288 pointsby gaplong 1 day ago232 comments

https://web.archive.org/web/20261020230542/https://www.thebe... https://archive.ph/Tb1SZ

Discussion

Loading discussion

gavinray · 23 hours ago
> Having kicked opiates cold turkey in the past, I felt nostalgic for three simple days of traditional nausea, sweatiness, and bone-deep ache. I am one of few people stupid enough to have, at one point, been addicted to and subsequently withdrawn from, almost everything but alcohol. There is no way to explain the hell on earth that is benzo/GABA-ergic drug withdrawal, and I would not wish it on my worst enemy. It is an order of magnitude more intense than opiate withdrawals, and the timeline is weeks/months rather than days. Like the author, I managed to quit via a year-long Ashton protocol taper. The irony is that benzos were the one class of drugs I wasn't abusing for recreation. I was using mega-doses of Etizolam to cope with PTSD flashbacks, and only discovered I had become physically addicted after flushing it all and winding up in the ER.
- nrjames · 23 hours ago
  I was on Ativan for acute trauma avoidance (to try to prevent PTSD) for about 6 weeks. I hate taking medicating and stopped it cold turkey. It took me another 3 weeks or so to feel "normal" again and the withdrawal period was so phenomenally physically uncomfortable and panic-inducing that I will never take it again for any reason. I spent most of that time thinking I was going to die. In the long run, I guess it helped with PTSD avoidance (which seems to be one of the things they do now), but even just thinking back to those few weeks makes my skin crawl.
- cj · 22 hours ago
  > weeks/months rather than days. Weeks to months is actually pretty fast for benzo withdrawl IME. For me it took nearly an entire year to feel completely normal. I was only taking 10mg diazepam per day (not a big dose). To anyone on the journey now... hang in there. It feels never ending. But I promise you... you will wake up one day and feel completely normal.
  - tylergetsay · 22 hours ago
    how long were you taking them?
    - cj · 22 hours ago
      14 months. (Usually) not every day, maybe 3-4 times a week. And 8 months to taper off. How long it takes to taper depends on the level of discomfort you’re willing to tolerate. Diazepam half life is so long that dependence can develop even when not taking it every day. Edit: and I totally believe there are people who can take the same amount as me and not become dependent as easily as I did. Everyone is different
      - retrac · 21 hours ago
        > Diazepam half life is so long This is a desirable trait when tapering a dose. It reduces hour-to-hour blood level variation which reduces the whole up-down of alternating between euphoria and rebound anxiety. Idea is to target a constant level which is tolerable and slowly lower it. The article implies this (a Valium taper is mentioned) but I don't think it outright states it so I'll say that for anyone who is addicted to a fast-acting one like Xanax or Klonopin - a switch to Valium might help. My taper was nearly one year. Ten years off now.
      - butlike · 6 hours ago
        'Discomfort' is one of those words that technically encapsulates the feeling, but feels too weak to use. Kind of like 'anxiety.' It runs the gamut between slight nervousness to abject terror.
- rnd0 · 21 hours ago
  I did everything under the sun, got sober, did klonopin for a bit to help with anxiety and was lucky -blessedly lucky that it didn't do too much for me. My best friend was not so lucky and was on ativan and had the worst experience getting off of it, and had years of problems with it because it aggravated the anxiety she was already experiencing. Benzodiazipenes (sp?) has it's medicinal uses, particularly with injury or surgery; but yeah -if you're not very careful and very lucky it's hell to get off of if you end up dependant on it. I'm very glad to see the word is getting out and is more wide-spread. I hope that it doesn't result in a complete freakout the way that oxycotin did. It's vital when it's needed, hopefully it will remain available. What gets me, as someone with chronic anxiety, is that they've only come up with one thing that reliably works -and it's this. It feels like the research stopped in the nineties or so. I often wonder wtf about that.
  - virtue3 · 21 hours ago
    Lavender extract is about as effective as klonopin according to a study. I use it to deal with my anxiety. I don’t trust benzos in the slightest. Especially so after reading the horrors of this thread.
    - hereonout2 · 20 hours ago
      It sounds a fantastic claim, but I'll read up a bit on it so thanks. Must admit though I've not had any drug - prescribed or illicit - that had a more immediate and powerful effect on my anxiety than a benzodiazepine (granted I've not tried heroin before!). Thankfully they are incredibly hard to get prescribed where I live due too all the above associated dangers.
      - astura · 20 hours ago
        https://pmc.ncbi.nlm.nih.gov/articles/PMC12500767/ - this is the study the GP is talking about.
        throwaway2037 · 15 hours ago
        Also: https://pubmed.ncbi.nlm.nih.gov/19962288/ > A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder FYI: CalmAid a brand name for Silexan, and Ativan is a brand name for Lorazepam.
      - zombocomvibes · 2 hours ago
        Lavender works but it takes a long time to build up to a therapeutic serum level.. like a couple weeks to a month. Once you're there it's lovely stuff. Look at Calm Aid.
  - MaxfordAndSons · 8 hours ago
    It seems like benzos are only suitable to be used as a short term solution, but in typical human's of capitalism fashion, we use them as a long term solution since the long term cost is usually far beyond the horizon of the next financial quarter.
- a34729t · 20 hours ago
  I'm convinced a small percent of people get addicted to anything much more easily. Ive enjoyed various things but it's like meh- though Ativan is fucking amazing (but only for fear of flying). I think it is a brain reward structure thing; I get bored very easily and i guess it takes a decent amount of danger or effort to get me very interested.
  - calebkaiser · 17 hours ago
    I think that's a common impression. Interestingly, while there are still a lot of questions marks around what makes someone predisposed to addiction, the few things we do know tend to run counter to the idea that people dealing with addiction are overly sensitive to feelings of reward and pleasure. Or that being less sensitive would make someone more resistant. One of the most well studied genetic risk factors for addiction vulnerability is the DRD2 gene, which encodes the dopamine receptor D_2. People who are particularly vulnerable to addiction commonly have a deficiency here, meaning getting bored very easily and feeling under stimulated/rewarded by typical things is in part what makes riskier sources of pleasure (i.e. drugs) so appealing. Disclaimer: Not a medical professional, just like reading about addiction and genetics.
  - Aurornis · 7 hours ago
    Interestingly, thinking this way is how many people get addicted. A couple of the people I knew who ultimately ended up in rehab would describe themselves as not having addictive personalities. One even bragged about how boring drugs had become to himself. This is the hubris that opened the window to their addiction. They thought it was a thing that happened to other people, so it was safe to dabble. Then dabbling became a little more frequent, then they decided the drugs were actually helping them and therefore it was logical to do more, then they took little breaks to prove that they could stop but came right back to the drugs as soon as their life got a little hard again.
- bhickey · 19 hours ago
  About a decade ago, my doctor prescribed me Klonopin for sleepwalking. 0.5mg daily. After two or three months I discontinued it. He suggested to just stop, but I thought better of that, tapering through 0.25mg and 0.125mg. What followed was weeks of unrelenting insomnia and headache. I wouldn't recommend.
- howunfortunate · 18 hours ago
  It seems like Jordan Petersen really permanently messed himself up trying to shorten the timeline of getting off prescription benzos in a dangerous way. I always feel awful when I hear people making fun of him for this. It seems like it's one of the most horrible and difficult things out there.
  - sixeyes · 10 hours ago
    strange end for a strange person.
  - mikert89 · 10 hours ago
    yeah very weird what happened to him, sad
- ShadowOfThePit · 16 hours ago
  Just curious, why not alcohol? With it being so common and easy to get...
- butlike · 6 hours ago
  Good job. Yeah benzo withdrawal is, ime, the only one that turns you into a 'wild animal'. Good job 'choosing life,' as they say.
lxe · 23 hours ago
Site seems down. Here's archive: https://archive.ph/Tb1SZ
lxe · 23 hours ago
I was on low-dose Ativan for a few weeks casually prescribed for anxiety. What followed is an absolute year of hell. The most unimaginably difficult time in my life. Usually they tell you that short-term low dose poses lower risk or protracted withdrawal, but it's not a purely statistical risk. There are potentially pharmacological, physiological, and other factors that govern how these drugs affect each individual and those are largely unknowable.
- dannyw · 22 hours ago
  On the other hand I took Valium 5mg daily for 2 weeks, and had no issues getting off them. There’s definitely a lot of factors
  - rnd0 · 21 hours ago
    I was on oxycoton (among other things) for pain relief after heart surgery, and during recovery. That lasted about a month -I was worried because of my history of substance abuse but I think between being aware of that and knowing they would not be available later gave me the will power (if you can call it that) to taper off of them without much fuss. I agree, it depends on what else is going on -and why you're taking things. No way in hell I could have gone that month without them, that's for sure.
  - zombocomvibes · 10 hours ago
    You don't know until you start to get off. And then when things start to go wrong and you realize that you're in too deep.. it's not a good tim
yodsanklai · 23 hours ago
To give a different point of view: I've been taking Bromazepam for 25 years, but very occasionally when I'm very anxious or can't sleep, a few times a year, never more than 1-2 days in a row. It's been helpful, especially when I was younger as sometimes I was paralyzed by anxiety. I never had the slightest sign of addiction but was also careful not to rely on that too much (and never had any addiction problem). I've also seen friends or family members who used and stop these drugs without much difficulty. This isn't medical advice obviously, but I wouldn't rely on anecdotal experience to form an opinion on this. These drugs can certainly be helpful to some people.
- ternaryoperator · 23 hours ago
  Seconding your experience. Used on an occasional basis, benzos can be helpful without resulting in the horror stories related here. Of course, everyone is different and YMMV, but confirming that your positive experience is not unique.
  - exmadscientist · 22 hours ago
    They really are extremely effective drugs when used correctly. That's why the calls to ban them (as seen elsewhere in this thread) are not terribly compelling. There's no replacement for what they do. That said: do not abuse benzos. They will fuck you up. I was prescribed temazepam for insomnia. It was the only sleep medication that worked, and it was the best sleep I've had in my life. It stopped being effective after around 30 days (or maybe 60, I forget). That was the end of that. I could have argued for a higher dose or a refill or whatever, but... you don't fuck with benzos.
    - rnd0 · 21 hours ago
      >They really are extremely effective drugs when used correctly. That's why the calls to ban them (as seen elsewhere in this thread) are not terribly compelling. There's no replacement for what they do. >That said: do not abuse benzos. They will fuck you up. This is pretty much my perspective, except I'd say that it doesn't even necessarily require abuse per se. I'd say just be very careful when using them, and get off of them ASAP. Myself, I only take them if there's a procedure of some sort they're called for. I'd say awareness is more called for than a total ban. A total ban would be messed up because there is zero replacement for them for what they do -none.
      - omgwtfbyobbq · 19 hours ago
        It depends what they're being taken for. There are certain conditions where low doses of benzos are fine for years or decades.
        zombocomvibes · 2 hours ago
        I don't think that the likelihood of dependence is correlated to the disorder being treated. The GABA receptors will do what they will.
    - Loughla · 11 hours ago
      Benzos can fuck you up good and proper without abuse. I was prescribed some for panic attacks. Take as needed, up to every 4 hours. I took one a day for 4 days, as the panic would flare up right before I tried to sleep. I figured, I could be taking 6 a day, so 1 a day shouldn't hurt. And it was only 4 days in a row. No problem. Day 5. Bang. Dt's. Immediate anxiety attack. Suicidal thoughts. Brain zaps. High blood pressure. Vertigo. They are no joke, but doctors throw them around like they used to with opiates.
      - azinman2 · 7 hours ago
        I wonder if there’s a way to predict how someone might react to them. This isn’t my experience.
    - QuadmasterXLII · 8 hours ago
      This needs the caveat that following the maxim "do not abuse benzos" means telling well meaning doctors no if they suggest taking benzos consistently for even a few days. Which is a bit of a stretch of the definition of abuse. It seems that you got lucky, which is wonderful but not necessarily actionable for others.
- cj · 22 hours ago
  > a few times a year, never more than 1-2 days in a row It takes at least a few weeks to a few months of daily use to develop dependence.
  - menomatter · 22 hours ago
    I also take it on as needed basis. .5 mg clonzepam before bed. Sometime I’d take 2 if the day has been especially rough and I need a good night sleep. It mostly help with falling asleep and feeling more centered the day after. During a crisis I took it for a month. Then stopped. Stupid as it may be, I only fairly recently learned that this drug can cause hell but for the life of me I couldn’t understand how. All it did for me is help me sleep. I didn’t understand how it can be abused or what’s the recreational part of it. When my doc told me about the dependence, and how it may creep stopped even my occasional use and the bottle I got last Jan still sits in my meds canbinet. Could it be that different people have different reactions or may be more susceptible to addiction to it?
    - zombocomvibes · 1 hour ago
      Klonopin is less fast acting and much less euphoric than something like Xanax. It's not something you'd abuse for fun.
  - mft_ · 12 hours ago
    Maybe there are different types of downside; and different people have different experiences? For example, if I take some sort of sleep aid (e.g. US OTC antihistamines, Ambien, or low-dose benzos) then after ~2 nights my subsequent ability to fall asleep without help is noticeably impaired. That’s already the start of a physiological change that, if not reversed, would continue to a dependency (albeit not necessarily an ‘addiction’.) It’s a process of analogue change, not binary, and individuals’ pace of change will vary.
- fnordpiglet · 22 hours ago
  My involvement in inpatient drug abuse clinics has been benzo addiction is one of the hardest to treat and accounted for nearly half the patients, the rest split between alcohol and opioids, even during the height of the oxy crisis. It’s much less reported on because it’s widely prescribed and it’s nearly impossible to OD on. The effects aren’t as dramatic as alcohol, but are no less debilitating. Furthermore because benzos and alcohol have similar pathways they are often abused together and they amplify each others effect. You can satisfy the addiction with either - so people withdrawing from alcohol are often given benzos and people addicted to benzos often drink to relieve their addiction. People describe klonopin and similar long lasting benzos as a six pack that lasts 18 hours - which is a long time to have than level of declined inhibition. This further leads to more drinking, but also to other out of character behavior like overspending - some patients have bankrupted their families through excessive and bizarre spending. Many people receive opioid treatment and do not become addicted. In fact most do. Most people can drink alcohol without becoming an alcoholic. This isn’t a proof that “anecdotal experience” that opioid addiction and alcoholism aren’t serious problems. In fact it is a demonstration that they are insidious for that exact reason - it’s fairly easy to slip through the cracks in the system into a serious problem that is life altering and extraordinarily difficult to emerge from. Finally, the hardest withdrawals I’ve seen are benzo withdrawals. Relapse is also extremely high because the profound anxiety that led to the addiction is amplified in the years of subsequent withdrawal with very little as effective as a benzo to mitigate it. Paralyzing irrational fear is in many ways worse than pain, and pain is often a symptom to boot. I feel that perhaps saying “well not everyone, take my anecdotal experience” isn’t the most empathetic response, and the statistics bear this out. The prevalence of benzodiazepine dependency is roughly on par with alcoholism in the US and several times that of opioids. The distinction is that crisis level addiction is roughly the same as opioid, while alcohol is roughly 7x worse. This likely because acute alcoholic behavior is rapid and very readily observable, while opioid and benzo dependency can be masked behind an otherwise normalish appearing life. The decline is fairly slow often unless you trip over into fentanyl. Further the prevalence of common use of both opioids and alcohol is much higher because surgery and recreational alcohol use is fairly prevalent while anxiety disorders less so. Stevie Nicks is a popular icon who has been very public about how hard her withdrawal from Klonopin was, including how her skin sloughed off among other horrible effects. She lost a large part of her life span to it. But otherwise it’s also a relatively under reported dependency given its prevalence. https://time.com/3482462/rolling-stone-stevie-nicks-drugs-mu... I’d also note in many countries benzodiazepines are highly controlled with much higher bars than US, including the UK, where they’re only allowed in crisis, not general anxiety disorders less.
- rnd0 · 21 hours ago
  No one questions if they're helpful. But the danger and the severity needs to be more commonly known. I certainly wouldn't want them removed -particularly after spending 4 months going through different surgical procedures where benzos were medically indicated. But awareness of the down-side is thin on the ground (from my perspective) and it's good to get out there.
- vjvjvjvjghv · 20 hours ago
  Some people are wired for addiction and some aren't. I knew a guy who did heroin or cocaine a few times a year when he felt like it and never got addicted. I also quickly lose interest in alcohol or marijuana but I can't stop eating sweets no matter how hard I try...
- igleria · 12 hours ago
  I have GAD and ten years ago when I was on my lowest, I was on 2 mg klonopin daily plus SSRI.When I asked to wean off the klonopin, we did over the course of two months and zero problems (fortunate).
- azinman2 · 7 hours ago
  Very similar. I had daily panic attacks for a while. Lorazepam and therapy helped me recognize the signs and slowly they went away.. along with how often I even took the lorazepam. It’s useful every now and then but it’s very rare.
freetime2 · 23 hours ago
Jordan Peterson has talked at length about his issues with benzodiazepine withdrawals. I know he is a controversial figure, but I wouldn’t wish that on anyone. Here’s a video of a doctor talking about the dangers of BIND (Benzodiazepine-Induced Neurological Dysfunction) in the context of some clips of Peterson and his daughter talking about his experience. [1] Definitely something that it’s good to raise public awareness about, because they are very widely prescribed (10% of women over the age of 50, for example) and a lot of people being prescribed these drugs likely don’t fully understand the risks. [1] https://youtu.be/_q44phEpFjA
- PaulHoule · 8 hours ago
  A lot of my friends have a problem with Peterson's beliefs, I have more problem with the lack of coherence in how he expresses things. For instance Peterson says "you should be a Christian" but refuses to say if he's a Christian. I think we all should agree on the categorical imperative so if somebody is advocating that something is good for you but not good for them it suspicious. Like I have Christian friends who will tell me they personally have benefited a lot from their faith and I will tell you the same thing about Paganism. Benzodiazepines can mess you up about as bad as Peterson says they have messed him up but his description of his symptoms (Tardive dyskinesia) is somewhere between incredible and fantastic, as is everything else he says these days. I think the saddest thing is that BZs impair learning and memory so that you don't learn to cope with life better with time the way most of us do. A friend of mine who has been taking them for 20 years still talks about the same subjects in the same way that he did back then whereas people who grow pick up new interests. SSRIs are a preferred choice for anxiety disorders because they seem to help people in the short-term with less suppression of long-term development. I do think there's a need for a message similar to Peterson, that is, somebody who advocates for tradition and encourages young men who've been turned off from learning by a gynocentric educational system to seek knowledge -- but Peterson doesn't deliver what he promises. Neema Parvini does: https://www.youtube.com/@AcademicAgent (Not to say I agree with Parvini about everything, like I'd have to pick Starhawk over Evola and I think second-wave feminism had something to say, no matter how hard it might be to live with, when it was countercultural in the 1970s -- but Parvini has a basic integrity which Peterson lacks.)
mulderc · 23 hours ago
I had a friend who got hooked on these and it really messed up his life. He had issues before but one he was hooked to those he became unbearable to even be around.
someothherguyy · 22 hours ago
doesn't seem like great advice to take someone who is "feeling unstable" off a decade plus of benzodiazepine therapy to make them more stable. also, that was probably too aggressive of a taper for that long of use.
miladyincontrol · 22 hours ago
Yeah, after witnessing a friend's troubles getting off theirs I wouldnt wish it upon anyone. It convinced me to get me off my own Clonazepam PRN prescription, which thankfully was rather infrequent and had minimal issues weaning off of. The psych had told me nothing of the nightmare that dependence on those meds can create, a situation somehow far worse than that which they're often prescribed to resolve. More recently another friend mentioned getting prescribed a rather hefty dose for his anxiety. I convinced him otherwise with science backed evidence and accounts like what OP linked, given his personality type I'm certain it would have ended him.
- ComplexSystems · 22 hours ago
  "The psych had told me nothing of the nightmare that dependence on those meds can create" I hear this all the time and never get it. Didn't these people go to school? People talk about this every day on the internet. It's right there on Wikipedia, even.
  - solyin · 22 hours ago
    They're dealing with neurotic (not being judgment, these are a powerful class of drugs) people. Like lines of code, (saying) less is more. "oh by the way, some people get how's hooked on them and it really sucks to get off them". then the patient doesn't take them and get the relief from the problem they saw the psychiatrist for. Any responsible psychiatrist is well aware of the problem and going to get their patient past their current crisis first, and then not give them a script for 18 months for the patient to build an addiction. Unfortunately, not all psychiatrists will do that.
    - agos · 16 hours ago
      Yeah, that’s a classic dilemma doctors have to face. Even my gastroenterologist stopped giving me details as soon as she convinced herself my issues were due to anxiety (they were not, but that’s another story).
- someothherguyy · 22 hours ago
  i mean, it says it right on the sheet you get with the medication "MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Never share clonazepam with another person. Selling or giving away this medicine is against the law. Some people have thoughts about suicide while taking clonazepam. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide. Get medical help right away if you stop using clonazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide. Do not stop using clonazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer." https://www.drugs.com/clonazepam.html
soniczentropy · 22 hours ago
I helped my mother go through this after her psych decided it was time for her to cold turkey a 4x a day xanax prescription she'd been taking for 20+ years. 5 total ER trips, 3 separate hospitalizations, and a full year of absolute misery before she started getting some relief. A YEAR. I have watched family members die of AIDS, cancer, and Alzheimers. I have myself recovered from alcoholism (5 years next month!). Nothing in all my life has ever held a candle to how hellish Benzo withdrawal is. These drugs need to be banned. Period.
- im3w1l · 22 hours ago
  How is forcing her to cold turkey that not malpractice?
- rnd0 · 21 hours ago
  >These drugs need to be banned. Period. I've lived with that as well, but I've also spent months carved up (surgically) and there is no replacement for the role that they play medically. I can't agree with a complete ban. It's better to get awareness out there about the harm they can do, and put better controls on access to them but not a ban. I live with anxiety -there's no other drugs that work for it. Luckily I'm able to use DBT and straight up avoidence to cope with anxiety. But if I didn't have that last option then I'd be hosed -because there really is not anything that works effciently for treating anxiety; at least not in my personal experience (which goes back decades).
- tredre3 · 21 hours ago
  People who have been taking benzos for decades with no dose escalation should be left alone. Most people develop tolerance quickly to the sedative and hypnotic and anti-convulsive effects. But not everybody develops tolerance to its anxiolytic effect, and few legitimate patients abuse the things for fun, despite what the recent zeitgeist and sob/horror stories would like us to believe. Obviously it's been overprescribed. Old school doctors likely still do prescribe it too easily. And new docs often plainly refuse to prescribe it at all. The solution doesn't have to be black or white. Doctors have the ability to limit the number of pills per month a patient can get, imagine that! It doesn't have to be nothing at all vs as-needed-which-means-the-full-30-pills-every-month-inviting-the-patient-to-start-taking-it-daily. It can be "give 5-10 pills per month". That way the doctor can monitor the patient needs more closely and effectively prevent both addiction and tolerance from developing (to preempt: no, most people cannot in fact easily source it from the black market, and doctor shopping is no longer a thing for controlled drugs thanks to the opiod crisis).
  - tpmoney · 18 hours ago
    This sort of panic about people who have been on a controlled dose for long periods of time or just straight up panic discontinuations of doses is the same crap that exacerbates opioid problems too. Too many stories from family members about their loved ones who were prescribed high doses of ${addictive drug} and then suddenly some other doctor (or sometimes the same doctor) suddenly decides this was all a mistake and cuts them off completely. Soon those family members who maybe did need to come down from where they were are seeking illicit sources of their drug. And it's near impossible to get out from under a doctor if you do think they're overprescribing because of just this. My own family had a similar problem. The family member was way over-prescribed a drug by a doctor who clearly wasn't helping treat the underlying issues and frankly barely remembered the patient from month to month (for a person they were seeing every month). It still took us nearly a year to find a doctor we could switch to because everyone we called was so freaked out by the dosing the prior doctor had prescribed that half of them wouldn't even touch the case at all, and the others wanted to just stop everything cold and start all over again. The problem with that being that the underlying reason they were getting prescribed these medications was still an issue. Asking someone who does need the medication in question (or similar treatment) to not only suffer without it for a few months but also just stop their escalated doses cold turkey is just needlessly cruel and harmful. We were lucky to finally get a doctor who accepted helping us get things under control, with a pre-made plan of action and a "sole-prescriber" contract, both of which was fine, we just needed someone whose plan didn't start with "and now you stop everything you're taking to treat your condition and we wait until you're detoxed before we try anything else".
- bbarn · 19 hours ago
  I take Xanax when I fly. I have a prescription for a whopping 10 pills, and it usually lasts me three months. It does exactly what it's supposed to. "Banned, Period" is assuming your experience justifies taking everyone else's away, and those of us using them responsibly benefit quite a bit. 4x a day is also over recommended dosages, depending on strength - so that's more on the doctor than the drug.
- Marha01 · 18 hours ago
  > These drugs need to be banned. Period. I don't think so. It should be drilled into doctors' heads to prescribe them very cautiously and always warn about the addiction potential. But they have their legitimate uses and in some cases are irreplaceable.
- gnarcoregrizz · 16 hours ago
  I need the occasional benzo (midazolam) as a rescue medicine for my seizures a few times a year. Banning these things just makes it harder for people who actually need these life saving medicines. Most epilepsy drugs, including non-benzo, are strictly scheduled and it makes my life hell. It is very hard to get these medicines sometimes because of these rules (fuck the DEA, and your opinion), seizures can be lethal, especially compounded with withdrawal. I was out of options for anti-seizure drugs outside of the benzo class, which I refused to take on a daily basis (clobazam). I have had to taper and switch many AEDs in the past, none were too hard (2-4 weeks) but I didn’t want to be stuck on this one and have to taper it for months should I have needed to.
  - alphawhisky · 6 hours ago
    I'm gonna ask a stupid question, forgive me. Have you ever tried using THC/CBD as a way to manage symptoms before? I'm always curious to get more people's experience on this since literature is so sparse.
- throwaway826361 · 7 hours ago
  I’m sorry to hear about her experience but it is unfair to leap to the conclusion that they should be banned. These drugs stave off suicide (and worse) for many families. This is the only viable pharmaceutical treatment for some people who face extraordinary mental health challenges. Denying this option may mean denying them life. How is it ethical for you (or a government) to make that decision?
- done_lurking · 3 hours ago
  Was the psych trying to kill your mother?
itqwertz · 22 hours ago
I’ve seen a few friends and coworkers go down this path, usually as a result of work stress or hustle culture. They start on neutropics and energy drinks, then get scripts for Adderall or Vyvanse to handle the perceived insurmountable workload, stabilize on those after an initial euphoria, then build up a heroic tolerance to (dextro|meth)amphetamines. Withdrawals from that high level of addiction leads to anxiety, insomnia, delusions, mania and all sorts of craziness (I suspect the lack of sleep is the culprit). Eventually this sends the patient to a doctor/dealer to escape their misery of detox/relapse cycles. The gates to hell are finally opened once a benzo is prescribed. One entrepreneur ended punching a bouncer and attempting to flee on a bus to some random city, spending more than a week in jail. Another fled the U.S. after making a lot of crazy purchases and life choices, he is now living in a war zone voluntarily. The amount of DGAF/YOLO these drugs give the user are very understated. The withdrawals were much worse. I’ve never seen someone down almost a whole handle of bourbon just to get “normal“. The brain zaps and the tics/twitches were very noticeable. Stevie Nicks has also spoken publicly about her struggles with Klonopin withdrawal. BEWARE!!!
- slowin · 22 hours ago
  > handle the perceived insurmountable workload This is so wild to me because output and work quality rapidly decline at (or well before) 40 hours a week. It sounds like a joke, but I probably have 4 good hours in me a day. Sure, more if I'm really into something, but working 4 hours a day 3-5 (max) days a week will actually achieve peak results in my experience.
  - gedy · 21 hours ago
    To be honest, I really think some people use the “I'm so productive“ as an excuse for why they’re doing drugs and cover for addiction (even if mild). A lot of this so-called productivity is spinning wheels and jumping around.
    - VonGuard · 21 hours ago
      One of the subreddits I used to read religiously (sorry, offensive name incoming...) was /r/bartards. It was diary-like entries from people who were addicted Benzodiazapines. I've never used them, but wow is it easy to see the lessons there. Here's a few things you should know about these drugs, all of which were very easy to learn if you read 2 or 3 stories on this subreddit: 1: Benzo's, as they call them, reduce inhibitions greatly, and also reduce short-term memory. If you take a 1 MG Xanax with no tolerance, and you have a bottle of 10 more pills, somewhere within the next 12 hours, you will take all 10 of those extra pills. The "High" has a very "I don't feel it" quality, because all that's really happening is your inhibitions are vanishing. So, geez, I don't feel it, I'll take more! Keep in mind, a 1 mg Xanax is usually supposed to be cut into 4 doses. 2: Driving on Benzo's almost always results in a "Americas Most Dangerous Police Chases" type behavior. The driver will likely have taken, now, 11 mgs of Xanax, and will awaken in a jail cell 2 to 3 days after the car incident, completely unaware of what has transpired. Guaranteed they fought the cops 100% of the way to that cell, too, so they don't know where the bruises came from. 3: A real Benzo fiend "blacks out" all the time. A common theme in this subreddit would be "I took 1 MG, had a 100 pills left. Woke up 1 week later with pictures on my phone of myself and 3 other people having an orgy. No pills left. I don't remember any of this." It's astonishing how much people can down in such a binge. Seems it's hard to OD. HOWEVER..... 4: If you are addicted to benzos and you quit cold turkey, you can die. Seizures, blackouts, flu-like symptoms. Its BAD. This is not Heroin. You have to slowly taper off of them, like you were decompressing from a deep ocean dive, over weeks, if not months. Or else you DIE! 5: You can go online right now and get a prescription for this stuff from some disgraced doctor through a startup like those Viagra, ADHD, or GLP1 pharma mills. 6: DON'T EVER TAKE A BENZO, EVER. Maybe 1 before eye surgery where they can't anesthetize you and you leave without any more pills.... Something like that. Otherwise, avoid.
      - Projectiboga · 19 hours ago
        The timing of dose reductions increase as one does down. And the amounts one can drop each time decrease a lot. Separately that lack of inhibition is the secret sauce for high power executives to deliver deceptive or outright false speeches and do horrible things like lie under oath or do mass firings.
      - hattmall · 18 hours ago
        Benzo blackouts are the most clear cut blackouts ever. No feeling of time lost, no amount of cues can bring back any memories, you just wake up and the pills are gone. It doesn't always mean you did something crazy though, you can very well have just had a normal week. And you can learn stuff, you just won't remember learning it. Like if you watch a show you can know what happened on the show a week later but just have no memory of watching it.
        fylo · 14 hours ago
        SWIM and other users they knew would call this tolerance dependant dosage threshold xanesia
      - safety1st · 17 hours ago
        Hunh. My personal experience with Xanax was that a psychiatrist prescribed 0.25mg pills for daily use, but out of caution I decided to only take it during episodes of high anxiety. I was going through a very emotionally volatile time in my life and was diagnosed with an anxiety disorder. I would take 1-2 pills occasionally to this end and it worked to stabilize my mood. Initially once or twice a week. When I told the psychiatrist about this he shrugged his shoulders and the next prescription was "take 1 as needed." I simultaneously did cognitive behavioral therapy. Life also got better. Over time the frequency with which I took the pills went down. Eventually I went about 2 months without taking any and decided there was no need to refill the prescription or see the guy again. I still keep some hydroxyzine on hand. It's an antihistamine with mild anxiolytic effects that tends to induce drowsiness. Occasionally if I'm really stressed out and anxiety is hitting hard I'll pop one of those at bedtime to ensure I get a good sleep, that's usually all it takes for me to set things right and do my best the next day. They're not as strong as benzos nor do they have the infamous downsides. All this to say, I don't doubt the Reddit stories are real but I think there's a bit of Internet effect going on there, I wouldn't agree with #6 and I think tightly controlled use of benzos can be helpful.
        pjc50 · 14 hours ago
        One of the characteristic diagnostics for ADHD conditions is that "uppers", substances that would normally make someone more jittery and excitable, have a calming effect on ADHD sufferers when taken in theraputic doses.
      - jampekka · 15 hours ago
        These are rather extreme cases. Very few of those who use benzos, tens of millions in US alone per TFA, will go on binges ever. Most problems are from the dependence caused by long-term prescription-level dosing.
      - jonasdegendt · 10 hours ago
        Feels like a bit of a Reddit LARP. These extreme stories are a good reminder to not abuse the drugs, but the nuanced take here is that your average person is not going to chug the whole bottle in one sitting the moment they get their first prescription. Like many drugs, they can be useful when used responsibly and under the supervision of a _good_ doctor (which can be a bit of challenge in some cases, I know). A blanket statement to completely dismiss a class of drugs is not useful.
      - throwaway173738 · 8 hours ago
        That’s a model of addiction as a “habit” with a loss of self-control. But the other definition of addiction is really more like “continued use of the substance is required to eliminate a syndrome which only occurs when use of the substance is reduced or discontinued.” I think the latter model is more useful because there are tons of medications out there where responsibly using them leads to addiction. Even SSRIs could be addictive under that definition.
      - stasomatic · 7 hours ago
        6: DON'T EVER TAKE A BENZO, EVER. Maybe 1 before eye surgery where they can't anesthetize you and you leave without any more pills.... Something like that. Otherwise, avoid. I bit of a harsh take. I started having out of nowhere physical panic attacks (GAD) in my early thirties and they worked wonders. 0.25mg did it. Taken when needed, not daily or as a party drug. I don't use them anymore, for a long time, but they were a crutch that I needed at the time. Breathing into a brown bag wasn't it.
    - fc417fc802 · 17 hours ago
      I look at it from a close but slightly different angle. I think the spinning wheels and jumping around that you describe is an aesthetic of being productive as opposed to actual productivity and that the drugs can genuinely fuel it. So many people (here I refer to other topics in addition to productivity) think they're doing A when really they're doing B which merely has a strong aesthetic that resembles A.
  - p00dles · 21 hours ago
    ^this
  - itqwertz · 21 hours ago
    Some people moonlight other gigs (overemployed) and put unusually high levels of pressure to perform in themselves. So, 2/3x-ing that normal output is unsustainable but profitable. Context switching does take a toll when you’re putting out fires that have meetings attached. This was just an anecdotal example of a person who is running themselves into the ground. Startup culture of the 2010s fostered a lot of the myths of ultra-productivity and wealth without the backstory of drug abuse.
    - throwaway2037 · 16 hours ago
      Why don't more people talk/blog about their drug (ab)use? As a parallel, there has been a generational change in body building where performance enhancing drug users are now much more open about it. Even a few years ago, it was a widely known secret, but almost no one talked about it publicly. For the most part, the stars in the industry have been responsible about how they share the info. They spend plenty of time telling you horror stories and negative side effects. And they stress that you need to build a plan with your doctor, even if you are using drugs that are not prescribable.
      - tdeck · 15 hours ago
        Your comment reminded me that a few years ago a Microsoft engineer stabbed a random guy on campus, and afterword it was discovered he had a public journal of his own drug habits https://web.archive.org/web/20230224010752/https://josephcan...
      - pjc50 · 14 hours ago
        People don't talk about it because it's often illegal and definitely something you will be shamed for. And in many contexts it's "cheating". It also totally torpedoes the carefully crafted Linkedin narrative of one as a superior hustler if it turns out that the one weird trick to hustling more is just benzos.
      - bluecheese452 · 8 hours ago
        I suspect the openness has done more harm than good. Most people didn’t know the first thing about steroids, now it is all over social media.
  - dlcarrier · 19 hours ago
    I work on hardware development, that matches pretty well the time I can spend on high-creativity design tasks. I fill the rest of the time with tasks that could be outsourced, like assembling prototypes or laying out circuit boards, but I do myself because they are more like relaxing puzzles than demanding work. When I have to work on single a software-only project, after about two weeks of sitting at a desk for eight hours a day, I absolutely have to do something else.
    - MSFT_Edging · 11 hours ago
      There is nothing like the feeling of getting off the nitpicky design tasking to assemble some SMD components under a microscope first thing in the morning. Especially if it's a known-working design assembling the second or third prototype. Feels like gardening.
    - consp · 9 hours ago
      8 hours of highly concentrated work is a unbearable load to do continuously for days, you definitely need some "normal" task as well. I can't imagine anyone claiming to do "12 hour work days" to engage in anything thoughtful for more than 12 minutes.
  - sneak · 19 hours ago
    That’s for maxxed out knowledge work. Most of running a business is simply doing mid grade knowledge/admin/management work in a responsible, cares-about-the-outcome aligned fashion, which you don’t get from some $50k/y admin person or middle manager. I would say that less than 25% of a startup CEO’s workload requires the “well-rested, highest quality thinking” that you describe. A lot of it is simply quantity and determination. The output of “having grit” is not that you are suddenly smarter - it’s that you are less willing to stop.
    - trollbridge · 18 hours ago
      Well said. I’d be a far more successful startup CEO if I were cracked out Vyvanse right now because I’d be getting g done mind numbing but necessary tasks with deadlines. As it is I made a decision a while ago to prioritise personal health over greater business success.
      - olivermuty · 15 hours ago
        I have been solving this by automating anything that is done more than once. Automation can mean building a micro app or building out a prompt that can be reused later or something in between. More work up front but easier to motivate myself when I know that next time the chore takes a few mins of input and output validation
        trollbridge · 10 hours ago
        I've automated everything too - the issue is, so is all my competition. We have to deliver far more for the same price, or less, than we did two years ago.
      - MSFT_Edging · 10 hours ago
        I'm prescribed vyvanse and man I can only do >40hr weeks for maybe 2-3 weeks before I burn out hard. Not even talking about 70-80 hrs, more like 55-60. At least for me, the fatigue snowballs hard. I don't take it on the weekends and saturday is hell for me unless I have something to distract me for many hours. At my dosage, 6ish hours after taking it, my brain still fights tooth and nail doing the mind numbing administrative stuff.
        trollbridge · 10 hours ago
        The doses that people are taking to hit hyper-productivity is basically beyond what is a therapeutic dose for you. Basically becoming a candle that burns the brightest, but fastest.
        MSFT_Edging · 9 hours ago
        totally. I dabbled in the hyper-productivity dose in college. 60mg would get me 12 hours of unstoppable ability to grind through homework. The dosages are never mentioned though.
        bluecheese452 · 8 hours ago
        Oof, that feels so much. Bumping up against the max rec of 70.
        MSFT_Edging · 8 hours ago
        I'd usually break them up into halves or thirds(pop open the capsule, poor some into some juice). A full 60 was a "oh shit final tomorrow plus a report due" dosage. You really feel super-human if your body isn't adjusted to it. There's a lot of danger to it. My friend who'd give me them would regularly take two, at 120mg. He's extremely successful, has since stopped, but a doctor let him know he had some scarring on his heart from a minor heart attack. Really amazing albeit dangerous drug. he took them since he was 8 or 9 and had no issue with stopping. It doesn't have remotely the same crash as straight adderall(dextroamphetamine). After over a year I still forget to take it. At my current dose it helps me through really rough ruts. When taking breaks, the withdrawal lasts about 1-2 days and then I'm back to "normal". All this being said, I really wish these rise-n-grinders would cut this abuse out before it gets further restricted. It's been life changing for me in my normal therapeutic dose.
        sneak · 1 hour ago
        When I quit, I was taking 140-210mg/day (ie 2-3 70mg). The major physiological consequences didn’t rear their heads until years later, after I had not touched it for 5+ years. I was lucky.
    - djtango · 13 hours ago
      We like to talk about startups here cos it's HN but when I watch the news it's clear that world leaders clearly don't work 40 hour weeks. Like whatever else you say about the POTUS it's shocking how many hours he must be working at 80 years of age with or without "help"
      - sneak · 12 hours ago
        How much of watching fox news, eating big macs, golfing, and cavorting with natalie harp is counted in those “many hours he must be working”? I can’t imagine he actually works that much. His output isn’t really there. We already know he doesn’t read the daily briefing (reports suggest he never reads anything at all) and it’s pretty clear 99% of what his admin does is the result of legwork from people who are not him.
        giantg2 · 12 hours ago
        Even if he's carted around as a show pony that's a lot more than I will be doing at 80. The real take away is that we need an upper age cap for holding federal office - 61 or younger to run/appointment and mandatory retirement at 70. We could try to say that office holders shouldn't have an age limit but be subjected to mental fitness tests, but those will end up being gamed or the results won't be released properly for national security reasons.
      - idiotsecant · 10 hours ago
        I think it's pretty well documented how much 'executive time' the current POTUS enjoys. There are lots of people working long hours. That guy isn't one of them.
        fhdkweig · 10 hours ago
        If you look at the before and after photos of past POTUSes, you can see a visible aging. If we ignore the current POTUS, I think we can say that there are a lot of long hours of stressful trolley problems.
      - bluecheese452 · 8 hours ago
        If he has a meeting on a golf course and spends all that time shooting the shit that is technically working time but probably not that taxing. If he is diving into low level details that is a different story. Basically all his waking hours will be counted as working.
  - ravenstine · 19 hours ago
    Organizations get in their own way when it comes to quality, almost every time.
  - PacificSpecific · 17 hours ago
    The problem is it's hard to realize that is indeed the case.
  - fzeindl · 16 hours ago
    100% correct and this resembles my experiences and countless anecdotes. You can’t reliably do more than 5 hours of heavy concentration work per day.
  - seer · 16 hours ago
    Funny how all of this changes with agentic development - once you setup your agents and the initial productivity euphoria , most of the time you spend in deep brainstorming and leave agents to “handle the details”. Which is both liberating - a lot less punishing mentally and not requiring so much flow focus, but on the other hand you have to keep more loosely held context in your head. And agents need you attention constantly throughout the day, you leave them working overnight. While you are not in the office etc, and it’s hard to justify when an agent just needs “a quick look” or some confirmation and direction. You leave being paged all the time so you never really relax. I think a lot of developers will end up feeling what founders actually go through, for better or worse, but also without actually getting the golden ticket option founders usually hold. It’s just a very different mindset for work, though maybe requiring less chemicals to actually make work
    - ianmarcinkowski · 10 hours ago
      Once everyone is using these tools, the rat race will have caught up and we'll have no choice but to race with the other rats. The punishment will resume.
  - throwaway2037 · 16 hours ago
    > This is so wild to me because output and work quality rapidly decline at (or well before) 40 hours a week. I see this comment regularly here. There are lots of people who can and do work for much more than 40 hours a week, and these are productive hours. Also, it is a sliding scale of productivity. It's not like hour 41 is 100% unproductive. However, I do appreciate that most normies are probably more productive if they work less than 40 hours a week, but make those hours very focused.
    - Tade0 · 15 hours ago
      I am yet to see such a person rawdog it without any performance enhancing substance or "winding down" in unhealthy ways without becoming severely depressed in the process.
  - mihaaly · 15 hours ago
    Probably no surprise some (Western) European countries allow you going to the GP, telling you are exhausted/burned-out/anxious, whatever fits the extreme fatigue, and you get some time of commonly agreed off, prescribed, paid. Everyone is better off that way (except the manufacturers of stimulants. Coffee excluded here! :-) ). Also, overtime is not a trend. Preserved for exceptional circumstances, for a brief period that an otherwise balanced person can handle. Europe is economically uncompetitive, the rest of the world makes circles around it performance and money-wise, also many abuse the system, still, without people a society is nothing, economy alone is crap if it is not for the people, as much people as possible so the streets are not crawling with too much crazy. We need to have a life first. Most of my European friends would never think of living in the US or Asia prolonged, only for an energetic period to boost some aspects (financial, experience, knowledge), mostly when they are young (but not with children, no!). Those places are not liveable from a European perspective.
    - ajuc · 14 hours ago
      > Europe is economically uncompetitive Meh. It's competetive enough. Productivity per hour worked is about the same (sometimes higher) than in US. We just work reasonable hours. > Those places are not liveable from a European perspective. If the sacrifices these people make were at least for something that was obviously good - I could maybe understand that. But it's mostly making the world worse (either through financial schemes, addictive social media, marketing, AI, or other pointless bullshit). Imagine wasting your life slaving away at making better ways to get people addicted to nicotine. That's IT now.
      - mihaaly · 13 hours ago
        Agreed.
    - Archer6621 · 13 hours ago
      Depending on where you work, in Europe it can be just as bad. It doesn't matter whether Europe is economically uncompetitive (is it?), if the people themselves think they have to compete and become deprived of time and energy then they will burn out regardless. I see it happening left and right lately. The only thing here is that there generally is a fairly robust social net ready to catch you if you do, as you mention. But my honest opinion is that this is not a solution, it's a bandaid for the real problem: why do people feel like they have to work themselves into the ground in order to be able to live? You are right though, many here including myself cannot imagine living in those circumstances in other continents. I think that is another problem in itself, that people are becoming complacent here due to the low risk. That might even be part of the reason why people are so careless with their work-life balance, because they can't really lose it all like in other places, so maybe people stop paying attention to things that are actually important. Just guessing.
    - simonask · 11 hours ago
      > Europe is economically uncompetitive, the rest of the world makes circles around it performance and money-wise, ... Don't buy the propaganda. You're talking about the second-richest part of Earth, with undeniably the world's highest average quality of life. It's also a big place with massive differences. You have to understand that when Germans are being dramatic over the economic state of their country, they are describing issues that the vast majority of countries would absolutely love to have. Economic growth of only 0.9% is very bad if you have a lot of catching up to do, but Germany doesn't, so it just amounts to being slightly behind other rich countries. "Deteriorating Europe" is a Russo-American psyop. Luckily we have better memory - we've heard this song for at least 100 years by now, and yet here we are. That's not to say that there aren't issues, but Europeans are largely unbothered by things like the GDP growth difference between the Eurozone and the US, because it's quite clearly driven by a runaway stock market and unfathomable inequality. You can't eat GDP figures.
    - holgerschurig · 56 minutes ago
      > Europe is economically uncompetitive Really? The last time I checked, Germany was sitting well in the middle of Europe * contrary to many countries it has had export/import surplus since decades. Not a single year with a deficit since 1952. Compare this e.g. with the USA, which had the last surplus in 1975. * it's tiny, look at it on a globe. And yet it's number 3 worldwide on economic power. Two years surpassed Japan that is larger by size and has double the people * in June it had the highest exports ever in it's history And that is just ONE of the European countries. Others, like Switzerland and Netherlands aren't shabby either, especially normalized to inhabitants or country size.
  - arjie · 14 hours ago
    This isn’t true for everyone. I have witnessed people whose curves are more gradual. Their performance exceeded mine and the gap increased with increasing duration. The principal difference I’d say is task focus. After many hours my attention falters, but I know people whose attention diminishes more gradually. I could see someone like that using more hours productively. In a sense, someone who is awake 18 hours lives 12% more life than the 16 h me.
    - tonyedgecombe · 13 hours ago
      I don’t know about that. What I have noticed is people who work long hours often have a distorted perception of their own productivity.
      - cesarvarela · 7 hours ago
        Just as some people can run two marathons back-to-back while others get tired after walking around the block, it has to be that way.
  - bluegatty · 14 hours ago
    ", but working 4 hours a day 3-5 (max) days a week will actually achieve peak results in my experience." Yes, we max out on focus time ... ... but no, you're not a concert violinist. The rest of you time is all the other stuff - meetings, light reading, sales reps, catching up with professional colleagues, filling out forms, HR stuff, all the inquires from he newbies, returning emails, etc. etc.. The 3hrs focus/day is one kind of work, all that non-focus time is the 'work part of work'. Literally most jobs is like that, it's 100% that kind of thing, there is no 'peak performance' it's just putting one foot in front of the next.
    - slowin · 6 hours ago
      No, I literally mean 4 hours a day is my max productivity. If I spend more time doing that stuff you list, then my actual output decreases in quality. This is why I avoid working for companies that value process over output.
      - bluegatty · 6 hours ago
        Since we can hire Engineers that have the 'stamina' to be productive for most of regular hours, like almost everyone else in the world, you might find yourself in a tough position; maybe learn to play the violin.
        slowin · 6 hours ago
        I'm always the top performer on my team (or entire company) and have my pick of places to work. I would attribute some of my success to knowing how to perform at a high level and that includes limiting the time I work.
  - alex7o · 13 hours ago
    I mean maybe a bit of a controversial opinion but this is how I hide at my desk job to try to build my own stuff. Like I give 3-4h of focused work to my employer and 6to myself every day. Some days I need to work more for work some I can do more stuff for myself.
  - ninalanyon · 13 hours ago
    > It sounds like a joke, but I probably have 4 good hours in me a day No joke at all. I eventually decided to never open email until lunchtime so that I could get four hours of productive work done while I was still fresh. Then lunch, then email, then plan what I'd do the next morning. I had to do the seriously difficult stuff in the morning or I'd be too worn out to do it right.
  - nycerrrrrrrrrr · 10 hours ago
    > Sure, more if I'm really into something I think this is the point of the stimulants - they make you really into whatever you're currently doing.
  - Eddy_Viscosity2 · 10 hours ago
    I likewise have about 4 good hours of thinking work capacity in a day. But even finding that can difficult because you have to navigate all the trivial non-thinking admin tasks, meetings, forms, approvals, and other soul-sucking semi-work which does not progress a project, but yet a project can exist without. Management will always find a way to fill up every last minute with this category of non-thinking semi-work so its a fight to even find a little window to do the hard thinking work.
  - apercu · 10 hours ago
    If people were honest this is probably it true of most. I can do light physical work for 8 hours pretty easily. I can only do knowledge work to a high level 3-5 hours a day.
  - Otterly99 · 7 hours ago
    Not a joke at all. It is well documented. Attention peaks a few hour after you wake up then it's all downhill from there. It seems counterintuitive, but somebody working at full capacity for "only" 4h a day can be more efficient that somebody working 12h every day (of course, these all ballpark numbers and depend on a lot of factors, sleep being one of the most crucial one).
  - QuantumGood · 1 hour ago
    It really, really varies, person to person, optimized time vs non-optimized time. With keto plus several other optimizations, I'm sometimes good (focused, motivated, energized) for over 12 hours. Alternatively, I can have days where I never reach "good" at all. For reference, I'm in my late 60's, and I don't inject anything. I've had a wide range of life-long health issues, but partly because I've optimized to be acceptably focused and productive while living with those issues (that I've been resolving one-by-one), I can have some pretty long periods of focus.
- tflinton · 21 hours ago
  Is it possible you have the cause and effect backwards? These people could have highly addictive personalities and were just switching from one drug to another and it’s not the actual drug that’s the issue. Take the adderall and benzodiazepines out of the equation and they might just as well be using cocaine and barbiturates.
  - hapless · 19 hours ago
    Barbituate withdrawal won’t kill you. Benzodiazepines, and alcohol, can actually induce death if you withdraw too quickly
    - NewsaHackO · 17 hours ago
      Barbiturate withdrawal can absolutely kill you, as it is the same process of benzodiazepines and alcohol withdrawals. The other issue is that barbiturates themselves can easily kill you due their MOA, and low therapeutic index
  - alexgoodhart · 18 hours ago
    There is no such thing as an addictive personality.
    - fc417fc802 · 17 hours ago
      There's approximately three possibilities that could lead to you believing that. Either you haven't formed close relationships with such people (unlikely), you lack the awareness to realize who they are, or you are one yourself and lack the self awareness to recognize the patterns.
      - vintermann · 15 hours ago
        Obviously some people get addiction problems, and obviously some people are more vulnerable to develop them than others, but I can understand the reluctance to ascribe that to their personality . Why can't it be the situation? Even to call it the internal situation if you find no obvious external reasons, is probably healthier than to ascribe to the essence of who you are.
      - gosub100 · 8 hours ago
        They never said "there are no addicts".
  - treis · 9 hours ago
    That was what struck me about the article. No doubt withdrawal is real but baseline for the author seems to be symptomatic anxiety. The focus on withdrawal as the single overwhelming cause is typical of the people I know with anxiety. They seem to be always searching for the one magic trick that will make them better. Which of course never does.
- nradov · 20 hours ago
  What are you seeing with Modafinil (Provigil)? It seems to be popular among the same crowd.
  - hattmall · 18 hours ago
    Modafinil is basically nothing compared to other drugs. Like you will go a longer time before feeling sleepy but it's not even on the level of caffeine for stimulation. It doesn't give you much of any wired feeling, you just are less tired when you normally would be.
  - petesergeant · 17 hours ago
    For many people, modafinil stops being effective as a performance enhancer pretty quickly (days to weeks of daily usage), and withdrawal is basically a few days of excessive sleepiness, so most people don't have an issue with it. Narcoleptics take it for years, mostly without issue, so it has a decent safety profile.
  - arjie · 14 hours ago
    I cycled modafinil/adrafinil and caffeine. For me it was a much stronger focus effect than caffeine and a much weaker effect than amphetamine. However, I developed an intense case of the hives after use which occasionally (1/2y) recurs without use with no prior history. This is not an uncommon side effect according to the doctor who I reported this to. In my case I experienced no physical dependency on any of the drugs and chose to stop because I wanted to perform other experiments. I’d say it’s about half a decade now since. I do know others who get weakened impulse control but I just get hyper focus of various degrees.
- shoobiedoo · 20 hours ago
  Pretty wild how common it really is. In places you wouldn't expect. I started working night shift in a warehouse when I was in my 20s, and got to know a couple of the funny yet seemingly regular guys. I asked them for advice on how to adjust to the graveyard shift. They said you gotta stay up on weekends, keep the same nightshift schedule, no exceptions. "Come out with us for a few beer sometime." So there we are in a regular pub, about 11pm. One guy starts dialing on his phone and says, "I'm gonna pick up. You want in?" I kind of smirked and said, "uhhh I don't smoke weed dude. Thanks." And he looked at me like I was an innocent deer and said, "umm, we're going skiing dude. this is how we stay up." Oh boy. I was never addicted to it thank god, but what a wild couple of years that was.
  - trollbridge · 18 hours ago
    I have made it abundantly clear to partners & employees health comes first, made sure they have access to a health plan, and made sure they can actually get appointments with providers. In fact that stance is probably the only reason we’re still in business and they’ve been loyal through some rough patches. Right before my cofounder and I wrote down our values, when we were done, I said, okay, now we’re both going to schedule the labs and checkups I know we’ve both been procrastinating. Let’s just say that was the difference between stage 1 and stage 4… by a few months. It has been probably our defining corporate value ever since. And yeah I don’t ever expect an outside investor to like that.
  - walthamstow · 14 hours ago
    A pub in Britain? Yeah, pretty much everyone is on the bag
    - shoobiedoo · 14 hours ago
      New West, Vancouver, Canada, so same deal pretty much. As I found out
  - fifilura · 12 hours ago
    > we're going skiing dude. I have a feeling this means something else than in Scandinavia. I am so innocent. I would take it literally "Where?" if someone said that to me. And probably ask if I could join.
    - frmrtntn · 11 hours ago
      Cocaine. It means the same thing here in Canada, despite plenty of skiing going on.
- cryptoegorophy · 18 hours ago
  Oh so that’s how people turn into drug addicts? So simple solution is not to go for a “drug” fix, performance enhancer, but to just accept that you just “can’t” and figure out a way to not burn out. Seems insane to me that there is 2 roads - one to never be a drug addict, second one is to have an extremely high chance turning into a drug addict. What am I missing?
  - hattmall · 18 hours ago
    Well most people don't actually turn into addicts, it's just the people that do, that's how they start. Lots more people use stimulants and benzos occasionally without crossing into an addiction threshold.
  - thin_carapace · 17 hours ago
    this thread discusses drugs of addiction that are prescribed en masse especially in north america. so a great imaginative starting point would be to imagine being told you must consume a hard drug to cure a condition that is inherently part of you. after a while you develop a tolerance to those drugs you have been taught are your savior. then you need more drugs to achieve the same feeling you were taught is 'normal'. could you begin to see how that might feel, and how the system could possibly be seen to push people to the brink due to systematic indifference in favor of systematic interests?
    - sixeyes · 10 hours ago
      and time and time again, in the original article, we are shown that when people are reporting to their doctor for withdrawal effects, they get a higher dose prescribed to cover it.
  - embedding-shape · 12 hours ago
    There are tons of ways people turn into drug addicts. Some of us just get started early, build our (sometimes successful) life patterns around it, and here we are :) Others are trying to treat "damages" they've experienced, in any way they can. Others get it prescribed by doctors, end up stuck in those patterns, then need help to get out of those, my mother experience this "legal drug addiction" with painkillers just some years ago but luckily managed to get out of it. There is probably as many reasons people become addicts, as there are things people can become :)
  - gosub100 · 8 hours ago
    You're missing that properly prescribed meds to the people who use them responsibility and don't have any unfortunate horror stores .... do not write their experiences in online social media sites or blogs.
  - butlike · 7 hours ago
    You found the hard part. The "just accept that you just “can’t”" part. VERY few people can do this. I'd even go so far as to say not being able to say "I can't" is the cause for ALL drug addiction. All substance abuse is painkilling, in a manner of speaking.
- petesergeant · 17 hours ago
  > The gates to hell are finally opened once a benzo is prescribed ... The amount of DGAF/YOLO these drugs give the user are very understated ... let's dial this back a little here. I've been a (prescribed) benzo user for ~15 years, across xanax, valium, and klonopin. I regularly go for weeks at a time without taking them or thinking about them. I have taken some very, very large doses before (as part of a now-resolved fear of flying). Firstly, yes, obviously, they are addictive. This is compounded by the fact that people are generally prescribed them when they really need them, and they are highly short-term effective. If you have acute mental distress and someone gives you a drug that switches that off in the short term, you are going to really want more of it when that distress comes back. Many people seem to have at least some low-level mental distress, and so many people respond really well to benzos. They also cause physical dependence, so cessation if you've taken them chronically for as little as a few weeks is going to be somewhere between annoying and extremely rough, quite aside from the addiction. Secondly, the "amount of DGAF/YOLO". Some users experience dose-dependent impaired judgement, probably similar to alcohol? If you've taken a serious dose, you'll know you've taken something psychoactive. This isn't something that needs to factor in to your risk profile for taking 5mg of valium. A very small number (1%?) experience severe impaired judgement. Test one first. Overall, they are a drug to approach with a lot of caution, and with the help of a doctor who you think understands the risks, like opiates. But like opiates, they are a miracle solution to a very difficult problem. If your doctor thinks you need to carry some Xanax around in your wallet for panic attacks, don't assume all hell will break loose. If your doctor wants you to take klonopin for five days while you switch SSRI, that's probably OK. If you're terrified of flying, but need to make your once-a-decade flight, gladly accept a dose of valium. On the other hand, if your doctor is prescribing a four-week once-a-day schedule, urgently seek out a second opinion unless they sit you down and are very clear on the risks with you first, and even then do some of your own research. But be aware that they are highly effective at removing your acute mental distress, and if that's an issue for you anyway, you might be about to feel better than you've felt in years, and you need to be sure you're not going to reach for them when you don't actually need them, and kick off an addiction that will be very, very hard to shake. Bottom line: miracle drug, but be as skeptical of them as doctor-prescribed opiates.
  - throwaway2037 · 15 hours ago
    Thanks for the share. I really like these first hand accounts on HN. Can you theorise on why you are not (less?) affected by the addictive elements of benzos? I'm not here to doubt, rather to ask: What are you doing differently? Are you someone with (insanely) high self-control... so you can back off if you feel the pressure of addiction?
    - pjc50 · 14 hours ago
      Parent post uses the word "doctor" throughout. People with serious addiction problems are getting their drugs elsewhere, usually from people who make money by selling them more drugs.
    - petesergeant · 14 hours ago
      I'm not regularly taking them more than once a week, which is more than enough time for it to get out of my system completely. Risky profile appears to be when it's in your bloodstream for several weeks.
  - devin · 7 hours ago
    Isn't it fairly standard these days for docs to offer hydroxizine instead of a benzo for panic attacks?
    - petesergeant · 6 hours ago
      Never had one even bring it up, although I've taken it before as a sleeping pill. I hadn't realized onset is as quick as Xanax, and the effect size looks good, but it's never done very much for me for anxiety.
      - devin · 6 hours ago
        Fair enough. I call it out because I know that some docs are trying it for people who have a history of substance abuse, and as a first line instead of jumping straight to benzos because of their risk profile. A lot of the reports I've read about hydroxizine are "it just knocks me out, which is I guess better than panicking", but also "it just knocks me out" seems preferable to risking dependency and the hell that benzo withdrawal can become. Edit: Granted, falling asleep is not really conducive to being able to work. So I imagine there a number of people where "it made me fall asleep, but I can't do my job like that" is a non-starter, and short-term benzos is the only way forward.
- aqme28 · 16 hours ago
  I run sometimes in a “party” crowd and see the same thing from the other side. People take drugs on the weekend, and a benzo to come down from it, and soon find themselves hooked just on the benzo.
- antihero · 16 hours ago
  Oh god, the jolts. They are horrible. They seem to get worse with screens and fluorescent office lights. The only thing that helps is going for a walk and necking some alcohol, which in turn, wrecks the sleep needed to actually fix them. It's almost like having some sort of momentary seizure.
- kiproping · 15 hours ago
  I don't know why this reminded me of that Palantir guy.
  - seattle_spring · 6 hours ago
    Is it weird that I can think of multiple "Palantir guys" and am not actually sure which zonked-out billionaire you're referring to?
- bossyTeacher · 12 hours ago
  I agree. The problem here is that these people are tackling symptoms rather than causes and tackling symptoms alone while the cause exists over a long period of time will produce new issues that come with their own symptoms. Then users tackle these new symptoms and the cycle begins anew.
- ianmarcinkowski · 10 hours ago
  Back in my early 20s starting a company with friends we had boom and bust cycles, and our boom cycles were so extreme that we would work 100+ hours for 3-6 weeks at a time, towards the climax of that given cycle. We didn't do drugs other than redbull and some of the other guys smoked tobacco. I am really glad there wasn't a hustle culture of taking amphetamines.
- merrygoround · 9 hours ago
  > The amount of DGAF/YOLO these drugs give the user are very understated. Not at all. From amphetamines to benzos, pretty much every doctor tells you what the fuck can and likely will happen if but you are zoned out and either desperate or want to avoid that despair at all costs. It's why parents let their kids have/start amphetamines pre- to mid puberty and why some give them shots to boost sexual development. They can't handle and have zero desire to build the skill or patience to parent the whiny little bitches they create. But the consequences are always the same. The extremes you described are just the most cinematic ones. The extremes you don't see are worse and much much more prevalent. The damage and bullshit these peeps cause outweigh any function they perform in society by crazy high factors. But they get to fake the fun without effort and doubt. And while doubt is imperative for a healthy, growing brain, it's extra painful when your meds' dosage is too low or you are currently off them. Ante up! Been there, stopped taking them asap and fought for better alternatives that might come with their own price downstream. Side effects have to be mitigated actively, and not just with Magnesium and Electrolytes and eye drops ... ... ... it's a mental effort, a matter of character ... but sure, opt in for that work and that ugly behavior you now don't have a feeling/intuition/instinct for anymore ... it certainly makes for a good recurring story in a YOLO kind of world and if it's the only way you can handle it, why beware?
- bluecheese452 · 8 hours ago
  That is wild to me. I have been on the same low dose (30) of Vyvanse for damn near a decade now. I don’t take it on the weekends or vacation. I have zero desire to up my dose.
- Aurornis · 7 hours ago
  I have a lot of friends in medicine in various roles like ER nurse or doctor. The over-prescribing problem in this country is really a problem. They are all so frustrated with the quantity of people being prescribed extreme controlled substance regimens by doctors, somewhere, who seemingly write high dose prescriptions for controlled substances with little thought. The stimulant over-prescribing problem can be self-limiting for many when they discover that the initial euphoria and feeling of being super productive disappear. It's wild how common the "my Adderall isn't working any more" complaints roll in from people who thought they were signing up for the pill from the Limitless movie instead of a concentration-enhancing pill that isn't fun or enjoyable in the long term. But not everyone stabilizes on a boring dose or gives up on the medication when tolerance takes away the fun part. It's the people who start stacking crazy supplements or even illicit drugs on top to go deeper. Some of these people wouldn't normally see themselves as drug users or abusers, but something about prescription treatment opens a blind spot in certain personalities. I knew a few people who got all the way to rock bottom and into rehab programs while fully believing that they were "self-medicating" a medical condition, despite using drugs and doses that were not helpful for concentration in any way. Those who go from unmedicated to being prescribed high doses of amphetamine and a benzo within a year or two are the craziest stories. Now they'll often have a ketamine prescription for depression as well. I don't know where these doctors are that prescribe these regimens so quickly to patients, but they go out and find them. I've heard so many stories of about patients trying to establish care with my friends and then showing up with crazy combinations of scheduled medications and a request for more prescriptions. Many of them haven't realized yet that controlled substances are tracked in a shared database that providers can read, and they can even see if you've been getting prescriptions in neighboring states too. I know I'm more exposed to these stories than normal by proximity to people who see them a lot, but it's getting really sad. I'm also worried that we're headed for an opioid-style backlash where prescribing medications to people who really need them becomes difficult due to the rampant abuse.
jart · 22 hours ago
There is such a thing as too much of a good thing. These pharmaceuticals were originally based off valerian root, which works too, and is cheaper, and easy to obtain. You can always try going back to the roots. I find it helps me sleep every now and then.
- rnd0 · 21 hours ago
  I'm not a big believer in valerian, based on my experience. It's certainly not a stand-in when it comes to treating panic attacks. For sleep, it could work but I generally tend to prefer melatonin.
- agos · 16 hours ago
  A pill of Valerian is enough to make it hard for me to wake up after eight hours of sleep. I can’t imagine how powerful benzos are or what he’ll are the people taking them going through
BikiniPrince · 21 hours ago
This also just reminds me of the sensible things to ask your doctor when they try to prescribe a drug. Can I simply stop taking this drug? For two people I know in the last year this would have been a nice question to ask.
fallinditch · 21 hours ago
I was prescribed diazepam and it was an important part of my healing when I suffered a back injury. The doctor prescribed the 'holy trinity' for severe back pain: diclofenac for anti inflammatory, cocodamol for pain and diazepam to control muscle spasms and help me sleep. It worked like magic. The doctor gave me the minimum amount of pills to get me through the initial chronic period, 7 days, and I was very grateful to be made comfortable. I was lucky that my back healed quickly, even after a few days on the drugs I detected a feeling of dependency creeping up.
dvduval · 21 hours ago
I had a strong reaction to Covid and that was the only time in my life I ever took what you might call mine drugs. I took Ativan for a while, but I read up on it and I was very careful not to take larger amounts. I was cutting the pills and halves or quarters and just using them for some mild relief, but I did have severe anxiety for a while. I think there could be a place for them but unfortunately, the way drug companies are they allow people to get too much and they profit from the addiction. And by the way to get off of them, I read that the most successful people statistically with the ones who did a very gradually. So again I took the scissors and I was cutting small amounts off of pills so that I was sometimes taking some multiple of 1/8 of a pill And when I made adjustments I might go down by 1/8 or 1/4 per week. My anxiety problem actually played a role in me being afraid to take too much anxiety medication ha ha and that probably saved me
amanaplanacanal · 20 hours ago
I just saw a YouTube video about a Soviet era benzo that became somewhat popular in the West as a research chemical. It really sounds like a nightmare: https://youtu.be/CAm_L6CTnD4?is=o1UjxkDQwFloZ8VM
GlenTheMachine · 20 hours ago
I've been on fairly low dose Klonopin for about fifteen years due to persistent insomnia (I work in a black room with no windows, and hence no circadian rhythm). The good news is that the Klonopin let me sleep -- the first regular sleep I'd had in three years, when I first started using it. However, I'm on a journey to get completely off of it. I managed to do that for several weeks, but when I then tried to ween myself off the other drug I'm on for insomnia, mirtazipine, it came back. So I started taking Klonopin again, temporarily. I'm now in the process of getting off of it for a second time. Personally, I didn't find this that hard. The key, for me, was just to take it very slowly. Reduce 10%-25% at a time, and stay at that dose for 4-8 weeks. Repeat. Be patient with yourself. It took around six months the first time. I did have one crazy symptom: in the middle of the night, if I woke up, I could close my eyes and watch my visual cortex go haywire. It was like a fireworks show. That eventually went way, but man, it took months.
- dmbche · 20 hours ago
  Just for kicks, what do you do? Radiology?
  - GlenTheMachine · 20 hours ago
    Space robotics
    - dmbche · 18 hours ago
      Cool!
    - potamic · 15 hours ago
      Why does this need a black room with no windows?
      - igleria · 12 hours ago
        he works FROM space, of course.
      - GlenTheMachine · 11 hours ago
        To simulate the lighting conditions of space
        potamic · 8 hours ago
        Could you elaborate on the nature of the work? I'm really finding it hard to imagine what kind of work would require one to work in the dark at all times.
        GlenTheMachine · 6 hours ago
        It isn’t that we have no lights. We do. They’re on most of the time. The walls are painted black and there are no windows, because occasionally we want the lab to be dark so we can simulate the lighting conditions of space. We have a spotlight that approximates the brightness of the sun for when we do those tests. The end result of this is that, especially in the winter, it’s really easy for me to drive to work in daylight, and then that’s literally the only time I see the sun. I leave work after dark. Totally screws with my circadian rhythm.
        potamic · 5 hours ago
        Very interesting!
        zombocomvibes · 1 hour ago
        Look at getting a set of Luminette glasses and work with them on! They're from Belgium which is a place that's almost as dark and depressing as your lab in the winter. I have a pair and I use them instead of a shot of espresso as a pick-me-up when it's dreary outside.
- hereonout2 · 20 hours ago
  I was given promethazine to help with sleep, an antihistamine with sedating properties. Was told by the doctor it was a much safer alternative to most other treatments. Could be worth asking about.
howtoquitwell · 20 hours ago
Fun story time: Almost a decade ago now, I was a happy, high-functioning alcoholic. Winery tours, Scotch tastings, workplace drinks, etc. It was all "fine" until I started struggling to get to sleep without a little "nudge"; then it was getting back to sleep in the wee hours; then it was every hour or two, 24x7. Then I decided to go cold turkey while on vacation in Hawaii with my family, because who wants to be the drunk asshole in search of a cocktail while everyone else is having a good, sober time at the beach? Boom: detox seizures, ER visit, and the ever-so-helpful prescription of Ativan so I wouldn't seize again. I was discharged with the instructions to "take as needed, up to every four hours." Since I was an addict in pain, I took that to mean, "take them every four hours, or maybe more often." Cut forward 3-4 days, and the scrip ran out. Boom: more DTs, this time from the benzos. It wasn't long after that when I went through my first inpatient psych visit b/c I was in no way equipped to handle withdrawals from two highly-addictive drugs at the same time. Sadly it took another couple of years and another trip through the ER + inpatient care before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort. It's been six years since the last big episode and I'm genuinely grateful I only threatened myself with my shitty brain chemistry (however aggravated by poor medical intervention) rather than putting other people at risk. It could have been much worse if, say, I routinely drove people around or did any kind of safety-critical work. Regardless: benzos are not "lightweight" drugs, and giving them to people with any kind of history of substance abuse disorders is a Bad Idea.
- nyargh · 17 hours ago
  I appreciate the bravery of you and others in this thread, sharing details of really horrible - and at the time likely very shameful experiences. I'm glad to hear you (all) made it to the other side, and hope your stories give others who are struggling with addiction courage to seek help and free themselves.
  - howtoquitwell · 15 hours ago
    Thank you for the kind words. Honestly, having gone through recovery and grappling with all the shit I didn’t want to acknowledge has been a gift. Learning to not hate myself for bad decisions I made in the past creates a lot of space to be compassionate and (hopefully) skillful in helping other people who are struggling. (Not to mention myself, when I fuck up…which is often.) It can always be worse, and I’ve lived through enough “bad” to be grateful for how much easier mundane shit like taxes, politics, and argumentative kids are by comparison. :)
- stingraycharles · 16 hours ago
  How are you feeling now, and how well does your brain recover from these things? I always wonder whether these kind of things have some lasting effect on, say, your ability to focus.
  - howtoquitwell · 15 hours ago
    Happy to say I'm in a much better place now. Recovery was/is hard, but therapy, meditation, sleep, and exercise -- plus boring old antidepressants -- keep me on much more stable ground. Also family: I have kids now, and being there for them and my wife is a bigger source of motivation than taking care of myself a good portion of the time. With regards to focus: I've struggled with that for my entire life, starting long before I ever took a drink or anything harder. Perhaps unsurprisingly, bipolar (which I 100% am) and ADHD (~95% sure; just not medicating for it b/c, y'know, "fun" drugs are a problem) are very common dual-diagnoses with substance disorders. So it's not so much that the substance abuse made me less able to focus; it's more that I've _always_ struggled with slowing down and staying put. Alcohol and other downers were always a form of self-medication.
- khazhoux · 16 hours ago
  > before I realized that doctors would and did prescribe me meds that were actively harmful in the interest of short-term comfort The number of times I've read about celebrities and random people in deep addiction (or eventual death), whose starting point was just pain relief from a run of the mill injury. Makes me wonder what idiocy has overtaken these doctors. "Here, take these so you don't have to suffer a sore back for the two next weeks. And btw, you may become deeply addicted and it might cost you your life. Good luck!"
smm11 · 20 hours ago
Lithium Orotate for anxiety. You're welcome.
- grvdrm · 7 hours ago
  Interesting. What motivated you to explore that and what helped support you taking it?