[UpshotKnothole]

A friend of mine got hooked on heroin and ended up on methadone maintence. He’s since managed to get off that and is clean, but he had horror stories of people on methadone abusing benzodiazepines like crazy. Apparently mixing methadone and high doses of drugs like Xanax produce effects similar to heroin, but benzos are really hard to get off. He talked about a woman who couldn’t get her Xanax fix, and she started having seizures. Benzodiazepines take months to titrate off safely, and higher doses associated with abuse do unpleasant things to your seizure threshold and memory.

Bad stuff unless you must have it.

[stryk]

It is incredibly, incredibly dangerous to mix benzodiazepines (Xanax, Ativan, etc.) with Methadone. This is common knowledge amongst opiate addicts, at least everywhere I ever went in the US back in my wilder days. I have 3 close friends whom I grew up with that all died before age 30 from abusing that exact combination of narcotics, and know of countless more just in my home state alone.

Benzos are a respiratory depressant, and when combined with Methadone it amplifies it to the point where you stop breathing in your sleep and never wake up from respiratory failure, lack of oxygen to the brain, or your body freaks out and has a coronary episode, etc. it's really really risky -- no joke & no exaggeration. If alcohol is in the mix too then it's even worse.

And I'm not going to pretend like it's not enjoyable -- because it is. It's a great fuckin' buzz if downers are your thing. IMO it's better than heroin (no 'rush' to it, but the effects hit you like a ton of bricks and it lasts all night long. And it's a cheap buzz too), but it's also asking for your life to end.

methadone clinics know this and every one that I've ever seen, heard of, or been to personally Benzos are their one big 'no-no' [as in: if we find it in your Whiz Quiz we kick you out, some won't even give you a second chance and most clinics have mandatory urine screening twice a month, some every week]. You can test positive for damn near anything else -- and they expect you to test positive for opiates -- but if you have benzos in there then you kick rocks.

[mnm1]

Do you have a source for this "common knowledge"? I've seen plenty of people on methadone do just fine with benzos, especially if they take prescribed doses. I'm not so sure this isn't some bullshit pushed by doctors without evidence so that they have an excuse to stop treating their patients and leave them without benzos in a state where they are forced to either go to the black market or potentially withdraw and die. I've seen a lot of this from doctors as regards to methadone patients, trying to take people who have been on benzos for years or decades off without proper tapering and without a proper reason. It's almost as if they think of methadone patients as less than human, creatures whose lives are not of value. Wait, not almost. Whatever happened to the hippocratic oath?

[stryk]

I mean I cannot link you to a direct source, it was just something everyone knew, ya know 'common knowledge'. This was on both coasts as well as the midwest.

And it was explained to me at 3 different clinics in 3 different areas of the country that it was really about #1) liability -- particularly at clinics that accepted insurance for payment but not exclusively, there were cash-only ones with the same rule: No Benzos full-stop. If you had a legit prescription for xanax or ativan then they would send a letter to the prescribing doctor and would not dose you until they got an affirmative, positive response -- and to a somewhat lesser extent #2) they know it has the real potential to be fatal, and they're not monsters they don't want to kill all the junkies. Despite what you might think, some of them actually do give a shit and got into substance abuse medicine trying to help. Sure, for some it's just a job, and if you own the clinic it's a gold-shitting goose, but there are a lot of them who are genuinely trying to do good.

[mnm1]

Taking patients off benzos without properly tapering them off can lead to death. Some clinics are putting their own liability worries ahead of patients' well-being and risking patients lives in the process. It's not every place, but the places that do this clearly do not have the patients' best interests in mind. It's hard not to think that it's because they are dealing with addicts that they even consider such actions. The way addicts are treated at some clinics is simply unbelievable. They are lied to, disrespected, and ignored. That's bad enough but putting their lives in danger based on something that's allegedly common knowledge but hasn't even been studied is beyond preposterous. However as you say, they are raking in the dough so what do they care. It's not everywhere, but it's like that at a lot of clinics.

[LeftTurnSignal]

I don't have any sources, but I've lost two people close to me who mixed xanax and methadone. They were in rehab, fell off the wagon and that was it. Blood tests showed just those two drugs in their systems.

> It's almost as if they think of methadone patients as less than human, creatures whose lives are not of value.

This is 100% what one friend who's going through methadone treatment says. They don't even want to get them off of methadone either. He had to fight to even begin going down, and he was on it at 2 years at this point. He'll be in "rehab" for 5 years early next year, and the dose is about 1/3 what it was when he started.

[ghostbrainalpha]

There is a pretty large community on Reddit just dedicated to recovery just from Benzo's.

https://www.reddit.com/r/benzorecovery/

[tnecniv]

Benzo withdrawal can, in some cases be even riskier than opiate withdrawal. You also build a tolerance to them very quickly, which makes addiction even worse.

[cc-d]

Not in some cases, almost all.

GABAergenics in general are pretty much the sole class of popular recreational drug which have a very real possibility of lethal withdrawals.

In the case of alcohol, it often takes years for addicts to reach a point where withdrawal becomes lethal. In the case of short acting benzodiazepines/barbiturates, this point can be reached in less than a month.

Of course, benzodiazepines are in schedule IV, which means they are viewed as being rather benign with no/low potential for abuse. In the eyes of the federal government, alprazolam (xanax) is far less dangerous than marijuana/the traditional psychedelics.

Just another data point demonstrating the utter absurdity of US drug legislation and regulation.

[tnecniv]

> Not in some cases, almost all.

That's what I had heard, but I was uncomfortable making a stronger statement without more knowledge.

[cc-d]

In terms of the symptoms people more classically associate with the concept of "withdrawal", these can last MONTHS TO YEARS after the cessation of long term benzodizepine use.

If one wishes to cease benzodiazepine usage, they effectively are forced to slowly taper over time period that can potentially take years. If one were to "cold turkey" after a multi-year long period of heavy benzodiazepine use, assuming they survived with no other long term damage, their severe-moderate withdrawal symptoms would still be apparent after several months. These include, but not limited to, constant paranoia/panic attacks, constant visible parkinson-like shaking, SEVERE unceasing insomnia, etc.

I've only elaborated on the withdrawal aspect of benzodiazepines as well. They are capable of causing far more harm than simply their lethal withdrawals. User behavior, synergistic effects on respiratory depression, etc.