We usually think of the word tolerance as having a positive meaning. After all, tolerance is sometimes defined as a fair and objective attitude toward those of differing backgrounds. Being tolerant or accepting of others with different backgrounds is generally considered a good thing. Some words that have similar meaning of tolerance include patience and impartiality. Tolerance can also mean endurance. All good things, right?
Well, the word ‘tolerance’ gets a little more complicated when we’re talking about drugs. If we say someone tolerates a drug well, this usually means that the person experiences no or low incidence of side effects while enjoying the therapeutic benefits of the drug. So tolerating a drug well is a good thing.
But tolerance can also mean something bad and altogether different depending on the context. What about if you hear the phrase, “become tolerant to a drug?” That’s not a good thing. But what does that mean? Tolerance in this context refers to a person’s diminished response to a drug, which occurs when the drug is used repeatedly and the body adapts to the continued presence of a drug. Simply put, some drugs don’t work as much or do not work at all after repeated use over a period of time.
What does it mean if I have become tolerant to a drug?
Again, tolerance to a drug is the failure of the drug to continue to work effectively or work at all after repeated use. In this situation, the drug fails to have the same or any therapeutic effect at some point during repeated or chronic use. Tolerance can occur as quickly as within just a few weeks of initially taking a certain drug, but it may not occur until after years of use, or it may not ever occur at all. Predicting if and when tolerance might occur is not possible.
Developing tolerance usually applies to psychoactive or mind altering drugs, and drug tolerance can mean more than just the drug no longer working effectively at the same dose you took when you first started the drug. If you are taking a habituating psychoactive or mind altering drug, say a benzodiazepine for example, you can experience more consequences than just the fact that the drug no longer makes you feel the way you want it to. Unfortunately, in this situation you may not simply be “back at square one” or in the same condition as you were before you began taking the drug. In fact, if you become tolerant to the effects of habituating mood altering drugs you may likely be in a worse place than you were before you started. This is because many mind altering drugs can lead to physical dependency or the need to continue taking the drug in order to avoid experiencing withdrawal symptoms.
You mean I can experience withdrawal symptoms even though I am still taking the drug?
After you become tolerant to a benzodiazepine that you are physically dependent upon, unless you increase the dose you may experience not only re-occurrence of symptoms of your underlying problem, such as anxiety or insomnia, but you may also experience withdrawal symptoms. So, yes, you can experience withdrawal symptoms while continuing to take a habituating drug such as a benzodiazepine. This is sometimes called “tolerance withdrawal” and it is milder than withdrawal experienced after discontinuance of the drug.
Wait a second…My doctor told me that I need to increase my dose of benzodiazepine because my condition got worse. He doesn’t think I have developed tolerance because I do not have an addictive personality. In fact, I only take the drug as prescribed. But I have a bunch of new and strange symptoms that are unexplainable. I’ve undergone many medical tests, and so far none show anything abnormal.
Doctors sometimes confuse addictive drug cravings and excessive use of the drug with tolerance. But these are two different things. Often times people become tolerant to a drug without abusing it. So, yes, you can take a benzodiazepine only in the manner prescribed by your doctor, but still develop tolerance. It is likely that your strange or unexplainable symptoms are linked to tolerance withdrawal. There is no medical test yet that can detect tolerance withdrawal from benzodiazepines. So this may explain why you experience such distressing symptoms, but none of them show up in medical tests or lab work.
It is not possible to distinguish the negative effects of tolerance to a drug, such as benzodiazepines, from an unrelated condition because the symptoms of withdrawal are so varied and overlap with symptoms associated with other conditions. Tolerance symptoms can include those considered to be psychiatric, such as anxiety, as well as those that are considered physical, such as changes in blood pressure. But it is important to note when a doctor says you need to raise the dose of a benzodiazepine in order to have the same therapeutic effect as when you first began taking it, you may in fact be experiencing drug tolerance, and perhaps even withdrawal symptoms.
Check out the Ashton Manual. You will need to Google it. I don’t have much information on it.
I have been taking sertraline and clonazepam for about 25 years. I was taking it for anxiety and had agoraphobia. It helped me very much until maybe 2 years ago. It stopped working and I’ve been experiencing depression, anxiety, overeating, sleep problems. I do not have agoraphobia but feel more comfortable if I stay at home. Is there anyone out there that can help me?
Karen there are groups you can join on Facebook. Please look into this, they can be very helpful. One is called Benzo withdrawal. Another one is Benzo friends.
Are you going to wean off or detox off since it’s not working anymore?
What percentage of people actually hit tolerance? Reading this makes it sounds like everybody does. Been talking one the last 25 years now just at bedtime. Should I be worried? I have GAD sure to a head injury.
Ii am tappering of diazapan. Took it for anxiety. Anxiety is a lot worse. My doctor said I won’t get withdrawal symptoms. How do i know if it is vwithdrawal. I’m sure it is. Thank you
A friend had a terrible time with Tolerance Withdrawal; I was with him throughout. When I told my own doctor that my friend was on Clonazepam, my doctor gasped and said disapprovingly THATS A Benzodiazepine! as if that said it all.
I have been taking clonozapam since 2006. How do you get off.
Check out the Ashton Manual. You will need to Google it. I don’t have much information on it.
For all the vulnerable people, especially during this pandemic, that medicines like klonopin help, your article is frightening and a real set up. If you more carefully clarified that this is “YOUR” story, though these medicines very successfully help other people..I would feel ok, it is what happened to you, and respect your story. But this is not a black/white tale, and your presentation can be very destructive to vulnerable people who were made more fragile the past 15 months in this pandemic. Klonopin helped, but they still hurt because it is a very difficult time for us all, but especially for some with anxiety issues. Klonopin may not solve their problems, but certainly in some case(not yours!) it helps them. Reading the article which did not tell of the benefits, but rather only the stories of the deficits, can frighten someone who benefits from this medicine into not taking it.
Benzodiazepines ruin lives ! I’m being 100 ! You go into tolerance or Interdose withdrawals. Benzonn no injury happens to everyone on the medicine and should not be taken for longer then 3 weeks ! Please understand. I have been going through benzo withdrawals after taking it last year for almost 9 months ! I am a healthy women . And the benzo is the worst hell to come off of . While on it is hell when stops working . I hope u take this into consideration that the drs don’t know what to do for u once this happens! I beg u ?
I’m 76 years old and was given diazepam in my 20s when out of nowhere I started having debilitating anxiety attacks. Doctor’s had no idea why, though i was diagnosed with a “thyroid problem” – later found to be Hashimotos. I leveled out and was doing fine on the diaz, no increases, achieved my dream of becoming a writer and spent the past decades as a successful publisher/editor. No increase in use, no side effects, mind working fine. Now my doctor says that because I’m ‘old’ I need to get off. She had no idea how to do a safe detox, so she gave me two months of diaz and said to find a professional to help me. Still looking. The entire situation is really increasing my anxiety,
Dear Danielle,
This whole issue with benzos is getting out of control. If someone has been on a benzo long term and all the benefits outweighed any risk, there is no medical rationale to just cut you off. What your doctor is putting you through it horrible. I know, because I am going through the same thing. My anxiety is also very high. Maybe we need to organize and start filing lawsuits against these incompetent doctors across the country. People are suffering and even dying from the withdrawal symptoms. Why fix something that is not broken? Regards, Anita
I agree. A doctor should never just cut someone off diaz. Rather they should initiate a taper plan or help their patient find someone who knows what they are doing before taking them off the benzo.
After doing a lot of research and reading the feedback of many, many benzo users posting on Facebook, there really is a problem with benzos, especially with withdrawal for many.
I’m down to 5 mg and once I’m under the care of an experienced doctor, which will be soon, I’ll continue tapering. However, it’s been suggested because of my “elderly” age I might benefit by holding at a small dose. It all makes me very nervous, but then in life you never what’s coming next…
I’m in tolerance withdrawal and klonopin helped me for years before this happened but the medication is not meant to be used long term I wish this weren’t true I’m suffering terribly now but it is a real thing.
Im suffering from 3mg of klonopin a day. I just started feeling deathly ill the past 4 days this is my second time on them the first time I did a rapid taper and I was so bad i couldn’t function get out of bed. Get dressed, leave the house , I had extreme anxiety ,and acquired Agoraphobia. So I went back on time after two months I just started feeling sick im not sure if it from the klotapin or antidepressants or suboxone they put me on when I was withdrawling. Im so lost its ruined my life my relationship. I need help!!
I hope you found out what was causing you to feel so ill. Yes this drug can help in many ways but if it doesn’t it is time to taper off and find a safer method to help anxiety.
I’m about to enter a rapid detox program. I’ve been on klonopin for 12 years and now on 3 mg a day, buy going through tolerance withdrawal really bad for the past 6 months.
Has anyone managed to keep working while going through tolerance and/or tapering off? This is my second time getting awful symptoms and I’m seriously about to give up on my life. Not in the sense of taking my life but rather than I just cannot keep working while feeling like this. I feel truly desperate and want my life back. I want to get off those meds and start living again. I can’t go anywhere alone.
My boyfriend has to drive me to work every day and I am not even able to walk to the bus stop.
An advice to anyone going through benzo tolerance or withdrawal: don’t let them put you on antidepressants. It just made things 1000 x worse for me. I just want my life back…
I agree! The antidepressant does-not help when you’ve developed tolerance withdrawal to a benzo! 2 separate issues! Why don’t drs. Admit this?
Do you mean my antidepressant will not work I wasn’t put on it for withdrawal I was put on it for depression
All benzos are horrific. Should never b used
Yes, but they have their place in medicine
Does anyone know a doctor in the Phoenix Arizona area to help with getting off of Ativan. My sister has been tearing off 5 mg daily for 4 months and is down to 2.5 mg daily. She has terrible agoraphobia and must be in tolerance. We are stuck here. Our psychiatrist doesn’t go along with the Ashton method but we need her because no one else will give her this much Ativan. We are desperate for a doctor.
Can’t believe how many specialists I saw for all my strange symptoms before realising what I was experiencing! Figured it out myself- benzos tolerance! Try talking to a doctor about your discovery, not much sympathy and definitely no agreement with my research and opinions.
My husband was in xanax for 22 years and kept gojng to doctors and emergency rooms for chest pain and many other bizzare symptoms, always with no answers and all tests normal. What a long , miserable life. After he decided to wean off( he had never increased his dose and only took it once or twice a day so was always in withdrawals), but no one had the brains to figure that out. After he decided to wean off the Xanax after he had weaned himself off of the anti depressants, antisiezure,and antipsychotic that he had been put on. He took 6 months to wean off and 8 months afterward, went into prolonged withdrawal symptoms. Of course, we have been going to specialists at a major University, every test normal for nearly TWO YEARS! They say, we do not know but if it was fatal, you would be dead by now. I figured out it was prolonged Benzo Withdrawal Syndrome by finding the Benzo site on the internet. No treatment for what my husband has and no one knows how long it will last or if it will even go away. My advice is, STAY THE HELL AWAY FROM DOCTOES!
Reach out to dr Jennifer leigh. Google her. This is a nightmare! With little help for us. Been struggling for 10 years PAWS. Prayers
What is a better benzodiazepine if I am getting tolerant to klonopin?
Tapering off benzodiazepines. https://www.benzo.org.uk/manual/
Discuss with your prescribing doctor and dedicate at least a year to tapering off.
Been on .25 for 4 weeks 1x a day weening off with liquid at .25 mg and got tolerance and weening off with liquid
I’m taking diazipan ( valium- 5mg) for anxiety, my anxiety seems to come from the hormone injections for prostate cancer, I quit drinking months ago & only take a valium once or twice a week, and it helps ( I am prone to panic attacks) are there other non- benzo drugs I can take? I take 60mgs Mirtazapine before bed but still get anxiety
Tya playing with fire on any benzo…all will turn on ya at some pt
Hi, I was just wondering how you can determine the difference between benzodiazepine tolerance withdrawal & an actual Psychiatric Problem? Both my medications have seemed to lose there effectiveness & my insomnia is getting extremely bad? Causing horrible physical symptoms through the day
See a clinician, get an assessment, learn stress tolerance and sleep hygiene skills. Benzos will stop working. They did for me and I used alcohol to sleep which was another whole disaster.