Clonazepam - The Speed of Tolerance?

[shilly_shillson]

Hello all. I have a friend that was a little anxious and a bit of an insomniac (the latter I can definitely relate to) so I recommended a doc visit. Long story short, she's been using high doses of clonazepam (4-8mg) almost every other day for about a month. Is it possible to experience withdrawal symptoms if she stops cold turkey now, after only a month?
Just a review of the facts: 4-8mg of clonazepam, maybe 16 out of 31 days (about every other day, sometimes less frequent, sometimes more)
If today or tomorrow is day 32 or 33, if she stops cold turkey, would she have clear signs of withdrawal and how long would it last?

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I just realized that this should probably go into "Dependency and Withdrawal". Sry!

[Roswell1947]

I'm surprised the Doc prescribed such a high dosage.
I'd call the doc and not cold turkey.
Time isn't the problem..The amount taken is quite large
and might cause discomfort.
Good luck.

[shilly_shillson]

Thanks for the advice. Not to throw anyone under the bus, but I'm sure she kind of made up her own dosing. She's done some doctor shopping before so she probably just had too much clonazepam for her own good. We're good friends though and I think I can get through to her especially now that I have someone else's input too. Thanks again!

[M77]

Hello all. I have a friend that was a little anxious and a bit of an insomniac (the latter I can definitely relate to) so I recommended a doc visit. Long story short, she's been using high doses of clonazepam (4-8mg) almost every other day for about a month. Is it possible to experience withdrawal symptoms if she stops cold turkey now, after only a month?
Just a review of the facts: 4-8mg of clonazepam, maybe 16 out of 31 days (about every other day, sometimes less frequent, sometimes more)
If today or tomorrow is day 32 or 33, if she stops cold turkey, would she have clear signs of withdrawal and how long would it last?

@shilly_shillson
One thing I hate is people that give advice on serious things they are not qualified to give advice on. I am going to break my own rules. Since I am not a doctor, I hate getting in to this, but with a lot of life experience, and knowledge, I think I can help.

Firstly, talk about over-prescribing! For a little anxiety, and insomnia, she probably should have started on lose dose Xanax - like .25 to .5 a TID (3*day), no way 4 - 8 mg of clonazepam. Way too much, appropriate for SEVERE anxiety disorder, not minor anxiety. I am not belittling anxiety. I have had it for 20+ years. The most Xanax I ever was prescribed (and am now) is 2mg three times a day, and I try to take less, because of multiple reasons, including being terrified of getting cut off, so I wanted to bring my tolerance down, so i did my own tapering. I was able to get down to .5 about 3 or 4 times a day, but have been needing to back to 1mg, 3 or 4 times a day. A lot of people have success with clonazapam for anxiety, but i have read extensively about it, and for someone NOT already on benzos, it is crazy to give them that much. I am a big guy, and I have a 20 year tolerance, and I could get away with half, or less.

Ok, now to withdrawal, which was what you asked. 30 days is enough time to get dependent, but probably more mental then physical. The problem with anti- anxiety treatment with benzos is they become a crutch. If I miss a dose, I might make it pretty far past the dose time, but sooner or later, I will start having an anxiety attack just from missing it. There is also withdrawai issues tied into the duration of the benzo, as in short acting, like triazolam, vs long acting, like clonazapam, and alprazolam (Xanax). Many people on here find that clonazapam isn't as bad as other benzos to get off. Despite long acting vs. short acting, I have found many forums that the people said kicking clonaz was really hard. Because of that, I pretty much just stuck with Xanax, even though at the time, my doc would give me anything I asked for (those days are long gone). I have used it, but honestly, I am so past the point of feeling anything from benzos, I could tell no difference. But I take it to prevent anxiety, so I do not expect any euphoria, but 2 mgs Xanax Brand, I feel nothing. I am sure if I took 2 or 3 at once, I might notice it, but honestly, that would just be a waste of meds to me, as I am not taking them for any recreational reason. I take Opana, and I hate it, but that's another story.

To summarize, I think your friend should get to another doc, maybe get on a low dose of Xanax, and that should help with her anxiety. She should take it AS NEEDED, no need to take it all day, unless really necessary, because all that does is build tolerance, and dependance. Also, that would prevent any WD issues, because she could maintain the low dose Xanax, or just taper off if she wanted to take nothing. Best of luck to your friend!

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I'm surprised the Doc prescribed such a high dosage.
I'd call the doc and not cold turkey.
Time isn't the problem..The amount taken is quite large
and might cause discomfort.
Good luck.

@Rowell10mg
Couldn't agree more, i was typing the same thing when you posted, except my phone rang, before I hit submit!!!

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Thanks for the advice. Not to throw anyone under the bus, but I'm sure she kind of made up her own dosing. She's done some doctor shopping before so she probably just had too much clonazepam for her own good. We're good friends though and I think I can get through to her especially now that I have someone else's input too. Thanks again!

@shilly_shillson
I missed your second post, but your friend "going off the reservation" make a lot more sense now. I thought that the doctor was one of these creeps that gives a high dose to get you hooked, so she came back every month for another visit. Just like a street dealer, I have met docs that operate like that. I knew a guy that dispensed diet pills from his office. No script, he bought jars of thousands, and would give you 90 dexedrine for $100 for the visit, plus $100 for the capsules. Flying under the radar, as the expression goes. I once asked him for a script for Valium. (This was the late 80's) Remember, this guy ran a pill mill for dexedrine. He looked at me like I had 3 heads and said "what are you nuts, I'm not losing my license for nobody....LOL"

[shilly_shillson]

@M77
Thank you for your input as well. I appreciate the detail, time, and effort you put into your post. I feel better knowing that the dependence will be "more mental than physical" because, as everyone knows, physical withdrawal is terrible. At the same time, I guess it depends on the person. I know physical withdrawal can often be handled by just taking other (less or non-addictive) medicine to deal with the symptoms. Nausea - take antihistamines, pepto, etc. Headache - take ibuprofen, acetaminophen, or aspirin. Rebound Insomnia - first generation antihistamines, non-benzo hypnotics (short term of course), and possibly low dose short acting benzos.
Mental addiction, on the other hand, does not always have such easy answers. I'll just have to see how she's doing today and get a feel for the current state of things.

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@M77
That sounds like a very bad doc btw. Giving high doses just to get people hooked is absolutely awful.

[M77]

@M77
Thank you for your input as well. I appreciate the detail, time, and effort you put into your post. I feel better knowing that the dependence will be "more mental than physical" because, as everyone knows, physical withdrawal is terrible. At the same time, I guess it depends on the person. I know physical withdrawal can often be handled by just taking other (less or non-addictive) medicine to deal with the symptoms. Nausea - take antihistamines, pepto, etc. Headache - take ibuprofen, acetaminophen, or aspirin. Rebound Insomnia - first generation antihistamines, non-benzo hypnotics (short term of course), and possibly low dose short acting benzos.
Mental addiction, on the other hand, does not always have such easy answers. I'll just have to see how she's doing today and get a feel for the current state of things.

@shilly_shillson
You are very welcome. You also are very right; physical issues can be dealt with, and there are lots of ways to get through them, but once your brain starts playing with you, all bets are off.

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@M77
That sounds like a very bad doc btw. Giving high doses just to get people hooked is absolutely awful.[/QUOTE]

Like the expression goes, "It is all about the Benjamins." The guy that ran the dexedrine pill mill finally got nailed, but it took a young kid, like 18, overdosing before they sent in under covers to bust him. When it made the papers, they said his practice made over $50k a week, which was sort of obvious as he actually had lines down the block!!! It looked like a concert was going on sale every morning 9AM when he opened!

There was a doc less the 2 blocks from my house that was selling oxycontin scripts to high school kids. This was just a few years ago. They got him on video, selling the scripts for $500, no exam, nothing. They took him out in handcuffs, it made the news, and the final result??? He got 6 months probation and lost his license!!! That was it!!! I know that game, in a few years, with a good lawyer, and a tearful admission to the state medical board, he will get his license back. What a country. We have to suck wind for meds, but dealing docs get less then a person with a few benzos in their pocket!!!

[shilly_shillson]

@M77
I'm glad those docs got nailed. Too bad it took a kid as a victim. The system is really screwed up. It lets money be the disease and the cure. 6 months probation is a joke. If the average person had a couple of those oxys that doc was giving out in their pocket upon arrest, it would be the last time that person saw daylight for a while.

[alumni]

Your friend is obviously abusing this drug. Benzodiazepines really should not be used for more than two-three weeks at a time for specific conditions such as PRN for panic attacks or for situational insomnia.
And, in my personal opinion, there is usually no serious difference between "mental" and "physical" withdrawals. They are related so closely that the difference is negligible unless referring to cravings that can occur after discontinuation.
Your friend should definitely taper off of this medication under a doctor's care. There is always a potential for medical problems if the drug is stopped too abruptly.

[BerndLocke]

[lang=de]i thougt clonaz are more somthing for epilepsy or strong anxiety/insomnia?
can't believe she prescibed 4-8mg per day (W/O tolerance).

you would sleep days with 4mg without tolerance and propertly die from cold turkey on 8mg.[/lang]

[billyboy1965]

@shilly_shillson;155590]Hello all. I have a friend that was a little anxious and a bit of an insomniac (the latter I can definitely relate to) so I recommended a doc visit. Long story short, she's been using high doses of clonazepam (4-8mg) almost every other day for about a month.


I agree with @M77 about people giving medical advice because there are so many factors involved with each individual; i.e., height, weight, previous health history, sex, single, married, kids, etc. Unless of course @alumni or @QVC1212 chimes in, and they're very cautious to keep advice generic as if you'd be reading the precaution list that comes with the pharmacy package.

I thought my PCP and shrink were generous with the prescription pad. Something doesn't ring right with the doctor's decision to prescribe that dosage.

Regardless, now it's the doctor's problem. It will be interesting to see what the doctor does when she goes for a refill. If she complains about any kind of mental or physical withdrawal, it's all in his court.

[Hemanne]

Great name @shilly_shillson

For "a little anxious and a bit of an insomniac / clonazepam (4-8mg) almost every other day for about a month." Doesn't add up does it, I mean who isn't at some time? Either your friend is buzzin or there are other factors. It's why I usually don't get into such issues, but it's Xmas.

I would expect some WD, if those are the facts, but doc should take care of it, if it's really doc's script. Me, just me, I'd probably have a couple nice cold ciders for the few WD days.

Merry Xmas and Happy New Year.

[Jeremy Fisher]

@shilly_shillson, I think some posters missed the doctor shopping part of your information about your friend.

It's good to keep in touch with her about this. So she wants to cut down? She realizes she can't keep obtaining the quantities? If I were you, I'd see if she'd be willing to have a heart to heart and start w/getting her daily intake down to a reasonable amt. Then she can talk one of her docs about how it's not working and maybe they can switch her. I guess the big question is how many pills does she have left and is it enough to taper.

@akl63, do you know anything about this drug?

[DeanMachine]

Yeah probably beating a dead horse here but WAY TOO much. When I was left to my own devices with Xanax, I caught a bad habit real quick, and eventually flushed my full script down the toilet. It was not an easy thing to do by any means but I had no choice cause I couldn't stop taking them.

[alumni]

I agree with @M77 about people giving medical advice because there are so many factors involved with each individual; i.e., height, weight, previous health history, sex, single, married, kids, etc. Unless of course @alumni or @QVC1212 chimes in, and they're very cautious to keep advice generic as if you'd be reading the precaution list that comes with the pharmacy package.
I thought my PCP and shrink were generous with the prescription pad. Something doesn't ring right with the doctor's decision to prescribe that dosage.

I'll concede that any advice I might offer is often conservative but I doubt that any "precaution list" would address a relatively new patient taking as much as 8mg/day of this drug.
In addition, I don't believe that the person in question is getting this level of Klonopin prescribed by one doctor. If she's doctor shopping or buying more online, she will have a little 'splaining to do with any doctor about effectively reducing the dosages. Still, she should be completely honest about her situation in the interest of her personal health safety.

[billyboy1965]

@shilly_shillson, I think some posters missed the doctor shopping part of your information about your friend.

And that would be me...so my previous post doesn't really apply. Didn't see she could have multiple sources.

She's in trouble and it's probably just the beginning.

[Jeremy Fisher]

I don't know, are benzos considered a gateway drug? Are any or all drugs considered gateway drugs?

I get the chasing the high concept. I get the tolerance concept. I get the need to take more meds to relieve the pain issue/problem, as the years and decades pass. That last one is the real problem for most of us, I think.

@billyboy1965, just not sure if a benzo problem is an indicator of a long trip downhill. @alumni, what do you think?

Maybe lack of control over meds is the indicator of future problems, no matter what the med is, that is being misused.

At least she has a friend that cares about her. That helps, right?

I do know that she has to want to cut down/quit.

Just some thoughts.

[billyboy1965]

Maybe lack of control over meds is the indicator of future problems, no matter what the med is, that is being misused.

.

My first thought when it comes to drug or alcohol abuse (which I believe is lack of control over meds) has something to do with self medicating an undiagnosed issue. Sometimes yes. Sometimes no.

[Hemanne]

That undiagnosed problem can be as profound as "I don't want to be here" - seeing the way the world is and not wanting or having the will to fit in. In which case the solution could be radical indeed ... and not socially acceptable. So it's self medication or self motivation ... to be a little vague.

[shilly_shillson]

Its been a topsy-turvy couple of weeks but she has successfully cut down use significantly. It took a long look at her life and behavior for her to recognize the issue. Thanks everyone who kept adding their bits of advice. She had a few bad nights of sleep and lots of toxic naps but its all looking good right now.