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Old 08-30-2012, 10:23 AM
 
3,244 posts, read 6,541,867 times
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Quote:
Originally Posted by Neemy View Post
He needs to taper off VERY SLOWLY under the supervision of a doctor. Benzos, particularly Xanax, are quickly habit-forming because of their short half-life, and how quickly they "kick in" compared to other benzos, such as Ativan. But it is extremely dangerous to come off cold turkey, especially from a high dose. He'll be at serious risk for seizures, and even death. I was told it was comparable to coming off heroine addiction, possibly worse. Depending on how long he's been taking it, it can take weeks to months (or more) to taper off, but it's the only safe way to do it, and the only way to minimize withdrawal. Of course, if he's not willing to admit he's an addict, then some intervention will have to take place to get him to see it.

I'll get personal, here, though it's not something I'm comfortable with discussing publicly; I'm speaking from my own experience. I was diagnosed with panic disorder and generalized anxiety disorder back when I was 20, because I was having debilitating, daily panic attacks. When I wasn't having panic attacks, I was having near-constant "anticipatory anxiety", which made me agoraphobic for an entire summer.

I was put on Xanax, .25 mg, and it worked at first, but when it would lose its effectiveness, my doctor upped my dosage, and kept upping it. At the end, I was taking 6 - 8 mg a day for years, 2 mg tablets, all prescribed. Please note that I was not taking this stuff to get high. I never got high on it. I was taking it to feel normal and at the end, the amount it took to feel "normal" was insane. I tried to drop down to "only" 4 mg on my own, and was nearly incapacitated for over two weeks, couldn't walk, slurred my words, couldn't get out of bed, had heart palpitations, vertigo - it was horrible. I stabilized at that dosage after two weeks, but it was a very risky thing to do, alone, and I was afraid to drop down any farther. I was so ashamed, afraid to tell anyone, even my family. I made an appointment with a doctor who specialized in benzo addiction. She had me taper down .25 mg every 2 weeks to a month (depending on how I felt). She made it clear I was not to go down any more than that at a time. It took over a year to come off.

My life completely changed once off. I haven't even had to deal with panic attacks (knock on wood), which was my fear (I was prescribed them for legitimate concerns, after all), and I learned safe ways of managing my anxiety without drugs.

The only reason I'm sharing my story at the risk of finger-pointing is because I cannot stress enough how dangerous it is to try to come off Xanax, yourself, especially cold turkey. It HAS to be done under a doctor's strict supervision. Google Xanax addiction, and that should be enough to scare the crap out of anyone.

I wish you and your brother all the best. It's not going to be an easy ride for any of you.

Hmmm..... not to derail this thread, but Ativan kicks in fairly quickly. Serax and Librium are longer-acting. Alcohol, barbituates and benzodiazipines are the hardest to come off of, in terms of risks from cold turkey. The good thing (if there is such a thing) about alcohol is that you can do a 10/3 taper and be off it in short order (a few days). Benzo's are way worse, depending on the level of abuse. Coming off the opiates (such as heroine) is considered far less dangerous than the three drugs I listed above. I have seen withdrawals many dozens of times.... it is rather textbook.

I hope he does ok.... If his addiction is severe, inpatient is needed. I really hope he wasn't mixing benzo's with alcohol.... we used to call it 'instant blackout'.

Anyway, he will need a lot of support from those around him, and I wish him the best of luck.

 
Old 08-30-2012, 11:59 AM
 
Location: Mississippi
1,248 posts, read 1,879,018 times
Reputation: 2500
You could always take him in through the ER. If he is a danger to himself or others they will at least hold him for 72 hours. I would be more worried at the moment about his psychiatric state because he could try to harm himself.

I would just like to add that it is obvious that he is an addict, but in order for him to get anything out of substance abuse treatment he must have his mental health issues under control. No matter which came first, right now you need to make sure that he is not having a psychotic break and could unintentionally harm himself or someone else. Take him to the hospital, and then you can go from there.
 
Old 08-30-2012, 03:00 PM
 
Location: Surfside Beach, SC
2,386 posts, read 2,885,353 times
Reputation: 4946
Default Anxiety does not equal depression!

Quote:
Originally Posted by Madeline2121 View Post
I would just like to say as a mental health professional that NO reputable doctor would prescribe xanax without also prescribing an anti-depressant. Good doctors are also hesitant to even prescribe xanax because of its potential for abuse. If he has such extreme panic attacks then he needs to be under the care of a psychiatrist and a therapist. Mental illness and substance abuse go hand in hand to the point that it is often hard to decide which came first. It would be nice if he could go inpatient to get off of the xanax, and then they could observe him free of medication and make a decision as to what treatment would be appropriate for his mental illness. Alcohol in combination with xanax is a recipe for death.
Sorry, but you are totally wrong in your statement about xanax needing to be combined with an anti-depressant. Anxiety and depression do NOT always go hand in hand. No reputable doctor would automatically prescribe both together as a rule of thumb!

I do, however, agree with the rest of your comments. He does need to be treated by a psych MD and also a therapist ~ at this point, from what I've read about him, preferably as an inpatient. I also agree with your statement about the mental illness and substance abuse, because so many people start out with the mental illness and end up addicted to drugs because they are trying to feel "normal" (whatever that is!) and they are basically self-medicating, or vice versa.

And last but not least, and actually most importantly, your statement that alcohol and xanax is a recipe for death is spot on. Sadly, so many people have lost their lives due to this deadly combination, and not just people who take a lot of xanax and ETOH together, but some who have just a small dose of xanax and one glass of wine, etc.
 
Old 08-30-2012, 03:03 PM
 
Location: Texas
44,247 posts, read 54,942,936 times
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He is a drug addict. DO NOT allow him in your house with your children.

Talk to him about going to rehab.
 
Old 08-30-2012, 03:04 PM
 
Location: Texas
44,247 posts, read 54,942,936 times
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Quote:
Originally Posted by Madeline2121 View Post
You could always take him in through the ER. If he is a danger to himself or others they will at least hold him for 72 hours. I would be more worried at the moment about his psychiatric state because he could try to harm himself..
Unless he's willing to go into a facility, no one can hold anyone unless they are an imminent threat to themselves or others. Meaning actively suicidal. You can't just strip someone's rights away from them. I wish people would stop bringing their drug addict relatives to the ER thinking we can force them to stop or force them into a program. We can do no such thing. All we can do is offer resources.
 
Old 08-30-2012, 04:05 PM
 
Location: Mississippi
1,248 posts, read 1,879,018 times
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You don't know that the reason that he is acting the way he is right now is because he is a drug addict. He can't leave the house and is scared of the bathroom tiles. At this point I would be scared that he is a danger to himself or others so he needs to be evaluated by a doctor who can make that call. At this point drug rehab should be put aside until first a doctor makes certain if he is not having a psychotic break, which can happen when you try to detox by yourself. I would never suggest just taking your average pill head to the ER for drug treatment, but from what the OP has stated he has a history of psychiatric problems that he has been treating by self medicating with xanax and alcohol. If nothing else she would find out if they thought he was faking the mental illness in order to get drugs.
 
Old 08-30-2012, 04:10 PM
 
Location: Mississippi
1,248 posts, read 1,879,018 times
Reputation: 2500
Quote:
Originally Posted by vrexy View Post
Sorry, but you are totally wrong in your statement about xanax needing to be combined with an anti-depressant. Anxiety and depression do NOT always go hand in hand. No reputable doctor would automatically prescribe both together as a rule of thumb!

I do, however, agree with the rest of your comments. He does need to be treated by a psych MD and also a therapist ~ at this point, from what I've read about him, preferably as an inpatient. I also agree with your statement about the mental illness and substance abuse, because so many people start out with the mental illness and end up addicted to drugs because they are trying to feel "normal" (whatever that is!) and they are basically self-medicating, or vice versa.

And last but not least, and actually most importantly, your statement that alcohol and xanax is a recipe for death is spot on. Sadly, so many people have lost their lives due to this deadly combination, and not just people who take a lot of xanax and ETOH together, but some who have just a small dose of xanax and one glass of wine, etc.

Anti-depressants are also used to treat panic disorder, generalized anxiety, and agoraphobia in combination with benzos. What I meant by that statement was that if he had as severe anxiety and panic attacks as he claims to have there would be no way that a reputable doctor would treat with just xanax. Ant-depressants are not just used to treat depression, but a whole range of other psychiatric disorders.
 
Old 08-30-2012, 05:00 PM
 
Location: Texas
44,247 posts, read 54,942,936 times
Reputation: 73250
Quote:
Originally Posted by Madeline2121 View Post
You don't know that the reason that he is acting the way he is right now is because he is a drug addict. He can't leave the house and is scared of the bathroom tiles. At this point I would be scared that he is a danger to himself or others so he needs to be evaluated by a doctor who can make that call. At this point drug rehab should be put aside until first a doctor makes certain if he is not having a psychotic break, which can happen when you try to detox by yourself. I would never suggest just taking your average pill head to the ER for drug treatment, but from what the OP has stated he has a history of psychiatric problems that he has been treating by self medicating with xanax and alcohol. If nothing else she would find out if they thought he was faking the mental illness in order to get drugs.
They cannot even force him to undergo evaluation if he does not want it.

In most states, detaining someone to do that is called assault.
 
Old 08-30-2012, 05:07 PM
 
Location: Mississippi
1,248 posts, read 1,879,018 times
Reputation: 2500
I might have misread, but I thought the OP said he was willing to get help for his mental illness situation, but that he did not think that he was an addict. I never said she should physically drag him to the hospital, and that the doctors should try to force some sort of treatment on him. I too am educated on the definition of assault. Perhaps you should try to assist the OP with her problem instead of trying to pick apart the posts of others.
 
Old 08-30-2012, 06:37 PM
 
Location: Texas
44,247 posts, read 54,942,936 times
Reputation: 73250
Quote:
Originally Posted by Madeline2121 View Post
I might have misread, but I thought the OP said he was willing to get help for his mental illness situation, but that he did not think that he was an addict. I never said she should physically drag him to the hospital, and that the doctors should try to force some sort of treatment on him. I too am educated on the definition of assault. Perhaps you should try to assist the OP with her problem instead of trying to pick apart the posts of others.
I will pick apart any post that serves to disseminate misinformation.

And I already addressed the op.
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