Hello everyone. I have been a long time lurker here over the years, doing site specific searches as needed for specific topics, drugs, etc.
I'm starting this thread as an important step for myself, to help build a bit of a support group from the neuropsychiatry part, strong thinking and like minded individuals, as well as just general support.
I am about to start a taper from a 4 year long daily use of moderate-high (depends on your definition) of benzodiazepines/thienodiazepines.
The majority of this use was 4mg/day of etizolam, and currently now am taking 2mg of clonazepam, and am about to start (hopefully) the Ashton protocol with the help of a Telehealth service in my area that uses the Ashton protocol. I say hopefully as I have a consultation scheduled in the next 2 days, and all of my benzodiazepines have been acquired and used without a prescription.
Now let me give some backstory on myself.
I have suffered from severe panic attacks since around 5th grade (~10 years old give or take). I state this date as I have two very powerful and profound memories of having panic attacks, although I did not know what I was experiencing at the time. This continued for many years, off and on, again without me really understanding what was going on.
I began to learn and understand about panic attacks probably around age 14-15. Around age 15-17, I took Sertraline as a treatment, with both really awful psychiatrists as well as psychologists that really didn't help much at all. It was so long ago, really hard to say if either had any impact.
I have some thoughts as to how and where it all began. Obviously it's likely there is a genetic component to it, but the major triggering events revolved around vomiting. A very strange occurrence in my life where vomiting was all around me in traumatizing ways, that all seemed to happen all at once, and at an age where I was not really able to understand the long term impact it was having on me.
So just before the onset of the panic disorder, I had a severe case of food poisoning. The whole lot, vomiting uncontrollably until my stomach was empty, and then dry heaving when it was, every 3 hours, for several days. This was for me, extremely scary and traumatized me a lot.
The rest of the timeline is very garbled, as they all took place over the next few years, and I was very young so it's hard to really put them in order.
But at some point, once again, I had food poisoning, not nearly as severe at this time, and a family member had some ondansetron (I'm assuming, as it was some sort of antiemetic syrup that finished things off pretty quickly) for when I reached the dry heaving stage. This is where things start to get interesting in my own self reflection.
I remember things being said like, "Perhaps you just felt sick because you took too long to eat" "Maybe you just swallowed some phlegm", among a few other things, which stuck with me for a very very long time, in an OCD like fashion.
As a result, 10-17 years old or so, I was obsessive about eating at the right time, all the time. I began to have massive anxiety form around the idea of missing a meal, and before going anywhere if I knew it coincided with meal time, I required knowing that I would have access to a meal.
There was also a period where I basically didn't eat the lunch my mother prepared for me (around 5th grade time, as I remember the particular cafeteria which only could have been accessible at that age/time period) because I was terrified that basically anything could give me food poisoning.
The surrounding events were bizarre. Obviously I was building some sort of PTSD type syndrome, as many others would never have noticed some of these events. But I remember a time being at a circus, where (I'm assuming, drunk) some people threw up in the bleachers just behind me. The smell, lack of way to exit, etc, made this a "banked" memory (I'll use that term as I'm not sure what a more appropriate term is for a very powerful memory that sticks out decades later and still affects me today.
Another time, a kid ran up to me, and just threw up at my feet, and then just kept running (seriously universe, wtf?!).
Another very notable one was when my mother and I visited her third world country home world, and she made the mistake of drinking the tap water that she had grown up drinking, but had since been removed for several decades.
She obviously got extremely ill, vomiting uncontrollably for days on end while my relatives took care of her, but that was scary too.
Another notable one was when I witnessed someone pull over their car, and lean out of it to vomit. The result from this one was a fear of vomiting while driving, or the need to do so.
In summary of the above, these events gave me a serious fear and phobia of vomiting, and I did everything I could ever do to avoid it. (which I realize is irrational, as it is a very crucial and necessary bodily function for survival)
Enter the Anxiety Disorder
From here on out, I was plagued with anxiety attacks/panic attacks, as well as anxiety about having anxiety or a panic attack. Even to this day, leaving the comfort of my safe space/home, I immediately jump to worrying about "what if I have a panic attack while I am out". I think this is pretty common for people with panic disorder in general.
And of course, my main symptom when I feel anxiety/experience a panic attack, or at least the one that is the most distressing and stands out the most, is nausea. Linked deeply to my hard imprinted fear of vomiting, unfortunately I would experience nausea as my main symptom.
During 2020, things changed. I had always gotten very nauseated during a panic attack, but nothing ever came of it except feeling petrified to move (being in a "freeze" state vs fight or flight) in case of making the nausea worse, although any time I'd have a panic attack, I'd immediately flee. If this was in a social situation, I'd leave immediately.
During 2020, I actually started to transition from simple nausea to actual dry heaving during severe panic attacks. Never actual vomiting, but dry heaving. Extremely uncomfortable, as it felt as though my body was physically fighting vomiting, as if a wall was being shoved against my esophagus and not allowing anything to come up.
It got to the point that at my apartment at the time, I would have a whole setup for it. I had nitrile gloves, a clean towel, and a bottle of bleach with some peppermint oil, a plug in fan. As soon as I felt the panic attack coming on, I knew I had about 90 seconds to get set up for it, so I'd move the bath mat to the toilet to lay on, put on the gloves and clean the toilet with the bleach and the towel, grab an electronic device (phone, tablet, computer, whatever) to play music/relaxation stuff and communicate with my people who would support me through it, and then it was off to the races. I'd spend around 30 minutes going through waves of dry heaving. Hot flashes, and all the usual panic attack symptoms were present as well. 30 minutes, well that's because that is when the etizolam would start kicking in and knock the panic attack out.
Enter the Benzodiazepines
It was at this point that I began to use benzodiazepines to manage my panic disorder. I had been prescribed various ones in the past, but only for things like airplane rides, so 5-10 at a time, with no refills. I also have had access and used benzodiazepines often in the past to manage things, and have a very good understanding of their pharmacology, so I wasn't too worried about using it as needed without a doctor overseeing my usage.
This was different. This was pre-ban Indian etizolam, which you could just order legally straight from India and unscheduled in the United States.
Etizolam was just a magic drug. No depressive symptoms like from alprazolam, extremely rapid onset, and extremely powerful anxiolysis that would stop a panic attack dead in its tracks and have me feeling perfectly wonderful once its effects kicked in. I'd clean myself up, clean up the space, put everything back, and all would be well.
I was perfectly fine when I was using it like this, as I had maybe a panic attack once every 2 weeks, sometimes more frequently, sometimes less frequently, just depended on what was going on.
One event changed this.
I was taking a 60 minute drive to a place I was unfamiliar with. I already am in an unfamiliar place as around this time I had just moved to a part of California I am not from, and so don't know the area, have friends or family close by to help me if I was in trouble, etc.
Around the 50 minute mark, I felt a full blown mega panic attack began to build, and I rapidly pulled off the freeway and just pulled behind some random business building into their alley.
I then proceeded to have one of the most intense panic attacks I can remember, mostly due to the circumstances. I was in a place I did not know anything about, had no one to give me aid, and it was getting dark. I was sitting there, dry heaving outside of my car, in a back alley of some random business, and I didn't even know what city I was in.
The only thing I had on me at the time was some leftover lorazepam that I kept as an emergency stash in my car, and so it took quite a while to get any relief. It was very scary as as mentioned, I was alone, had no one to help, and was in legitimate potential danger considering it was dark, I was physically and mentally incapacitated, etc.
Eventually the benzo kicked in, and I felt well enough to call a friend of mine to help talk with me while I drove home to safety.
This is when my use changed dramatically.
After this event, it went from using benzo's during acute panic attacks, to any time I was going to take a long drive, as I knew I couldn't afford to have a panic attack while on the road as it would be dangerous. This then changed to basically anytime that I was entering into a situation where I knew I would likely have anxiety, or the potential would be there, and I couldn't afford to have that happen, I'd pre-benzo as a preventative.
From there, it was natural to just transition to daily use, and that is how it's been ever since.
The Daily Use Era
My use at one point got as high as 16mg of etizolam per day. India banned exports, so I was forced to rely on making a volumetrically dosed solution of pure etizolam powder. I dosed it at 4mg/ml, and was often using 4ml per day.
I knew that was out of hand, so I got myself back down to 4mg/day, with very little difficulty/withdrawal symptoms. (Etizolam really is a unique substance, being that it seems to accrue tolerance and dependance much slower than traditional benzodiazepines, as well as never really building much of a tolerance to the anxiolysis, only the muscle relaxant and sedative effects)
Making The Choice to Get Off The Wagon
I realize that my use of benzodiazepines has just been spiraling out of control, and it really got to me when I realized I could take 160mg of diazepam with only minor sedation and almost no noticeable effects. I also began to notice interdose spikes in anxiety with the daily dosing of etizolam, as I was taking the 4mg all at once in the morning.
I realized I needed to split this dosage into 2mg in the morning, and 2mg in the evening to even this out and not experience interdose withdrawal.
This was putting me down the path towards making the choice to jump off with conviction.
It's worth noting that during the entire time I have been on the benzo's, I have had almost zero panic attacks, which obviously reinforced the use.
I have noticed I have made some pretty serious misjudgments, with the most recent one costing me my relationship with my significant other (like, literally 4 days ago). We had discussed my desire to taper off the benzo's for a while, and I made some attempts to lower my usage, but when things would get hard (in life, not the relationship), I would just go dose as needed.
I won't blame my actions on benzo's and dissolve my responsibility for my own actions, but I can certainly say that they haven't helped me make proper decisions. The lack of anxiety seems to really make making poor choices easy, as I very subtlety don't pay attention as much to the potential consequences of my actions.
I have also noticed that my benzo use (as my own "personal rules" have relaxed) fluctuates as needed. If I'm having a rough day, I just take more, to "smooth out" the day, so that even on a high stress day, I feel the same as a no stress day.
The breaking up with the significant other is obviously extremely painful and that's something I'm dealing with right now, but that's not fully relevant to this story other than it being part of the catalyst to me finally deciding once and for all to make this jump. I guess it's part of the pain driving me to try to right a lot of wrongs that I feel I have in my life, this being a very big one.
Let's do it!
If you've made it this far, bless your heart lol. I basically just unpacked the majority of my most inner and difficult struggles in life. I appreciate you reading this far if you'll be along for the journey, as it really gives a ton of context to this journey. For those that didn't read all of it, that's totally fine, as getting all this written down is half for me as well, as this log is going to be a bit of a self reporting journal (along with my own personal journal that I'll be keeping) for people to chime in.
In the next, post, I'll get into the plan, and the details, which people just jumping in to put some input in can just read over and provide some thoughts and feedback on.
Thanks for having me in this community and wish me luck! I'm definitely going to need it...
Edited by sadgaba, 02 January 2023 - 03:14 AM.
