[Disclaimer: What follows is *not* medical advice. I am not a doctor. This is a personal account of addiction, unfiltered and unbiased.]
It never fails. Every time I talk about drugs or medicine, some well-meaning goomba busts into the comment section like a holier-than-thou Kool-Aid Man, to lecture me that I should absolutely not be doing that.
It happened again, yesterday, about my Xanax intake. The latest vintage is so pitch-perfect boilerplate that I’ve had to reshuffle my content calendar just to address it. So, here it is, taken as [sic].
It scared the shit out of me to read that you are taking Xanax every day from last 9 years…it doesn’t heal you but just makes you numb and devoid of the the feeling to be alive.
I have understood in my 30 years of living that what works is being with someone who actually loves you, support you and take care of you, that’s the most effective remedy of every problem out there. I wish this blessing for every individual on this earth…Amen!
It’s not the first time I’ve — and therefore they’ve — addressed my low-grade benzodiazepine dependence. It’s a recurring aside here in the canon, but it’s usually slipped very casually inside of other, larger, more socially relevant points.
Yet, let’s do some navel-gazing and talk about Xanax: why I take it, how it weaved its way into my nightly routine, my attempts to quit, and what I’m doing about it now.
The Origins of Pill-Popping
In the decade of the 2000s, I endured roughly 200-ish panic attacks. On November 13, 2011, I had my first panic attack in almost a year.
I was driving home to Austin from Dallas, following watching my beloved — and up until woebegone — Buffalo Bills lose 44–7. It was about a three-hour drive, and about halfway through, I had to pull over and lay flat on my back in the grass at a rest-stop. My girlfriend at the time was, shall we say, less than pleased.
I had yet another panic attack less than a week later. I went to the ER. I was prescribed a week’s supply of Xanax. I took it. I calmed down.
On November 27, I — then, in transit from my girlfriend’s birthday dinner to a surprise party I’d planned for her — had another panic attack, which forced me to leave said party early. It was pretty fucking humiliating and, as I think about it now, still kinda is.
The following day, I had yet another panic attack, and I went back to the ER, where I was, again, prescribed a week’s supply of Xanax. The following week I went to a psych, complaining of recurring panic attacks. I’d had at least one damn near every day for the previous three weeks. She prescribed me a month’s worth.
Every month since, for the past eight-and-a-half years, I’ve re-upped. 30 days of 0.5mg peach generic alprazolam pills, every 30 days. I take it. I calm down.
How much is 0.5mg? Precisely one-quarter of a bar. It’s a comically low dose. Yet, for those of you who aren’t used to chronic tranquilizer intake for chronic anxiety, let me inform you: even at that low dose, it’s surprisingly difficult to stop.
Yes, I’ve Tried to Quit
Let me unequivocally state that I, too, wish I was not taking Xanax. It’s obviously not an ideal method for controlling anxiety, and it’s not a form of healing.
And, let me unequivocally also state that, if the withdrawal was even remotely tolerable, I would’ve quit already. In fact, I’ve tried that.
I first tried quitting in late 2012 and early 2013. It led to repeated trips to the ER, thinking I was dying of respiratory failure, a hidden heart condition, a neurodegenerative disorder, or cancer. I racked up quite the tab at St. David’s Medical Center in North Austin.
As it turns out, hypochondria is a side-effect of benzodiazepine withdrawal. It’s accompanied by sweats, insomnia, fog-brain (not a medical term), cognitive impairments, emotional instability, panic, depression, muscle twitching and a host of other assorted unpleasantness. (It can also be deadly.)
I tried again in late-2014, as I was recovering from shoulder reconstruction surgery, and alprazolam is a contraindication with oxycodone. I stopped one to take the other — because they had just super-glued my labrum back onto my shoulder socket — and I immediately found myself back in the ER thinking I was dying of lung cancer.
Once I’d stepped down to Tylenol-3, some four weeks post-op, I restarted the Xanax regiment. Why? Because I was dizzy and sick and sad, and quitting Xanax cold-turkey is not recommended by any reputable medical source.
The Cost-Benefit Analysis
I am, mostly, quite healthy. Sure, I’m immunocompromised and I’ve had chronic asthma my entire life, leaving my lungs to function like a used Ford Escort, so I’m no stranger to medicine. In fact, I actively wonder what life might be like without needing to take medicine. I yearn for such a life.
Yet, my mind is sharp, I’m in decent shape, my blood pressure’s great, and all my organs and vitals look good. I pass physicals with flying colors.
The cost of chronic Xanax use at that 0.5mg dose is … well, that I can’t just will myself to stop without a taper plan in place. To my knowledge, that’s it. The cost of stopping? Well, I just read you the menu.
The benefit? I don’t have panic attacks the way I used to. I’ve had precisely zero panic attacks in the past decade that weren’t directly related to Xanax or alcohol withdrawal. I don’t much drink anymore, either. And so I choose to soldier on, as I have.
I could go to a 28-day rehab — which … no, no, no … It’s expensive, time-consuming, and a bit like killing an ant with a bazooka — but I’ve done the calculus and I’ve, instead, elected to quit on my own. My doctor and psychotherapist said I could do this, also.
And so, I started a taper in February. Three weeks in came Coronavirus, three months of self-isolation, economic depression and civilization collapse.
That fucked with my plans and, when I told my doctor I needed an early refill in April, a nurse informed me, “This is one of the most common calls we’ve gotten since this whole thing started.” Apparently, I’m in good, anxious company. I’ll try again when a deadly virus I’m at high risk for isn’t breathing down my neck.
The Difference Between “Use” and “Abuse”
So, yeah. Nine years of nightly benzodiazepines. Are you scared? I’m not. I’m scared of not taking them. I’m aware that they don’t heal me. They treat me.
You know what else treats me? Therapy, running, attempts at SSRIs, ketamine infusions, plant-based diets, going easy on the booze and smokes, quality time with friends, writing and music.
And, up until March, it was going just fine. I use Xanax, as prescribed. I do not abuse Xanax … I never have, and never will.
Spare me your magical recommendations of “being with someone who actually loves you, supports you and takes care of you.” I’ve had that, too. And I took Xanax all the way through those relationships, also.
Maybe that makes me an addict. If so, then candidly, I wish I did more drugs, because taking Xanax has never been fun for me. It’s always been medicine … just like the Symbicort, Singulair and Albuterol I’ve breathed into my lungs, every day, since age 3. Those aren’t fun, either, but if I quit them, I die.
There will come a time, again, when I will work up the strength to taper. I have a 14-week plan in place to do so. It’s been 14 weeks since I last tried to stop. I’d be free and clear right now if a goddamned global pandemic didn’t get in the way. I didn’t bank on that, and I’ll bet you didn’t, either.
Nobody knows how to handle what we’re facing, and I’m calling bullshit on anyone who claims to be handling this well. We all have our own ways of coping, and this is one of mine. I’d enjoy it if you didn’t judge me for it. I don’t need the substance-shaming in the midst of all [*gestures at the tire-fire that is America, 2020] this.
There’s plenty of bigger evils worth aiming our ire at, plenty of more severe concerns worth addressing. I’m far more scared of all that outside world nonsense than I am about a measly nightly quarter-bar of Xanax. I’m not glorifying or excusing it, I’m merely informing you of what is, and what has been, and what will be, until it’s not.
I promise I’ll address my sedative ritual at a later date, and I’d appreciate it if you gave me the grace that I — and my doctor — am giving myself in dealing with it. My ultimate goal is survival; this helps me survive.
Now, if you’ll excuse me, I’m going to take my inhalers and go for a run.