Benzodiazepines: more “behavioural” addiction than dependence (2003)

[Jatelka]

A new entry has been added to Drugs Archive

Description:
Psychopharmacology (Berl). (javascript:AL_get(this, 'jour', 'Psychopharmacology (Berl).');) 2003 May;167(3):297-303.

de las Cuevas C (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22de%20las%20Cuevas%20C%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstractPlusDrugs1), Sanz E (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Sanz%20E%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstractPlusDrugs1), de la Fuente J (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22de%20la%20Fuente%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstractPlusDrugs1).

AIMS: To estimate the prevalence, characteristics and risk factors associated with the development of benzodiazepine dependence in the users of these active ingredients. DESIGN: A representative sample of patients currently receiving benzodiazepine treatment for 1 month or longer (mean 38.2+/-52 months, range 1-360 months) was studied. PARTICIPANTS: One thousand and forty eight (1048) consecutive patients attending 20 primary-care health centres of the Canary Islands Health Service participated in this study during 2002. MEASUREMENTS: The severity of dependence scale (SDS) was used as a screening test of benzodiazepine dependence among patients using benzodiazepines. FINDINGS: Of patients using benzodiazepines for more than 1 month, 47% developed dependence to these compounds. Benzodiazepine dependence was more prevalent among women who were middle aged, separated, of low educational background, unemployed or housewives. Patients using short half-life benzodiazepines registered higher rates of dependence as well as those using higher doses or the patients with longer use. However, multivariate logistic regression analysis shows that benzodiazepine dependence was closely related only to three of the variables considered: the benzodiazepine dose used, the duration of this use and to the concomitant use of antidepressants. CONCLUSIONS: The distribution of dose and length of treatment shows no evidence of pharmacological tolerance, neither in the whole sample nor in those patients with addiction (SDS+), reinforcing the idea that psychological dependence (addiction) is more relevant than pharmacological or physiological dependence in benzodiazepine chronic use.

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[radiometer]

Which drug company paid for this study? Not that I wouldn't agree that psychological dependance is the bigger factor, but they seem to be almost negating potential physical issues ("no evidence of pharmacological tolerance").

[saorsa.elegy]

I too can't understand why anyone would state that there is no evidence of pharmacological tolerance. That is the exact opposite of what docs say when they are perscribed to you.

[Ezy Ryder]

This is to everyone know how the pharmaceutical industrie manipulate research. I use benzos since teenager(fuck to my fuckin parents and docs) and now almost ten year late trying to leave this shit.Would you say that my jaw pressing my teeth during sleep and waking with a horrible pain in my teeth because of withdrawal is behavioral. Go to hell your criminals.

[Laudaphun]

I think what they may be "trying" to say is that tolerance to the anxiolyic effects for example, are not overly apparent in patients using therapeutic doses, for therapeutic reasons, for average durations of time. I believe that benzodiazepines can most definitely cause an unpleasent withdrawl in some cases and should be treated with respect.

However, at the same time I am pretty certain that tolerance to the anxiolytic effects is not common with prescribed use. It's kind of worded in such a manner that it could be argued/interpretted in two ways.

SWIM's marmoset has been taking them for... 13 years... /cough /cough and does not have to take them to prevent physical withdrawl, nor does she take them everyday (anymore). However, she is well aware of how easily they can sneak up on one... even just one dose per day can often turn into (in her case) just sort of a habit... like a night cap or a way to relax after a hard day. The marmoset is sure that some anxiety was likely caused by not taking them after taking them after taking them for too many days straight, but the fear of the consequences. Even today, the marmoset takes prescribed doses that have never really been increased and still, the same prescribed dose works as well as it did long ago. The only difference is that the reinforcing effects tempting to her to take more than prescribed are no longer present, so she just takes them when she needs them. Also, she tends to rotate her benzos... temazepam, diazepam, alprazolam, clonazepam depending on the circumstances and takes less than prescribed so has a fairly ample supply. Another fear is that academic could suffer if taken more often than absolutely necessary. The marmoset's education is the most important thing to her currently so. SWIM would gladly chat with anyone who is struggling with an addiction or dependancy, whether she can help or not, the marmoset will gladly share any advice based on her 13 years of benzo use. Also, it should be noted that 13 years ago, she did not take them in the same manner as she does today. Temazepam was the benzo that initially gave the marmoset difficulties using them as directed, however alprazolam by far was the most habit-forming, but caused less craving. After being being treated for adult ADD, for some strange reason they became needed less often as the ADD, while diagnosed as a child, was left untreated until later in life.

This is to everyone know how the pharmaceutical industrie manipulate research. I use benzos since teenager(fuck to my fuckin parents and docs) and now almost ten year late trying to leave this shit.Would you say that my jaw pressing my teeth during sleep and waking with a horrible pain in my teeth because of withdrawal is behavioral. Go to hell your criminals.

was not really a nice thing to say, calling people who are willing to help you criminals. Perhaps the recovery forum is not the best place for SWIM to post stuff like this.

[drug-bot]

no evidence of pharmacological tolerance
bullshit, swims been to detox's multiple times for heroin and seen some of the other patients coming off of benzos and wouldnt wish that on his worst enemy- seen more than 1 person fine one minute and having a seizure the next, seen the detox ship a patient to the ER because of extremly high blood pressure, talked to people who say that it feels like their coming out of their skin, talked to others who havent slept in over a week.
sure all these people took alot more than the recommended amount, but still the study seems to ignore this very real phenomenon as well as benzos high potential of abuse.

[sirdrugalot]

bullshit, swims been to detox's multiple times for heroin and seen some of the other patients coming off of benzos and wouldnt wish that on his worst enemy- seen more than 1 person fine one minute and having a seizure the next, seen the detox ship a patient to the ER because of extremly high blood pressure, talked to people who say that it feels like their coming out of their skin, talked to others who havent slept in over a week.
sure all these people took alot more than the recommended amount, but still the study seems to ignore this very real phenomenon as well as benzos high potential of abuse.

swim will second that, swims been taken between 18-24mg of clonazepam per day and other benzos + codeine for 9 to 10 months, down to 2.5mg of clonazepam per day now. went at one stage with no sleep for five nights, swims been getting pains in his face, eyes, head and legs, knee caps, hands and so on. it's like coming off codeine with the feeling you get on a Tuesday after a weekend taking e's. you be fine one minute and ready to burst into tears the next, swim thinks there bullshit for the toucher you go through giving them up the pleasure you get from them is no way in hell worth it.

swim would not wish it on his worst enemy.

[xxxSuSHixxx]

Personally, SwiPF feels the truth lies somewhere in between, however... He gets no recreational feelings what so ever from benzos, just a little tired if he binges out, .. He feels that ....alot of it is just "being used to taking them" setting aside obvious withdrawl for emmense use...but the acctual act of sucking on the pills((anyone who does this will immediatley recall that sweet minty taste yummm)), or insuflating them, the taste, are SwiPF's real benzo addictions, just the act of use is addicting, rather .... its like smoking meth, SwiEveryone remembers smoking foils and out of glass and how fun it was, its the same with the kpin for SwiPF.. although, he feels benzo is more addicting than meth... that says something....not sure what it says, but its definatley talking, long story short... its both habit, adiction ((phisical and mental)), and probably behavioral as well, SwiPF is no Pharmacist ((yet)) but thats what he gets from his own personal benzo hell. ((im glad you could all share it with me and just say NO to BENZO))

[H4U2C]

swim will second that, swims been taken between 18-24mg of clonazepam per day and other benzos + codeine for 9 to 10 months, down to 2.5mg of clonazepam per day now. went at one stage with no sleep for five nights, swims been getting pains in his face, eyes, head and legs, knee caps, hands and so on. it's like coming off codeine with the feeling you get on a Tuesday after a weekend taking e's. you be fine one minute and ready to burst into tears the next, swim thinks there bullshit for the toucher you go through giving them up the pleasure you get from them is no way in hell worth it.

swim would not wish it on his worst enemy.


Swim here will THIRD that! Swims experience with benzo addiction is real, swim has been using benzos for 10years straight to primarily relieve anxiety during daytime and as hypnotic at nighttime. Swim cannot go a day without these very addictive meds.