Mykeru wrote:
Benzos isn't even close to an answer.
I agree and don't agree at the same time. I don't think there's any question that there are a lot of people who have been totally fucked up by benzos, on the other hand, as a class of drugs, they've gotten a very bad rap based on that segment of people who have either deliberately or accidentally abused them. The best book I've ever read covering this is this one, which at this time is becoming a bit dated, but still valid IMO:
Salient features that I recall from reading it:
Most therapists realize that there are some people who do very well on long-term, monitored benzo use, and very badly off them. The idea that a person will begin to tolerate and then escalate benzo dose is largely a myth. While people do tend to tolerate the tranquilizing effects of benzo, then don't usually tolerate the anxiolytic effects they have, therefore there is no need to escalate dose to control anxiety.
Also, there's a very important distinction between addiction and physical dependence. They aren't the same, though most practitioners, even psychiatrists, never make the distinction.
However, due to the stigma that they're addictive drugs, physicians will sometimes label chronic users as addicts, often with disastrous consequence. One anecdote the author gives (this from my memory of reading it several years ago) is seeing a woman who went to a clinic for some odd ailment who happened to be on a low maintenance dose of benzodiazepine for general anxiety or agoraphobia. The attending physician immediately diagnosed drug addiction and sent her to a recovery program, halting her medication. The woman grew progressively worse, eventually lost her job and at the time he saw her was about to lose her housing. He reinstated her medication and she gradually began to recover. All of this was caused by stigma and misunderstanding of the utility of benzodiazepines.
In general, and as with many other things, I think this is a case of a few people ruining it for the majority of others. Although the stigma of benzos as addictive doesn't seem to have hampered their use. AFAIK, they're still one of the most prescribed class of drugs there is.