I suffer from a painful, degenerative condition named Marfan syndrome, and frequently suffer debilitating back spasms in which the muscles of my lower back cramp up to such an extent that the doctor can feel them bunched and hard. I also suffer from debilitating panic attacks, during the course of which I suffer terrifying feelings of impending doom; these attacks make it impossible for me to function as a productive member of society when not appropriately medicated.
When my back goes into spasm, I take diazepam 10 mg. I should point out, in the interests of full disclosure, that I have taken benzodiazepines for well over 25 years; when I was a freshman in South Africa, the campus doctor prescribed clobazam (Urbanol, Frisium) to control these panic attacks. Clobazam was the first of the 1,5-benzodiazepines, and was thought to be less sedating than alternatives such as lorazepam, diazepam, clonazepam, etc. Upon leaving South Africa and moving to the USA, I found it almost impossible to obtain benzodiazepines – the vast majority of doctors simply refused to prescribe them to their patients, regardless of medical necessity (this attitude was the result of what I consider to have
been grossly overhyped fears pertaining to the addictive potential of drugs in this class).
I went without benzodiazepines for about fives years, before meeting a doctor who was willing to prescribe alprazolam (Xanax) to control my panic attacks and anxiety. At no point during this five-year period did I suffer severe withdrawal symptoms – for a few days, I was irritable and out of sorts, but at no point in time did I suffer any of the withdrawal effects noted so prominently by researchers who condemn these drugs out of hand…
Towards the mid-1990s, doctors (particularly in the New York City region) slowly reverted to prescribing the benzodiazepines. For unknown reasons, the benzodiazepine of choice, which is still prescribed more heavily than any other drug from this class in the New York City region, is alprazolam (Xanax, Xanor); however, it is once again possible to obtain diazepam (Valium) from doctors in the USA.
I am deeply thankful to Roche laboratories for developing the benzodiazepines (first Librium, then Valium). When I take diazepam, I feel calm and relaxed and am able to go about my daily business without fear of panic attacks, and without suffering the manifestations of Generalized Anxiety Disorder (a diagnosis that was made when I was about 23 years old).
I moved to the UK about two years ago, and noticed that doctors in the UK are much more likely to prescribe lorazepam than they are likely to prescribe alprazolam. Both lorazepam and alprazolam are extremely potent benzodiazepines – most conversion tables rank lorazepam as being about 10 times more potent (on a gram for gram basis) than diazepam, and also rank alprazolam as being about 20 times more potent (on a gram for gram basis) than diazepam. That is to say, lorazepam 1 mg is equivalent in anxiolytic potential to diazepam 10 mg, whereas alprazolam 0.5 mg is equivalent in anxiolytic potential to diazepam 10 mg. However, I have noticed a definite difference between lorazepam and diazepam – although lorazepam is highly effective in calming me when I am upset or agitated, I do not obtain the same degree of relaxation as that which I obtain when taking an equivalent dose of lorazepam.
I am well aware of the addictive potential of the benzodiazepines – and I quite honestly don’t give a damn. These tranquillizers have made it possible for me to function normally, and my greatest fear is that overzealous patient groups will pressure the authorities to impose even tighter controls over the prescription of drugs from this class. Already, temazepam (which is a highly effective sleeping pill) has been rescheduled and is now a Schedule 3 drug in the British system (whereas all of the other benzodiazepines are Schedule 4 drugs). The decision to reschedule temazepam was based on the fact that some people misuse this drug and inject the contents of temazepam gel capsules into their veins, often leading to gangrene as the affected vein closes up. Since when is medical policy dictated not by patients who take their medication as prescribed, but instead by miscreants who abuse the trust in which their doctors place them? Since when did abuse of a particular drug become confused with its legitimate usage?
In short, I have nothing but praise for drugs from this class, despite the knowledge that they are addictive. When my New York City doctor prescribed alprazolam, he made me sign a waiver in which I attested to the fact that he had warned me about the addictive potential of these drugs – and I have never looked back or regretted my decision to take medications from this class.
PHILIP CHANDLER
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Oct 26th, 2009
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