It is currently Tue Aug 22, 2017 4:04 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 8 posts ] 
Author Message
 Post subject: Benzodiazepines.
PostPosted: Tue Jan 25, 2011 5:13 am 
Offline
Average Poster
Average Poster

Joined: Sat Dec 04, 2010 10:28 pm
Posts: 24
Hi all,

So I figured it's time I get some real advice and start a good thread about using benzos while on suboxone. I was diagnosed with anxiety and depression long before I ever started using, and I was prescribed clonazepam during that time. After failing some drug tests with my old psychiatrist (pre-suboxone), I lost my clonazepam script and was just on paxil from him and wasn't seeing any other doctor. I now see a more local family doctor who is great, I really enjoy going to him. I see him monthly to check up on my anxiety and depression and the associated meds.

I've been on suboxone for just over 2 months, and I saw the new family doctor for the first time on December 28th. He told me to stay on paxil and gave me diazepam for episodes of extreme anxiety or anxiety/panic attacks. He first prescribed me fifteen 2mg tabs, then gave me an additional twenty 5mg tabs later in the month. So, as of now, I'm just on 2-5mg as needed, and I rarely take them at all. Sometimes I will buy a few 1mg klonopin, xanax, or ativan off a friend to keep on hand for serious attacks or issues, but again, I rarely take them. My doctor also doesn't know I'm on suboxone.

I saw my suboxone doc the other day and told him that I've been taking benzos as needed in small amounts/doses and he basically freaked out and said he can't really prescribe me suboxone knowing that I'm using any contraindicated medications. His big deal is about the respiratory depression that can occur when mixing the two types of drugs. During my using days, I would mix anything and everything, including opioids with benzos, and I have not had any scary or near-death experiences to this day due to that. When I've taken a benzo recently, there has been absolutely NO noticeable side effects or slowing in my breathing. I can understand his concern, but he even told me that I had relapsed because of it and was quite stubborn about the whole issue.

So I have two doctors, neither of which know I'm seeing the other and taking the medications that each are prescribing. I know this isn't good, I don't need a lecture, but I'm serious when I say I use them in moderation. Over the last month, I've used only four of the 2mg diazepam pills and a couple klonopin, and that's all. I plan on keeping both doctors, but definitely not going to go overboard on whatever benzo Rx my new doctor decides to hand over. When I require a benzo, klonopin really doesn't help, but valium and xanax seem to be the most helpful. For me, 10mg of diazepam and 1mg of alprazolam are sufficient for resolving my issues when they arise. Since I'm only on the 5mg diazepam and only getting 20 per month, I don't know if I should try to ask him for the 10mg tablets or not. On one hand, they would be more helpful and more efficient, but on the other hand I increase the risk involved in taking it while on suboxone in the first place.


I have talked to several people online and off who are on suboxone and a benzo, many times both are prescribed from the same doctor! What are your opinions on the matter and on my situation specifically? I've read about a lot of people on here who are on about 0.5mg of either xanax or klonopin, and 10mg of valium is equivalent in strength to either of those dosages, just to clarify I guess. So when I take a 2mg valium, it's like taking 0.1mg of klonopin, which I don't think could be harmful at all, and a 5mg tab is equal to 0.25mg. I used to be on 2mg of clonazepam per day, and have always had a relatively high tolerance for benzos. Klonopin never helped me as much as even a low dose of diazepam does. Anyway I'll quit rambling and open the floor for replies.



Thanks!
Caleb


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jan 25, 2011 7:34 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Your sub doctor is not the only one who refuses to prescribe benzos along with the sub. However, some do prescribe it, as you know. We've discussed this issue before.

I do think having two doctors and keeping them both in the dark about your other treatment is heading down the wrong path. Some might even say that it's old addict behavior. Because you are the only one who knows you're seeing both and taking both meds, you've put yourself in the position of being your own doctor. That is old addict behavior.

Also, without going over all the numbers and dosages of benzos, it sounds like you're starting to need more and more to get the effect you need. I think that's something to consider and look at.

So your sub doc freaked out, but is he saying he won't continue to prescribe the sub to you? Or did he tell you to stop taking the benzos? From his point of view, if he continues to prescribe it knowing you are also on the benzos, he's opening himself up for some huge liability, plus I'm sure he doesn't want you to die. The only overdose deaths from suboxone are those that were mixed with benzos and other respiratory depressants. His concerns are not completely unwarranted, that's all I'm saying.

So do you have an idea of what you'll do now? Have you considered trying to address some of your sporadic anxiety with meditation or something like that? I used to take a very high dose of xanax and thought I'd just die without it. Then I learned meditation. Now I have pretty much zero anxiety. Obviously that's only my experience and it doesn't necessarily generalize to yours or anyone else's. But I did want to point out that there are other ways of addressing anxiety.

Dr J has some great blog posts about anxiety and benzos. I encourage you to check them out. Good luck and let us know how it turns out.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jan 25, 2011 10:15 am 
Offline
Super Poster
Super Poster
User avatar

Joined: Thu Dec 02, 2010 2:28 pm
Posts: 134
I hope you are not looking for someone to say that your actions are OK. It seems you have a pretty fluid definition of "moderation". I self-prescribed for years and (of course) I was always justified. Be honest with your doc(s) and perhaps they can help you!


Top
 Profile  
 
Our Sponsors
PostPosted: Tue Jan 25, 2011 2:03 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Jun 17, 2009 9:59 pm
Posts: 993
Location: Carson City, Nevada
I don't feel strongly that one should or absolutely should not take a Benzo while on Sub. However, obviously there's a real risk involved, so it's best for the same doctor to be overseeing it. My questions for you is, since you take such a small amount of Benzos and you do not take them everyday, do you think you may have an opportunity to figure out how to handle the episodes of anxiety without the Benzo? I know that's probably a scary thought, but I've also heard people report their shock when a natural anxiety remedy actually works. :D There are anxiety support groups; you could see a therapist you specializes in anxiety issues; etc. Maybe if you were doing those sorts of things, your Sub doc would be okay prescribing you a very small number of Benzos to take once in a while during the time you are learning to deal with anxiety without them. Honesty can go a long way, KWIM? Also, you sound like you are truly carefully policing your use of Benzos, and it's gotta make you feel not good to have to keep stuff from your doctor. That may mess with your mind all by itself.

I know this isn't normal, but my first Sub doctor was really shady. That's the only way to put it. He started me on .5 mg Sub and worked me up to 32 mg, and he ALSO later started me on Klonopin 1 mg/3 X a day for epilepsy because my neurologist had me on a med that was kicking my butt. He never mentioned I could have died from that combination! I'm still taking my Klonopin but since I had a clear EEG, I reduced my dose a lot and once I'm done tapering off Sub, I'm off the Benzos too. Klonopin is the only Benzo I can tolerate. I've had three Sub docs in total and they have requested my records and then prescribed both the meds to me. Maybe the seizure thing is scarier to them than the possibility of an interaction? I've never taken more than my prescribed dose because it's just not my thing. I guess I don't have true anxiety disorder and maybe that's why? I also carry Ativan with me every single place I go and I will always have to in case I get an aura. I really am interested in researching the interaction of Sub and Benzos. I wonder at what dose people died and if there's an amount considered relatively safe or if it's just so variable that it scares doctors to where they just don't want to do it.

laddertipper

_________________
First you take a drink, then the drink takes a drink, then the drink takes you. ~F. Scott Fitzgerald


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jan 25, 2011 9:22 pm 
Im on lorazepam as needed for anxiety and suboxone from the same doctor and he is not concerned about repsiratory depression because to be blunt, he's not an idiot. If you are tolerant to suboxone ( which anyone on maintenance is) there is no danger in taking a moderate dose of benzos. I can understand the reason a doctor would be worried but I think they quote the depressed breathing when in fact they are just worried they are gonna get in trouble some how for prescribing both which I dont blame them for it but they can at least give you the honest answer and be straight up about it not tell you you are gonna die from mixing the two when in fact you wont. Im so glad my doctor is a good doc I used to test dirty for weed everytime early in treatment and also benzos (the benzos were from a different doctor at that time) and all he ever did was ask me what benzo I was taking and how much of it and that was that, my doc would never tell me he's kicking me out of treatment for something like that because he actualy wants me to do good in recovery and isnt in it all for the money. Taking the benzos your Rx'd is one thing I dont think anything is wrong with it but buying xanax off the street is different, that IS addict behavior.


Top
  
 
 Post subject:
PostPosted: Tue Jan 25, 2011 9:31 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Suboxone and benzos CAN mix and be deadly. Yes, the person has the opiate tolerance from being on sub, but if they take too much of the benzo - above their tolerance - then they can definitely overdose. Most of the overdose deaths related to suboxone are due to mixing it with a benzo. But if the person is tolerant to BOTH and does not over-take the benzo, then, no, they will probably not die. Just needed to clarify that.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
 Post subject:
PostPosted: Wed Jan 26, 2011 2:52 am 
suboxOWNED wrote:
. If you are tolerant to suboxone ( which anyone on maintenance is) there is no danger in taking a moderate dose of benzos. .

Yes I know you can die from mixing opiates and benzos thats why I said moderate dose like I quoted here in bold. But it is not as easy to overdose on the combo as people make it out to be. I overdosed on opiates and benzos my last relapse and used 200mgs of pure raw phenazepam powder mixed with opiates and blacked out for 5 days and I was majorly fucked up and dont remember a thing but I did not die and it was not the first time I took a combination like that either. But yea you can die but its not like people make it out to be, taking a couple xanax with your normal dose of opiates is not gonna automicaly kill you.


Top
  
 
 Post subject:
PostPosted: Fri Feb 04, 2011 8:38 am 
Offline
Average Poster
Average Poster

Joined: Sat Dec 04, 2010 10:28 pm
Posts: 24
suboxOWNED wrote:
suboxOWNED wrote:
. If you are tolerant to suboxone ( which anyone on maintenance is) there is no danger in taking a moderate dose of benzos. .

Yes I know you can die from mixing opiates and benzos thats why I said moderate dose like I quoted here in bold. But it is not as easy to overdose on the combo as people make it out to be. I overdosed on opiates and benzos my last relapse and used 200mgs of pure raw phenazepam powder mixed with opiates and blacked out for 5 days and I was majorly fucked up and dont remember a thing but I did not die and it was not the first time I took a combination like that either. But yea you can die but its not like people make it out to be, taking a couple xanax with your normal dose of opiates is not gonna automicaly kill you.


200mg of raw phenazepam? You must have had a death wish. That shit is as potent as xanax/klonopin by the milligram I believe, so 200mg of phenazepam ~200mg of xanax. And I have read that phenazepam is extremely sedative. I thought about buying some for my anxiety issues, but do you know how hard it would be to measure out 1-2mg of phenazepam powder out of a 1 gram bag? The stuff is pretty cheap online, but way too potent and now that I have a steady prescription for my as needed benzo, I'm staying far away from that stuff.


I'm not going to keep lying to my doctors either, but I can't really tell my sub doc I have a benzo on hand or else he literally already told me he won't continue prescribing it, which I need to save me from going back to opioids. Since I saw my sub doctor a couple weeks ago, I've taken a benzo maybe twice, and neither time did I have any respiratory or health issues. I understand his concern and that of everyone else's too, so I'm being very careful.


On another note, some old using buddies of mine are absolutely stupid. They don't think twice about mixing drugs. One of my buddies specifically, usually has some kind of benzos on him, usually a bunch of 1mg klonopins, and he'll pop a handful of hydro/apap pills with those. Or he'll take a 40mg methadone wafer and a few klonopins, which I've actually done before too. Back in my using days, I'd mix them just as carelessly so I guess I don't have much room to talk but I just think my body is used to handling both kinds of medications without having deadly interactions. I have a pretty healthy liver too since I don't drink or take a bunch of tylenol or pills.


Thanks for all of the comments


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 8 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group