Disappointed in Dr. Drew

By now Dr. Drew Pinsky is considered to be very knowledgeable about drugs. There's no doubt that he cares about what he does. He tackles some severe cases of addiction and substance abuse.

I was curious to see how he'd handle Mindy McCready's seizure on this week's episode of Celebrity Rehab, this same seizure that was aired at least five times in the previews before it occurred on the show.

I was hoping that Dr. Drew would know something about benzodiazapines (aka "benzos"). The problem with stopping benzos is that a patient cannot detox from them safely without the risk of seizures. And because benzos change the actual chemistry and structure of the brain, the seizures and other symptoms must be managed with other drugs if a person goes cold turkey. Even Hoffman-La Roche, the manufacturer of both Valium and Klonopin recommends a taper schedule for getting off benzos. One must reduce the amount of the drug very slowly.

Part of the danger of benzos is their elusiveness to a polydrug user--and to the doctors. An individual can successfully go cold turkey off of opiates and other drugs, but still have extreme long-term side effects from benzos. Unless patients know what to expect, they will think they're weak, sick, clinically depressed or even bi-polar when changes to the central nervous system cause severe and dibilitating symptoms that last for several months or even years.

When Dr. Drew interviewed Mindy during inception, she told him that she was taking 5 mg. Alprazolam (she probably meant .5 mg.). She stuttered the word, as if she wasn't familiar with the drug--to hide her intimacy with it; she knew how to be slippery at this point. She said she was taking Alprazolam for a medical reason. When Mindy was talking with another patient in the house, she said she was taking both Xanax (she used the brand name here because she didn't hide her familiarity with the drug) and Ativan (another benzo). I wondered how the show (Dr. Drew) was going to handle benzos. Since Mindy had placed herself under supervision to detox safely, Dr. Drew should have pursued the topic of Alprazolam with her to see if withdrawing would be a problem.

There can be legitimate reasons to take benzos or painkillers, but not in Mindy's case. She's an addict who needs to be off all chemical substances. (Google her name and see how difficult her life has been.) Mindy wouldn't be the first person who downplayed her relationship with "Alprazolam." Dr. Drew has both knowledge and finesse with these patients. When Mindy had a seizure, my first thought was that she is withdrawing from benzos. She could be taking a large amount. She's the only one who knows.
Dr. Drew should have been suspicious. This would have been a good time to ask Mindy again how much Alprzolam she'd been taking. He told Mindy that he'd put her on a drug to stop the seizures, and she would stay on this drug for a year while they got to the bottom of the seizure problem. While Mindy was in the hospital, a doctor did a scan of her brain. The next day, while this doctor consulted with Dr. Drew, he asked if Mindy had a history of taking pills. Her brain had been physically altered. Dr. Drew said that Mindy had denied taking pills (he forgot about the Alprazolam because he honestly doesn't understand the significance of it).

It was at this point that their search to find the reason for the seizure took a turn. They brought in Mindy to show her the picture of her brain. She took the opportunity to skirt the pill issue by getting their sympathy. She has been smacked in the head several times during physical abuse. She'd rather talk about her abuse than her relationship with pills, but she doesn't understand the damage their doing. Dr. Drew should understand. He was taking notes when Mindy said she took Alprazolam. Mindy also has a history with alcohol. For some reason, doctors would rather think that it's alcohol that is changing the structure of Mindy's brain. At this point the Xanax is all but forgotten.

All these things could contribute to seizures. But I think that with Mindy's secrecy about her benzo use and Dr. Drew's ignorance about benzos, the real cause of the seizure was totally hidden. Here's what eMedTV says about Xanax:

"Seizures are often the most dangerous possible withdrawal symptom. These are most likely to occur if Xanax is stopped "cold turkey," but they are also possible if the drug is not stopped slowly enough. Even forgetting a single dose of Xanax can lead to withdrawal symptoms. As your body gets used to the medication, you may even begin to experience withdrawal symptoms between your usual Xanax doses."

Why are benzodiazepines treated like other narcotics? They cannot be stopped cold turkey unless something is given for seizures. But even seizure medication will not cover the other possible symptoms. Here's what Alprazolam.com says:

"Sudden discontinuation of Alprazolam can lead to GABA under activity in the brain, causing the nervous system to become over-excited. This can often cause more serious Alprazolam withdrawal symptoms such as restlessness, depression, difficulty sleeping, convulsions, and hallucinations."

Do you notice that the show Intervention never deals with benzodiazepines? Doctors don't seem comfortable dealing with them, so they're buried under other addictions. I'd like to see a show totally dedicated to benzodiazepine addiction, but I'm still waiting. A patient might have a cross-addiction, but benzos are never the main drug on the show. These drugs are so insidious that they can prevent a well-meaning individual from keeping off other drugs. If a patient feels extremely depressed or suicidal after stopping their drug of choice, for instance, he'll have no idea that he's having benzo withdrawals, unless he has an educated doctor who has told him what to expect.

When Mindy had her seizure, I thought: "Please let Dr. Drew bring this problem to light." But Dr. Drew let me down. I hope Mindy can stay clean and sober. But she won't understand the effect of Xanax on her. If she gets sick or agitated, she will either think she's having symptoms from alcohol or opiates, or here's the biggest lie at all. She may think that she must stay on that anti-seizure medication for the rest of her life. After all, her head got bashed in by her ex-boyfriend, and if her doctors tell her that something is permanently wrong with her, they are throwing away every chance she has to get off all pills, even anti-seizure pills. As long as she has a prescription for something, she's getting refills and carrying pills in her purse and taking a little round thing to deal with her feelings.

I had hoped that Dr. Drew would finally educate America about benzos. I'm not sure what it's going to take for people to become informed. Look at Michael Jackson and the vast array of pills he took. I firmly believe that he could no longer sleep because his sleeping pills (benzos) had turned on him, which is what they eventually do. He was probably dealing with awful symptoms day-to-day, and he was desperate for a few hours of peaceful sleep. He found something that worked for a little while anyway, and that was the anesthetic propofol. He probably died from a combination of these drugs. A smart doctor would have forced Michael to taper off his sleeping pills (benzos), and his sleep would have gradually returned on its own. Most doctors are so indoctrinated with the 12-step methods that they can't embrace the idea of tapering a drug, even when it's supported in the drug literature.

For those of us who know where to look, accurate information on benzos is available. But this information is not usually disseminated by addiction doctors like Dr. Drew who seem oblivious to the characteristics and dangers of sleeping pills and other benzos.The drug companies are getting rich from selling benzodiazepines. If Dr. Drew isn't hip enough to recognize Xanax as a big adversary, who will?