. "Managing the Fear of Benzo Withdrawal (Part 3 of 3)." The Benzo Free Podcast. February 20, 2019. https://www.easinganxiety.com/post/managing-the-fear-of-benzo-withdrawal-part-3-bfp005. Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, et al. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Disclaimer This post is for informational purposes only, and should never be considered medical or professional advice of any kind. Please visit our disclaimer page for more info. This article was written by a living, breathing, human person. No A.I. was utilized in its creation.

3:02am. Thursday morning. I'm awake. Actually, it's now 4:23am as I write this, but I woke a little over an hour ago to a thunderstorm. Chances of returning to sleep... maybe 10%. This has happened a lot lately. Not the thunderstorms, but waking early. I have a feeling some of you can relate. When this happens to me, I usually stay in bed, open up my iPad, and watch some YouTube videos or sitcom reruns on PlutoTV. I try not to start a movie or TV series since it takes too much of my attention, preventing me from returning to my slumber. Still, I'm usually up for a few hours regardless. I may get drowsy and fade in and out while watching, but not enough to fully fall asleep. And then, it's time to get up. Yes, yes, I know the horrors of screens in bed. In fact, I've written blog posts about them. "Good sleep hygiene," is what we usually call it. And yes, I do believe in it. It's just that sometimes I get out of practice, develop bad habits, and have to be reminded of what got me here. This morning, I decided to take a different route and be productive. Some may say that getting up and working is the wrong direction, in that it wakes us up even more. And, I get that. For me, though, I know the odds of returning to sleep are very low — so I might as well make the most of it. The truth is, I've been struggling with insomnia lately. In fact, I've been in a wave lately. Yes, yours truly at almost nine years off benzos, is still having waves. Please remember, this is me, not you, and my journey will not be yours. (see My Personal Symptom Disclaimer at the end). Insomnia, the Mental Game I haven't talked about this topic for far too long. Insomnia is a BIND symptom that has significantly improved for me over the years, even though I still have short bouts now and again. I have a tendency to let my own struggles and symptoms lead me to the topics for these posts. Maybe that's a bit selfish of me, but I don't know, sometimes I think it's more real and even natural when I can write about a topic as it's happening. The rain just picked up outside, and the thunder is a low rumble in the distance. Middle-of-the-night thunderstorms are not the norm here on the front range of Colorado. Back home in Kansas City, it was a different story. And I think I miss them. Not necessarily waking up in the middle of the night, but there is some comfort to a good rain storm. And, normally, it's great for sleep. For most of us, insomnia is a mental game. At least, that is the case for me. Once I wake up, to use the restroom, from a nightmare, or because of a loud noise, I'm usually up. Getting back to sleep is rare. Ah, the insidious demon of an anxious mind. If I wake in the middle of the night, can manage to stumble to the bathroom and pee, and return to bed without waking myself too much, I might be able to get back to sleep. But, that is a big if. If during that time my mind finds just one tiny, little thought, or worry, or fear to latch on to — it's over. Ruminations, looping thoughts, a cascade of "what ifs" and "why did she say thats" and "I'm so far behinds" and of course the classic, "why am I still struggling with this," flood our psyches and demand that we pay attention. Our minds are our worst enemies sometimes, and we long to find a way out. That's why I started opening my tablet to watch shows in the first place. It would take my mind off my own, well, mind. Sometimes, it would pull me away just enough to let me get back to sleep. But, most of the time, it's not very effective. Screens rarely are. I don't have the answer for insomnia here. I know a lot of tools and techniques, many of which can be effective, but this is not one of those posts. It's more the "stream of consciousness" type. It's 4:54am now, and even though I can write this, I don't think I'm up to research right now. Instead, this is just one of those posts where I say "hi," I'm here, I still struggle too, and I get it." That's it. More often than not, that's all I do. And, according to many of you, it seems to help. DVDs, Movies, and Pleasure Let's change the subject a bit. Why? Well, since this is one of those "stream of consciousness" posts, and this is where my consciousness is taking me, I guess I'll go along for the ride. Don't worry, at the end of this section I'll desperately attempt to tie it back to the original topic, and probably fail, as I often do. It's still dark outside, my brain is working at about 35% capacity, and this is all I have in me. What can you do? Anyway, what I was going to say is that as I'm writing this, I'm also ripping DVD's onto my PLEX server. Like I said, I'm changing the subject here. So, sue me. I like movies. Some of you may recall that I used to be a screenwriter and taught screenwriting at college in a former life. While I'm still partial to the older movies, there are some recent ones that have impressed me too. I have about a thousand movies and TV shows on a server in my basement which is accessible throughout my house via a software app called PLEX. Following so far? Good. Now, before I get too far, for those who think I'm pirating videos, don't worry. As a former screenwriter, I've lost revenue along the way from video piracy. So, I can't say I'm a fan of that. No, instead I keep all of the DVDs that I rip onto my server in boxes in the basement. By having them on a server too, I don't have to manually pull out the DVD each time to watch it. Instead, I just pull up a movie as if it was on Netflix or Hulu. Yes, I can't be bothered to stand up, pull a DVD from a box, and put it in the player. Another sacrifice to the convenience Gods. So, why am I telling you this? Let me see. I know I can relate it to something psychological, philosophical, or something else that ends with "-ological." Oh, I think I have one. Here it goes. I enjoy finding movies, ripping movies, updating my database about the movies, seeing the new movies on the app on my TV, and reselling the movies I didn't rip or donating them to the VA or other charities. I enjoy that, because I like movies. I realize it may not be the most healthy obsession, but it's also not the most destructive either. It just makes me happy. And, that's my point. I can't sleep right now. So, I could lay there in the dark obsessing about my latest ache or pain or twitch. I could watch some YouTube video or movie on my PLEX app. I could even turn on the light and read a book — which I do on occasion, but not as often as I'd like. Or, I could get up, throw on a robe, and go to my office and do this — rip movies and write to you. Both of these are productive and pleasurable. Not a bad use of my time, I'd say. Hang on... I need to change out a movie. Give me a sec... Okay, I'm back. Now, I will admit that getting up isn't always the best idea. For those who may fall back to sleep, laying there might be the better choice. Plus, even if you are not sleeping, you are still getting rest. Perhaps adding a soothing soundscape might help, or a meditation recording, or the sound of a podcaster's voice (yes, I know some of you fall asleep to my voice). If that is the case, give it a go. But, if you know that for you this is not going to work, then perhaps change things up a bit. Who knows? My point is this. I'm making good of a bad situation. I will eventually sleep. It will catch up to me. Perhaps this afternoon I will find time for a short nap. Perhaps I will wait until tonight and will sleep through the night. Perhaps I'll even have short nights for a while. But, eventually, I'll get back to my normal pattern. Sleep will return. It always does. In the meantime, though, I really have two choices. I can obsess about it, get angry about it, blame anybody from here to there about it, and ruin a brand new day from the ground up. Or, I can make the most of it. I just wrote a 30-something paragraph blog post for my site, ripped six DVDs, and feel pretty damn good. I made the best of a bad situation, and I'd say that's a good start to the day. My Personal Symptom Disclaimer Now, the disclaimer. Yes, I still have symptoms. Sometimes strong symptoms. In this recent wave I'm dealing with cognitive issues, dysphagia, throat tightening, tinnitus, muscle aches and pains, gastric distress, insomnia, and others. Is this all caused solely by benzos and BIND? No. It's not. Does this mean you will have symptoms at nine years out? No. That is highly unlikely. I am definitely in a small minority. Every one of us has more than one factor at play here. None of us can truly say, "it's absolutely the benzos, and only the benzos." There are too many factors. I updosed during my taper, have moderate to severe ADHD, took a fluoroquinolone antibiotic which can cause neuropathy all by itself, have had three bouts of COVID including long COVID, recently lost my father, mother, and dog all in the same year, been under constant stress, let many of my tools which helped me recover lapse, and on and on and on. I have plenty of comorbidities, as they say in the medical profession. So, I can't say it is definitely one thing or another. In fact, the reason that I am doing well now is in part, due to my BIND. It taught me how to enjoy the little things, how to see the good in each day, and how to make the most of life and live it to the fullest — even for those of us who have certain limitations. In addition, I have come a long, long way. I am significantly improved from the early days of my withdrawal. And, that includes my insomnia. I typically get 6-7 hours of sleep a night now, and that is wonderful. I never was a long sleeper, so it's rare for me to get an eight-hour night. Only in the past week or so has the insomnia returned. And, I'm not really worried about it. I know that it will pass and I will get back to restful nights again soon. I am pleased more than you know, that sharing my story has helped thousands of people who are struggling with benzo withdrawal and BIND. But, please, don't use my experiences as a litmus test of what to expect for yourself. We all are different. Very different in this journey. I happen to be in the minority of individuals who still struggle this far out. Will this be you? Most likely, not. In fact, the odds are definitely against it. Also, times have changed. We know more and have significantly better support systems now than when I started my taper over 10 years ago. The truth is, with education about what to expect, a team to support you, and a positive mindset, anyone can taper from benzodiazepines successfully. I truly believe that. I often wonder why I still struggle with symptoms from BIND to this day. And, it comforts me to think that maybe there is a reason for it. Maybe, just maybe, it's because I'm supposed to. Because, by being reminded of what it is truly like dealing with BIND's symptoms, I can relate better to you. And you know what, I'm okay with that. It's amazing what we can tolerate in life when we believe it is for a purpose. I have a purpose, and that's a wonderful thing. I Am Happy Please take care of yourself, and don't use me as an example of what it will be like for you. I am happy. Honest. I am happy. Who cares if I have a few sleepless nights. They will pass. They always do. So what if I still have some symptoms now and then. They're not nearly as severe as they were in the early stages of my withdrawal. This experience has made me stronger. My symptoms don't own me. They're just there, I deal with them, and I get back to my life. I'm actually excited right now. I've had a ball writing this blog post. Insomnia can be so incredibly lonely and isolating. But, as with all my posts and podcast recordings, when I speak to you I don't feel so alone. It may seem corny to say that, but that doesn't make it any less true. I love talking with you, and that hasn't changed. And, I am grateful for that. I am grateful for you. It's 5:33am. The thunder is still rolling outside in the distance. I'd go for a walk, but I might get drenched. I could go back to bed, but I know I would just lay there in the dark — sleepless. And that isn't very productive. I'll try and find time for a short nap this afternoon. I guess I'll just keep working. I'm in a zone now, and I might as well make the most of it. We do what we have to do. But, what's more important, is that it's a brand new day. And, I get to decide if it's a good day, or a bad day. I chose the former. Now, try and get back to sleep, With love, D :)

Our research paper on BIND is still getting attention from academia and the media almost three weeks after its publication. In the last week alone, the study was picked up by the U.S. Sun, Forbes, and Vanderbilt University, among others. The paper, "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey," published in the open-access journal PLOS ONE, was the third paper on the Benzodiazepine Survey of 2018/2019, and it formally introduced the term benzodiazepine-induced neurological dysfunction (BIND) into medical literature. Research team members include Alexis Ritvo, MD, MPH (University of Colorado, Anschutz Medical Campus), Christy Huff, MD (Benzodiazepine Information Coalition), A. J. Reid Finlayson, MD, MMHC & Peter R. Martin, MD, MSc (Vanderbilt University Medical Center), Bernard Silvernail (The Alliance for Benzodiazepine Best Practices) and D E Foster (Easing Anxiety, author of this article). Highlights from Recent Articles Of particular note this past week, is the article from Vanderbilt University Medical Center titled "Study highlights consequences of chronic benzodiazepine use." This article highlighted two distinguished members of the research team who call Vanderbilt University Medical Center home: Dr. Peter Martin, Professor of Psychiatry and Behavioral Sciences and senior author of the study, and Dr. Reid Finlayson, Professor of Clinical Psychiatry and Behavioral Sciences. Benzodiazepines are toxic to brain functioning, especially to the anxiety mechanisms in the brain — Dr. Peter Martin, Vanderbilt University Medical Center In this article by VUMC Reporter Danny Bonvissuto, Drs. Martin and Finlayson shared some insight into the effects of benzodiazepines on the brain and body. This study identified that more than 50% of the respondents to the survey had suicidal thoughts or had attempted suicide. The author also cautioned that, "because benzodiazepines change the biochemistry of the brain, they require a slow tapering process to avoid elevated blood pressure, anxiety and seizures." [Benzodiazepine] is an anesthetic agent generally assumed to be helpful for anxiety symptoms. There are a few studies that, unfortunately, show worse outcomes for anxiety symptoms, particularly if the benzodiazepine use exceeds several weeks. — Dr. Reid Finlayson, Vanderbilt University Medical Center Another team member and co-originator of the study, Christy Huff, MD, was interviewed for the Sun article in which she shared that, "[benzodiazepines] can take months to years to fully resolve." The Sun article also highlighted the correlation between benzodiazepine use and physical aggression, sexual disinhibition, impulsive decision-making, and acts of physical violence. According to a 2018 report from Cambridge University Press, "benzodiazepines act by reducing 5HT (serotonin) neurotransmission, which may, in turn, lead to aggressive behavior." The continuing coverage of this research is raising awareness and improving opportunities for education. We welcome the feedback and inquiries it has generated. References Bonvissuto, Danny. Study highlights consequences of chronic benzodiazepine use. VUMC Reporter, Vanderbilt University Medical Center. July 19, 2023. https://news.vumc.org/2023/07/19/study-highlights-consequences-of-chronic-benzodiazepine-use/. Ghlionn, John Mac. BENZO ABUSE Xanax and other anxiety medications linked to horror side effects including ‘aggression and acts of violence’. The U.S. Sun. July 15, 2023. https://www.the-sun.com/health/8567743/xanax-anxiety-medications-linked-aggression-violence-seizures/. Paton, C. (2002). Benzodiazepines and disinhibition: A review. Psychiatric Bulletin,26(12), 460-462. doi:10.1192/pb.26.12.460. https://www.cambridge.org/core/journals/psychiatric-bulletin/article/benzodiazepines-and-disinhibition-a-review. Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, Martin P. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Varanasi, Anuradha. Benzodiazepine Use Might Result In Long-Term Neurological Dysfunction. Forbes. July 11, 2023. https://www.forbes.com/sites/anuradhavaranasi/2023/07/11/benzodiazepine-use-might-result-in-long-term-neurological-dysfunction.

In a very simplified way, this video explains how benzodiazepines affect the nervous system and body. This video was created by the Benzodiazepine Action Work Group (BAWG) at the Colorado Consortium for Prescription Drug Abuse as part of the Recovering from Benzodiazepines Peer Support Training Course. To learn more about this course, please visit https://benzopeertraining.org. For more information about the Benzodiazepine Action Work Group, visit: https://benzoaction.org Video ID: BAWGTraining001 Watch the Video Chapters 00:00 Introduction 00:27 The Key Players 02:13 Binding of Benzos 02:43 Balance and the Brain 03:03 Tolerance, Dependence, & Withdrawal 03:40 The Car Analogy 04:56 Withdrawal Symptoms 05:33 Why Do Symptoms Persist? 06:22 Take Home Messages 06:56 Support is Essential 07:15 Closing Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Benzo Free of the resource or any recommendations or advice provided therein. FOR MORE INFORMATION ON THE TRAINING COURSE — Recovering from Benzodiazepines for Peer Specialists — https://benzopeertraining.org FOR BENZO SUPPORT, PLEASE VISIT THESE PARTNER ORGANIZATIONS — Easing Anxiety (EA) — https://easinganxiety.com — Benzodiazepine Information Coalition (BIC) — https://benzoinfo.com — The Alliance for Benzodiazepine Best Practices — https://benzoreform.org — Benzo Warrior — https://benzowarrior.com Video Credits This video was produced by, and is property of, the Benzodiazepine Action Work Group at the Colorado Consortium for Prescription Drug Abuse Prevention. VIDEO PRODUCTION SERVICES — JBCM Media Production — https://gojbcm.com PARTNER ORGANIZATIONS — Easing Anxiety (EA) — https://easinganxiety.com — Benzodiazepine Information Coalition (BIC) — https://benzoinfo.com — The Alliance for Benzodiazepine Best Practices — https://benzoreform.org — Benzo Warrior — https://benzowarrior.com — The Schreiber Research Group (TSRG) — https://tsrg.org PRODUCTION TEAM — Produced by: The Benzodiazepine Action Work Group — Project Lead / Writing: Nicole Lamberson, PA — Animation / Video Production: Jay Billups (JBCM Media Production) — Narration: D E Foster — Consortium / Program Management: Shayna Micucci This video is for general educational purposes only. It does not constitute professional medical advice, encouragement, or recommendation that any individual reduce or withdraw from benzodiazepines and/or other psychiatric medication(s). Copyright: ©2023 Colorado Consortium for Prescription Drug Abuse Prevention (https://corxconsortium.org) Disclaimer All content provided on this YouTube channel is for general informational purposes only and should never be considered medical or health advice. The author of the content provided on this channel is not engaged in rendering medical, health, psychological, or any other kind of personal or professional services. Health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. https://easinganxiety.com