Blood samples from 24 severely affected patrons (median age 22) revealed polysubstance use, with toxicology confirming a median of four drugs per individual. MDMA, ketamine, and cocaine were most common, and nearly half of the samples contained NPS despite none reporting intentional use. If you’re receiving benzodiazepine treatment through Maps for Recovery, it’s important to carefully follow your personalized medication schedule. However, if it’s close to the time for your next scheduled dose, you should skip the missed dose and resume your regular dosing schedule. They will guide you based on your unique medication regimen, dosage, and overall treatment plan.

At Isha Health, we remain committed to staying at the forefront of mental health advancements to provide transformative care. Migraines are more than just headaches—they are a neurological condition often linked to depression and anxiety. Research shows that chronic migraines can contribute to mental health challenges, highlighting the need for comprehensive treatment. Ajovy, a CGRP inhibitor, is a breakthrough medication for migraine prevention, reducing both the frequency and severity of attacks. While not a direct treatment for depression, Ajovy’s ability to prevent migraines can positively impact mental health by improving quality of life, sleep, and social engagement. At Isha Health, we take a holistic approach to migraine and mental health care.

Quality Care

• One study evaluated the use of social workers in a telephone-based poison centre, where they assisted with tablet identification and overdose information 78.
• In response to increased overdose risk and gendered violence, with particularly attention paid to the risk of sexual assault in the context of benzodiazepine use, women developed informal peer networks to support and check on each other during this time 76.
• Primarily prescribed for anxiety, panic and sleep disorders, and substance withdrawal; these medications hold anxiolytic, hypnotic, muscle relaxant, and anticonvulsant properties 3.
• Nevertheless there is no magic rate of withdrawal and each person must find the pace that suits him best.
• Usually the best judge is you, yourself; you must be in control and must proceed at the pace that is comfortable for you.

I especially recommend avoiding benzodiazepines in people with memory concerns or a dementia such as Alzheimer’s disease. Benzodiazepines act on the same brain receptors as alcohol, and they almost always keep people with dementia from thinking at their best level. Benzodiazepines can also cause death if there is an accidental (or intentional) overdose, as high doses will slow down breathing to dangerously low levels.

Q: I can’t sleep when I don’t take Ativan. How am I supposed to get off of it?

This patient has developed numerous concerning adverse effects, including tolerance, physiologic dependence, and withdrawal. Additionally, her use of supratherapeutic doses of alprazolam poses a safety concern. Because risks of continued use outweigh any potential benefits, tapering her down and off of the medication should be discussed. There is absolutely no doubt that anyone withdrawing from long-term benzodiazepines must reduce the dosage slowly. Abrupt or over-rapid withdrawal, especially from high dosage, can give rise to severe symptoms (convulsions, psychotic reactions, acute anxiety states) and may increase the risk of protracted withdrawal symptoms (see Chapter 3).

Young people

Low-cost tools such as FTS (~ $1 USD) provide rapid, albeit less specific, results 51, whereas more sophisticated methods such as PS-MS offer higher sensitivity at greater expense and complexity 44. This indicates an ongoing need for innovation and investment to improve drug checking technologies that can meet accuracy and speed requirements when detecting emerging substances. A 45-year-old woman with a history of anxiety and insomnia transferred to our clinic requesting alprazolam (Xanax), which she had been taking for the past year. It was prescribed by another physician who had since retired, and she insisted that it was the only thing that helped her symptoms.

• To reduce overdose deaths, the clinics removed benzodiazepines from the approved medication list and provided patients with individualised treatment plans, including psychoeducation, psychotherapy, slow taper, and inpatient detoxification.
• Today, we’re unwrapping the story of N-Acetylcysteine (NAC), a supplement stepping into the limelight of mental health research.
• The second study found most participants saw the benefits of agonist treatment, such as reduced criminal behaviour and greater stability 58.
• In withdrawal you need a long-acting drug which can be reduced in very small steps.
• Over the past several months, she had been taking more alprazolam during the day and at bedtime, because it had not been working as well as when initially prescribed.

Women who use drugs

This calibration process was completed before continuing with the full screening of all identified records. All remaining discrepancies were resolved through discussion, with RML providing the final vote where required. A free, quick-reference digital tool to provide healthcare providers with instant access to current guidelines in a clear concise format. Ketamine-assisted psychotherapy has been gaining attention in recent years for its potential to help…. Marcia Frellick is a Chicago-based healthcare journalist and a regular contributor to Medscape.

Ideally, your mentor should be someone who understands about benzodiazepine withdrawal or is prepared to read about it and learn. It need not be someone who has gone through withdrawal – sometimes ex-users who have had a bad experience can frighten others by dwelling on their own symptoms. Often the help of a clinical psychologist, trained counsellor, or other therapist is valuable, especially for teaching relaxation techniques, deep breathing, how to deal with a panic attack etc. Some people find alternative techniques such as aromatherapy, acupuncture or yoga helpful, but these probably act only as an aid to relaxation.

If you prefer someone else, any primary care physician or psychiatrist can help you taper your dose. If you are pregnant or are thinking about becoming pregnant, talk to your OBGYN or psychiatrist about your plans. Your doctor can help you weigh the potential risks and benefits of benzodiazepine use and your pregnancy. Some people, such as those with a history of complicated withdrawal, seizures, or severe mental illness, may be better suited for an inpatient setting. This can involve living at a detox facility or hospital for several weeks, where you can receive constant medical monitoring and psychological support. During your taper, you may still experience some of the symptoms of withdrawal.

At MAPS for Recovery, we understand the complexities of benzodiazepine dependence and withdrawal. Benzodiazepines, often prescribed for anxiety, insomnia, seizures, and other medical conditions, carry significant risks when discontinued abruptly or without medical stopping benzodiazepines safely supervision. Many patients undergoing withdrawal also experience mood fluctuations, depression, emotional instability, confusion, and cognitive difficulties. Physical manifestations often include muscle aches, tremors, sweating, headaches, dizziness, and nausea. Although rare, these complications can become life-threatening if withdrawal occurs abruptly after prolonged or high-dose use.

Among people taking benzodiazepines for longer than six months, about 40% experience moderate to severe withdrawal symptoms when they quit suddenly. But ideally, benzodiazepines should be used as a last resort, after making a serious attempt to treat insomnia and anxiety with non-drug approaches. These can include techniques such as cognitive-behavioral therapy, regular exercise, and stress-reduction techniques. For people with Alzheimer’s, providing caregivers with coaching on managing difficult dementia behaviors can also help. Compounding pharmacies can be used to obtain very small doses near the end of the taper.

Sudden withdrawal from benzodiazepines leaves the brain in a state of GABA-underactivity, resulting in hyperexcitability of the nervous system. This hyperexcitability is the root cause of most of the withdrawal symptoms discussed in the next chapter. However, a sufficiently slow, and smooth, departure of benzodiazepines from the body permits the natural systems to regain control of the functions which have been damped down by their presence. There is scientific evidence that reinstatement of brain function takes a long time. Recovery after long-term benzodiazepine use is not unlike the gradual recuperation of the body after a major surgical operation. The evidence on the effectiveness of agonist treatment for benzodiazepine dependence remains limited and methodologically diverse.

Yet some people might prefer to reduce faster and some might go even slower. It is sometimes claimed that very slow withdrawal from benzodiazepines “merely prolongs the agony” and it is better to get it over with as quickly as possible. However, the experience of most patients is that slow withdrawal is greatly preferable, especially when the subject dictates the pace. Nevertheless there is no magic rate of withdrawal and each person must find the pace that suits him best.