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Medication - A Difficult Decision

When you're concerned about addiction

From Cathleen Henning Fenton, for About.com

Updated: November 28, 2006

About.com Health's Disease and Condition content is reviewed by Steven Gans, MD

Concern about addiction usually focuses on the benzodiazepines (Xanax, Klonopin, Valium, Ativan, etc.). However, I have seen people concerned about addiction with any psychiatric medication. There is much misinformation and misunderstanding about the differences between addiction and medical dependence. Unfortunately, some of this misinformation is perpetuated by doctors even when research to the contrary is available.

If you are concerned about addiction and benzodiazepines, I urge you to read more about it before making your decision. I've already written about this issue in another feature: Addiction vs. Dependency: Benzodiazepines & Anxiety Disorders. I also recommend the other Web documents under "Elsewhere on the Web" in the same article.

The key points to my feature and the related articles are

  • Addiction often is marked by tolerance (a need to increase dosage again and again over time to achieve the same effects) and psychological dependence (a need to take the medication no matter what the consequences).
  • Most people who take benzodiazepines for anxiety disorders do not become addicted to the medication.
  • Using benzodiazepines for a few months or more often leads to physical dependence which means that the body adjusts to the medication and will experience withdrawal symptoms if the medication is discontinued abruptly.
  • Withdrawal symptoms are often reduced or eliminated by slowly tapering off the medication.
  • Medical dependence means that you need to continue a medication in order to prevent the return of anxiety disorders symptoms.
  • People with a history of addiction to other substances are at risk of addiction to benzodiazepines.

Your body will also adjust to antidepressants and other medication used for anxiety disorders, if used for a few months or more. You may feel symptoms if these medications are stopped abruptly. It's important to discontinue all medications gradually and to do it only with your doctor's knowledge.

Withdrawal is not the same problem as the return of anxiety symptoms. Sometimes, though, it may be difficult to distinguish between the two. Your doctor should be aware of any new symptoms you are experiencing. If your anxiety symptoms return, it may mean it's not time to stop the medication. However, if you're choosing to stop the medication for other reasons, it's probably a good idea to start cognitive-behavioral therapy (if you're not in it already).

It's important to let your doctor know about any concerns you have about addiction. Don't simply avoid medication without telling your doctor why. Meanwhile, read all you can about this topic. Form your own decisions based on research and your doctor's advice before believing everything your peers have to say on the matter.

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