Benzos vs Opioids: Which one should you quit first?

Dr Craig Swainey, who specializes in addiction medicine and is in long-term recovery himself, discusses whether it's better to quit opioids or benzodiazepines first, if you're using both substances.
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For short-acting opiates like oxycodone, most patients complete their detox and begin Naltrexone therapy within 5 days. Longer-acting opiates like Suboxone and Methadone typically take 8 days. Our standard opioid treatment package in Richmond, VA includes the detox and 6 months of case management and Naltrexone therapy. As a non-addictive opioid blocker, Naltrexone dramatically reduces cravings so that patients can focus on their recovery. We have a 98% success rate for completing detoxification and starting Naltrexone therapy. During the detox, we work with patients and their families to develop an appropriate aftercare plan. We also offer a convenient, 3-day outpatient alcohol detox and a Benzodiazepine Detox.
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[@scarlettwinters5642]

Is this still the same if it’s Buprenorphine? I’m on both for many years and need to get off both. I’m having severe insomnia and haven’t been cutting, not sure if I’ve been on them so long they’re now causing insomnia

[@gonootropics2.065]

Benzodiazepines require tapering over a long period of time, you can kick opioids cold turkey and not run the risk of death unlike benzos

[@ghostwriter1415]

Dr. Swainey, what drugs can an average, upwardly mobile citizen (with no diagnosed physical/psychological ailments) start taking to enrich their lives, and climb more rungs in the success-ladder? If you had to take a drug just to take a drug, whcih drug(s) would you "get on"?

[@samyup9680]

What’s the difference between opioids and benzos? They seem to have the same effect of depressing the nervous system and the surge of dopamine but I don’t know what’s the defining difference

[@annalucy89]

They're not close to being the same thing. Benzo's were created for anxiety, insomnia and shit like that and affect that part of your brain but have no effect in stopping pain, and it doesn't slow your breathing to a dangerous levels unless you are using it with opioids. Opioids on the other hand bind to those endo receptors in your brain and give you a high like no other while also being painkillers obviously but they can also put your breathing "system" to sleep. So even without benzo's you can easily stop breathing from opioids or it slows down your breathing to such a dangerous level that there isn't enough oxygen flowing through your bloodstream. Benzo's and opioids used together is of course extremely dangerous because both of them together do slow your breathing quite a bit. I've OD twice from that mix of drugs and both times I stopped breathing but was thankfully saved at the last minute after I had already become purple really. Benzo's are however very dangerous drugs and extremely hard to get off of. Opioid withdrawals is the worst thing you could ever go through but it's not life threatening. Although you feel like you're dying and you most certainly want to die while going through it but Benzo is the only drug withdrawals along side alcohol that can actually kill you. Seizures and shit like that. So I'd say that opioids are the most dangerous drugs to be addicted to because you can so easily overdose and die but Benzo's are more dangerous when you want off them so doing it cold turkey can seriously harm you. The exact difference between then I can't really tell you, the chemistry behind them and all that. I just know the effects of them, their withdrawals and the consequences of using them, and they don't produce even close to similar effects.

[@georgehays4908]

..... great , I'm doing it backwards ! It is hellish . I think you should do an episode on Opium .