Kicking Mother's Little Helper: Benzodiazepine support group launched
The first time Bill Kellagher saw his wife, Alison, he was cycling a mountain pass in New York's Hudson Valley.
"This hot babe came tearing past us," he said of the 1980 encounter. The two met later that day in an ice cream parlor — the petite, raven-haired cyclist approached him to ask how far he and his friend had ridden.
They made a date to go riding; six months later they were married.
But the intense, driven woman he met that day started to become withdrawn and lethargic five years into their relationship. Pills prescribed to treat job-related anxiety had softened the edges of her fast-paced life.
"The doctor told me to take it every day and that I'd be fine," said Alison Kellagher, 50, who today is a Naropa University student and Gunbarrel resident.
She fell deeper into herself with every dose of Xanax, Klonopin or other benzodiazepine prescribed as her tolerance grew. Friends stopped calling.
Before Alison Kellagher knew it, a decade passed. The once-elite athlete — a cross-country ski racer and national bronze-medal winning cyclist — threw herself into her sports apparel career. But outside of going to work, she had no desire to leave the house.
"I didn't feel good," she said. "It calmed me enough to function, but it didn't make me healthy ... the world begins to get dark. One's mind and spirit are drugged."
In all, Kellagher spent 17 years addicted to benzodiazepines, which are commonly referred to as sleeping pills or tranquilizers; she sought professional help seven times before overcoming her dependence.
Her experience prompted her to organize Boulder County's first benzodiazepine support group, which recently began meeting on Monday nights in Gunbarrel. It's only benzodiazepine-specific support group in Colorado and perhaps in the United States.
State statistics scratch the surface in illustrating the problem, addiction recovery experts say.
In 2000, the most recent period for which numbers are available, the state's alcohol and drug abuse division counted 77 people seeking treatment for tranquilizer addiction.
"It's deceptive because people who are using benzodiazepines are often using other drugs as well, and they don't identify benzos when seeking recovery," said Ann Noonan, clinical coordinator for Boulder County's Public Health Substance Abuse Program.
"It's a hidden drug problem," she said.
Many users don't see benzodiazepines as a problem, Noonan said, because the pills are prescribed. But the people who've struggled to recover from their dependence on benzodiazepines tell a different story, one that sometimes involves months of terror-inducing withdrawal.
In 2001, about 1.2 million people in the United States used a tranquilizer for the first time, according to the Substance Abuse and Mental Health Services Administration. Over-the-counter drug sales show that doctors endorse upwards of 80 million prescriptions for benzodiazepines every year.
"It's one of the most commonly prescribed medications," said Dr. Roger Cambor, a Boulder addiction psychiatrist.
About 1 percent to 2 percent of the U.S. population uses benzodiazepines regularly and about half of those users become hooked, Cambor said.
Quitting benzodiazepines can be far more challenging than recovering from cocaine addiction, he said. The family of prescription drugs, which hit the market in the 1960s with Valium, are generally meant to treat anxiety, sleeplessness and pain for the short-term, Cambor said.
"When you've been on the drug for years, the brain is changed," Cambor explained. Being on the drug can impair one's memory and reflexes. And withdrawal often results in chronic insomnia, severe anxiety, depression and pain. It can drag out over months, often resulting in relapse, he said.
"You just don't feel normal at all for months," he said.
Rehab
When Kellagher first sought help, she was forced to go cold turkey.
She took time off of work, checked herself into a 30-day recovery center and prayed that she'd pull out of the cave in which her mind had made its nest. She had no idea what laid in store for her.
Extreme fear, anxiety, irritability and insomnia took hold. She was alone. No one else at the recovery center suffered from that kind of drug dependence.
"I had no support," she said. "Almost no one would believe what I was going through. It was state of mental torment."
The torment continued after leaving the center, prompting Kellagher to seek the advice of her psychiatrist.
Kellagher said she didn't fully understand that the drugs were at the root of her anguish — she felt bad when she was on them and off them. Her doctor told her he knew of no other way to stop the pain but to prescribe her a benzodiazepine, she said.
What she learned much later was that time was the true antidote.
Every year for seven years, Kellagher made an attempt to quit. The last time, three years ago, she gave up a year of her life to overcome her dependence.
Today finding help is far easier, experts say.
"For people to be successful in getting off these drugs, you need to understand the chemistry," Boulder addiction psychiatrist Cambor said.
Kellagher, he said, was lucky not to have died. Taking a cold-turkey approach when quitting benzodiazepines can be extremely dangerous, given that it can result seizures. Doctors now work with those dependent on benzodiazepines to wean them from the drug.
More importantly, doctors can tell their patients what to expect as they suffer withdrawal.
"The only thing that can help is knowing that it will get better," Kellagher said. Cambor compared the addiction to smoking and nicotine addiction. "There's a psychological and physical dependence," he said. "You've got to commit yourself to a period of time. Months are more likely than weeks."
While Valium was coined as "Mother's Little Helper," in the 1967 Rolling Stones' song, benzodiazepines are taken for a variety of reasons.
They're taken in conjunction with other drugs such as cocaine or alcohol to take the edge off of a hangover or to sleep. Some people self medicate for problems such as anxiety or depression, conditions for which benzodiazepines are not a long-term solution, Cambor said.
Others start taking benzodiazepines as a way to cope with stress or insomnia and but then continue taking them as they would a vitamin, popping them with their morning glass of orange juice.
In Kellagher's case, her physician initially prescribed Xanax to help her deal with her high-pressured career as a sports apparel designer. He continued to prescribe higher doses of different benzodiazepines as her tolerance increased.
"It was the 1980s," she said. "At that time, success in my career was so important to me. I was relieved that nothing was getting in my way ... I didn't know what I was getting into."
She said she had no idea how addictive or harmful the drugs could be when she began taking them.
Answering the question of why benzodiazepines are prescribed so casually can be frustrating, Cambor said.
"A certain amount has to do with the fact that most people don't spend that much time with their doctor," he said. "A patient may want to stay on them. Nowadays with consumer advertising, everybody's telling you what kind of pills they want to be on."
Older patients pose their own set of unique problems, he said.
Senior citizens are often prescribed benzodiazepines to offset the effects of other drugs.
But, unfortunately, Cambor said, they're often over-dosed, as older people don't metabolize as quickly as their younger counterparts. Plus seniors tend to forget to take their drugs, take too many pills and mix their drugs with alcohol.
Back in the 1960s, he said, benzodiazepines were initially thought to be a safe alternative to barbiturates. There was a perception that the tranquilizers were relatively innocuous.
But Cambor said he feels confident things have changed.
"A lot of doctors are very reluctant to prescribe them," Cambor said. "They know they're meant for insomnia and anxiety in the short term. There are still people who prescribe them more liberally and that gets them into trouble."
Doctor shopping
Still, addiction recovery workers say scoring a popular benzodiazepine is generally easy. On the street, for example, Klonopin can be purchased for $5 per 1 milligram pill. The spendy pricetag is a sign, they say, that there's plenty of demand.
Making matters worse, Boulder County's Noonan said, is the fact that pharmaceutical companies have begun touting "non-addictive" benzodiazepines that have yet to stand the test of time.
Physicians, feeling assured that these new drugs pose less of an addiction risk, "have gotten a lot freer in prescribing," Noonan said.
What they're not considering, she said, is drug users who mix their benzodiazepines with other choice poisons.
"When you use benzos and alcohol, instead of one plus one equals two, it's more like one plus one equals four or five," she said. "It's a cheap high."
People also doctor shop — if they can't get a prescription one place, they'll get it another or they'll get more than more prescription.
Having a support group is key in staying clean, said Mike Lewis, a licensed clinical social worker at Boulder Community Hospital's recovery program. Friends and family can benefit from them, too, he said.
"There's no cure for chemical dependency. There's only management," he said. Twelve step programs are one option, he said. But they're not for everyone.
Kellagher said she started her benzodiazepine support group because she believes the addiction and the effects of benzodiazepine withdrawal are so unique. She said she wanted to give people dependent on benzodiazepines a source of additional support.
Plus, when you take benzodiazepines — such as Xanax, Valium, Klonopin, Ambien, Dalmane, Halcion, Restoril and Ativan — it's not to get high. She said too few medical professionals understand the mental hell into which prolonged use of these drugs can take you.
Which was worse: Suicidal thoughts, while on the drug, or the mental collapse that occurred when she stopped? Kellagher described a period during her recovery in which she was unable to read. The words didn't make sense.
"I was lucky to have the luxury of time to get well," she said. "My central nervous system needed to heal."
Kellagher said she had to learn how to be a person again at the age of 47.
The support of her husband, Bill Kellagher, made it possible, she said.
Throughout it all, he said he could always see at least a glimmer of the woman he first knew as having both a mind and body of steel. And with the intensity of the high-powered business woman and elite athlete she was in her younger years, Alison Kellagher made it up the mountain.
Now she's pouring her energy into earning her master's degree in transpersonal counseling psychology at Naropa. She said she feels whole again.
"It's a terrible addiction," Bill Kellagher said. "You take the stuff for four weeks and you're in it. All I can figure is there are lots of people, who right now are out there quietly suffering."
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