Uh. Reassurance Required, I guess? [Diazepam]

[WinterTidings]

So, um. Been on 20mg diazepam p/w for a while now, pretty stably. But.. For the past 3-4 months, Life Stuff is currently Horrific (homelessness, huge-stress, people trying to kill me, etc, etc, its been a blast), and Trauma Crap is through the roof, and.. Yeah, it's been getting worse and worse, and the cycle of breaking and rebreaking with no healing period is doing permanent psychological & physical (ohi, new wheelchair user cuz of this mess) damage.

So, yeah. After a Week of Hell, and spending most of today curled up crying/shaking/staring, or curled up crying/shaking/staring on the floor with a knife, best-friend & partner both kinda agreed that I should seriously up my dose. This is people with varying degrees of benzo experience themselves (BF is on some quite heavy stuff, looking to gradually tone down her dose when safe, partner is on 10-20mg of diazepam a week, too. 

Basically, 5mg is good for cutting off an upcoming Huge Headfuck at the first signs, or for making one gentler. Works on most things to Some Degree, it's just guessing the Thing and the Degree when your head is made out of dog poo. 10mg is a kinda "fuck this is a huge crisis" and I probably (definitely) shoulda taken that earlier today. 15mg is "holycow I need to be unconcious" and that's like, once or twice a year. That's how I've been using it.. Prettymuch consistently for 5 years. The effect on us hasn't changed/lessened, just the amount of crisise have and how fragile and smashable I am (often in times when I Can't Be). Sometimes 5mg does Fuck All, but that's always been the case when we're clawing at the walls enough, yknow?

Anyway. BF/Partner/PDoc have agreed on 10-15mg a day (and see where we go from there when in a more stable life space in a few weeks/months) and.. I dunno. I've always been paranoid about getting addicted. I don't have a particularly addictive personality, but still. And.. I dnno. I'm anxious about this. We all are. So.. Made a thread where knowledgable ppl can.. Say something? Whee.

Wynn

Edited June 27, 2016 by WinterTidings

[Sloane]

I've taken Valium once and it was medical related, so I can't say anything about it specifically. That being said I won't even pretend to know about diazepam and it's possibility of addiction or dependence, and step aside for members who have experiences.

I did want to reply to add some general benzo info and remind the difference between addiction (psychological) and dependency (chemical). Dependence and addiction depends on dose, frequency, and use. Once you start to take any medication for reasons separate from why it is prescribed, it is a red flag. Some form of physical dependence is normal when taking Benzodiazepines long term (esp. when increasing dosages), but if you find yourself taking it to prevent withdrawal symptoms instead for MI symptoms it is also a red flag.

IMHO awareness and compliance are your biggest weapons against fear of addiction or dependency. It can help to keep a symptom/medication/side-effect log as well as reporting any and all side affects/adverse affects/positive affects to your Pdoc so they can be a second pair of eyes.

Pretty much all benzodiazepine use is stigmatized these days, but they are perfectly safe when taken responsibly and under your doctors care (which you are).

[WinterTidings]

Thankyou for the reply.

Our pnurse is now in the process of dropping us from the service (a long, convoluted story), and appears to have not had any plan in mind with regard to diazepam. So.. Apparently.. This is our permanent dose now? Is that safe longterm?

Tri

[dtac]

Benzos are hard to generalize. I was on 10-20 mg Valium PRN anxiety for about a year and had no tolerance/addiction/dependence issues. I came off it just fine with no rebound problems. Didn't bother me one bit. At my worst, I was probably taking it 5x/week.

However, there are people on here who have terrible problems getting off of benzos and struggle to taper them because of dependence issues. It really is something to work closely with your pdoc on monitoring.

[WinterTidings]

Ah. Our pnurse is.. Yeah, dumping us from the service with a "we have to have a 3 month checkup on ADD meds, or you can just ditch those, your call". We don't have a pdoc. But since she's the one who prescribed them.. She's responsible? And.. Didn't mention diazepam at all, so.. Maybe the checkups will have that, maybe they won't, and we'll have to bring it up ourselves.

Right now I don't want to see her at all; She almost dumped an emotional nuke in our laps in the form of a "ok my real reason for this meeting is stopping your therapy" when we've been in a huge crisis & begging for help the whole time. The only way we avoided that was Whisper sending a "What's the point in this meeting anyway? Meeting in person is painful for us." depressive-email and she leapt on it like "Good point, we shouldn't have anymore treatment, bye!".

So.. Feeling pretty.. Antipathic towards her right now. But realise that most likely we will have to meet her sometime in the future; However, a 3 month "legally required checkup" for ADD meds does not close monitoring make (or actual treatment ¬_¬).

So.. The TL;DR is: We can't have close monitoring, or a pdoc.

Tri

 

[HAL9000]

I'm sorry to hear about the things your dealing with and really feel for you on the curled up on the floor thing.  Been there and done that.  Thats when you really need your PDoc (Or whoever prescibes) to jump in and help get you functional / stable.  Therapy is great but personally I don't think its meant for that serious a situiation.  I wish I had something useful to say about the knife.  Never been to that place and never want to.

If you have fears about addiction I would make a regular date with your P or GDoc to review meds and report how your doing with them.  Tell the doctor its a "concern" not an issue you've had.  Otherwise I think the doctor will be the one in a panic.

Valium - I started at 2mg prn.   That did nothing.  I mean it didn't take the edge off it was like I took an aspirin.  Anyway I complained to Doc and went from 2 to 5 to 10mg with 6 hours between doses?  *I think the time changed a few times.   Like 12, 6, 4hrs?  It came in 2mg tabs so I normally took 3 for a total of 6mg and that actually worked most of the time.  When I took 10 mg it was like your 15 where you just needed to be konked out.  I did that for a couple years and I didn't think it had any baggage for me.  I read about people who have terrible problems with Benzos but so far I've never talked with anyone.   No, wait... If you include Xanax I know a guy and when I asked him "What happened to you?" he said, "Xanax"    But this is a rock band guy that probably was putting handfulls in his mouth or up his nose.

I got switched to Xanax prn and I have to say it doesn't work the same way.   Valium in the right dose is you take it and your not dealing with anxiety.  Your not doped up, your ok.  Normal.   I think it took half and hour or less and it kicked in.  Its hard to say how long it lasted because it wasn't like Xanax which is like a firecracker of relief.  BAM your anxiety is blown away.  dah dah POW its back.  And the lower dose of Xanax was kind of underwhelming.  Valium is more like the sparkler of anxiety meds.  You light it off and its a subtle firecracker.   No BLAM and gone and it lasts a while. 

I'm guessing if your taking 3 times daily versus prn you have much more to be concerned about with addiction?  I dunno...   I'm not into feeling medicated so personally the 10 mg dose would probably be a couple times a year.  Although this year?    Outside issues (money, medical stuff, legal, relationship stuff) seems to often make my anxiety worse.    prn for me is that there are times I take it several times a day and there are times I don't take it for weeks but I'm not at the curled up on the floor level now.  I don't notice and addiction type things on the times I don't take it but I'm just one person. 

I hope things turn around for you soon.   Like right now or sooner.

[notloki]

I think this is a whole lot of fuss over very low doses of valium.

[Gearhead]

Hi, Wynn-just checking in to see if you've gotten things sorted out with your doc. Did you end up seeing your GP, as HAL9000 suggested? Are you doing OK?

[WinterTidings]

On 13/08/2016 at 5:24 PM, Gearhead said:

Hi, Wynn-just checking in to see if you've gotten things sorted out with your doc. Did you end up seeing your GP, as HAL9000 suggested? Are you doing OK?

We don't have a GP at the moment. Technically we do, but she's a few towns away. We just get meds from them, but they're starting to cut those off because they know we've moved. Gotta apply for a new one, but that'd require a grilling over "ZMGO you're on what benzo dose?" and right now we don't have the stamina to coddle your average paranoid-ignorant GP into agreeing to prescribe/not just writing us off as an addict. Not only that, but we flat-out refuse to be weighed, so. There'll be a lot of conflict in the first-impression there. Not something we can deal with in the middle of a depression-slump. Maybe when partner next visits. Maybe not.

On 20mg a day atm. Actually taking it after taking to Pnurse. We sorted out the misunderstandings there. She seems pretty shocked at her psych's behavior. But again. No energy, no emotional stamina for a formal complaint & all the shit that goes with rn.  Anyway. 5mg breakfast, 5mg lunch, 10 PRN, per day. It's.. Helping. I dunno about longterm. Just focusing on survival rn.

Wynn

Edited September 11, 2016 by WinterTidings

[notloki]

Never had a problem with GP's and benzos. Mine is always offering me Ativan for some reason. The problem I see is that a GP is fine with PRN use but if it goes every day and long term, a maintenance med, there is a problem. The DEA really wants to see Scheduled meds taken long term being prescribed by the appropriate specialist. Presumably they have to training and know how to do this. Pain doc's for opioids and pdoc's for benzos, long term sleeping meds (scheduled ones) and any Schedule 2 meds. (amphetamine, ritalin and it's related meds) for example. Doc's malpractice insurance is a factor to. Docs that prescribe a lot of Scheduled meds pay a lot more for insurance my GP and pdoc tell me. The DEA has tightened oversight for these meds the last few years, my pdoc's nurse is always telling me. My friend used to get his ADD meds from his GP but recently she said she can's any more of insurance will drop her.

 

[JustNuts]

Fears of malpractice claims, misuse, diversion, and the DEA are certainly a major factor, but it's a bit shocking to see how strong the ideological split is between practitioners who think that long-term benzodiazepine therapy is inappropriate, and practitioners who think it's appropriate to varying degrees.

Anyways, OP, the dose range for diazepam goes up to 40mg/day - 20mg is not huge at all. I take 2.5-5.0mg qid (so up to 20mg/day). I'm also on temazepam for sleep, but have been on the diazepam for much longer than the temazepam (averaged ~15mg/day before it, maybe slightly less on it). While I was in the psych ward recently I took 20mg/day for most of my stay simply because they wouldn't let me have the option of a dose range.