.png)
That’s a picture of my father.
Three years ago he was diagnosed with Alzheimer’s disease. This is a diagnosis no one ever wants to hear, but it’s a fact-of-life for so many. My mother has become his full-time caregiver. It’s a thankless job and her health has deteriorated in tandem.
Soon after my father’s diagnosis, a doctor prescribed him a benzodiazepine. As you might imagine, this didn’t go over well with his son who has spent the past five years in protracted withdrawal from clonazepam (aka Klonopin). Thankfully, my father never started taking the drug — but for me, this was another wake-up call.
Especially troubling is that benzo use is ridiculously high (nearly one out of ten) in the elderly, the group most likely to be harmed by them. — DR. ALLEN FRANCES, PROFESSOR EMERITUS AT DUKE UNIVERSITY
When I wrote the book Benzo Free, I paid particular attention to the use of anti-anxiety drugs and sedatives in the geriatric population. I was very curious as to how prevalent this type of prescription is for our older generation. Unfortunately, the answer was far from comforting.
Benzo Use in the Elderly
Benzos are prescribed more frequently and more long-term for seniors than for any other age group.
In 2008, 8.7% of U.S. adults aged 65–80 were prescribed benzodiazepines over the course of a single year compared to 5.2% in the overall population. According to the study published in JAMA Psychiatry, the proportion of benzo users who took the drugs long-term also increased with age from 14.7% (18-35 years) to 31.4% (65-80 years). This is despite the American Geriatrics Society (AGS) Beers Criteria, which includes a strong recommendation to avoid any type of benzodiazepine for the treatment of insomnia or agitation.
Benzos are prescribed more frequently and more long-term for seniors than for any other age group.
The AGS identified the use of benzodiazepines in older adults as one of 10 things physicians and patients should question. A 2017 study in the Journal of the American Geriatric Society found an alarming number of older adults being prescribed benzos without any diagnosis or alternatives even mentioned. In the study, only 16% of continuation benzo users over the age of 65 had a mental health diagnosis, and less than 1% had been provided or referred to psychotherapy.
The complications and risks these drugs inflict on the older population should be of serious concern and can include dementia, falls, hip fractures, confusion, automobile accidents, and many others. We will elaborate more on these effects this week in Benzo Free’s week-long series on benzos and aging.
The Lost Years
While my dad never took the benzo he was prescribed when he was diagnosed with Alzheimer’s disease, his son had been on one for over a decade unaware of its toll. Like so many others, I consider those 17 years affected by benzos as “the lost years.” Whether dependent on the drug or in protracted withdrawal as I am now, I’ll never get those years of my life back, and I have had to learn to accept that hard truth.
Unfortunately, those are also my last years with my dad. And that is a loss I haven’t been able to accept.
I consider those 17 years affected by benzos as “the lost years.”
When I was on clonazepam, I didn’t feel. I was emotionally numb. I wasn’t the son I wish so desperately I had been. I wasn’t there as much as I should have been. And when I decided to withdraw, my life became a nightmare. I found myself in an isolated bubble of which there was only one focus — me. My parents were wonderfully supportive during this time but I couldn’t see any other answer than to recover in solitude.
Now that I’m reaching out again to both to my family and my friends, I’m trying to make up for the lost time. But it doesn’t work that way, does it? My dad is still there physically, but mentally he is fading. And the toll this is taking on my mother is wearing on her too. I’m afraid my time with both of them is nearing an end.
Please, don’t think I’m one to whine. I realize how blessed I am to still have my parents around well into their 80s. This is a gift, and I am so grateful to be able to experience it. Most of my peers have lost at least one parent by now, if not both. I sympathize with their loss and I truly treasure my good fortune.
But there are days when I just can’t get past the loss of those years, and what might have been had I never taken that drug.
On my last trip back to Kansas City to see my family, I also made time to catch up with several of my friends from my childhood. One phrase was repeated more than any others in those conversations: “You look a lot like your father.” I couldn’t have been prouder.
This one's for you, Dad. I’m sorry.
Keep calm, taper slowly, and take care of yourself, D
References
American Geriatrics Society (AGS). “American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.” Beers Criteria Update Expert Panel (2015). Accessed April 9, 2018. http://www.sigot.org/allegato_docs/1057_Beers-Criteria.pdf.
Foster, D E Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018. – https://easinganxiety.com/book.
Frances, Allen. “Yes, Benzos Are Bad for You.” Pro Talk: A Rehabs.com Community, June 10, 2016. Accessed October 13, 2016. https://www.rehabs.com/pro-talk-articles/yes-benzos-are-bad-for-you.
Maust, Donovan T., Helen C. Kales, Ilse R. Wiechers, Frederic C. Blow, Mark Olfson. “No End in Sight: Benzodiazepine Use in Older Adults in the United States.” Journal of the American Geriatrics Society 64(12)(December 2016):2546-53. Accessed February 17, 2017. doi:10.1111/jgs.14379.
Olfson, M., M. King and M. Schoenbaum. “Benzodiazepine Use in the United States.” JAMA Psychiatry 72(2)(February 2015):136-42. Accessed March 7, 2017. doi:10.1001/jamapsychiatry.2014.1763.