Benzos & Opioids

“I need some good dope while I’m kicking” – quote, any addict
Benzodiazepines (anxiolytics) and opioids (analgesiscs) are addictive and problematic when taken on a continuous basis, no matter what the justification may be. The brain does not differentiate.
In addiction treatment, anxiety management with long-term benzo prescription, as well as pain management with long-term opioid prescription is highly problematic, and may seriously interfere with the chance of achieving or maintaining sobriety.
Even if the patient has not abused benzos or opioids beyond the prescribed amount, the alcoholic user self-medicates with alcohol to enhance the declining effectiveness of these drugs. As soon as the alcohol is removed from the equation, they won’t provide sufficient relief – and therefore it’s a set-up for relapse with alcohol or drugs (AOD). MD’s usually comply with patient requests as they tend to believe in chemical relief and aid the patient to increase, switch, or combine substances to regulate.
Since benzo withdrawal tends to be protracted and uncomfortable, a titration schedule is usually suggested, where dosage is gradually reduced, then discontinued within a few weeks. Suggested alternatives to benzos are Propranolol, Hydroxyzene, Gabapentin, Paxil (SSRI). Alternatives to opioids are Tegretal (very short-term), NSAID’s (non-steroid anti-inflammatory drugs), and Acetomenophen.
Due to decreased endorphin levels during opioid withdrawal, patients complain of hyperalgesia (intensified pain) and hyperesthesia (the sensation of pain without cause), not to be confused with a legitimate reason to uptake a long-term opioid regimen…
Also, avoid switching – as benzos trigger opioid cravings. Addiction treatment is about abstinence from habit-forming substances - while processing of underlying issues, and establishing functional thought and behavior patterns, even when this means that one must endure discomfort for a while.
The best treatment for an addict is a combination of abstinence & 12-step program & meditation & non-abusable meds if necessary, and this is where treatment (IOP, PHP, rehab) comes into play – to support the early phase of patient stabilization when a solid foundation for a sober life is to be built.
Recovery is a gradual process - on an ongoing basis. Even though it may involve a challenging experience, sobriety is a prerequisite for establishing a meaningful and worthwhile life.