Benzodiazepines are very controversial. Many psychiatrists will not prescribe them. They are prescribed frequently by physicians who are not familiar with the research that shows they do not work for flying but CAUSE panic when flying.
We cannnot allow people to mislead users of this board to advocate - in any way - the use of controversial, addictive and potentially dangerous medications. Lisa Hauptner, Vice President of SOAR, is a certified addictions counselor. Our experience has been that people who ARE dependent upon benzodiazepines make recommendations as a way of denying how seriously dependent they, themselves, are on the medications, by claiming these meds are no big deal.
Medication is between you and your doctor. Even though your doctor prescribes them there are risks.
No anti-anxiety medication is effective for flight anxiety.
When the medication fails to provide relief, a person in a state of panic may be tempted to take more medication and/or to combine medication with alcohol.
WHEN MEDS FAIL, DO NOT TAKE MORE.
DO NOT COMBINE MEDS WITH ALCOHOL. DOING SO DURING FLIGHT WHERE THE AIR IS THIN CAN BE FATAL.
1. The majority of psychiatrists never prescribe them or prescribe them only with great caution with carefully screened clients.
2. Doctors who are not psychiatrists often do not understand the risks (or, just give patients what they want in spite of the risk).
WHAT ARE THE OTHER RISKS?
1. Dependency. Once dependency exists, getting off these meds is more difficult than getting off heroin.
2. Seizures. Once dependent, the only way to get off them safely is to be hospitalized and weaned off them because to come off too rapidly can cause seizures.
3. Fatal Interaction With Alcohol. When in the throws of high anxiety, when one has already taken Xanax and finds it is not working, it is common for the person to take another dose and then have a few drinks. This can be fatal. Alcohol and Xanax (or Ativan) when combined causes a disturbance in the regulation of breathing.
You may want to be knocked out, but do you want to stop breathing when knocked out?
4. Birth Defects. Animal studies indicate the possibility of birth defects when these meds are used in the earliest stages of pregnancy, such as becoming unexpectedly pregnant.
5. Limited effectiveness. For anxiety on the ground, Xanax and Ativan do not work at all for one person in three. In the air, they increase anxiety and panic.
NO-BRAINER
Once you know the risks - and lack of effectiveness for flying - of Xanax and Ativan, whether to use them or not is a no-brainer.
These medications are not a responsible way to deal with anxiety on a daily basis and make flight anxiety worse.
If you need medications on a daily basis for anxiety, and you are being prescribed Xanax or Ativan, you need to find a responsible psychiatrist who will switch you to a non-addictive alternative.
If you think you need Xanax or Ativan for flying, think again. At safe levels, they provide no relief at all, and increase panic attacks ten-fold.
A word about meds for day-to-day anxiety (non flying anxiety). If a doctor prescribes Xanax or Ativan for routine use, find another doctor. That is simply not responsible, and there is no question about it. Why? Because there are anti-anxiety medications which are effective and which are not addictive such as Buspar, and anti-depressants which help with day-to-day anxiety such as Lexapro, Zoloft, and other SSRIs.
If after all this, you still are going to use Xanax or Ativan, educate yourself thoroughly on the internet.
Here is some of what you will find at www.drugs.com.
Xanax is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if Xanax is stopped suddenly after several weeks of continuous use. Seizures may be a side effect of sudden discontinuation of the medication. Your doctor may recommend a gradual reduction in dose.
Avoid alcohol while taking Xanax.
Before taking this medication, tell your doctor if you
have kidney disease;
have liver disease;
have glaucoma
have a history of alcohol or drug abuse;
have asthma, bronchitis, emphysema, or another
respiratory disease;
are depressed or have suicidal thoughts; or
have mania, bipolar disorder, or another psychiatric
condition (other than anxiety or panic disorder).
Xanax is in the FDA pregnancy category D. This means that Xanax is known to be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
It is not known whether Xanax passes into breast milk. Do not take Xanax without first talking to your doctor if you are breast-feeding a baby.
Why use anti-anxiety meds which lead to dependency when there are anti-anxiety meds which do NOT lead to dependency.
Yes, they may take a few weeks to take effect, but if cannot wait for them to take effect, it means you are too needy of instant relief, and you are the kind of individual who should not be prescribed Xanax or Ativan.
The Following Is Added By Certified Alcohol And Substance Abuse Counselor, Lisa Hauptner, MS, LMHC, CASAC, NCC., Vice President of SOAR, Inc.
I just wanted to add my thoughts (professional expertise, actually) on
the recent postings about Xanax and other anti-anxiety medications. I
first, however, want to say that our goal in SOAR is to help people face
and work through their fear by looking inward, which can be a very
difficult thing to do. Everyone is welcome to get help here, but we
would be irresponsible if we advised the use of medications as part of
our goal. It is not.
Capt. Tom mentioned that I work with
substance abusers in a psychiatric hospital helping them get off drugs
and alcohol. Actually, I do not help them get off these substances.
That is done through medical detoxification. That's the easy part
compared to the work they have to do afterward -- dealing with the
issues underlying the addiction. What I do help them do is work on
those issues in therapy. The interesting thing about this population is
that more than half of the people admitted on an inpatient or
outpatient basis for a primary diagnosis (anxiety disorders, mood
disorders, etc.) also have a second diagnosis of alcohol/drug abuse or
dependence or both. What started as anxiety and panic attacks now
becomes a dual diagnosis due to the use of medications to escape the
feelings considered intolerable.
Just to add another point of
credibility, I teach graduate psychology classes at one of the
universities here. Besides courses on psychotherapy theory and skills, I
also teach Addiction Counseling I and Addiction Counseling II. From
both an academic and clinical viewpoint, denial around substances is the
trickiest thing you will ever observe or experience. It takes all
shapes and forms and is extremely powerful. Don't underestimate
substances even if you take them only for . . . Addiction does not mean
physical dependence and withdrawal but, rather, behavioral changes and
psychological reliance. It starts very subtly in many cases, so you can
see why we are being cautious here. If we sound alarmist, so be it.
We are not judging people for taking medications, we are just being safe
and professional and ethical.
