Sleep med addiction

[MarkP]

I suffer from insomnia. Have all my life, including in the womb apparently (so my mother tells me!).

Its only become so debilitating in the past year that I finally dragged myself into treatment. I was getting sleep deprivation psychosis essentially, and it was becoming quite dangerous as I was doing things like walking out into traffic without looking both ways, and had no depth perception (ie: running into walls).

After trying a wide assortment of anti-depressants, anti-psychotics, and a few different benzos, temazepam seems to be the med that provides the best effect versus the lowest equivilant diazepam dose.

I've taken either Ativan or temazepam for the past 6 months. A night or two a week, I naturally am sleepy enough that I don't need the pills to fall asleep. Only once or twice a month I will get wound up enough that I need 2 pills and maybe a shot of whiskey to fall asleep. I feel that the effectiveness of benzos has improved over the past 6 months, to the point where I want to try a lower dose of temazepam (which is unfortunately unavailable as they only market the 15mg and 30mg capsules here, and I already take the 15mg's).

If I arbitrarily just don't take temazepam for a night, I simply don't sleep, and if I don't take the pills for 2 or 3 days, my original symptoms return, no better or worse than they were before starting on the pills.

For someone like me, what would physical dependance on the medication be like? Would I feel daytime anxiety? Would I get seizures if I skipped doses?

And what should my GP (nice fellow, albeit fresh off the boat from Africa) be watching for? Dose escalation is an obvious warning sign. The GP is almost in disbelief at my response to this med at the low dose given, because all of his other insomnia patients are on the 30mg dose (I work at a pharmacy, and actually see all the prescriptions!) and many even want an increase over that, or have a habit of taking two, too often, etc.

Is addiction to short-acting benzo hypnotics, taken as prescribed, a serious issue that causes people serious problems? Or are the problems with benzo addiction associated with the people who use them 3-5 times a day, all week, for years at a time? And what does benzo addiction/benzo withdrawal really imply anyways? I see plenty of people horrified at the withdrawals online, but incredibly few who can actually describe what its like.

[Persephone]

If you're trying to lower your dose, I don't think you have a problem. Honestly, taking benzos makes me nervous too - I have never had a drug problem and I'm terrified of developing one. IMHO, the level of sleep deprivation you're describing sounds far more dangerous than tolerance to benzos. Have you tried ambien or lunesta? Although I'm skeptical that they're any less addictive than benzos, it might relieve some of your fears to try them. Also have you had a sleep study? Do you have problems with depression or anxiety? It's worth seeing if there's an underlying you can solve that might decrease your need for sleep meds.

[gizmo]

Congrats on finding something to help you sleep. Like you, I too have a, let's say, unusual, sleep pattern without medication and have as long as I've been alive. I have tried everything, including benzos, to get the sleep I need.

The thing about benzos is this: if you take them almost every day, the chances are fair to good that you will get tolerant of the med. This just means that you will need more med to get the same effect. There is nothing wrong with this, it's just the way your body works. And you may be fine for forever on the 15mg.

The chances of you becoming physically dependent on the med (this is NOT the same as addicted) depend on your body, your brain, how often and how long you take the benzo. I took xanax every day for 6 months to sleep, and had physical withdrawal symptoms when I stopped. Course it wasn't the first time (nor the last time) I took xanax, either.

To be physically dependent on a drug is not a bad thing solely reserved for benzos. I mean, SSRI's cause withdrawal symptoms all the time. The trick is that, when and if you stop taking the benzo, you titrate off slowly and invest in a pill splitter.

After 6 months of a xanax nightcap, I stopped. I honestly miss is a great deal. It's been about three months, and I've done everything from remeron to hypnotherapy relaxation music. It's not easy, but I'm still here.

[LanceLarson]

I suffer from insomnia. Have all my life, including in the womb apparently (so my mother tells me!).

Its only become so debilitating in the past year that I finally dragged myself into treatment. I was getting sleep deprivation psychosis essentially, and it was becoming quite dangerous as I was doing things like walking out into traffic without looking both ways, and had no depth perception (ie: running into walls).

After trying a wide assortment of anti-depressants, anti-psychotics, and a few different benzos, temazepam seems to be the med that provides the best effect versus the lowest equivilant diazepam dose.

I've taken either Ativan or temazepam for the past 6 months. A night or two a week, I naturally am sleepy enough that I don't need the pills to fall asleep. Only once or twice a month I will get wound up enough that I need 2 pills and maybe a shot of whiskey to fall asleep. I feel that the effectiveness of benzos has improved over the past 6 months, to the point where I want to try a lower dose of temazepam (which is unfortunately unavailable as they only market the 15mg and 30mg capsules here, and I already take the 15mg's).

If I arbitrarily just don't take temazepam for a night, I simply don't sleep, and if I don't take the pills for 2 or 3 days, my original symptoms return, no better or worse than they were before starting on the pills.

For someone like me, what would physical dependance on the medication be like? Would I feel daytime anxiety? Would I get seizures if I skipped doses?

And what should my GP (nice fellow, albeit fresh off the boat from Africa) be watching for? Dose escalation is an obvious warning sign. The GP is almost in disbelief at my response to this med at the low dose given, because all of his other insomnia patients are on the 30mg dose (I work at a pharmacy, and actually see all the prescriptions!) and many even want an increase over that, or have a habit of taking two, too often, etc.

Is addiction to short-acting benzo hypnotics, taken as prescribed, a serious issue that causes people serious problems? Or are the problems with benzo addiction associated with the people who use them 3-5 times a day, all week, for years at a time? And what does benzo addiction/benzo withdrawal really imply anyways? I see plenty of people horrified at the withdrawals online, but incredibly few who can actually describe what its like.

Hi MarkP,

Have you ever considered a "sleep study" where you are monitored at a hospital, or clinic overnight, with gadgets attached to your body, to develop interpretations for a diagnosis? (usually searching for sleep apnea) it is quite expensive, usually over $1,000.00 It sounds to me like you are monitoring your dose of Restoril quite well, as 15mg is not a high dose, as your M.D. noted.To address your concerns about "benzo tolerance and/or benzo addiction"........I am a survivor of Upjohn Xanax addiction (3 times) over a span of six years. I am not a medical doctor, but I have several decades of intense use of the alpha to the omega of barbituates, hypnotics, sedatives, benzodiazepines........IMHO "Xanax" (alprazolam) each time was the most addictive minor tranquilizer I have had in 20 yrs, I feel it is in a totally different class of "the benzo world" being short-acting, it gives most users a quick fix from either panic disorder, or any kind of anxiety, plus, a distinctive "lift" that is quite contagious, just my 2 cents worth. The final time I went back to it, after a 60 day addiction, later a 6 month addiction, and finally, a 24 month addiction, I'd upped the dose of Xanax from .5mg twice a day to 1mg twice a day to the 2mg. (soapbars) swallowed whole every 6 to 8 hours, (6mg. per day) and the subjective feeling, after I was "hooked" was when the alprazolam began wearing off, I would get hot & cold chills, a noticeable tightness in my chest, my breathing felt restricted in a uncomfortable way, I got very anxious, (a complete reverse effect from the early days of use, to the point, I would have to lay down, if I was not at work, or take a break, and sit somewhere if I was at work, and do some deep breathing, trying to avoid a feared panic attack, I usually developed a racing, irregular heartbeat (tachacardia) and I made extremely sure I had more Xanax in my front pocket "pill box" and a backup supply in my car, and, another backup supply at home in my medicine chest. I ended up so fearful and so dominated by the Xanax, that I procured a 2nd M.D. to write me a alprazolam script, in a large quantity, like 100 with 1 refill, or 90 x 2mg. take every 4 to 6 hrs, with at least 4 refills. My co-workers, friends, and my new wife, (4 months of courtship) got married quickly, noticed my extreme mood swings, and my middle of the night "sweats" and "restless legs syndrome" (she was a R.N) I was confronted to go to a outpatient detox ASAP or a marital annulment was forthcoming. It took me 8 very hard weeks to taper down, and, I was quite edgy for at least 3 entire months after my last Xanax, the craving to return, (for me) was very strong, under the slightest "trigger" from any kind of perceived intense stressors. All of this happened in the 1990's............The only other tranquilizer/hypnotic/sedative that had a similar fast addiction for me, was over 25 years ago, I got highly addicted extremely fast, I'd say within 14 to 21 days, using the (now banned) Methaqualone 300mg. (Rorer & Lemmon 714's) and I would do without for months, and when I obtained a script of only 60 tabs (no refills) I always stayed bombed until I ran completely out, had a tolerance up to 1800 mg. per day. absolutely no ability to control my intake. Withdrawal was "unpleasant to say the least" but it was mostly over in 4 to 5 days. But alprazolam withdrawal is far more intense, and if you cut down too fast, the liklihood of a full blown seizure is high, IMHO. I've taken probably, 2 dozen other benzo's, & other hypnotics, some are no longer available, but I was able to manage most of them, it wasn't a big thing for me.

As another board member here suggested, it seems the higher danger in the case you have described is the true danger you confront, from extreme sleep deprivation......you could easily get harmed physically, and have accidents, if you go into a dissociative trance state, or a state of depersonalization, due to a run of nights without enough sleep! A 2nd opinion might not hurt, I don't call that doctor shopping.......my issues with insomnia...chronic insomnia...I found that even 30 mg. of Restoril, or, 10 mg. Ambien wasn't strong enough by itself, I ended up with a M.D. well trained in Addictionology, who has settled me on Trazodone 100 to 150mg per night. (not for everybody) I have side effects, negative ones, always a hangover next day for 1hr to 1.5 hrs, but I have never heard of anyone getting addicted to the anti-depressant Trazodone. Some people try Seroquel, a heavy & effective sedative (really a anti-psychotic) for many people in the beginning weeks of use........sodium oxbate

IMHO is overrated & very, very expensive (Xyrem) that I have tried, and will not keep all users asleep for a full 8 hrs dose. I agree with other posters, that eventually, with all benzo's, one will sooner or later develop a tolerance to the drug, and it will require higher doses to get the same effect, and the risk of withdrawal increases over time, if you are on it 24/7, excluding Klonopin perhaps, most intermediate to long half-life benzo's create tolerance issues. Taking a break as you do for a few days,

as you say you do with temazepam, is often a good idea, to flush the body from building a dependency......I do this with other controlled meds, on purpose, for as long as 3 to 5 days, to avoid tolerance issues...sometimes easier said than done. In my experience over 30 yrs, I find a Psychiatrist, is often more familiar with psychotropic meds than a G.P. or PCP. Just my 2 cents worth....I wish you well with your endeavors!!!!