(3 min read) It’s important to respect the addiction potential of benzos, as any stint in rehab will clearly show you: it’s deadly, addictive, and just downright awful to recover from (the worst). This is not being melodramatic. Benzos are astonishingly difficult: dead serious. This article isn’t in support of benzos, it’s advocating how to navigate bias in psychiatric treatment. Benzos are just example. Talk to your provider about all meds (and their risks) before trying.

That said, their application in mitigating acute mania is undeniable and irreplaceable (for me). So every blue moon I request no more than 5 low-dose benzos prescribed per month, specifically to avoid dependency risk.

As my “emergency med”, it can be a very valuable tool when all else fails. Offering unique damage control socially and physically. I am yet to find an alternative, despite trying many.

But it’s also fraught with stigma and bias. To a problematic detriment.

One time my prescriber denied these 5 benzos, offering me a blood pressure med without explanation instead. I trusted her advice and tried, as I always do, never pushing back. But this BP med was completely useless. 7 mixed manic episodes later (in 1 unusually bad week), I got frustrated and asked again for benzos. “Why are we avoiding legitimate clinical applications here? The textbook says: benzos.” (PS never call them “benzos” lol)

Her response? “I just… the DEA will be up my ass if I prescribe you benzos.”

My jaw dropped. “What?! You mean I just white-knuckled 7 manic attacks because you didn’t want the red tape hassle?? Not cool!” I responded bluntly: “The DEA has nothing to do with me! This is bias! I can’t have a prescriber making decisions based on bias. Why didn’t you tell me sooner?”

It got contentious quick and she got very offended. But she knew I was right, coldly recommending I find someone else as if I did something wrong. I have not requested benzos since, well over a year and many manic episodes ago.

To be clear, it wasn’t the benzos that bothered me (I don’t like benzo fatigue anyway), it was this unspoken bias I got cornered with. I trust these tools will be there for me when shit hits the manic fan. They weren’t. And I got caught with my pants down. Never again.

Similarly, my partner’s psychiatrist openly and proudly “refuses to prescribe any stimulants/benzos at all” to any patient, simply due to this same DEA red tape. So all on their own, these 2 prescribers effectively negated an entire classes of meds, without clinically significant reasons or effective alternatives. This proclivity of personal preference is clinically inappropriate (opinion), and a dangerous precedent to set in treatment. Legitimate time-tested medicines literature supports have every right to be in your treatment toolbox, so long as risk mitigation and due diligence get addressed professionally.

To prevent this headache from happening to you, consider having this bias discussion early on with your prescriber, and making the treatment parameters (and risks) very clear. Rather than waiting until you need these meds in a panic. If your med provider is against specific meds for any reason other than safety, consider this a red flag worth leaving over (opinion). Handling the DEA is their responsibility, not yours.

As a patient, you are not here to serve your provider, they are there to serve you, fairly and bias free as science requires. So long as risks are communicated and abuse mitigated, my opinion is the patient ultimately decides what medicine to ingest, at the leadership of provider; an experienced patient will know their toolset needs well.

Your treatment plan depends on having access to the entire toolset, not just the ones that make your prescribers job easier.

Disclaimer: This article is not supporting benzo use, but advocating how to navigate bias in treatment. Be careful if benzos are prescribed and take their addiction potential very seriously. Ask your provider to discuss more before taking any med, especially benzos. I am not an expert and only offer patient insight here.

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