Hi again,
I think the sedative effects of diazepam vary greatly depending on you initial state of arousal (not the sexual kind).
Because I was first prescribed them for anxiety, I had a very high baseline state of arousal - i.e. keyed-up, on edge - whatever you like to call it.
Because of that, the only effect of diazepam was to bring me down to what most people would consider a “normal” level of functioning - i.e. able to leave the house without throwing up, not having the No. 2s so much I bled, that sort of thing.
Because I was on such a distressingly high state of alert to begin with, there was no way diazepam was going to make me literally fall asleep - it just neutralised an exaggerated and misplaced fight-or-flight response. I didn’t feel drowsy at all - I just stopped throwing up, which was brilliant!
Obviously, if you are NOT taking them primarily for anxiety, your baseline state of arousal will be different.
Even so, I personally don’t feel drowsy on them if I’m busy or engaged - I get no sense of intoxication.
I do go to sleep more easily IF I take one and then lie down (no external stimulation), but as that would typically be at bedtime anyway, it’s no bad thing. I don’t want to lie awake for ages, contemplating all the things that hurt.
Benzodiazepines (the class of drugs both diazepam and clonazepam are in) can be considered similar to alcohol, in that they affect the same part of the brain, and can have the same paradoxical effects - i.e. they can make you somewhat more lively and disinhibited, OR more sleepy, and a lot depends on the context in which you take them. Take them when you’re sufficiently mentally and emotionally engaged, and you probably won’t feel drowsy. Take them when you’re tired and bored, and you probably will.
It is because of the similarities with alcohol that they also have potential for addiction - but just as not everyone who ever drinks becomes an alcoholic - or is even at risk of it - neither does everyone who takes benzos develop a problem.
IF you have ever had a problem with, or felt you might have a problem with alcohol, this could be an indication benzos are not the drug for you, as it might be an indication you are more susceptible to dependency - because of the similar mode of action. If you’ve always had a healthy relationship with alcohol - able to take or leave it - you’re probably not at heightened risk from benzos.
I always ponder the nature of “addiction” in the context of incurable disease, anyway. I accept I will probably need to take most of my drugs (including the diazepam) for life - unless they either stop working, or something even better comes along (but then I’d need that for life, instead). I think it’s rather unfair to stigmatise this as “addiction”, because obviously, you can’t just scrap symptom relief if the symptom itself is never going away - or you could, but quality of life would plummet.
Someone who is using drugs as prescribed, to treat ongoing symptoms, is not, in my view, an addict, regardless that they couldn’t easily stop. If the problem doesn’t go away, why would they want or need to stop? We don’t say diabetics are “addicted” to insulin, so if someone has to manage ongoing spasticity, cramp, or pain, why should we denounce them as addicts? My father, during his final illness, was on doses of morphine that would kill a beginner, but it would have been quite wrong to label him an addict, because what was the alternative? Untreated pain?
I don’t think refusing to live with pain is moral weakness, and there’s far too much made of this “addiction” thing, in the context of those of us with lifelong illness. Obviously, a five-day course of something won’t fix anything (unless it’s steroids for a relapse). Most stuff you take - assuming it helps - will be long term or forever. So is “addiction” even relevant to us?
None of us are on permanent drugs because we’re junkies, but because we have a permanent problem!
Finally, I don’t consider I have spasms. I have what I call cramp (even people without MS know what that is, but without treatment - and occasionally with - mine is very severe). Technically, cramp is a form of muscle spasm, so I might just be playing with words. But I don’t have the kind of spasm where an arm or leg flies out involuntarily. In fact, there is usually very little to see. Sometimes my toes have involuntarily parted, like the Vulcan greeting, but usually the only outward sign is me cursing and shouting, and suddenly not being able to use the leg, or find any comfortable way to sit, stand or lie down.
Muscle stiffness by itself is NOT a spasm. This would come under the heading “spasticity”, and is particularly common with MS and other spinal cord problems. It basically just means resistance to movement, and is sometimes further defined as speed-related resistance to movement - i.e. you might be able to complete a movement slowly, but the faster you try to do it, the more resistance you encounter.
Yes, the benzos, being muscle relaxants, should help with all forms of muscle tightness - whether it’s the ongoing one of spasticity, or the one-offs, like cramps and spasms.
If you’re not having spasms, then tell him, but I don’t think it will necessarily affect the recommendation.
Sorry this is long-winded. Hope something here helps.
Tina
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