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Jordan Peterson is a psychologist and author from the University of Toronto. While his political views have created much controversy in recent years, it’s his dependence and rapid detox from benzodiazepines that triggered today’s blog post. Several listeners to the podcast have alerted me to this topic and although stories in the news are not our typical focus, I felt this one needed some clarification.
*** Caution: This post includes descriptions of extreme withdrawal methods and withdrawal symptomatology. ***
Watch the Video
On February 7th, Jordan’s daughter, Mikhaila, posted a YouTube video detailing her father’s horrific experience withdrawing from an undisclosed benzodiazepine. The video went viral and acquired almost two million views in just three days. Many media outlets have picked up the story including the NY Post, the Canadian Press, and the Independent. While these reports have helped raise awareness about benzodiazepines, they have also created some confusion.
Addiction vs. Dependence
Most of us know the controversy surrounding the term “addiction” when it comes to benzodiazepines. While addiction is possible with benzos, it is rare. Physiological dependence is the more accurate term to use and we attempt to correct this inaccuracy in the media when it is spotted. In fact, Benzodiazepine Information Coalition (BIC) even has a team dedicated to this very task. Thus, when we see articles with titles such as the NY Post’s, “Jordan Peterson recovering from tranquilizer addiction in Russia,” or the Independent’s, “Jordan Peterson suffers year of ‘absolute hell’ and needs emergency treatment for drug addiction…,” we as a community take note and attempt to correct the errors.
A perfect example of this is the article from The Independent mentioned above. In that piece, the author uses terms like “getting hooked,” “drug detox,” “highly addictive,” and of course, “addiction.” While “physical dependence” was mentioned referring to Mikhaila’s statement, it is lost in the gluttony of addiction terminology.
In fact, despite the journalists’ repeated missteps, Mikhaila attempted to clarify that her father suffers from dependence. In an article in Insider, she was quoted as saying, “Neither our family nor our doctors here believe this is a case of psychological addiction. Benzodiazepine physical dependence due to brain changes can occur in a matter of weeks.”
Using “dependence” instead of “addiction” is important. One of the key reasons for this concern is that treatment for addiction is different than that for dependence. Standard procedures for drug detox are often far too rapid, focus more on craving and psychological addiction than on physiological withdrawal, and frequently fail, complicating any future attempts the patient may take to remove themselves from the medication. People who believe they are addicted and check-in to a detox facility that specializes in addiction can be putting themselves at risk.
Rapid Detox – Miracle Cure?
While the terminology is important, there is an even more pressing topic here that begs for clarification. In fact, most of the questions I have received on this story have been related to Dr. Peterson’s treatment in Russia.
Peterson was prescribed a benzodiazepine a few years ago for what his daughter, Mikhaila, refers to as an “autoimmune reaction to food.” When his wife was diagnosed with cancer he became aware of his physical dependence. He went to a rehabilitation center in New York, but with little success. His severe akathisia triggered suicidal thoughts and after failed attempts to withdraw the family sought out desperate measures.
Mikhaila and her husband took Peterson to Moscow last month, where he was “medically detoxed” in a hospital setting. She said it was “horrific,” worse than anything she had ever heard about and that he is now “taking anti-seizure medication and cannot type or walk unaided, but is ‘on the mend’ and his sense of humor has returned.”
Following Mikhaila’s video, social media was abuzz with controversy about benzodiazepine “addiction” and this secretive procedure he endured in Russia. Mikhaila’s description of her father’s treatment in Moscow, including the fact that she stated he was “in a coma” and that he is currently taking “anti-seizure medication,” made me think of one very extreme treatment method — “ultra-rapid detox” using flumazenil. I do not know for a fact that this is the procedure he endured, but the signs do appear to point in that direction. Either way, I believe it is a topic that needs to be addressed.
Flumazenil and Rapid Detox
The “ultra-rapid detox” type of procedure is extremely risky. The patient is given general anesthesia to sleep and then the flumazenil is administered intravenously. This procedure can take 1-2 days and when the patient wakes up they are considered “benzodiazepine free.” Slightly less extreme methods of treatment by flumazenil, such as “rapid detox,” can last around eight days, and are still administered in many countries, including the U.S.
Flumazenil is a GABA receptor antagonist and is used for this procedure because it has been shown to have a beneficial effect on symptomology in some patients. In 1992, a study by Lader and Morton published in the Journal of Psychopharmacology found that patients who received flumazenil infusions had rapid relief of protracted withdrawal symptoms in the range of 27–82%. It was thought that flumazenil may help the GABA receptors return to their natural state after being damaged by long-term benzo use.
Unfortunately, there were a couple of problems with flumazenil in the treatment of benzodiazepine dependence. First off, the drug must be administered intravenously and has a very short half-life. As a result, symptom relief is only temporary. And second, treatment with flumazenil comes with a high risk of seizures.
So, where does that leave us?
A Slow Taper
I have yet to see any evidence which would lead me to believe that there is a better solution for benzodiazepine withdrawal than a slow taper under doctor supervision. This is the standard treatment recommended by Prof. Ashton and most experts who have spent any time working directly with patients of long-term use.
A statement on the British Medical Association’s (BMA) website titled “Slower sedative withdrawal recommended,” last updated on December 7, 2018, highlights the BMA’s recommendations on benzodiazepine withdrawal. It stated that there is concern that the previous best practices of reducing benzodiazepine dosage by an eighth every two weeks, was “too rapid,” and that a new emphasis on “longer withdrawal schedules” and “withdrawal at a flexible rate,” per the Ashton manual, is now recommended. This text was approved by the Joint Formulary Committee, which is comprised of the BMA, Royal Pharmaceutical Society, and the UK health departments among others.
Now, I am not a medical professional, and as I have said hundreds of times on the podcast and in blog posts, I cannot give medical advice. But, if I had to withdraw from benzos all over again, God forbid, I would stick with Ashton and the BMA.
References
Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual/.
Brean, Joseph. “Jordan Peterson’s year of ‘absolute hell’: Professor forced to retreat from public life because of addiction.” National Post. February 7, 2020. Accessed February 9, 2020. https://nationalpost.com/news/jordan-petersons-year-of-absolute-hell-professor-forced-to-retreat-from-public-life-because-of-tranquilizer-addiction.
British Medical Association (BMA). “Slower sedative withdrawal recommended.” BMA News. Last Updated December 7, 2018. Accessed February 9, 2020. https://www.bma.org.uk/news/2013/november/slower-sedative-withdrawal-recommended.
“Family says controversial professor Jordan Peterson recovering from addiction.” The Canadian Press. February 8, 2020. Accessed February 9, 2020. https://www.nsnews.com/family-says-controversial-professor-jordan-peterson-recovering-from-addiction-1.24071605.
Foster, D. E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, CO: Denim Mountain Press: 2019. https://easinganxiety.com/book.
Jordan B Peterson. “Peterson Family Update – February 2020.” YouTube. Accessed February 8, 2020. https://youtu.be/DTwEFa5NW2k.
“Jordan Peterson Goes to Russia for Emergency Treatment After 4 Weeks in ICU, Daughter Says.” Sputnik News. February 8, 220. Accessed February 9, 2020. https://sputniknews.com/russia/202002081078259858-jordan-peterson-goes-to-russia-for-emergency-treatment-after-4-weeks-in-icu-daughter-says/.
Lader, M.H. and S.V. Morton. “A Pilot Study of the Effects of Flumazenil on Symp-toms Persisting After Benzodiazepine Withdrawal.” Journal of Psychopharmacology 6(3)(January 1992):357-63. Accessed March 6, 2017. doi:10.1177/026988119200600303.
Oppenheim, Maya. “Jordan Peterson suffers year of ‘absolute hell’ and needs emergency treatment for drug addiction that forced him to withdraw from public life, daughter says.” The Independent. February 8, 2020. Accessed February 9, 2020. https://www.independent.co.uk/news/world/europe/jordan-peterson-drug-addiction-benzo-valium-xanex-russia-mikhaila-a9324871.html.
Perrett, Connor. “Daughter of controversial academic Jordan Peterson says he flew to Russia for treatment after developing a ‘physical dependency’ on prescription drugs.” Insider. February 8, 2020. Accessed February 9, 2020. https://www.insider.com/jordan-peterson-treated-in-russia-for-addiction-daughter-says-2020-2.
“Rapid Benzodiazepine Detox FAQs.” The Coleman Institute for Addiction Medicine. Accessed February 9, 2020. https://thecolemaninstitute.com/about-addiction/faqs/rapid-benzodiazepine-detox-faqs.
Disclaimer
The Benzo Free Blog is for informational purposes only, and should never be considered medical nor professional advice. Please visit our website for our complete disclaimer.