INTRODUCTION
On the 7th of February, 2020, Mikhaila Peterson, the daughter of Dr Jordan Peterson, the Clinical Psychologist from Canada who shot to fame in 2016 following some controversies and later went on to write the international best seller, “12 Rules for Life: An Antidote to Chaos”, posted a third family update, this time concentrating exclusively on her Father’s battle with the benzodiazepine known as Klonopin (Clonazepam).
Benzo Warrior takes no view on the issues that Dr Peterson has addressed in his book and lectures.
We hope to raise awareness by highlighting his case and to ask for his help in broadcasting our message about the dangers of benzodiazepine dependence and withdrawal.
On the 9th of February, the Benzodiazepine Information Coalition posted a video commenting on the case.
From the thumbnail of Mikhaila’s video we can see that she has been through a lot with her Father’s journey through the hell of Klonopin dependence; she admitted that this has been ‘the hardest time of their lives’.
As Prescribed
Dr Peterson took Klonopin as prescribed by his Doctor in the United States; this is the case for the vast majority of people who end up with a problem with benzodiazepines such as Klonopin (Clonazepam), Valium (Diazepam), Ativan (Lorazepam) and Xanax (Alprazolam), to name the most common.
This case demonstrates that even an esteemed Clinical Psychologist with a wealth of experience and knowledge can place their trust in Doctors who may not be aware of the risks that benzodiazepines carry.
In the benzodiazepine recovery community, we call this an Iatrogenic problem - i.e. a medical problem caused by a Doctor.
Small Doses
What became clear from this latest video from Mikhaila Peterson, is that Dr Peterson had been taking Klonopin for longer than previously stated. The dosage had been increased in 2019 when his wife became gravely ill with a form of cancer, which Dr Peterson quite understandably needed extra support to manage along with his plethora of projects and responsibilities.
The use of the term ‘low dose’ is in fact, erroneous. There is no such thing as a low dose of Klonopin, as it is currently prescribed. Consider these equivalencies.
Based on the table below, 1mg of Klonopin would be equal to 20mg of Valium.
The pharmaceutical companies, as pointed out by the Benzodiazepine Information Coalition, use this as marketing ploy to make the medications sound less potent.
Source: https://www.benzo.org.uk/bzequiv.htm
Poly-drugged (On multiple psychiatric medications)
Dr Peterson was also on an SSRI medication for a long time, as well as Wellbutrin and has been open about his history of depression.
We know from experience within our community that those who are prone to depression and/or are polydrugged can suffer more when trying to come off benzodiazepines and are more likely to encounter paradoxical reactions. Dr Peterson also had autoimmune issues that can also add complications and speak to a sensitive physiology.
Long Term Use of Benzodiazepines
Benzodiazepines are classified as minor tranquillizers and are not designed for long term use. Professor Heather Ashton, who was the leading expert on benzodiazepines, was unable to complete full neurobiological and epidemiological research due to funding blocks, for which the pharmaceutical companies were likely to have been instrumental in.
It is therefore difficult to know how many long term users (>1-4 months of everyday use) have problems with the medication, either while on it or when withdrawing, but there are many thousands worldwide.
Professor Ashton lists the following as being common in long term users.
Over-sedation
Affective reactions
Endocrine effects
Possible neurotoxic effects
Adverse effects in pregnancy
Benzodiazepine dependence
Withdrawal Symptoms
This article does not have space to list the many hundreds of withdrawal symptoms that can occur, often simultaneously, but the World Benzodiazapine Awareness Day site has a very comprehensive list.
Many of the members of the Benzo Warrior Community and other online communities have more than 100 of these symptoms simultaneously. Some have experienced severe symptoms while still on the dose as prescribed by their Doctor - before they even started the withdrawal process (see Paradoxical symptoms below).
Cold Turkey
According to Mikhaila Peterson, Dr Peterson decided to stop taking the medication suddenly. It is not clear if this was under the advice of a Doctor, or if he took this decision himself.
In the recovery community, this is known as ‘Cold Turkey’ ; this is very dangerous and can lead to serious health problems that can be protracted in nature and in extreme cases, death. No one taking benzodiazepines for more than a couple of weeks should abruptly stop taking their medication.
It should be noted that there are cases of people taking benzodiazepines for as short a time as 6 days, abruptly stopping their medication, only to find themselves thrust into years of suffering.
Although rare, such cases do exist and while the risk of this happening may not be highly probable, the consequences of being unlucky are nearly intolerable and unpredictable.
Paradoxical Symptoms, Tolerance and Kindling
Mikhaila Peterson mentioned that Dr Peterson had experienced paradoxical symptoms.
Paradoxical symptoms are those that are the opposite of what we would desire from a medication, so in the case of Klonopin, they would likely include severe agitation, akathisia, mood destabilisation and many more. Only a small percentage of benzodiazepine users experience these symptoms..
It appears as though these symptoms occurred when he tried to reinstate the medication after a failed cold turkey attempt.
What we see in the recovery community, time and time again, is people who experienced a central nervous system shock from a rapid taper or a cold turkey, reinstate, only to find that the medication no longer works as expected. This seems to be the case with Dr Peterson. This process is informally known as ‘kindling’ and also occurs with alcohol withdrawal, which also has a big effect on the GABAa receptor sites that benzodiazepines bind to.
As the Benzodiazepine Information Coalition stated in their excellent video, this is one of the toughest situations a sufferer can be in. They are essentially between a rock and a hard place and the path to navigating successfully through to a state of health is extremely difficult.
Mikhaila Peterson stated that Dr Peterson had even tried to ‘taper’ and ‘micro-taper’.
Tapering is the process of lowering the dose of a medication, usually between a period of months and years, often in 4 week decrements or similar.
Mico-tapering achieves the same goal in smaller, more frequent decrements. Patients will often shave off their pills with razor blades and cut a tiny amount each day using a scale, or they will use a liquid solution to withdraw small amounts every or most days.
The fact that Dr Peterson was unable to do this speaks to the level of his suffering. What we must understand however, is that for many patients, not just those with paradoxical symptoms, tapering itself can be a long, brutal and life changing process.
The statistics on those who find tapering particularly hard are not easy to get hold of, but the number of people who are members of Facebook support groups and sites such as BenzoBuddies attests to the fact that a highly significant minority of people who have taken a benzodiazepine for more than a few weeks often struggle to taper and find their health and financial security highly compromised.
The World Benzodiazepine Awareness Day Website states that
“An estimated 50-80% of people who have taken benzodiazepines continually for many months or longer will experience withdrawal symptoms when reducing the dose; a smaller percentage may experience severe withdrawal. People who have been taking benzodiazepines regularly for many years (and sometimes for shorter periods) can have symptoms of withdrawal most of the time, even when they have not reduced the dose— tolerance and/or interdose withdrawal. They can experience a phenomenon referred to as “medication spellbinding”, and do not connect that their poor physical and mental health is related to their long-term use of the benzodiazepines (or in the case of other prescribed drug dependencies, other psychoactive medications).”
Withdrawal Symptoms
Dr Peterson was said to have experienced akathisia and suicidal ideation, along with becoming critically ill with pneumonia. These are some of the most serious symptoms sufferers can experience.
As the Benzodiazepine Information Coalition pointed out, pneumonia is often treated with fluoroquinolone antibiotics, which block benzodiazepines from binding the GABAa receptors and thus can make withdrawal many times worse and should be avoided at all costs.
Benzodiazepines are also respiratory depressants and can make people more susceptible to conditions such as pneumonia.
Mikhaila Peterson stated that this was the most scary thing her family had had to ever deal with, even more so than his wife’s cancer diagnoses in 2019 and their combined autoimmune issues.
This is something many in the recovery community can relate to and we have every sympathy with the family and Dr Peterson.
Protracted Withdrawal and Detox Centers
Experience has taught us as a community to avoid detox centres in almost all cases.
In their initial video back in September 2019, the family talked about the detox centre they had elected to send Dr Peterson to.
At the time, the strategy was to use Ativan to taper from Klonopin. The idea was, according to Mikhaila Peterson, to use a shorter acting benzodiazepine to help get off a longer acting one.
Looking at the table again, we can see that Ativan has a much shorter half-life elimination time than Klonopin.
With a half life of up to 200 hours, Valium is often the wisest choice when switching from a shorter acting benzodiazepine - however, many find that the reasonably long half life of Klonopin to be adequate for tapering; it’s only downside being the difficulty in getting the dosage precision right. (Please refer to The Ashton Manual for more detailed information about half lives and tapering.)
The reason this is preferred over the shorter acting benzodiazepines, is that their short duration often means that users suffer from ‘interdose withdrawal’, whereby the drug they are tapering stops working between doses and thus causes more suffering.
The idea of using a shorter acting benzodiazepine to get off a longer acting one has been known to be incorrect for many years.
Many of the studies that have looked at success rates of rapid tapers in detox centres are not longitudinal. The common experience of many who attend such centres is that they are given substitute medications, such as the above or barbiturates and are then left to suffer protracted symptoms for months or years. This is not taken into account by the detox centres, who only measure short term morbidity.
According to Mikhaila Peterson, Dr Peterson is doing better. We wish him the best and hope that he is on the road to recovery, though she does say that he still has a long way to go. Many of us can relate to this.
Addiction Versus Dependence
The difference between addiction and dependence is significant. Much of the media has gotten this wrong and we would agree with Mikhaila Peterson that her Father is not an addict, but rather, he had become dependent.
Addiction is defined as being a cycle, with the following components.
Using > Guilt > Emotional Trigger > Craving > Ritual > Using
Physical Dependence defined by ‘Wikipedia’ as,
‘Physical dependence is a physical condition caused by chronic use of a tolerance-forming drug, in which abrupt or gradual drug withdrawal causes unpleasant physical symptoms. ... Protracted withdrawal syndrome is noted to be most often caused by benzodiazepines.’
One can be dependent and addicted, addicted but not dependent; and dependent and not addicted. This is something that we in the benzodiazepine recovery community try to make people around us, including physicians and family, understand.
Though we also see that the stigma around addiction should also change, it must be understood that most sufferers of benzodiazepines, including Dr Jordan Peterson, are not addicted; they are dependent.
Russia and Flumazenil
As a last resort, Dr Peterson went to Russia to go to a clinic to get treatment that is currently unknown. Benzo Brains suggested that this might have been in order to receive treatment with Flumazenil, an experimental medication that some believe may relieve some withdrawal symptoms, though there is little empirical or anecdotal evidence of this. It is however a treatment we are keeping an eye on, as something is needed to help people in these dire medical circumstances.
A Plea for Help
Dr Peterson: We need your help.
At the time of writing, you have 2.54 Million YouTube subscribers, 1.3 Million Twitter followers, are a best selling author and a man of integrity, intellect and passion.
Please use your platforms to fight for us, as we fight for our lives. Most of us do not have anything close to your resources and we need more authoritative advocates to fight for us.
