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Her primary is gradually lowering the dose and now she hardly eats. She does drink ensure all day but stays in bed and is becoming more depressed. Not sure who or where to turn for proper help.
If there are serious mental health issues, I'd consult with a psychiatrist. They can properly evaluate her medication. I've never heard of Ativan for depression. I hope they can help her with treatment.
Ativan is a benzodiazepine. If she is truly abusing it, she'd sleep all day. I cannot imagine a dr prescribing this in doses high enough to cause this. Sounds more like depression/anxiety.
My mom has been on Lorazapam (also a benzo) for several years as well. At one point in time she was taking them consistently throughout the day. What kind of doctor is weaning her off of them. Like any type of mental health medication, it needs to be done carefully as the withdrawal can be difficult. It can even cause nausea so that may explain why she isn't eating. I would definitely speak with her doctor or consult a psychiatrist who knows how to wean someone off slowly without as many withdrawal symptoms.Maybe her primary is doing it a bit too fast.
Maybe she should be taking Lexapro which treats both anxiety and depression. Maybe she needs better medical care instead of the standard approach of many medical providers, which is to take your mother off a medication rather than to evaluate her medically and make changes as if she were a person not just an "old" person. IMHO she needs a geriatrician.
I going to jump back in here. Your mom needs to be seeing a psychiatrist who is well versed in the aging brain. There is a HUGE stigma about taking any kind of psychotropic drugs--trust me, I know all about it. I can't imagine her dr prescribing enough that she can be taking more than, say, 8 mgs per day. (DON'T use my dosage as anything but a comment, I don't know much about Ativan.)
Honestly, at the end of life (if that is where she is) does it MATTER? If she needs these to remain calm or deal with anxiety that's severe enough she can't function--then why the worry?
Many antidepressants are used in conjunction with benzos. They can take weeks to see if they "work" and then if one doesn't, weeks to get off that one and try another. This is not an easy fix.
Until the FDA went crazy a couple of years ago and began putting drs in the hotseat about prescribing some classes of medication as being too addictive, etc., thinking they were solving the drug problem in America--a dr could write a scrip for a patient and not quake in fear they'd be censured for it.
You need a better kind of dr., and you need some empathy for mom. Maybe she is having night terrors or just general anxiety. There's more to this story than "Mom is addicted".
I can say that I have had to take a benzo everyday for the last 20 years. It works for me, every time, every dose. When my dr has tried to lower my dose, I also don't want to get out of bed, and I also don't want to eat. The anxiety is truly crippling.
Please find a dr who better able to treat your mom. My heart goes out to her.
If your mom is addicted to something then you need to get the authorities involved and get her involuntarily committed to a detox center. There is a detox center advertising on our TV stations all the time around here in Ohio. What you need to do is check your local resources and get someone involved. Doing a family intervention will also be required, but get the law to back you up because "gradually lowering the dose" doesn't work other than to keep enabling them and making money off of those people. Furthermore, it doesn't get them off the medication now when they're already addicted. It sounds like another doctor who really knows what they're doing needs to get involved here, and step in to initiate an immediate intervention and just completely take her off cold turkey and replace it with something that will deal with the side effects of sudden withdrawal. Believe it or not, when she enters rehab she will have to go completely dry and what do you think they do in jail? Yep, you got it! They don't enable you by giving you the drugs you're addicted to, they dry you out cold turkey and monitor you through the withdrawal symptoms. That's what dry out cells are for, to dry out people who come in addicted to drugs and even alcohol. This woman needs to be completely caught off immediately, there are certain medications to help her through the withdrawal process as she's drying out and getting the drugs out of her system. This is exactly what rehab does believe it or not. They're not going to enable you by continuing to give you the drugs you're addicted to, they're going to dry you out.
Where I personally would start is finding out where she keeps this particular drug and then I'd much flush it down the toilet or better yet throw it in the fireplace. This is the best thing to do when someone is addicted to any kind of drug is to get rid of it, this is the first step toward a family intervention. Any drug you're addicted to will eventually do some kind of harm and I wouldn't be surprised if it already has harmed her in some way. Sometimes a drug you're addicted to will at some point kill you, and someone needs to find that drug and get rid of it. What someone needs to do is first call the law and have them come out to the house. They will deal with her while someone else goes and finds the bottle and brings it to one of the officers and then they deal with it as she is being taken to a rehab center. They take people of all ages, so your mom will fit right in. No, I've never been addicted to drugs or alcohol but I've watched enough on intervention and how they are dried out to know how the system works. In some cases, they must do a sneaky ambush in the middle of the night or at an unexpected hour and catch the person off guard and then they ambushed them, then take them off to treatment. This is often done with teens who are addicted to drugs or even out of control because of the drugs and alcohol they may be consuming. You may want to try staying with your mom around the time it's arranged for an intervention and just be there ready to answer the door because she may not answer the door, some people don't. Believe it or not, people who go through drug rehab are actually thankful later, they feel better. Her age doesn't matter, she can go into rehab and she can be immediately pulled off that drug. She really needs to be in rehab where they specialize in this because there again are certain types of medications only meant for short-term use to help with drying someone out. I seriously doubt she'll have any lasting repercussions from being immediately pulled off that drug cold turkey, if she dies, it won't be from rehab and forcing her to go dry. It's most likely to happen if she has some underlying problem but definitely not rehab. Furthermore, she should've never been allowed to be on this drug for so long to the point she became addicted. I don't know if you ever read the leaflets that now come with medications, some of them are only meant for short-term use, and if this woman is addicted to this medication, she's been taking it too long and if there's any damage from this drug, two people are liable, her and the doctor giving her this medication without proper testing. Many years ago I used to take another medication and I had to have regular blood work done to see where my level was and to make sure I had the right amount. Part of this was to make sure I wasn't taking too much or too little. The blood results would reveal whether or not I was taking my meds and how much. Some doctors are pretty good at making sure your medication levels are at the right level. I don't know how your mom got this particular medication in her hands, I don't know if she lied to the doctor about her condition or if he's one of those kinds of doctors who will hand out pills like candy, I don't know. Proper testing really needs to be done on the patient before giving them narcotics or any other medication. Then, there are some medications that require you to have periodic bloodwork every so often.
You may not know this, but did you know that a good many of the modern conditions can be corrected through a proper healthy diet and lifestyle changes? Yes, this is actually true! When this woman goes completely dry and has all of the medications she was addicted to out of her system, she really needs to start excluding processed foods from her diet and she needs to eat a proper healthy diet and most likely she needs to start exercising if she doesn't already. I don't know what this woman is condition is but she definitely needs to be retrained on taking care of herself, she definitely needs some serious help right now, and the answer is not drugs! Perhaps we can all learn how they lived back before processed foods ever existed. Yep, we can all learn a lot from our forefathers. Gardening is more than just a hobby, it was actually a necessity. Sadly though, too many people have gotten away from it and we now all depend on commercial gardeners to supply what we should be supplying our own households with. If you want to know why the common household is going broke, lazy and getting diseases that didn't exist back in history, you can blame it on our modern diet, lifestyles an the change in how we get our foods.
Don't ask4 handout--- We don't know the mom's age of general physical health. Taking her meds and destroying them and throwing mom into detox is probably not the way to go.
I think some gentleness and a better dr's care is more appropriate. Drugs have their place in our lives. Yes, they can be dangerous and they can be abused. Not arguing that--but take an elderly person, throw away their meds, take them to an involuntary commitment and you run the chance of death from withdrawal.
If you haven't walked the path of addiction--well, you can't talk about it so lightly.
Mom isn't a criminal. She's likely sick or depressed or something. Let's get some more info from the OP. Age? General health? Recent loss? Something is going on.
Being "addicted" (more likely, just taking more than prescribed occasionally) to Ativan isn't going to land anyone in rehab. I just feel such pain for this poor woman.
Yikes! I'm sitting quietly on a Sunday morning and then I read dontask4ahandout very strongly worded suggestion that you should throw your Mom into detox, have a family intervention, change her diet, change her food and force her to start exercising. I got anxiety just reading that.
Some questions? How old is your Mom? Is she at the end of her life? What is the dosage of Ativan? Have you told your Mom she is "addicted"? How did she react to that? Just because someone has used a RX for 15 years doesn't always mean addicted even if it is a benzo.
My Mom's primary care Dr. is wonderful and caring. Her whole philosophy is "don't bother the old people" and she enforces it. She believes in caring and loving attention couple with common sense situations. If you want a glass or two of wine or a Ativan to make you happy while you watch Lawerence Welk reruns she is full support. My Mom is 91, has vascular dementia and a host of other things but will fight everyone on taking a simple aspirin. So we don't.
I agree with others, there's more details that we don't know. Detoxing anyone is not as easy as people think and can cause many more problems if you attempt to change their entire life at the end of their life.
My recommendation is to talk the Dr., find out the dosage, and do your own research. Drinking ensure all day is not healthy either as it should just be a supplement not the main source of nutrition so a caring round of questions might be more beneficial than a forced situation "for her own good".
I understand your situation but don't panic, and move a little more slowly. She's been doing something for 15 years, don't attempt to do anything in a quick fashion and update us if you can on more details.
DO NOT THROW HER MEDICATION OUT as suggested above. You cannot just stop mental health medication without horrible side effects. Please speak to a medical professional who is knowledgeable about benzos and how to safely stop...if she truly needs to.
Go to ReformU.com to find where a meeting will be held at a church near you. This is a bible-based addiction support group. Benzos have very addictive properties.
The problem with benzos in older adults is that they worsen balance and mental function. So they increase the risk of falls, and they make thinking worse. Both of these issues might be barely noticed in someone who is middle-aged but can become serious problems as a person ages and becomes more prone to falls and memory issues. There is also some research that suggests benzos may be associated with an increased risk of developing dementia.
(If you are middle-aged and taking these drugs, I highly encourage you to look into getting off them. It tends to get harder to do so as you get older, especially if you develop any memory problems.)
So this is why doctors are supposed to try to help older adults taper off benzos. The problem is that benzos cause physiologic dependence, so it's often hard to taper them without causing withdrawal symptoms. These can range from uncomfortable to crippling to life-threatening, depending on how much of a dose decrease the person experiences.
In response to the original poster, my thoughts would be: - Is the Ativan taper a sensible slow taper? Experts in this topic recommend reducing the total weekly dose by 15% every two weeks, so it usually takes several months to reduce. A faster taper often causes more withdrawal. If the person is experiencing too many withdrawal symptoms, the taper needs to be slower. Some people also benefit from being switched first to a longer-acting benzodiazepine, although this can br tricky to manage. Google the "Ashton manual" for more info on this.
- Signs of depression and loss of appetite are very concerning. This absolutely needs to be discussed with the primary doctor. It could be related to benzo withdrawal or it could be something else, either a physical illness or psychiatric one.
In terms of "why bother an old person with an Ativan taper?": it's true that for some older people, the likely burdens seem to outweigh the likely benefits. This tends to be true for those who are declining and seem likely to die within the next year or so.
Otherwise, often an older person and a family do want to reduce the risk of falls, and do want to help the older person think their best. In such cases, it's usually worth attempting a taper.
Not all doctors will make this attempt because honestly, it is a lot of work for everyone involved. But clinical studies have shown that it IS possible for many older adults to taper off these drugs. So I believe all older adults and families should give it serious consideration.
Lastly, re "addiction" and the need for recovery groups: it's important to distinguish between an older person who is physically and psychologically dependent on benzos, versus someone who is exhibiting problematic behavior such as escalating the dose, abusing other substances (painkillers, alcohol, etc), "doctor-shopping," lying to people in order to get the drug, and so forth. I have encountered some older adults with these behaviors and yes, they need services (such as rehab, specialized counseling, special support groups) designed for this type of addictive behavior.
But most older adults "addicted" to ativan are people who have been on a steady dose for a while and develop symptoms if they miss a dose or if a reduction is attempted. They don't need rehab; they need a more thoughtful approach to slowly reducing their benzos and finding other ways to manage any insomnia or anxiety that might have put them on benzos in the first place.
The OP is working with her mother's primary physician. If there are problems and she suspects withdrawal is the reason, the first person she should talk to about it is that PCP.
Dr Kernisan addresses the quality of life points very clearly - thank you!
Okay, I have to interject here. I was taking Ativan, lowest dose, 0.5 mg. once a day. One doctor told me the dose is so low that it was almost a placebo. Well, I beg to differ. I did not get my prescript refilled in time and decided to quit cold turkey. Not a good idea........I felt like I was going through an emotional roller coaster, had severe headaches, crying jags. I went on-line and it said it is extremely dangerous to try to quit Ativan without a doctor's supervision. Some people can even have seizures and die. I doubt that would happen at the dose I was taking. But your Mom is elderly and probably taking a higher dose than me. Definitely, do not throw out her medicine. Take it back to the pharmacy and get them to throw it out safely but don't do anything until you've spoken to her doctor.
Thank you Gershun--people who have attempted to quit benzos cold turkey have experienced seizures and death.....you do NOT want to play with these things.
I have taken Clonazepam for 20 years. It is the ONLY thing that has kept me sane the past 20 years. Same dose, no early refills. It's simply self limiting. The few times I have run low at the end of a refill have been awful---and I am far too proud/embarassed to go the ER for what is simply a panic attack.
The MAX dose of most benzos is pretty high, if used for epilepsy, for one, and nobody who has simply GAD would be on more than 4mg per day.
I hope the OP comes back. I really feel sorry for her mom.
My Mom has been on antivan for over 20yrs. The dosage has been up and down as needed due to losing 2siblings in less than a year. Caring for Grandfather and grandmother through losses and illness plus working. My Mom is now 70. Every one has passed. She was a wonderful caregiver and Mom and grandmother. Just because she took and takes the Antivan as needed is no reason to call her an addict. I would speak w the prescribing physician first and secondly just a consultation w a psychiatrist to get a baseline of where she is mentally. Preferably one who specializes w geriatric patients. I would be very upset if someone called my mom an addict over this medication. I hope you can get the answers and help you need for her. My heart goes out to you and your family.
My Mom has been on antivan for over 20yrs. The dosage has been up and down as needed due to losing 2siblings in less than a year. Caring for Grandfather and grandmother through losses and illness plus working. My Mom is now 70. Every one has passed. She was a wonderful caregiver and Mom and grandmother. Just because she took and takes the Antivan as needed is no reason to call her an addict. I would speak w the prescribing physician first and secondly just a consultation w a psychiatrist to get a baseline of where she is mentally. Preferably one who specializes w geriatric patients. I would be very upset if someone called my mom an addict over this medication. I hope you can get the answers and help you need for her. My heart goes out to you and your family.
I think the term addict has negative connotations but I truly think it is so commonplace today. There are a lot of functioning addicts out there carrying down jobs, bringing up families. You don't necessarily have to be living in a crackhouse and injecting into your veins to be an addict these days.
So, if a person prefers to be called someone who has lost control due to taking too much of something .........okay, have it your way. But if it walks like a duck and talks like a duck, it's still a duck. If being afraid of a label interferes in someone getting the help they might need then they should just suck it up and be honest. And no, Alicia, I am not calling anyone's Mom an addict.
Gershun: An addict is someone who cannot quit their habit without the help of a program such as Reformers Unanimous.com or ReformU.com. "Functioning addicts"-no, that is not the case. When they need more of their substance, it becomes more and more difficult to stop this dangerous behavior.
Here is what I was taught to be true. Unless a pill has a scored mark across it, the tablet should not be cut in half. This is because with a scored tablet, it is guaranteed to have the active ingredient, the medication, equally distributed with the pill's fillers, and equal on both sides of the cut tablet.
The OP never came back, which is sad, b/c there was some good advice given. Perhaps she felt overwhelmed as there were so many different "takes" on this particular subject.
I hope she got some help for her mom and some education along the way. Taking a few Ativan a day for a long period of time is NOT the worst thing A person can do. Many aging elders in NH's are on something to help them with the adjustment to aging...or for whatever reason their Dr. deems necessary.
I have known people whose families have "intervened" with them and they simply started some other method of "coping". Nobody would have blinked an eye had she said "My mother has 2 glasses of wine a night. I think she's addicted". Yet, 1 Ativan has about the same "calming effect" as a glass of wine. Doesn't last as long, but, still.
I would check out www.benzobuddies.org for more information. I was addicted (unknowingly) to Klonopin (another Benzodiazepine in the same family as Ativan) for 7 years. I worked with 4 different psychiatrists and 2 family doctors to try and come off of it. It took me 5 1/2 years to come off of this drug and I am still experiencing withdrawals. Depression can occur when a person is weaned off of benzos too quickly (as can seizures, etc.).
At any rate, benzos are VERY addictive. They are generally not recommended longer than 9 weeks. It's best to be find a benzo-wise doctor to deal with when coming off of them and to let the patient be in charge of the tapering. I learned this the hard way. Generally speaking, the slower the taper the better.
At any rate, check out www.benzobuddies.org for more information. There are many people there who can offer tapering advice, etc.
outdoorguy - excellent site. I lived on it when I went through withdrawals from cold turkey. Damn near lost my mind. The quick taper often suggested is not reasonable as per half life of the medication...benzo buddies is such a great sense of helpful community of support.
I had to taper my mom from klonopin as she was having major memory loss from it...doctor approved and we went so slowly. No withdrawal. A PCP prescribed it nightly to help her sleep knowing full well she was an alcoholic at the time. Not only that, but benzos often tend to cause psychosis in some elderly. If my mom takes it now, she hallucinates and god forbid she is in hospital when it is given. She becomes completely psychotic and the staff let us know this is all too common.
Addiction to any substance is difficult and very frightening for those having little to no exposure to it. Sadly, I have had far too much in my lifetime and it is astounding how these serious medications are prescribed in tandem with other psychiatric drugs without cross referencing. My mom drinking on this crap along with the other meds was a recipe for death.
Scaredtaker, thanks for your post. I too am amazed at how "willy-nilly" these drugs (benzos) are prescribed by physicians. I was given Klonopin as a muscle relaxant and was never told of the addictive potential of it (or that it is an anti-anxiety, anti-seizure drug and sleep aid - along with being a Class IV controlled substance). I nearly had a seizure trying to come off of it (multiple times through the years) and am still recovering 23 months after having my last dose in 2015. I went to two hospitals to "detox" from it and nearly died. It was only later that I found out these types of drugs should be tapered very slowly as the patient can handle it. It's frightening to think that doctors put elderly patients on these powerful meds.
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Has she seen a geriatric psychiatrist?
Hasn't another medication been started as a substitution medication? My hubby is on Zoloft and I only give him the prescribed 1/2 pill daily.
I can't imagine her dr prescribing enough that she can be taking more than, say, 8 mgs per day. (DON'T use my dosage as anything but a comment, I don't know much about Ativan.)
Honestly, at the end of life (if that is where she is) does it MATTER? If she needs these to remain calm or deal with anxiety that's severe enough she can't function--then why the worry?
Many antidepressants are used in conjunction with benzos. They can take weeks to see if they "work" and then if one doesn't, weeks to get off that one and try another. This is not an easy fix.
Until the FDA went crazy a couple of years ago and began putting drs in the hotseat about prescribing some classes of medication as being too addictive, etc., thinking they were solving the drug problem in America--a dr could write a scrip for a patient and not quake in fear they'd be censured for it.
You need a better kind of dr., and you need some empathy for mom. Maybe she is having night terrors or just general anxiety. There's more to this story than "Mom is addicted".
I can say that I have had to take a benzo everyday for the last 20 years. It works for me, every time, every dose. When my dr has tried to lower my dose, I also don't want to get out of bed, and I also don't want to eat. The anxiety is truly crippling.
Please find a dr who better able to treat your mom. My heart goes out to her.
Where I personally would start is finding out where she keeps this particular drug and then I'd much flush it down the toilet or better yet throw it in the fireplace. This is the best thing to do when someone is addicted to any kind of drug is to get rid of it, this is the first step toward a family intervention. Any drug you're addicted to will eventually do some kind of harm and I wouldn't be surprised if it already has harmed her in some way. Sometimes a drug you're addicted to will at some point kill you, and someone needs to find that drug and get rid of it. What someone needs to do is first call the law and have them come out to the house. They will deal with her while someone else goes and finds the bottle and brings it to one of the officers and then they deal with it as she is being taken to a rehab center. They take people of all ages, so your mom will fit right in. No, I've never been addicted to drugs or alcohol but I've watched enough on intervention and how they are dried out to know how the system works. In some cases, they must do a sneaky ambush in the middle of the night or at an unexpected hour and catch the person off guard and then they ambushed them, then take them off to treatment. This is often done with teens who are addicted to drugs or even out of control because of the drugs and alcohol they may be consuming. You may want to try staying with your mom around the time it's arranged for an intervention and just be there ready to answer the door because she may not answer the door, some people don't. Believe it or not, people who go through drug rehab are actually thankful later, they feel better. Her age doesn't matter, she can go into rehab and she can be immediately pulled off that drug. She really needs to be in rehab where they specialize in this because there again are certain types of medications only meant for short-term use to help with drying someone out. I seriously doubt she'll have any lasting repercussions from being immediately pulled off that drug cold turkey, if she dies, it won't be from rehab and forcing her to go dry. It's most likely to happen if she has some underlying problem but definitely not rehab. Furthermore, she should've never been allowed to be on this drug for so long to the point she became addicted. I don't know if you ever read the leaflets that now come with medications, some of them are only meant for short-term use, and if this woman is addicted to this medication, she's been taking it too long and if there's any damage from this drug, two people are liable, her and the doctor giving her this medication without proper testing. Many years ago I used to take another medication and I had to have regular blood work done to see where my level was and to make sure I had the right amount. Part of this was to make sure I wasn't taking too much or too little. The blood results would reveal whether or not I was taking my meds and how much. Some doctors are pretty good at making sure your medication levels are at the right level. I don't know how your mom got this particular medication in her hands, I don't know if she lied to the doctor about her condition or if he's one of those kinds of doctors who will hand out pills like candy, I don't know. Proper testing really needs to be done on the patient before giving them narcotics or any other medication. Then, there are some medications that require you to have periodic bloodwork every so often.
You may not know this, but did you know that a good many of the modern conditions can be corrected through a proper healthy diet and lifestyle changes? Yes, this is actually true! When this woman goes completely dry and has all of the medications she was addicted to out of her system, she really needs to start excluding processed foods from her diet and she needs to eat a proper healthy diet and most likely she needs to start exercising if she doesn't already. I don't know what this woman is condition is but she definitely needs to be retrained on taking care of herself, she definitely needs some serious help right now, and the answer is not drugs! Perhaps we can all learn how they lived back before processed foods ever existed. Yep, we can all learn a lot from our forefathers. Gardening is more than just a hobby, it was actually a necessity. Sadly though, too many people have gotten away from it and we now all depend on commercial gardeners to supply what we should be supplying our own households with. If you want to know why the common household is going broke, lazy and getting diseases that didn't exist back in history, you can blame it on our modern diet, lifestyles an the change in how we get our foods.
We don't know the mom's age of general physical health. Taking her meds and destroying them and throwing mom into detox is probably not the way to go.
I think some gentleness and a better dr's care is more appropriate. Drugs have their place in our lives. Yes, they can be dangerous and they can be abused. Not arguing that--but take an elderly person, throw away their meds, take them to an involuntary commitment and you run the chance of death from withdrawal.
If you haven't walked the path of addiction--well, you can't talk about it so lightly.
Mom isn't a criminal. She's likely sick or depressed or something. Let's get some more info from the OP. Age? General health? Recent loss? Something is going on.
Being "addicted" (more likely, just taking more than prescribed occasionally) to Ativan isn't going to land anyone in rehab. I just feel such pain for this poor woman.
Some questions? How old is your Mom? Is she at the end of her life? What is the dosage of Ativan? Have you told your Mom she is "addicted"? How did she react to that? Just because someone has used a RX for 15 years doesn't always mean addicted even if it is a benzo.
My Mom's primary care Dr. is wonderful and caring. Her whole philosophy is "don't bother the old people" and she enforces it. She believes in caring and loving attention couple with common sense situations. If you want a glass or two of wine or a Ativan to make you happy while you watch Lawerence Welk reruns she is full support. My Mom is 91, has vascular dementia and a host of other things but will fight everyone on taking a simple aspirin. So we don't.
I agree with others, there's more details that we don't know. Detoxing anyone is not as easy as people think and can cause many more problems if you attempt to change their entire life at the end of their life.
My recommendation is to talk the Dr., find out the dosage, and do your own research. Drinking ensure all day is not healthy either as it should just be a supplement not the main source of nutrition so a caring round of questions might be more beneficial than a forced situation "for her own good".
I understand your situation but don't panic, and move a little more slowly. She's been doing something for 15 years, don't attempt to do anything in a quick fashion and update us if you can on more details.
(If you are middle-aged and taking these drugs, I highly encourage you to look into getting off them. It tends to get harder to do so as you get older, especially if you develop any memory problems.)
So this is why doctors are supposed to try to help older adults taper off benzos. The problem is that benzos cause physiologic dependence, so it's often hard to taper them without causing withdrawal symptoms. These can range from uncomfortable to crippling to life-threatening, depending on how much of a dose decrease the person experiences.
In response to the original poster, my thoughts would be:
- Is the Ativan taper a sensible slow taper? Experts in this topic recommend reducing the total weekly dose by 15% every two weeks, so it usually takes several months to reduce. A faster taper often causes more withdrawal. If the person is experiencing too many withdrawal symptoms, the taper needs to be slower. Some people also benefit from being switched first to a longer-acting benzodiazepine, although this can br tricky to manage. Google the "Ashton manual" for more info on this.
- Signs of depression and loss of appetite are very concerning. This absolutely needs to be discussed with the primary doctor. It could be related to benzo withdrawal or it could be something else, either a physical illness or psychiatric one.
In terms of "why bother an old person with an Ativan taper?": it's true that for some older people, the likely burdens seem to outweigh the likely benefits. This tends to be true for those who are declining and seem likely to die within the next year or so.
Otherwise, often an older person and a family do want to reduce the risk of falls, and do want to help the older person think their best. In such cases, it's usually worth attempting a taper.
Not all doctors will make this attempt because honestly, it is a lot of work for everyone involved. But clinical studies have shown that it IS possible for many older adults to taper off these drugs. So I believe all older adults and families should give it serious consideration.
Lastly, re "addiction" and the need for recovery groups: it's important to distinguish between an older person who is physically and psychologically dependent on benzos, versus someone who is exhibiting problematic behavior such as escalating the dose, abusing other substances (painkillers, alcohol, etc), "doctor-shopping," lying to people in order to get the drug, and so forth. I have encountered some older adults with these behaviors and yes, they need services (such as rehab, specialized counseling, special support groups) designed for this type of addictive behavior.
But most older adults "addicted" to ativan are people who have been on a steady dose for a while and develop symptoms if they miss a dose or if a reduction is attempted. They don't need rehab; they need a more thoughtful approach to slowly reducing their benzos and finding other ways to manage any insomnia or anxiety that might have put them on benzos in the first place.
Dr Kernisan addresses the quality of life points very clearly - thank you!
I have taken Clonazepam for 20 years. It is the ONLY thing that has kept me sane the past 20 years. Same dose, no early refills. It's simply self limiting. The few times I have run low at the end of a refill have been awful---and I am far too proud/embarassed to go the ER for what is simply a panic attack.
The MAX dose of most benzos is pretty high, if used for epilepsy, for one, and nobody who has simply GAD would be on more than 4mg per day.
I hope the OP comes back. I really feel sorry for her mom.
I would be very upset if someone called my mom an addict over this medication. I hope you can get the answers and help you need for her. My heart goes out to you and your family.
I would be very upset if someone called my mom an addict over this medication. I hope you can get the answers and help you need for her. My heart goes out to you and your family.
So, if a person prefers to be called someone who has lost control due to taking too much of something .........okay, have it your way. But if it walks like a duck and talks like a duck, it's still a duck. If being afraid of a label interferes in someone getting the help they might need then they should just suck it up and be honest. And no, Alicia, I am not calling anyone's Mom an addict.
Unless a pill has a scored mark across it, the tablet should not be cut in half. This is because with a scored tablet, it is guaranteed to have the active ingredient, the medication, equally distributed with the pill's fillers, and equal on both sides of the cut tablet.
I hope she got some help for her mom and some education along the way. Taking a few Ativan a day for a long period of time is NOT the worst thing A person can do. Many aging elders in NH's are on something to help them with the adjustment to aging...or for whatever reason their Dr. deems necessary.
I have known people whose families have "intervened" with them and they simply started some other method of "coping". Nobody would have blinked an eye had she said "My mother has 2 glasses of wine a night. I think she's addicted". Yet, 1 Ativan has about the same "calming effect" as a glass of wine. Doesn't last as long, but, still.
At any rate, benzos are VERY addictive. They are generally not recommended longer than 9 weeks. It's best to be find a benzo-wise doctor to deal with when coming off of them and to let the patient be in charge of the tapering. I learned this the hard way. Generally speaking, the slower the taper the better.
At any rate, check out www.benzobuddies.org for more information. There are many people there who can offer tapering advice, etc.
I had to taper my mom from klonopin as she was having major memory loss from it...doctor approved and we went so slowly. No withdrawal. A PCP prescribed it nightly to help her sleep knowing full well she was an alcoholic at the time. Not only that, but benzos often tend to cause psychosis in some elderly. If my mom takes it now, she hallucinates and god forbid she is in hospital when it is given. She becomes completely psychotic and the staff let us know this is all too common.
Addiction to any substance is difficult and very frightening for those having little to no exposure to it. Sadly, I have had far too much in my lifetime and it is astounding how these serious medications are prescribed in tandem with other psychiatric drugs without cross referencing. My mom drinking on this crap along with the other meds was a recipe for death.