(Trigger warning: drug addiction, suicide)

When I saw the preview on Netflix for their new “Take Your Pills XANAX” documentary discussing the possible dangers of benzodiazepine use (eg Valium, Klonopin, Xanax etc) I got excited…

“Is this finally hitting the mainstream?”

As a naturopath & functional medicine practitioner working with anxiety patients I’ve seen firsthand the damage that these medications can do when prescribed for too long…and I’ve also witnessed the absolute ignorance and denial b the orthodox medical profession that these drugs can cause a living hell for some people…and even suicide for others.

And secretly I was glad this doco came out because truthfully it’s something I feel nervous talking about despite being REALLY passionate about this topic and despite the fact that one of the main reasons I chose to focus my practice on anxiety and depression – besides the fact that I’ve suffered from severe anxiety and deeply empathise with sufferers – was after reading the excellent book “Anatomy Of an Epidemic” by investigative medical journalist Robert Whitaker, which really opened my eyes to the fact that when it comes to mental health, the current mainstream medical model is not only failing most people, but harming many. Plus there are so many little-known but highly effective natural options that can really make a difference.

HOWEVER…

I don’t talk or share about it much because as an alternative health practitioner it’s so easy for me to be quickly dismissed as being anti-orthodox medicine, anti-science or even a whacko conspiracy-theorist….and fair enough, there’s actually too many of those folks in the natural medicine space in my opinion and they annoy the sh*t out of me too (and sadly give the whole industry a bad name).

The truth is I’m NONE of those things.

When I was younger and injured my back at a care job, I was prescribed valium as a muscle relaxant. I also was extremely stressed as I’d just been fired by said job (where I also lived, in a foreign country) due to the injury. I had no money and nowhere to go. I distinctly remember almost tearing my hair out with worry about what I was going to do and where I was going to go, then popping my first valium, and within half an hour thinking calmly “oh well, nothing I can do about it right now” and plopping myself down to enjoy some colouring-in!

These drugs work really, really well at reducing anxiety and I believe there is definitely a place for them in certain situations.

Also, (here comes my sordid past…*deep breath*) I’ve worked for several years as a pharmaceutical rep for some of the world’s biggest pharmaceutical companies and won the national sales award…twice! (Go figure…those docs had no idea they were talking to a naturopath and frequently praised my grasp of relaying scientific information clearly & succinctly, haha)

In that time I worked closely with doctors and specialists and developed a deep respect for the amount of knowledge they have and the huge responsibility they carry. And while there’s definitely well-documented issues of corruption within the pharmaceutical industry (as I’ve also seen in various natural medicine corporations too – human greed is human greed), it’s not black and white, there are so many amazing medications out there and excellent research being done, and people that really care within “big pharma”.

And lastly, in my clinic, I frequently work with medicated patients alongside their doctors and respect whatever choice they make in regards to medication. In fact, in a few rare cases of very acute, severe anxiety, I’ve even referred them to psychiatrists in order for them to get a benzodiazepine prescription for short-term use to bring them to a calmer, base-line state so that all the natural interventions I use can have a better chance to work.

So hopefully you can see I have a fairly balanced view and am not simply biased against psychiatric medication.

Now to the documentary…

THE GOOD

There was a lot of things in Take Your Pills XANAX, currently streaming on Netflix, that I really liked, so lets start with the positive.

It was great that they combined perspectives from different patients as well as psychiatrists and a professor of addiction medicine and that they gave a good overview of *some* of the issues within modern-day society that are leading so many people to suffer from anxiety these days.

One of the anxiety-sufferers, 50-something Regina, hit the nail on the head for a lot of the clients I see when she talked about being a burnt-out mum with so much relentless responsibility caring for others and zero time for her own self-care plus work stress which precipitated her anxiety, I see this ALL THE TIME in women with anxiety!

But there was a good mix of several anxiety-sufferers from all walks of life who had a range of experiences on benzodiazepines.

I was also very happy to see John’s story portrayed, as this really illustrated the reality of the living hell a lot of people go through when trying to come off these meds as well as the lack of support and knowledge from doctors that many sufferers have to contend with.

John was prescribed Valium for minor anxiety at 18 years old from his student health clinic and was advised to stay on it indefinitely….gradually as his tolerance grew his dose was pushed up and up. After a couple of DECADES when his wife was pregnant with their first child and life was going pretty good, he decided to come off them.

This is when the hell began.

Constant ringing in his ears, neurological symptoms, cognitive issues, everyday sounds feeling unbearable to hear, feeling like his skin was on fire, terrible anxiety much worse than ever before, to the point where he ran from the house, got in his car and started driving towards a mountain to kill himself…

Thankfully he managed to remember his kids and wife and stopped himself just in time.

John suspected it might have been the benzo withdrawal but was told by 32 (!!!) different doctors that it was impossible that benzos could cause these symptoms. He was even referred to the prestigious Mayo Clinic where a specialist diagnosed him with a rare auto-immune condition (which he didn’t have).

Eventually John resorted to “Dr Google” and began researching “benzodiazepine withdrawal” and came across not only countless patient anecdotes that reflected his own experience, but the “Ashton Manual”, a guide to benzodiazepine withdrawal written by Prof. Heather Ashton, a physician and psychopharmacologist who has helped thousands of people safely taper from benzos and was a huge advocate for trying to spread the word to the medical community about the dangers of benzodiazepine dependence. In it he saw listed EVERY SINGLE ONE of his symptoms.

The problem with mainstream medicine not grasping how incredibly addictive benzos are, is that they therefore don’t know how to taper people safely to avoid potentially debilitating withdrawal symptoms. Patients are usually tapered down over several weeks, but this for many people, especially if they’ve been on them for decades like John, is actually waaaay too fast.

Like many others I’ve come across, John had to taper so minutely, with a whole chemistry-set up at home as most doctors don’t know how to do this (though I believe some compounding pharmacies can sometimes assist with this), reducing the dose so gradually, that it will actually take him years to come off the medication completely. Any faster, and he’s straight back to his hell-zone.

I also liked that the documentary touched on a few issues such as the problem with pharma companies being able to advertise drugs directly to the public in some countries such as the US, and also how other holistic interventions can be useful such as the importance of sleep, meditation, social connection, being outdoors, therapy and exercise. One psychiatrist also shared her great success she has with prescribing cannabis/CBD for some of her anxiety patients.

I also liked the prudence that the psychiatrists demonstrated when discussing how these medications can have a place short-term, but typically are prescribed too often and for too long and I wholeheartedly agreed with anxiety-sufferer Phoebe when she said

“Medication is a tool for me to make space for non-medication things to work in my life”.

I nodded in agreement when some patients used the medication situationally for things like panicking when flying or public speaking, these meds can be really helpful for things like that (though there are some great natural options too that some of my patients have shared work just as well).

So that was all good.

THE BAD…

Now for what I didn’t like…

I felt that in the interest of being “balanced” the documentary was trying too hard not to be too scathing towards benzodiazepines and the medical profession. This did annoy me as they kind of presented John as an outlier when actually his experience is sadly quite common, both the severe withdrawal symptoms and the total ignorance of his doctors.

I thought they should’ve held the medical profession and Big Pharma more accountable, and really pressed the point that long-term benzo prescribing is actually both unscientific and irresponsible, (and something has to be done about this!!) because most of the studies (and this goes for anti-depressants too) rarely span more than 6 weeks. I feel doctors are essentially going “rogue” when they leave patients on these meds beyond that when we don’t have the evidence to support the safety of this, nor any commonly-known guidelines on how to safely taper long-term users.

The other thing I was disappointed in, was the addiction professor suggesting that it’s better to just switch people to SSRIs (anti-depressants) as they are less dangerous and addictive. While perhaps somewhat less addictive than benzos, long-term users often run into the exact same problems when tapered too fast, several of the meds now have a black-box warning about possible suicidal ideation as a side effect, and just like benzos, patients are left on them for years or decades when there is no scientific validation of the safety of long-term use.

What’s more, in a recent training I did with integrative psychiatrist Dr James Greenblatt MD (who has successfully tapered thousands of people on SSRIs safely and this year published a book on a functional medical approach to SSRI withdrawal) shared in his presentation that after the “bad press” benzos received as being more addictive than heroin and cocaine, drug companies didn’t want the same stigma attached to SSRI’s so essentially invented a new term for the same problem of addiction called “SSRI discontinuation syndrome” to deflect attention….which is essentially withdrawal and no different to what happens to some people on benzos.

The other thing I took issue with, was while they did mention some useful holistic interventions, it was still pretty limited in my book. Diet can have a profound impact, many herbal medicines and nutraceuticals have good anti-anxiety effects, not just cannabis and also it didn’t go into the many possible physical root causes of anxiety that often need addressing for patients to truly heal such as thyroid issues, hidden gut infections, physical changes to the stress-response system due to trauma, nutrient deficiencies or hormonal imbalances just to name a FEW).

In fact, I actually found it somewhat victim-blaming by suggesting that anxiety patients just want a quick-fix magic pill and really just need to develop more resilience to cope with anxiety without drugs. This saddened me as so many anxiety patients turn to their doctors in good faith, genuinely wanting to get to the bottom of their symptoms but are only offered “a magic pill” with no real informed consent or education as to the potential dangers nor any other options given.

And also, while I agree that building resilience is an important skill to develop, as someone who has suffered from panic attacks so severe that they’ve resulted in 24 hour vomiting and utterly uncontrollable hyperventilation to the point where I’ve ended up in the ED, I find this perspective quite harsh…anxiety can cause immense suffering and terrible quality of life, and suggesting sufferers just build some resilience to essentially just “put up with it” is pretty cruel and out-of-touch with the reality in my view.

1. You don’t realise you’re addicted generally speaking until you try to come off them, so how does she know she’s not addicted? She could be in a world of pain if she even tries to drop her dose slightly.
2. Having to take a benzo every day just to function is not a success-story of well-managed anxiety in my view.
3. She’s so young and I hate to think what’s happening to her young brain…whose to say she won’t be in the same situation as John in 20 years time?
4. I found it both ironic and sad that she was saying all this while baking cookies: sugar and diet are majorly under-estimated players in mental health symptoms like anxiety and depression, and I’ve seen phenomenal reductions in symptoms in both myself and my patients with a few diet changes including eradicating sugar completely. (I have a free downloadable anti-anxiety diet that outlines this approach in-depth, feel free to try it for yourself!)

OTHER RESOURCES 

All in all, I was happy that some of these issues are beginning to hit the mainstream. However, if you suffer from anxiety and depression and want to dig into this deeper so that you really understand the potential risks of these medications, there are many other better sources of information such as:

This CNN documentary titled “The Benzo Crisis” which is a lot more critical and realistic about the enormity of the problem and predicts that the benzo crisis, though not well-publicized, will actually become much worse than the better-known opiate crisis.

I also HIGHLY recommend you read Robert Whitaker’s Anatomy of An Epidemic which covers these topics in-depth, including SSRI’s and also the rising over-medication of children and is incredibly well-researched with excellent references.

And for information and resources on Benzo withdrawal these websites can be helpful:

FUNCTIONAL MEDICINE SUPPORT FOR WITHDRAWAL AND MEDICATION TAPERING

Functional medicine can be really beneficial during medication tapers also. Let me first give the caveat that it’s beyond the scope of my practice as a naturopath to encourage a patient to start, stop or alter the dosing of their  prescribed medication. However, with the supervision of their prescribing doctor, I’ve helped support patients with holistic interventions to enable their taper to go as smoothly as possible. One key piece of advice to consider is that, because it can be so grueling for some patients when tapering, I recommend being in the best state of physical and mental health possible before potentially beginning this process, and naturopathic medicine can certainly assist with this. If this is something you’d like to discuss, you’re welcome to schedule a free introductory consultation here.

Now over to you…have you watched this documentary? What are your thoughts? Have you been prescribed benzodiazepines or tried to taper? What was your experience? Let me know in the comments below and let’s discuss this very important topic 🙂