Depression, Anxiety, Opiates, and Benzodiazepines

The untimely passing of musician, Chris Cornell came as a shock to many people and resonates with an empty space left by others who have passed in a similar way. Being that it's Mental Health Awareness Month, it's important to explore what may have happened, and see how we can prevent this from happening to anyone else.

One of the top questions related to this tragedy is about the medication, Ativan. People are wondering if it was Ativan that caused him to become suicidal, or if this would have happened regardless of the medication.

In response, here are some facts about depression, substance use, and Ativan:

1. Chris spoke about his struggles with alcohol and opiate addiction, childhood trauma, and depression in various interviews. As you may know, addiction is a lifelong battle, as is depression. It doesn’t go away, but you can improve how you deal with it so it doesn’t have as much power over you.

2. If someone is on anti-anxiety medication, that implies they are probably dealing with anxiety. Depression and anxiety often go hand in hand, and they are inherent in most addictions, even if you are in recovery.

3. Ativan is the brand name of Lorazepam, and it's part of a class of drugs called benzodiazepines. Benzodiazepines are psychoactive drugs often prescribed as a short term treatment for anxiety and insomnia. Other popular benzodiazepines include Xanax (Alprazolam), Valium (Diazepam), and Klonopin (Clonazepam). Benzodiazepines are HIGHLY addictive. They have hypnotic, sedative, and relaxant properties.

4. If a former addict uses benzodiazepines, they activate the addiction and everything that comes with it. An addict who uses benzodiazepines is not sober, even if it was prescribed by a doctor.

5. Benzodiazepines do increase your chances of suicidal ideation and self-harm, even if you weren’t depressed or feeling suicidal before you start taking them.

Unfortunately, there is no way to know whether Chris Cornell was dealing with one or a combination of these factors. Many people can likely relate to what he was going through but aren't sure what to do. While conversations about mental health and therapy are becoming more acceptable, there is still a long path forward to normalize the prevalence of mental health challenges.

Instead of creating greater access to counseling and therapy, we're seeing a systemic normalization of prescription drug addiction. The death rate related to benzodiazepines has been increasing rapidly at an alarming rate each year. The use and abuse medications such as opiates and benzodiazepines have become more socially acceptable, even with their dangerous consequences.

This can be confusing because you would think that medication should be helpful and alleviate depression, not make it worse.

Opiates and benzodiazepines aside, there are certain antidepressant medications that can potentially alleviate symptoms of depression and anxiety temporarily. However, medication alone isn’t necessarily a sustainable solution for depression and anxiety. Numerous studies show that medication combined with consistent therapy is significantly more effective than medication alone. In some cases, antidepressant medications on their own are no more effective than a placebo, and come with their own set of harmful side effects.

Negative Side Effects of Opiates and Benzodiazepines

People often get into a pattern taking higher doses of opiates and benzodiazepines as they develop higher tolerance levels. This can damage your brain, your liver, and it can exacerbate mood and sleep disorders. In some cases, these medications can change your brain to a point where you can't reverse the brain damage.

Long term use of benzodiazepines can cause dementia (like Alzheimer's). Benzodiazepines can trigger mood swings and depression, and impair your memory. They are highly addictive, even for people who don’t fit the typical “addict” category. Opiates, benzodiazepines, and even some antidepressant medications can cause suicidal or homicidal thoughts and behaviors. The withdrawal process from these medications can be incredibly uncomfortable and challenging.

Opiates and Benzodiazepines are Like a Band-Aid Covering a Wound

Taking these medications over a long period of time temporarily alleviates symptoms of anxiety and depression, but it ultimately prevents you from addressing the root of the issue. Ongoing healthy lifestyle choices are essential to maintaining good mental health, as well as working through trauma and releasing stress in therapy. Without engaging in introspective healing processes, symptoms of depression and anxiety become worse over time.

In addition to increases in benzodiazepine deaths, rates of addiction, anxiety, depression, and suicide are also soaring more than ever before. Here are some recent statistics to bring this into focus:

  • Anxiety affects over 40 million adults in the United States every year.

  • Depression affects over 15 million adults in America.​

  • More than 50,000 people died in the U.S. in 2016 due to overdose. This is the highest rate of overdose death than ever before.

  • Nearly 43,000 people die of suicide in the U.S. every year. Suicide rates are currently at a 30 year high.

  • According to the American Society of Addiction Medicine, nearly 276,000 adolescents abuse prescription painkillers.

In summary, mental health issues are increasing throughout the world, and so are opiate and benzodiazepine addictions. This is affecting people from all walks of life.

Modern Faces of Substance Abuse and Overdose

The modern-day heroin overdose looks very different than it used to. When you think of an overdose, you probably imagine a classic junkie lying on a public bathroom floor with a needle stuck in a sore. These days, substance abuse is occurring among creative types, business professionals, elderly people, teenagers, and even straight-laced people looking for a quick solution to chronic pain, or a sleep or anxiety disorder. Additionally, there is a condition called opiate-induced hyperalgesia, which can distort your perception of pain, causing you to take more opiates than you need and develop further dependence. Click here to read a blog post about how opiates can distort your perception of pain.

One of the reasons why the opiate and benzodiazepine epidemic is rippling through so many different communities is that you don’t have to become a stereotypical junky to get your fix to numb your physical and emotional pain. It comes in an official-looking orange prescription bottle with a label and doctor’s orders. This is what has normalized prescription drug addiction, and the collective numbing of underlying trauma, chronic stress, mood and personality disorders.

Even though doctors now have to follow regulations to ensure they aren’t prescribing opiates or benzodiazepines irresponsibly, it’s possible to obtain them online, and through other means.

On top of that, many people combine opiates like Vicodin, oxycontin, and codeine with sleeping pills, alcohol and/or benzodiazepines. This can make your heart slow down to a point where it stops beating.

Remember: It is extremely dangerous to combine opiates and benzodiazepines. About 75% of benzodiazepine deaths involve some type of opiate as well.

Alternative Solutions

The good news is that there are safer alternatives to Xanax and Opiates. Consider Seroquel (Quetiapine), Neurontin (Gabapentin), or an SSRI (like Celexa, Lexapro, Prozac, Zoloft). Like most medications, they also come with side effects, but they aren't addictive and won't cause suicidal ideation.

If you’re on a benzodiazepine, make an appointment with a psychiatrist right away to discuss safer alternatives.

If you’re struggling with depression, anxiety or any type of mental illness, here’s what you can do:

1. Remember that the brain is part of the body and sometimes it gets sick. People mistakenly don't take mental health issues as seriously as other physical disorders like cancer and heart disease. Mental health problems don't get better by themselves, they get worse.

2. Go to counseling once a week or multiple times a week.

3. Attend group therapy and avoid isolation. Isolations fuels depression.

4. If you're an addict or a codependent, go to at least one 12-step meeting every day.

5. If you think you need medication, go to a PSYCHIATRIST if possible, not your family doctor or general practitioner. Psychiatrists specialize in disorders of the brain, whereas a general doctor can give you a prescription, but they don't tend to specialize in the delicate intricacies of the brain. And tell them you don't want any benzodiazepines (like Xanax or Ativan) because they are highly addictive, can cause dementia, and increase your risk of suicidality.

6. If you're having suicidal thoughts or urges, or if you’re worried about someone in your life, call the National Suicide Prevention Hotline: 800-273-8255. They are available 24/7. Another option is to call 911. They'll take the suicidal person to the hospital and give them medication to stabilize their mood for 72 hours.

Hopefully, we can gain wisdom from Chris's death and spread awareness about mental health issues, addiction, and effective treatments to prevent suicide and overdose. Dealing with mental health issues can be challenging, but there are numerous sustainable solutions available.

May Chris Cornell rest in music and peace, and may his family find healing during this painful time.

Drop me a line in the comments below and let me know about your experiences with benzodiazepines. I’d also love to hear how Chris Cornell impacted your life.

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