Crackpots #58: Brad Phillips on Benzos (Patreon)

Brace here: We've got Brad Phillips in the barrel once more, talking about benzodiazapenes. Longtime listeners will know that I loved heroin; I loved it so much that my quite natural fear of needles melted away and (think of this as a sort of summation of the power of dope) was even replaced by deep affection. And, of course, I had a small fondness for cocaine and methamphetamine and liquor. But Benzodiazapenes were a mystery to me. I thought of them like a super Gatorade, something you took when you were hungover or paranoid or wanted down gently off LSD. Overall I disliked the way they made me feel when I tried to abuse them, which was mostly sleepy and discontented. But I found that more and more people I knew were taking benzos, even buying them off the street, they were all over drug songs, they were hugely popular with people a little bit younger than myself but generally popular overall. I want to understand the world and I think this piece by Brad helps with that. You can buy his book here.

I spent the last twelve months researching and writing an article about my long, traumatic relationship with benzodiazepines. It was contracted by a Big Time Magazine, but they recently ‘killed’ it, which means it won’t be published. Maybe my editor decided that pieces like this in The New York Times, or like this in The Washington Post—which came out while I was conducting interviews and making revisions—meant that my article was no longer relevant, or maybe it really was what he said; that I hadn’t delivered my best writing, the kind of writing showcased in my 2019 short story collection Essays & Fictions, of which he was a fan. I explained that I wrote that book while I was still taking a prescribed benzodiazepine (Klonopin), but that I was trying to write this article for him after coming off Klonopin, and that I had—according to experts I’d interviewed—what amounted to brain damage. I couldn’t organize my thoughts. I wasn’t at my best. I argued that this made the writing more authentic. He didn’t buy it. 

I call my relationship with benzodiazepines ‘traumatic’, but I didn’t realize I was being traumatized by Klonopin until I came off it in 2021 and wanted to kill myself. The urge to commit suicide wasn’t even the worst part of my detox experience, not by a longshot. If you don’t know about benzodiazepines—if you haven’t read those New York Times or Washington Post articles—then here’s a brief summary; brief because the idea of going back into the subject after twelve months of back and forth with an editor feels too painful, too exhausting. 

Benzodiazepines are among the most widely prescribed drugs in America. You know them. They’re Xanax, Ativan, Valium, and Klonopin—amongst others. Anxiety and agoraphobia began making my life small when I was a teenager. I tried many medications, both legal and otherwise. Nothing ever worked. But in 2002 I was prescribed Klonopin—0.5 milligrams daily—and for a moment I could breathe. The sensation was indescribable. My anxiety returned a few months later, only now it was worse, and involved somatic symptoms. My doctor said this was a recurrence of my ‘mental illness’, and increased my dosage, so that by 2021 I was taking 5 milligrams of Klonopin daily, always as prescribed, and always prescribed by a doctor. I only ever felt worse, not better, year after year. 

This is the beginning of a story shared by tens of millions of Americans. What doctors never told me is that benzodiazepines are absolutely not intended for long-term use. They’re supposed to be used for one to two weeks—max. Doctors didn’t tell me this, I learned, because they only spend a few hours on benzodiazepines in medical school. They don’t know any better. And pharmaceutical manufacturers bend over backwards to make sure this fact about their medication isn’t well known. 

Junkies get sick when they’re between fixes. I was experiencing the same thing, but instead of a runny nose, sore legs, and nausea, my withdrawal symptoms were the symptoms of anxiety. My doctor’s prescription pad had me trapped in a state of perpetual withdrawal, but neither of us knew it. So by 2021, after having been on Klonopin for nineteen years, I was deep into a physical dependence not of my own making. I was always scared. I vomited randomly, sweated through my bedsheets, lost my temper, and wept like an infant (all things I haven’t done since coming off Klonopin). Because my wife is smarter than me, she suggested my medication might be the problem. She intuitively knew what countless studies have shown; that people on benzodiazepines have increased anxiety, poorer emotional regulation, and a host of other problems, each more frightening than the last. I was never happy.

Miserable and open to my wife’s suggestion, I went to a hospital, where I was told to taper off Klonopin in three weeks. I did what I was told, because, well, a doctor told me. Two days into my taper I lost my mind, and developed a host of alarming, frightening physical problems. Anytime I suggested to my doctors that my suffering might be related to having just come off Klonopin I was dismissed. Suspecting they were wrong, I began doing research. I discovered an online community of doctors and patients raising awareness of the dangers of benzodiazepines. I discovered research connecting long-term benzo use to brain damage. I read that the safest way to taper off a benzodiazepine is over the course of many months, sometimes years. I found a doctor who knew about these things, which was inordinately difficult. He prescribed me Valium—which is easier to taper over long periods of time—and I took it, reluctantly, now terrified of reintroducing a benzodiazepine. I felt less sick, less insane, and less suicidal almost instantly. I took a smaller dose each month until January of 2024, when I stopped altogether. I feel better today than I did when I came off Klonopin, but I sure as shit don’t feel great. I’m occasionally agoraphobic and often anxious (plus I’ve now got strange phobias) but compared to 2021 when my hands and feet were numb, when I couldn’t sit still or stop sweating (when I was misdiagnosed with multiple sclerosis) today’s a dream. 

It’s disappointing when things turn out to be predictable. There really is a benzodiazepine crisis in America, and probably throughout the world. And the culprits are the people you see in George Clooney movies—corrupt politicians, immoral pharmaceutical executives, greedy doctors. There are thousands of people on the internet telling stories just like mine. Nobody seems to give a shit. Like me, they’re desperate to turn off the movie, but they live inside the screen. Maybe these quotes from Fleetwood Mac’s Stevie Nicks can speak for all of them. 

“The only thing I’d change (in my life) is walking into the office of the doctor who prescribed me Klonopin. That ruined my life for eight years.”

“That doctor – he’s the only person in my life I can honestly say I will never forgive. All those years I lost – I could have maybe met somebody or had a baby or done a few more Fleetwood Mac albums or Stevie Nicks albums. 

“I was sad and I was sick. I really didn’t understand right up until the end that it was the Klonopin that was making me crazy. I really didn’t realize it was that drug because I was taking it from a doctor and it was prescribed. It just hit me really hard that that was the foundation for why I was completely falling apart.”

I have a friend who jumped off a bridge hoping to end his life, but didn’t succeed. He says that if he had died he’d have killed the wrong person, because at the time he was addicted to crack and heroin, and it was his addiction to drugs that made him suicidal, not the childhood trauma he used drugs to forget. He’s one of the nicest people I’ve ever met. I’m glad he didn’t kill that other person, who I can’t imagine living inside of his smiling face. 

I think about my friend surviving that jump a lot, now that I know Klonopin was making me far more anxious than imprints from my childhood were. It’s painful when the thing you believe is your solution is revealed to be your problem, as anyone in Alcoholics Anonymous can attest to. But it’s also liberating and helpful, because suddenly you’ve got perspective. I’ve been prescribed many psychiatric medications. I’ve had many unpleasant periods in my life. Maybe Klonopin isn’t the only drug that did me more harm than good.

I was prescribed Paxil–an SSRI—in 1991. I was seventeen years old and anxious, occasionally depressed. My profoundly menacing father would only be alive for five more years, at which point the greatest contributor to my emotional and mental ill-health would cease to exist. I wish I’d known to wait him out. 

It seems to be widely acknowledged that children and teenagers are overprescribed psychiatric medication. It’s probably normal to be depressed and anxious when you’re eighteen, regardless of who your parents are. But in the early 90s psych meds were everywhere. They promised relief from the slightest emotional discomfort, and there was no suggestion they might be bad for you. I remember people cracking jokes about Prozac and Valium on Cheers and Murphy Brown. So when a doctor suggested I take Paxil, I felt reassured that I’d be fine—happy even—just like the people I saw on television.

Most psych meds make you feel like shit when you first take them. I can still remember the internal tremor I felt on Paxil, and the taste of metal in my mouth. I’d never taken a psychiatric medication before—Paxil popped my cherry. Coincidentally, around this time I met my first girlfriend, who I’ll call Cookie. I told myself I’d been able to get a girl’s attention precisely because I was medicated, and therefore less outwardly crazy. Unfortunately, Paxil hit me with another common side effect of SSRIs; I was sexually handicapped. Cookie was kind, but not wrong to be confused. She was cute and we were teenagers, so sexual problems didn’t make sense, unless of course there was something deeply wrong with me, or her. I remember showing her the list of possible side effects on the pamphlet that came with Paxil. It warned vaguely of sexual side effects, which were understood to be decreased sex drive and difficulty getting an erection. I was horny, and I could get it up, I just couldn’t have an orgasm. This stung Cookie even more, because it implied she wasn’t doing it for me, when in fact she was. She pointed at other listed side effects—problems with urinating, feeling of unreality—and asked why I didn’t have any of them. It seemed suspicious that Paxil only made it impossible for me to have an orgasm. I shrugged my shoulders. I didn’t understand either. My doctor hadn’t told me shit. We broke up soon after. I’d see Cookie around school, usually with Andrew Good, who surely came when they had sex. 

After Cookie and I broke up—ironically—I began to develop many of Paxil’s other listed side effects. I felt drugged and couldn’t concentrate, I was always yawning, and my body felt like it belonged to someone else. When I complained to my doctor he put me on other medications to manage the side effects, and so the cycle began. There was one side effect of Paxil I never experienced, the one it’s advertised to produce; I didn’t feel any happier. I stopped taking it a year later. 

It could have been much worse. I know that. I felt sexually and romantically inadequate instead of confident after being in my first relationship. Maybe it’s good for men to feel inadequate at a young age. I’m aware of the damage inflicted on the world by men who are pleased with themselves.

I spent most of my twenties working as my own doctor, and my prescriptions were typically filled on the street, not in pharmacies. It didn’t work out so well, but in defence of street drugs, they never sidelined me with a laundry list of obscure side effects. I knew what I was getting into each time I copped dope. That hasn’t been my experience with prescribed medications. Drug dealers are vastly more informed about their products than doctors are about theirs.

I moved to Vancouver in my late thirties, unaware that it contained the largest open air drug market in North America. My partner and I moved to the centre of the mayhem. At first it felt like home, and I was comfortable. Then it started to remind me of home, and things quickly went sideways. I surrendered to psychiatry for the second time. I don’t put much stock in diagnoses. It seems apparent that each illness is a different manifestation of the same thing—discomfort with reality. 

My psychiatrist Dr. Fung loved his prescription pad. He was the one who introduced me to Klonopin, which soon stopped working, so along with an increase in my Klonopin, over time Dr. Fung added Risperidone (antipsychotic), Lithium (you know about Lithium), Celexa (SSRI), and Zyprexa (antipsychotic). Nobody ever suggested I was psychotic, so it’s strange I was prescribed not one but two antipsychotics. Live and learn, I thought. He’s a  doctor, you’re not. Maybe you are psychotic. People do say you’re hard to deal with. 

Unshockingly, my life did not improve while on this cocktail. My weekly appointments with Dr. Fung were only ever about adjusting this medication to balance that medication, never about the issues that drove me to therapy. Eight months after being prescribed Zyprexa something strange happened. I’d always loved drugs, but drinking was never my thing. I’d leave half a beer at a restaurant and not think twice about it. I got drunk maybe once a year, usually because I was trying to keep up with someone else. Suddenly I’d become that someone people tried to keep up with. At 8:30 in the morning I’d follow the bartender into the Country Music Bar on Hastings, where I’d be blackout drunk when The Price is Right came on at 10. Every aspect of my life was negatively affected by my drinking. The art career I had carefully nurtured over the course of a decade was in the toilet. My relationships were in shambles. I arrived at Dr. Fung’s office an hour early so I could drink three pints and three shots while eating poutine before our appointment. Eventually he brought up something other than my medication—my drinking. Our sessions, he said, would never be helpful if I was drunk. I told him I didn’t know how to stop, or why I’d started. He made his first suggestion—that I go to AA. 

So I went to AA meetings, drunk. If I wasn’t drunk, I’d get drunk immediately afterwards. I absolutely could not stop drinking, just like they talked about in meetings. Alcoholic, finally a diagnosis that seemed to fit. 

I went to a meeting every day, and I got a sponsor. I kept drinking. He took me through the steps while I claimed to be sober. We both knew that I wasn’t. My inability to stop drinking and my commitment to lying hammered home that I was an alcoholic. It got to the point where I couldn’t manage anything. I stopped seeing Dr. Fung. My GP took over my prescriptions. He berated me for drinking, which felt appropriate. He also said I shouldn’t be on two antipsychotics, seeing as I wasn’t psychotic. He decided to taper me off of them, but one at a time so as to not overwhelm my system. Zyprexa was the first to go. 

I’d been on Zyprexa for three years, during which I felt pathologically driven to drink alcohol, as if my life depended on it. Two weeks after flushing it from my system, I woke up with zero desire to drink. Being the type stupid enough to test a miracle, I went to a bar and drank a beer. One beer. I wasn’t compelled to drink more. For the previous three years, like every alcoholic ever, I’d dreamed of being able to drink just one beer. But now even the one didn’t interest me. Maybe this was what AA promised, and the compulsion to drink had been lifted from me. It wasn’t though, because I hadn’t done the work in AA. I’d gone to some meetings loaded and lied to a sponsor, just like everyone who ends up dead of cirrhosis. Then I met a guy named Jeff. 

Jeff was from Manchester, and moved to Vancouver to snowboard. His brother back home had recently been involved in a campaign to have ‘compulsive behaviours, including gambling’ included as one potential side effect of Zyprexa. Apparently in the UK there was an astonishing amount of evidence connecting Zyprexa to uncharacteristic addictive behaviours. People felt compelled to drink, to gamble, to fornicate with strangers athletically. Of course, this might just be a convenient way to sidestep shame by casting blame on Big Pharma. And similarly, people who find themselves prescribed serious psychiatric medications are more likely to have substance abuse problems, or to self-medicate with sex. But what if it’s actually the medication? 

I don’t drink today. Of course I’ve entertained the idea that I was never an alcoholic, that I was just someone dealing with the very strange, unadvertised side effect of a medication. I’ve fantasized about having just one drink, the way I did throughout my life before being prescribed Zyprexa. But I remember how bad it was during those years in Vancouver, and it doesn’t seem worth the risk. The fact that I have this conversation with myself occasionally points to my being an alcoholic, not the victim of Big Pharma. It gets confusing.  

It’s hard to overstate how much those years spent drinking fucked my life up. I also caused a lot of damage to the people around me. The dysfunctional dick of my teenage years on Paxil seems less important, but still instructive. I took a medication for relief from what was essentially nonsense mental noise—depression, anxiety, fear of the unknown, fear of the known—and it led to my having concrete, actual problems based in reality. Klonopin skinned my nervous system alive, so that now I’m the psychic equivalent of a burn victim. That’s partly on me. I could’ve done what other doctors suggested; gone to the gym, meditated, ate healthy foods—all things I do today. I just wish I’d had what I now know is called informed consent. It was there with Paxil, albeit in small print, sexual side effects. When I told my doctor I couldn’t bust a nut, he could’ve taken me off the medication. Instead he prescribed new meds to manage the side effects, which had their own side effects. Looking back I should’ve done the research not when numb, palsied, and hyperhidrotic from Klonopin withdrawal, but the very first time I faked an orgasm with Cookie, in 1991.