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I've posted a lot lately, but it's all been about BIND and the research paper we just published. I wanted to take today to just touch base and say hi. And perhaps ramble on a bit on a non-sequitur, as I often do. I started working on this anxiety article yesterday morning, and then walked away from it for a while. This is also common for me. Sometimes I never return to the topic, and it stays in my draft folder until I delete it. And sometimes I return to it a bit later, with new focus and energy, and create a post out of it. This time, thankfully, it was the latter. During the time I stepped away, a dear friend called me for some counsel. She was struggling with some fear of an upcoming event, and we connected over the similarity of our struggles. After that conversation, I knew the topic might be useful to others and that I needed to finish it. So, here it is. Laying the Groundwork of Fear A cornerstone of Easing Anxiety and the Benzo Free Podcast has been honesty — from day one. And that often includes sharing much of myself — even my flaws, my failures, and my embarrassments. By doing this, we have connected, and that connection is the heart and soul of what we do here. Since January, I've been dealing with some health difficulties which I shared on occasion with you. In an effort to keep this short — a quest who's goal continues to elude me — I am not going to repeat them in detail here. Suffice it to say, I've had about 15 doctor visits, tests, and procedures since the first of the year. And that brings me to June 23. A couple of weeks ago, I had what I like to call a triple-header procedure — a colonoscopy, endoscopy, and esophageal dilation. The endoscopy was diagnostic for my dysphagia (difficulty swallowing), the esophageal dilation was an attempt to help with that condition, and the colonoscopy was preventive. The good news is that everything turned out pretty good. A few polyps removed, some acid reflux which we knew going in, and some pain for about a week from the dilation. But, all in all, things were better than I had expected. But, that's far from the whole story. That's the "after." What about the "before?" What were things like leading up to the procedure? Fueling the Fear Seven years ago, I visited the gastroenterologist about my stomach distress. I was a year or two off clonazepam (Klonopin), which I had taken for 12 years prior, and I was having some strong benzo belly symptoms. The doctor scheduled me for an endoscopy, and since I had recently turned 50, a colonoscopy too. I didn't like the idea, but I thought it was needed. Well, it didn't take long for me to twist an upcoming medical test into a Greek tragedy. My anxiety was already through-the-roof from the benzo withdrawal and BIND, and adding this upcoming event was the lighter fluid, gasoline, TNT, and nuclear warhead it needed to send me over the edge. In the month leading up to the procedure, I obsessed about every little thing that could go wrong. Trust me, I left no stone unturned. The "what if's" were endless. Here are some examples: What if they find something? Throat Cancer? Colon Cancer? What if they make my throat worse? What if it tears? What if I have a reaction to the anesthesia, and never wake up? What if they want to give me a benzodiazepine? Do I say yes? No? What if they want to give me fentanyl? What would be my reaction to that? What if I screw up the prep? Eat something? Drink something? Forget any part of it? What if I can't go through with it, and have to cancel at the last minute? Another factor, was that I have a tendency to wake up during surgery and medical procedures — something common with gingers, of which I am one. The last time I had an endoscopy, I woke in the middle of the procedure with a large tube down my throat, gagging. It's a memory that has stuck with me, and one I would prefer not to repeat — as you might imagine. And on top of all of this, is the shame — why am I so embarrassingly weak and full of fear? Ah, there's the rub. The eternal threat of the anxious mind. Why am I so weak, when others — millions in this case — do this every year? Why am I lying awake night after night, sleepless, obsessing about something that is as common as having a physical? Why am I so broken? So screwed up? Such a useless and utter loser? It's harsh, I know, and mostly unrealistic —but these are some of the thoughts we have. I had some anxiety before I started taking benzos, but never anything like this. This was extreme. Four days before the procedure, I cancelled it. I couldn't do it. The anxiety was so severe, and my symptoms so elevated, I almost couldn't function. Once I cancelled it, I felt immediate relief. I found a new gastroenterologist, explained my complications, and he was okay postponing it a while. I knew I still needed the procedure at some point, but for now it would have to wait. I never thought it would be seven years, though. While I felt much better immediately after cancelling the procedure, there was another side effect of this whole experience. A very significant side effect. One that I hadn't anticipated. Creating a Fear Event The whole experience of the fear, worry, and eventual cancellation of the procedure created what I like to call a "traumatic anxiety event." The ruminations were so intense, lasting for weeks, that it left its legacy in my psyche. While not formally PTSD, some of the reactions I experienced were quite similar. This dark cloud hung over me for seven years, affecting my reaction to any topic that was even remotely related. A general visit to the doctor, a neighbor diagnosed with cancer, the latest Cologuard commercial — you name it. Even a diet ad for laxatives could set me off. It didn't take much. Anything that would remind me that I I still needed this procedure would send me into an anxiety spiral. I had built the event up to be this mental maniac of misery, who's sole purpose was to scare the hell out of me — and it was quite effective. And I wondered, if I can't handle this, what would I be like if I was actually diagnosed with cancer, or some terminal illness? The irony of the situation is that the anxiety I experienced those seven years was far worse than if I had just had the procedure the first time. At the time, I just couldn't go through with it. My anxiety levels just off of Klonopin after 12 years of use were too severe. But, if only I could have pushed through back then, my life would have been less fearful. And then there's the embarrassment of the whole thing. I'm even feeling pangs of shame as I write this. I'm a 57-year-old man afraid of a very common medical test and procedure. It's ridiculous. I have to admit, I am not proud of being this way. In fact, I've had second thoughts of posting this article right up until I hit "publish." Still, I know that by sharing my experiences, even my most embarrassing experiences, that others' fear may be lessened. And I'm okay with that. Being a Person in Fear I have neurological damage. It's a fact. Long-term prescribed use of a benzodiazepine has reduced the effectiveness of my GABA-A receptors. I can get revved up easily, but I can't calm down like I used to — I just don't have the brakes. And that makes me more susceptible to anxiety from daily stressors and events. This is not a matter of will for me, or for many like me. Whether the cause is genetic, traumatic, environmental, iatrogenic, or something else, some of us just feel more anxiety than others. We're "wired" differently, and it's harder for us to let go of the fearful thoughts. Even though there are tools and techniques we can practice that can help us manage our reactions to these events — and I'll mention a few of these below — they don't eliminate the problem. They just help us ease it a bit. Get it? "...ease it a bit?" "Easing Anxiety?" Yes, that is where the name came from, in case you were wondering. While we rarely can do anything to eliminate the anxiety completely, we can ease it, and that alone can make a huge difference. Easing the Fear So, how did I get through it in the end? Well, I used some visualization and focus techniques. Here are a few that worked for me: LESSEN THE SEVERITY — The first one that helped me was learning to lessen the severity of the upcoming event in my mind. If I was reminded of my upcoming procedure by some external stimuli, and my thoughts started to go there, I'd try and lessen its effect. I'd tell myself that millions of people have this procedure every year, without complications, and that it will be fine. And then I'd immediately go back to what I was doing before, attempting to put it behind me. And sometimes it worked. ANTICIPATE THE SUCCESS — Another technique I used was to anticipate the success after the procedure was over. I would think about how amazing it would be to have this procedure done. After seven years of worry, what would it feel like to have it behind me? It must be amazing. And that positivity would help me get through. BUILD ON SUCCESS — And once we have those successes, we can build on them. In October 2022, I had foot surgery. This event was also fearful for me, although not to the degree of the endoscopy / colonoscopy. Still, that foot surgery, that success, was a building block. Having overcome my fear back in October, gave me a foundation of courage and confidence which helped to push through on this one. Help Others with Their Fear Another technique that I found useful, was to be less selfish. The truth is, anxious people are often selfish. I'm not saying this to put any of us down, it's just that managing our anxiety and trying to control the world around us is a 24/7/365 kind of job. It's overwhelming. Our fear demands that we focus all of our attention on avoiding being triggered. The penalties if we don't, can be quite severe. Purposefully thinking of others can pull us out of our own mind and its misery, at least for a little while. Here's an example. Leading up to my procedure, I'd envision a child. I'd be in a bed at the hospital waiting for them to wheel me in, and next to me was a 5-year boy waiting on the same procedure. The boy is frightened, and I need to be strong for him. I'd imagine what I'd say to him, how I'd soothe his fears. Soon, I actually felt stronger myself, and my fears lessened. I'd also realize how ridiculous some of my fears, and even my behaviors, might have been in context. I'm not a parent, but I'm sure that this is something parents have to do every day. Sometimes we have to be strong for others, and that action can help take our minds off our own problems. This process was perhaps the most successful for me of the ones I've mentioned here. When I'd focus on helping another, my worries seemed small. In case you're wondering, the boy I envisioned was me, as a child. I had my first endoscopy at six-months-old, and my first pre-ulcer at five. Living with Fear Whether you struggle with chronic anxiety, panic attacks, or perhaps your nervous system was damaged by medication, there are techniques that can help. I've only listed a few here, but there are hundreds more. Changing the way we think, even in the slightest degree, is a good first step. By using the above techniques, the week before my procedure was relatively manageable. I'm not proud of my fear leading up to it, but I'm also not ashamed by it. This is me. I have anxiety, and I have to deal with it. And perhaps, by sharing my fears here, others may get on that plane, speak at that seminar, ask the girl for dinner, or even have that medical procedure that's been plaguing them for so long. Perhaps. Take care and be at peace, D :)

It appears that our research article on benzodiazepines and BIND has gained a bit of attention lately. The article published in the open access journal PLOS ONE on June 29, 2023 is titled "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey." This article formally introduces BIND to the medical community, in addition to highlighting some of the more persistent symptoms and adverse life effects of benzodiazepines. The last few days have been interesting, to say the least. Despite my experience as a podcaster and support site founder, I'm still pretty naïve when it comes to online marketing and promotion. I only returned to social media for Easing Anxiety a few months ago. Thus, I am learning this as I go along and have found this journey educational and enlightening. Recent Media Attention On Thursday, several online news agencies picked up our research immediately such as Medical Express and Mirage News, which got a buzz going. Then that evening, Christopher Lane published an article on our research in Psychology Today. This is the second article that Chris has written related to our work on the Benzodiazepine Survey of 2018-2019. Chris was amazing to work with and I thank him for his attention to the benzodiazepine issues that plague so many individuals. After that, the dominoes started to fall. The New York Post quickly followed, as did Yahoo! Finance and WebMD. BioSpace, Worldhealth.net, Newswise, Study Finds, MarketWatch, and many others also published articles on the study. Here at Easing Anxiety, we produced a few blog posts on the paper. One initially announced the paper, another introduced the BIND Research Roundtable video, and another commented on the Psychology Today article. And on Saturday, "Medicating Normal" held a Live Facebook Event with my colleague Dr. Christy Huff, dedicated to the paper and its findings. After that, the story seemed to get a second wind and even became a topic of discussion on some popular podcasts and other related outlets. One of these articles has now garnered over one million views on Twitter. In fact, Elon Musk even replied to the tweeted article with an exclamation mark "!". Not the most verbose of replies, but I'm just glad he, and others, have seen it. What's Next? What's next in this PR parade? Will the attention ease up with the U.S. holiday and all, or will it regain steam on Wednesday? I have no idea. All I know is that this is the most attention benzodiazepine issues have received in a while, and that's a good thing. Thank you to everyone who helped us raise awareness. This has been a team effort, and what an amazing team we have. If anyone knows of another contact or outlet that may help us get the word out, please let us know. Take care of yourself and we'll talk real soon, D :)

Personality changes. Loss of ability. Loss of confidence. Loss of self. These are common in benzo withdrawal and BIND, and yet we rarely talk about them. What does this look like? What are its causes? And most of all, what can we do about it? In today’s episode, we explore the loss of self during benzo withdrawal. We also respond to a question on tinnitus, share a comment on the benefits of nature, and hear a benzo story from New Zealand. Video ID: BFP122 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 INTRODUCTION 01:28 Back from Vacation 03:36 Benzo Work Updates 04:57 Still Have Some Symptoms 07:00 Today’s Format 08:11 MAILBAG 08:17 Benzos and Tinnitus 12:58 Nature and Connection 15:39 BENZO STORY 16:29 Eta’s Mum’s Story / New Zealand 22:04 Medical Communication Failures 25:40 FEATURE 26:59 BIND Refresher 27:43 Our Lives Have Changed 28:29 Benzo Life Effects Data 30:41 Loss of Confidence 35:00 Humility vs. Egoism 35:54 Symptoms that Affect Confidence 38:23 What Can We Do? 38:42 Making Use of the Extra Time 40:35 Finding Acceptance 42:59 Six Tips for Improving Self-Esteem 47:22 MOMENT OF PEACE Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. — Ackerman, Courtney E. “What Is Self-Confidence? (+9 Proven Ways to Increase It).” Positive Psychology. July 9, 2018. Accessed May 11, 2023. https://positivepsychology.com/self-confidence/. — Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. https://easinganxiety.com/ashton. — Finlayson, AJ Reid, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. — Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, CO: Denim Mountain Press, 2018. https://www.benzofree.org/book. — Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. — Ravenscraft, Eric. “Practical Ways to Improve Your Confidence (and Why You Should).” New York Times. June 3, 2019. Accessed May 11, 2023. https://www.nytimes.com/2019/06/03/smarter-living/how-to-improve-self-confidence.html. — Tinnitus. Mayo Clinic Patient Care & Health Information. Accessed May 11, 2023. https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156. — “Top 10 Tips for Overcoming Low Self-Esteem.” Ditch the Label. September 26, 2022. Accessed May 11, 2023. https://www.ditchthelabel.org/overcoming-low-self-esteem/. The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITS Music provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

Naftal Benisty is the creator and host of the podcast, “Benzo Tired.” A social worker by trade, Naftal’s personal experience with kindling, seizures, and multiple prescriptions for benzodiazepines steered him into the world of benzo advocacy. In our conversation, Naftal shares his benzo story and the reasons he decided to start a podcast. We also talk about seizures, the indefinite hold, BIND, deprescribing guidelines, medical education, remaining positive, and so much more. Video ID: BFP123 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 0:00:00 INTRODUCTION 0:01:06 Feeling Good / Taking a Break 0:02:54 Peer Support Training 0:04:34 Checking in with You 0:08:54 FEATURE: Naftal Benisty 0:13:51 Welcome 0:14:36 A Bit About Naftal 0:16:15 Naftal’s Benzo Story 0:26:32 Benzos and Seizures 0:29:20 Tapering & the Indefinite Hold 0:35:18 How Are You Now? 0:36:18 Starting His Podcast 0:38:29 Making the Podcast Is a Gift 0:41:04 Benefits of Lived Experience 0:43:44 BIND Discovery 0:44:59 Consortium’s Deprescribing Guidelines 0:46:28 U.S. vs. International Benzo Support 0:50:31 Educating Medical Professionals 0:52:08 Are There Good Benzo Uses? 0:53:48 Haeley & Tom Episode 0:56:22 Our Caregivers 0:59:16 Future for Naftal / Podcast 1:00:47 Long COVID and Benzos 1:01:16 How Podcasts Help 1:03:48 Balancing Honesty and Positivity 1:06:09 Doing Great Work 1:06:58 One Piece of Advice 1:07:17 Deprescribing Guidelines 1:08:57 Shane Kenny’s Movie 1:09:20 Final Words 1:10:50 CLOSING Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. — Benzo Tired on Spotify: https://open.spotify.com/show/7HHdbrsbTpMMmlrL9TCWfi — Benzo Tired: Haely & Tom Episode: https://open.spotify.com/episode/1VTFkXLVDrMVrHdHiaoMaV?si=P5_pecyKSyap3iSweKPwsg — BAWG Documentation (scroll down to see “projects”): https://benzoaction.org — Deprescribing Guidelines from BAWG: https://corxconsortium.org/wp-content/uploads/Benzo-Deprescribing.pdf — BIND Description: https://easinganxiety.com/BIND The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITS Music provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

June 30, 2023 – Great News! The third paper from the Benzodiazepine Survey of 2018-2019 — which focuses on benzodiazepine-induced neurological dysfunction (BIND) — was the subject of an article yesterday in Psychology Today. In the article titled "Benzodiazepines Linked to Long-Term Neurological Dysfunction, " author Christopher Lane, Ph.D. reviewed the the paper and highlighted some of its key findings. The third paper was titled "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey," and was published in the open access journal PLOS ONE on June 29, 2023. Our team has been working on this survey for four years now, and we now have three scientific publications published reporting on the direct experiences that patients have endured from exposure to benzodiazepines. Previous studies on this survey include, “Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey.” and “Enduring neurological sequelae of benzodiazepine use: and Internet survey., both published in the journal Therapeutic Advances in Psychopharmacology. Our research team includes Alexis Ritvo, MD, MPH (University of Colorado Anschutz Medical Center), D E Foster (Benzodiazepine Action Work Group / Easing Anxiety), Christy Huff, MD (Benzodiazepine Information Coalition), Bernard Silvernail, MS (The Alliance for Benzodiazepine Best Practices), and Peter R. Martin, MD, MSc and A. J. Reid Finlayson, MD from Vanderbilt University. Special thanks to Dr. Jane Macoubrie for conceptualizing this survey, to Jo Ann LeQuang for her amazing writing services on the paper, and to the Alliance for Benzodiazepine Best Practices for their unyielding support of this research. But most of all, I want to thank the individuals who struggle with BIND each and every day, and who took the time to share their stories and experiences with the survey. Thank you! Psychology Today Article: https://www.psychologytoday.com/us/blog/side-effects/202306/benzodiazepines-linked-to-long-term-neurological-dysfunction Research Article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285584

June 29, 2023 – The third and final paper on the Benzodiazepine Survey of 2018-2019 was published today in the open access journal, PLOS ONE. The publication titled "Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey" formerly introduces the term benzodiazepine-induced neurological dysfunction (BIND) into medical literature. As a member of the research team, I can say that this is our most significant paper yet from this ground-breaking survey. Our analysis uncovered unique trends in symptomatology and adverse life effects revealing a differentiation between acute withdrawal and a separate protracted neurological condition. Previously, all post-discontinuation symptomatology has been lumped together and identified as "withdrawal." This paper suggests that the protracted state (lasting months or years) may be due to neuroadaptation and/or neurotoxicity, and is separate from traditional withdrawal. A nosology team of approximately 23 professionals identified the BIND terminology as it is presented in this paper. Two earlier papers on this survey were published in 2022 and 2023 (listed below). The first paper was highlighted in a 2022 Psychology Today article titled, "Benzodiazepine Withdrawal Tied to Serious Long-Term Harms." Previous publications on the Benzodiazepine Survey of 2018-2019 Experiences with benzodiazepines use, tapering, and discontinuation: an Internet survey Enduring neurological sequelae of benzodiazepine use: an Internet survey BIND Roundtable Video Available! For more information about BIND and the research that lead to its identification, please check out the BIND Research Roundtable. Hosted by the Benzo Free Podcast and Angela Peacock of APeacock Consulting, this video is a lively discussion which unveils the findings behind the paper. Official Press Release Benzodiazepine use associated with brain injury, job loss, and suicide PORTLAND, Oregon, June 29, 2023 (eReleases) – Benzodiazepine use and discontinuation is associated with nervous system injury and negative life effects that continue after discontinuation, according to an article published 06/29/2023 in the open access journal PLOS ONE. “Despite the fact that benzodiazepines have been widely prescribed for decades, this survey presents significant new evidence that a subset of patients experience long-term neurological complications,” stated first author Alexis Ritvo, M.D. “This should change how we think about benzodiazepines and how they are prescribed.” Previous studies had described this injury with various terminologies, perhaps the most well-known being protracted withdrawal. As part of the PLOS ONE study, a scientific review board unified these names under the term benzodiazepine-induced neurological dysfunction (BIND) to more accurately describe the condition. To better characterize BIND, Dr. Ritvo and colleagues analyzed data from a previously published survey of current and former benzodiazepine users that asked about their symptoms and adverse life effects attributed to benzodiazepine use. The survey of 1207 benzodiazepine users from benzodiazepine support groups and health/wellness sites is the largest of its kind. Respondents included those taking benzodiazepines (63.2%), in the process of tapering (24.4%), or fully discontinued (11.3%). Nearly all respondents had a prescription for benzodiazepines (98.6%) and 91% took them definitely or mostly as prescribed. Symptoms were long-lasting, with 76.6% of all affirmative answers to symptom questions reporting symptom duration to be months or over one year. The following ten symptoms (out of a possible 23) persisted over a year in greater than half of respondents: low energy, difficulty focusing, memory loss, anxiety, insomnia, sensitivity to light and sounds, digestive problems, symptoms triggered by food and drink, muscle weakness, and body pain. Particularly alarming, these symptoms were often reported as new and distinct from the symptoms for which benzodiazepines were originally prescribed. In addition, a majority of respondents reported prolonged negative life impacts in all areas, such as significantly damaged relationships, job loss, and increased medical costs. Notably, 54.4% of the respondents reported suicidal thoughts or attempted suicide. BIND is thought to be a result of brain changes resulting from benzodiazepine exposure. A general review of the literature suggests that it occurs in roughly 1 in 5 long-term users. The risk factors for BIND are not known, and more research is needed to further define the condition, along with treatment options. Christy Huff, M.D., one of the co-authors, said, “Patients have been reporting long-term effects from benzodiazepines for over 60 years. I am one of those patients. Even though I took my medication as prescribed, I still experience symptoms on a daily basis at four years off benzodiazepines. Our survey and the new term BIND give a voice to the patient experience and point to the need for further investigations.” The survey was a collaborative effort between CU Anschutz, Vanderbilt University Medical Center, and several patient-led advocacy organizations that educate on benzodiazepine harms. Several members of the research team have lived experience with benzodiazepines, which informed the survey questions. Online Article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285584

Join the Benzodiazepine Survey Research Team for a lively roundtable discussion about their research, the findings from the survey, and their latest paper which formally introduces the term benzodiazepine-induced neurological dysfunction, or BIND. Benzodiazepine use and discontinuation are associated with nervous system injury and negative life effects that continue after discontinuation, according to the article “Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey” published June 29, 2023, in the open access journal PLOS ONE. The research team in attendance includes A. J. Reid Finlayson, MD, D E Foster, BA, Christy Huff, MD, Peter R. Martin, MD, MSc, and Alexis D. Ritvo, MD, MPH, along with moderator Angela Peacock, MSW. Video ID: BFP124 Watch on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:41 Introductions (Peacock) 06:02 Where It All Started (Huff) 07:27 Intro to the 3rd Paper (Ritvo) 09:15 Recognizing BIND Differentiation (Foster) 09:51 Is Withdrawal and BIND Different? (Martin) 12:00 Limitations / More Research Needed (Finlayson) 13:32 Delphic Process for Determining BIND (Ritvo) 16:23 Appropriateness of the Term BIND (Finlayson) 16:44 BIND Definition (Ritvo) 17:18 Neuroadaptation & Neurotoxicity (Martin) 20:40 Adverse Life Events (Ritvo) 22:22 What’s Next for the Team? (Martin) 24:45 What About Other Psych Drugs? (Ritvo) 28:12 Any New Research Projects? (Foster) 28:44 Narrative Study of Benzo Buddies (Huff) 29:22 Scoping Literature Review on Long-Term Benzo Effects (Ritvo) 30:35 Overuse, Effectiveness, & Mental Health (Finlayson) 32:17 Toxicity of Benzodiazepines / Patient Resistance (Martin) 34:54 Confusing for Doctors Too / Never Realized How Toxic Benzos Are (Martin) 36:11 Most Symptoms Are New (Martin) 37:44 Large Data Analysis (Finlayson) 38:04 Any Research on Actual Neurology / Physiology (Martin) 38:55 Important to Narrow Down Symptoms of BIND (Finlayson) 39:17 Long Term Effects of Benzos & Other Psych Drugs (Finlayson) 41:31 Neurotoxicity & Hope / People Do Heal (Foster) 42:41 People Do Heal / She Is Healed (Huff) 43:18 Connections with Others/ Anesthetize Our Limbic System (Finlayson) 45:16 It’s Hard on Doctors Too / Pathologize Life Problems (Martin) 49:40 Marathon Not a Sprint (Ritvo) 51:47 That’s a Wrap (Peacock) 52:22 Acknowledgments (Foster) Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. NEW PUBLICATION (3rd Paper / Focus of Roundtable) — Ritvo A, Foster DE, Finlayson R, Silvernail B, Martin P. Long-term consequences of benzodiazepine-induced neurological dysfunction: A Survey. PLOS ONE. June 29, 2023. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285584. OTHER PUBLICATIONS ON THE BENZODIAZPINE SURVEY OF 2018/2019 — Reid Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. — Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. BIND INFOMORMATION — BIND Definition (The Alliance for Benzodiazepine Best Practices) — https://benzoreform.org/BIND — Basics of BIND (Easing Anxiety) — https://easinganxiety.com/BIND BENZODIAZEPINE RESOURCES — The Alliance for Benzodiazepine Best Practices — https://benzoreform.org — Benzodiazepine Information Coalition (BIC) — https://benzoinfo.com — Easing Anxiety (The Benzo Free Podcast) — https://easinganxiety.com — The Benzodiazepine Action Work Group (BAWG) — https://benzoaction.org — A Peacock Consulting (Angela Peacock) — https://apeacockconsulting.com The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

A recent tweet from Benzodiazepine Information Coalition (BIC) brought my attention to an excellent article on fluoroquinolones (quinolones). It was a 2017 post by Brad Verret titled, "Hidden Dangers Of Fluoroquinolone Antibiotics In The Benzodiazepine-Dependent Population", and it's well worth the read. In my post today, I am going to highlight the basics on this topic in addition to sharing a few words about my own personal experience. But, if you want to learn more about the science and how quinolones affect benzo-dependent indivduals, please read Brad's article. Sadly, Brad passed away in 2017. But thankfully, his work lives on helping thousands that follow. Thank you, Brad. And thanks to BIC, for their relentless work educating the benzo community. NOTE: This article is for informational purposes only, and should never be considered medical advice. Please work with your doctor if you are concerned about any medication. Fluoroquinolones Fluoroquinolones (or quinolones) are a class of broad-spectrum antibiotics commonly used to treat bacterial infections. They include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), and ofloxacin (Floxin). Their use is increasing worldwide and prescribed for a number of medical conditions, despite frequent warnings and cautions. Quinolone Dangers Those of us who have experienced iatrogenic injury from a particular medication sometimes develop specific terms for the harm done. In the benzodiazepine community, we have benzo belly, benzo brain, benzo burn, and many others. But, benzos are not unique in this etymological endeavor. Patients who have suffered serious effects from other medications such as antidepressants, pain killers, and yes, quinolones, have created their own terms too. "Floxing," or being "floxed," refers to an adverse reaction to quinolones. According to an article from the North Carolina Medical Society, these drugs have been "connected to a bewildering array of serious health issues — from peripheral neuropathy to aortic rupture." And also similar to benzodiazepines, the FDA has taken notice. In 2016, the U.S. Food and Drug Administration (FDA) updated their boxed warning on fluoroquinolones cautioning about "their association with disabling and potentially permanent side effects," and recommended limiting their use in patients. The side effects can occur hours to weeks after exposure "and may potentially be permanent." And this was not the first warning. In July 2008, the FDA issued a boxed warning for quinolones regarding the increased risk of tendinitis and tendon rupture. In 2011, they added the risk of worsening symptoms for those with myasthenia gravis. And, an update in 2013 cautioned about the potential for irreversible peripheral neuropathy (serious nerve damage). Chemically speaking, the mechanism of action of the fluoroquinolones closely mirrors that of certain chemotherapy drugs, so it is rather unsettling that these powerful agents are sometimes prescribed for relatively benign infections that would probably resolve on their own or with a milder drug. — Brad Verret According to Verret, this class of drugs are "neurologically active at commonly prescribed dosages" and they are capable of binding to GABA-A receptors in the brain, spinal cord, and peripheral nervous system. Other possible side effects cautioned by the FDA include ruptures or tears in the aorta, significant drops in blood sugar levels, ruptured tendons, pain, "pins and needles" sensations, depression, anxiety, and suicidal thoughts. Some of these side effects appear to be permanent. Benzos and Quinolones Quinolones are also a frequent subject of discussion in the benzo community — a discussion that has been going on for some time. According to Ashton Manual Supplement from April 2011, C. Heather Ashton stated the following: "Antibiotics for some reason sometimes seem to aggravate withdrawal symptoms. However, one class of antibiotics, the quinolones, actually displace benzodiazepines from their binding sites on GABA-receptors. These can precipitate acute withdrawal in people taking or tapering from benzodiazepines. It may be necessary to take antibiotics during benzodiazepine withdrawal, but if possible the quinolones should be avoided." The quinolones affect the same GABA-A receptors as benzodiazepines and can intensify withdrawal symptoms. In fact, quinolones have GABA antagonistic effects and have been found to displace benzodiazepines from benzodiazepine receptor sites in the body. Fluoroquinolones should be contraindicated with chronic benzodiazepine exposure in nearly every scenario, including nonmedical benzodiazepine use. — Brad Verret My Experience with Fluoroquinolones I quite often feel like a broken record on Easing Anxiety and on the podcast. So many of the questions and scenarios I am asked about are ones I also have direct experience with. Unfortunately, that includes quinolones, as I described in detail in my book, "Benzo Free." In brief, I was prescribed Ciprofloxacin (Cipro), a fluoroquinolone, for ongoing groin and abdominal pain during my recovery from benzodiazepines. The urologist misdiagnosed "benzodiazepine-induced pelvic floor dysfunction" as prostatitis — a common misdiagnosis. Even though I had read the Ashton manual in full, I didn't remember the warning about this class of drugs — and I took the medication as prescribed. Considering what I know now, it is hard for me to believe that this prescription isn't a factor in my protracted state of benzodiazepine-induced neurological dysfunction (BIND). I'll probably never know how many of my lingering symptoms are caused directly by my 12 years on clonazepam (Klonopin) vs. the added influence of outlying factors such as quinolone use during withdrawal — but I do wish that I had paid more attention to the cautions of Ashton and the benzo community when I first started out. Takeaways The primary takeaway from this article should be this: Educate yourself. While we will always recommend here at Easing Anxiety to work with your doctor, and never to discontinue any medication without medical supervision — we also know that doctors are not flawless. For those of us injured by benzodiazepines, this has become abundantly clear. All doctors should be aware that prescribing a fluoroquinolone to a benzodiazepine-dependent individual carries a serious risk for disability which could potentially be permanent. It is equally important that benzodiazepine-dependent individuals become aware of this interaction so that they can better advocate for themselves. — Brad Verret I like to think of the relationship with your doctor as one of a partnership. You don't know everything, your doctor doesn't know everything, but together you can make some very wise decisions. And if you have a concern about a prescription or treatment, ask questions. And if you are still concerned, it is your right to get a second, or even third opinion. It's your health, and you have a say in what happens to you. So, when it comes to quinolones — use caution. Work with your doctor and find a solution that is best for you. Take care. References Aldridge, Randy. "Do You Know What 'Floxing' Is? Could It Be Deadly To Your Patients?" North Carolina Medical Society. April 11, 2023. Accessed June 27, 2023. https://ncmedsoc.org/do-you-know-what-floxing-is-could-it-be-deadly-to-your-patients/. Ashton, C. Heather. “Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual).” 2002. Accessed April 13, 2016. https://easinganxiety.com/ashton. Baggio D, Ananda-Rajah MR. Fluoroquinolone antibiotics and adverse events. Aust Prescr. 2021 Oct;44(5):161-164. doi: 10.18773/austprescr.2021.035. Epub 2021 Oct 1. PMID: 34728881; PMCID: PMC8542490. Fluoroquinolones: Safety, Risks, and Side Effects. WebMD. April 27, 2023. Accessed June 27, 2023. https://www.webmd.com/cold-and-flu/fluoroquinolones-safety-risks. Foster, D E. “Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal.” Erie, CO: Denim Mountain Press, 2018. https://www.benzofree.org/book. Verret, Brad. Hidden Dangers Of Fluoroquinolone Antibiotics In The Benzodiazepine-Dependent Population. Benzodiazepine Information Coalition. October 12, 2017. Accessed June 27, 2023. https://www.benzoinfo.com/2017/10/12/hidden-dangers-of-fluoroquinolone-antibiotics-in-the-benzodiazepine-dependent-population. Disclaimer This post is for informational purposes only, and should never be considered medical advice. If you have any concerns with medication you have been prescribed, please notify and work with your doctor on alternatives. Never disregard or delay in seeking medical advice. Please view our complete disclaimer for more information.

This is my fourth attempt at writing this blog. The other three sit in my draft folder — perhaps to be finished another day. Each time I'd start writing with a simple concept in mind, then I look back and I have this half-completed novella on a completely different topic. And I don't know where to go from there. And I try again. Not this time. I'm just going to write. Whatever I come up with is what I will release. No re-writing. Maybe just add a few graphics at the end to give it some color. I doubt it will be my best, hopefully it's not my worst, and yet, it's me, where I am now, and that's okay. Let's see what happens. Anxiety and Indecision Yesterday, I was in the kitchen and needed to go to the bedroom to get something. After about two steps, I turned back to the kitchen to get something else. Before I was back in the kitchen, I headed to the basement stairs to grab something different. Half-way down the stairs, I turned around and walked back to the kitchen. When I arrived, I just stopped and stood there. Baffled. Whether it's trying to write a blog post, or grab something from the bedroom or basement, my brain has not been operating at peak performance lately. Part of this is emotionally driven. I've had this pressure slowly rising up in my chest all week. It's a combination of fear, overwhelm, and dread. It's not the first time I've had this by far, but that familiarity doesn't lessen its effects. I have an upcoming event I am not looking forward to, and that clouds everything else in my life right now. Even when something good happens, I have a tendency to block it. It's an old pattern for me. I unconsciously tell myself, "not now. I can't feel good now. How can I feel good when something bad is coming?" And the good feeling wanes. I'm not a whole lot of fun to be around like this, and I wish I wasn't this way most of the time. But sometimes, it's where I'm at, and I have to accept it as it is. Handling Emotions I think many of you can relate to this. We've all faced adversity in our lives, and we've all had to find ways to overcome it. I'm no exception to that rule. When our emotions overwhelm us, we have to decide how we are going to respond. Do we push them aside and hope that they won't return? That was my method for many years, and well, it hasn't worked out too well. Or, do we deal with them at the time and take the bad with the good? While that seems a lot more logical, it's rarely the path we tread. Perhaps you're dealing with something similar. Perhaps it's boarding an airplane for the first time in years, or confronting a perceived enemy face-to-face. Maybe it's an upcoming social gathering, public speech, medical test, or college exam. Maybe it's just leaving the house for the first time in two weeks. The cause is irrelevant. The effects are anything but. How we deal with our emotions matters. We can't always deal with them in the moment, but we also can't shove them aside and assume they will never return. Finding healthy ways to process them is essential. Summing It All Up Perhaps this was all gobbledy-gook. I wouldn't be surprised. I liken it to a consciousness stream with no direction. Just open my mind's door, and let it flow. Then again, perhaps there was a touch of wisdom somewhere inside there. Who knows. One of the key things I've learned throughout my past decade recovering from benzo withdrawal and BIND, is to just be me. I am me. Warts and all, as I often say on my podcast. And I will never be anybody else. Comparisons lead to disillusion, which leads to depression. Yes, we can improve ourselves in many ways, and we should try when possible. But, many aspects of ourselves will never change. And learning to accept, and even like, those aspects of ourselves is key to a better life. Our emotions are part of us. An important part. An essential part. Even the ones that don't feel so good. We may not want to make major decisions based on them, but we still need to feel them. At some point, we have to give our emotions the attention they crave. Process them. And let them pass in a healthy manner. Well, that's what I had to say — I guess. I know this post sounds a bit negative. It wasn't my intention when Is started to write it. I'm doing okay, actually. I'm going to push through this upcoming event and I know I'll feel better on the other side. I'm just very introspective today and perhaps it showed. Thanks for your patience. take care, D :)

On June 9th, I joined Angela Peacock, of APeacock Consulting, for a Facebook Live event. It was a true delight and we discussed so many different topics related to benzodiazepines, psychiatric medication, recovery, BIND, coaching, anxiety, support, and much, much more. The video is now available on Angie's YouTube channel and you can view it below. I hope you'll check it out, and thanks to Angie for inviting me to be a guest on her channel. To learn more about Angela Peacock, please visit her website at https://www.apeacockconsulting.com. You can also listen to Angela's guest appearance on The Benzo Free Podcast back in 2020 for the release of the film, "Medicating Normal." Watch on YouTube... Link to the video on YouTube: https://youtu.be/6-BLK6rRQ9A Background D E Foster ("D") is founder of the support site Easing Anxiety, host of The Benzo Free Podcast, and co-chair and founding member of the Benzodiazepine Action Work Group at the Colorado Consortium for Prescription Drug Abuse Prevention. He is a published author on multiple research papers and a global advocate for anxiety and benzodiazepine awareness, education, and support. In 2002, D was prescribed clonazepam (Klonopin) by his primary care physician and he took the medication for 12 years without warning. His withdrawal experience was extreme and became the foundation for his book, Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. D is now eight-years benzo-free, still deals with the lingering effects of BIND (benzodiazepine-induced neurological dysfunction), and spends most of his time working in the benzo community. More details: https://easinganxiety.com/defoster ABOUT EASING ANXIETY Easing Anxiety is an information and support site for individuals dealing with the complications of anxiety and/or anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). We are home of the Benzo Free Podcast and a vast library of support videos, articles, stories, resources, and more. Visit us at www.easinganxiety.com Other Guests in the Series Kevin Kirk: “Active Recovery - Driving, Facing Fears, & Learning How to Work w/ Your Symptoms” — Friday, June 16th @ 12PM EDT Emma Saunders: “Creating to Make Sense & Bring Awareness to Psychiatric Drug Withdrawal” — Friday, June 23rd @ 12PM EDT Michelle Fuchs: “Suffering, Surviving, & Finding Our Paths to Recovery” — Friday, June 30th @ 12:30PM EDT

Angela Peacock, of APeacock Consulting, has graciously invited me to join her for a Facebook Live event tomorrow morning (June 9th, 11:00am ET) as part of a lived-experience series she is producing. We will discuss an assortment of topics including benzodiazepines, BIND, research, advocacy, coaching/consulting, and much more. To learn more about Angela Peacock, please visit her website at https://www.apeacockconsulting.com. You can also listen to Angela's guest appearance on The Benzo Free Podcast back in 2020 for the release of the film, "Medicating Normal." How to view the event: RSVP to see the event live here. If you miss the live conversation, you can also check it out on Angela's YouTube Channel after the event. I've included her blog invitation below. D E Foster ("D") is founder of the support site Easing Anxiety, host of The Benzo Free Podcast, and co-chair and founding member of the Benzodiazepine Action Work Group at the Colorado Consortium for Prescription Drug Abuse Prevention. He is a published author on multiple research papers and a global advocate for anxiety and benzodiazepine awareness, education, and support. In 2002, D was prescribed clonazepam (Klonopin) by his primary care physician and he took the medication for 12 years without warning. His withdrawal experience was extreme and became the foundation for his book, Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. D is now eight-years benzo-free, still deals with the lingering effects of BIND (benzodiazepine-induced neurological dysfunction), and spends most of his time working in the benzo community. More details: https://easinganxiety.com/defoster ABOUT EASING ANXIETY Easing Anxiety is an information and support site for individuals dealing with the complications of anxiety and/or anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). We are home of the Benzo Free Podcast and a vast library of support videos, articles, stories, resources, and more. Visit us at www.easinganxiety.com Other Guests in the Series Kevin Kirk: “Active Recovery - Driving, Facing Fears, & Learning How to Work w/ Your Symptoms” — Friday, June 16th @ 12PM EDT Emma Saunders: “Creating to Make Sense & Bring Awareness to Psychiatric Drug Withdrawal” — Friday, June 23rd @ 12PM EDT Michelle Fuchs: “Suffering, Surviving, & Finding Our Paths to Recovery” — Friday, June 30th @ 12:30PM EDT

It's been unusually wet in Colorado for the past few months. And this morning, I decided to take full advantage of it. My wife slept in, it was a bit wet to take my morning walk, and even though I had tons of work on my desk — including a new interview to edit for the podcast — I decided to just stop for bit. A little "self care," you might say. As you can see above, I headed out to our covered patio, turned on the fire pit, and enjoyed the sound of the constant rain. Yes, those are my feet in the picture — nice a toasty from the warmth of the fire. For about an hour, I just soaked it all in. Few things relax me more than the sound of the rain. I did a little meditation. A little thinking. A little watching the squirrel hop along the top of the fence. And a little bit of just letting things be. No agenda. No pressure. No stress. What a way to start the day. You Deserve a Break Today If you know that reference ("You Deserve a Break Today"), you might have just had a sudden urge for a cheeseburger, or a sausage biscuit. You might also be a little closer to my age than you'd like to admit. Still, it's a great message. We are all busy. Too busy. I know this because I have a Ph.D. in feeling overwhelmed and busy. But, I'm working on changing that. The truth is — even though most of us don't like to admit it — being busy is more about perception than about reality. Life is what we make of it. Taking time for yourself, taking time to relax, taking time to reset, is a choice. I have a crazy week ahead of me with doctor appointments, research team meetings, training development, website development, and two live podcast events to produce. And yet this morning, I took an hour to spend by myself, on the patio, watching a squirrel in the rain. And it was probably the smartest thing I'll do all week. We are human, we get busy, and we burn out. The work will always be there. If you don't make time to take time for yourself, your body and brain will find a way to force you to do it eventually. And trust me, you won't like their methods. And your family and colleagues will appreciate it too. We are better people to be around, happier people, more relaxed people, when we take some time for ourselves. Today, if you do nothing else, take 30 minutes for yourself to sit and watch the rain, or take a walk, or meditate, or play with a pet, or whatever helps you reset yourself. And maybe, if you're really crazy, you might do it again tomorrow. Thanks for taking this break with me, Talk with you soon, D :)