Andrés Gómez Emilsson | Benzos: Why the Withdrawal is Worse than the High is Good (+ Flumazenil/NAD+ Anti-Tolerance Action) @/Andr%C3%A9sG%C3%B3mezEmilsson | Uploaded January 2021 | Updated October 2024, 17 hours ago.
Most people have low-resolution models of how drug tolerance works. Folk theories that "what goes up must come down" and theories in the medical establishment about how you can "stabilize a patient on a dose" and expect optimal effects long term get in the way of *actually* looking at how tolerance works.
In this video I explain why benzo withdrawal is far worse than the high they give you is good.
Core arguments presented:
(1) Benzos can treat anxiety, insomnia, palpitations, seizures, hallucinations, etc. If you use them to treat *one* of these symptoms, the rebound will nonetheless involve *all* of them.
(2) Kindling - How long-term use leads to neural annealing of the "withdrawal neural patterns".
(3) Amnesia effects prevent you from remembering the good parts/only remembering the bad parts.
(4) Neurotoxicity from long-term benzo use makes it harder for your brain to heal.
(5) Arousal as a multiplier of consciousness: on benzos the "high" is low arousal and the withdrawal is high arousal (compared to stimulants where you at least will "sleep through the withdrawal").
(6) Tolerance still builds up even when you don't have a "psychoactive dose" in your body - meaning that the extremely long half-life of clonazepam and diazepam and their metabolites (50h+) entails that you still develop long-term tolerance even with weekly or biweekly use!
I then go into how the (empirically false) common-sense view of drug tolerance is delaying promising research avenues, such as "anti-tolerance drugs" (see links below). In particular, NAD+ IV and Flumazenil seem to have large effect sizes for treating benzo withdrawals. *I AM NOT CONFIDENT THAT THEY WORK*, but I think it is silly to not look into them with our best science at this point. Clinical trials for NAD+ IV therapy for drug withdrawal are underway, and the research to date on flumazenil seems extremely promising. Please let me know if you have any experience using either of these two tools and whether you had success with them or not.
Note: These treatments may also generalize to other GABAergic drugs like gabapentin, alcohol, and phenibut (which also have horrible withdrawals, but are far shorter than benzo withdrawal).
Further readings:
"Epileptic patients who have become tolerant to the anti-seizure effects of the benzodiazepine clonazepam became seizure-free for several days after treatment with 1.5 mg of flumazenil.[14] Similarly, patients who were dependent on high doses of benzodiazepines [...] were able to be stabilised on a low dose of clonazepam after 7–8 days of treatment with flumazenil.[15]"
"Flumazenil has been tested against placebo in benzo-dependent subjects. Results showed that typical benzodiazepine withdrawal effects were reversed with few to no symptoms.[16] Flumazenil was also shown to produce significantly fewer withdrawal symptoms than saline in a randomized, placebo-controlled study with benzodiazepine-dependent subjects. Additionally, relapse rates were much lower during subsequent follow-up.[17]" - en.wikipedia.org/wiki/Flumazenil#Treatment_for_benzodiazepine_dependence_&_tolerance
NAD+ for Benzodiazepine Withdrawal - kenstarrmd.com/nad-for-benzodiazepine-withdrawal
REVIEW: NAD+ for Detox and Post Acute Withdrawal. - youtu.be/PStTZhc8Zyc
Addiction Clinics Market Unproven Infusion Treatments To Desperate Patients - npr.org/sections/health-shots/2019/08/22/741115178/addiction-clinics-market-unproven-infusion-treatments-to-desperate-patients
Benzo Withdrawal: Why I Ignored Medical Advice and Listened to the Internet - benzoinfo.com/2018/11/13/benzo-withdrawal-why-i-ignored-medical-advice-and-listened-to-the-internet
Xanax withdrawals 'like being tortured alive' - youtu.be/eRCmnWD9pms
Anti-Tolerance Drugs - qualiacomputing.com/2018/11/07/anti-tolerance-drugs
Benzodiazepine Withdrawal Suppor - tbenzobuddies.org
Using Ibogaine to Create Friendlier Opioids - qualiacomputing.com/2019/08/06/using-ibogaine-to-create-friendlier-opioids
Most people have low-resolution models of how drug tolerance works. Folk theories that "what goes up must come down" and theories in the medical establishment about how you can "stabilize a patient on a dose" and expect optimal effects long term get in the way of *actually* looking at how tolerance works.
In this video I explain why benzo withdrawal is far worse than the high they give you is good.
Core arguments presented:
(1) Benzos can treat anxiety, insomnia, palpitations, seizures, hallucinations, etc. If you use them to treat *one* of these symptoms, the rebound will nonetheless involve *all* of them.
(2) Kindling - How long-term use leads to neural annealing of the "withdrawal neural patterns".
(3) Amnesia effects prevent you from remembering the good parts/only remembering the bad parts.
(4) Neurotoxicity from long-term benzo use makes it harder for your brain to heal.
(5) Arousal as a multiplier of consciousness: on benzos the "high" is low arousal and the withdrawal is high arousal (compared to stimulants where you at least will "sleep through the withdrawal").
(6) Tolerance still builds up even when you don't have a "psychoactive dose" in your body - meaning that the extremely long half-life of clonazepam and diazepam and their metabolites (50h+) entails that you still develop long-term tolerance even with weekly or biweekly use!
I then go into how the (empirically false) common-sense view of drug tolerance is delaying promising research avenues, such as "anti-tolerance drugs" (see links below). In particular, NAD+ IV and Flumazenil seem to have large effect sizes for treating benzo withdrawals. *I AM NOT CONFIDENT THAT THEY WORK*, but I think it is silly to not look into them with our best science at this point. Clinical trials for NAD+ IV therapy for drug withdrawal are underway, and the research to date on flumazenil seems extremely promising. Please let me know if you have any experience using either of these two tools and whether you had success with them or not.
Note: These treatments may also generalize to other GABAergic drugs like gabapentin, alcohol, and phenibut (which also have horrible withdrawals, but are far shorter than benzo withdrawal).
Further readings:
"Epileptic patients who have become tolerant to the anti-seizure effects of the benzodiazepine clonazepam became seizure-free for several days after treatment with 1.5 mg of flumazenil.[14] Similarly, patients who were dependent on high doses of benzodiazepines [...] were able to be stabilised on a low dose of clonazepam after 7–8 days of treatment with flumazenil.[15]"
"Flumazenil has been tested against placebo in benzo-dependent subjects. Results showed that typical benzodiazepine withdrawal effects were reversed with few to no symptoms.[16] Flumazenil was also shown to produce significantly fewer withdrawal symptoms than saline in a randomized, placebo-controlled study with benzodiazepine-dependent subjects. Additionally, relapse rates were much lower during subsequent follow-up.[17]" - en.wikipedia.org/wiki/Flumazenil#Treatment_for_benzodiazepine_dependence_&_tolerance
NAD+ for Benzodiazepine Withdrawal - kenstarrmd.com/nad-for-benzodiazepine-withdrawal
REVIEW: NAD+ for Detox and Post Acute Withdrawal. - youtu.be/PStTZhc8Zyc
Addiction Clinics Market Unproven Infusion Treatments To Desperate Patients - npr.org/sections/health-shots/2019/08/22/741115178/addiction-clinics-market-unproven-infusion-treatments-to-desperate-patients
Benzo Withdrawal: Why I Ignored Medical Advice and Listened to the Internet - benzoinfo.com/2018/11/13/benzo-withdrawal-why-i-ignored-medical-advice-and-listened-to-the-internet
Xanax withdrawals 'like being tortured alive' - youtu.be/eRCmnWD9pms
Anti-Tolerance Drugs - qualiacomputing.com/2018/11/07/anti-tolerance-drugs
Benzodiazepine Withdrawal Suppor - tbenzobuddies.org
Using Ibogaine to Create Friendlier Opioids - qualiacomputing.com/2019/08/06/using-ibogaine-to-create-friendlier-opioids
