There are more than 15 different types of FDA-approved benzodiazepine medications. These drugs
are referred to as Benzos and are widely prescribed for a variety of medical and mental health
concerns. The benzodiazepine drug Xanax is the mostly widely prescribed psychiatric
medication. Other types of Benzos include Alzam, Xanor, Zopax, Urbanol, Rivotril, Lorazepam,
Librium, Pax, Rohypol, Dormonoct, Ativan, Dormicum, Zopiclone and Valium.

Why do people use Benzos? They can provide anxiety relief and are often prescribed to treat anxiety
disorders including social anxiety and panic disorders. They are also used to treat alcohol withdrawal
and to assist for the first few days of starting an anti-depressant. They are only intended to be used
for short term acute symptoms. This is because long term use leads to tolerance (the need for more
to get the same effects) and dependency (compulsive use with withdrawal symptoms if the drug is

How do they work? Benzos are central nervous system depressants. Our central nervous system
regulates our heart rate, breathing, blood pressure and temperature. When we take a Benzo these
functions slow down by interrupting the brains messages to our bodies through our
neurotransmitters. Whereas stress stimulates our brains and central nervous system, Benzos slows
down the brain by inhibiting the production of neurotransmitters. The result is a feeling of calm and
relaxation. However, the brain quickly adjusts to Benzos and they have less and less effect on the
brain over time, and thus less effect on the body’s central nervous system. This is called tolerance.
Symptoms of tolerance and over-sedation are extreme sleepiness, problems with memory, cognitive
impairment, mood swings, shallow breathing, depression, psychosis and even death. Mixing Benzos
with alcohol increases their potency and risk of overdose.

Withdrawal symptoms include insomnia, anxiety, confusion, inability to focus, irritability, restlessness,
muscle weakness, shakes, difficulties concentrating, irregular heartbeat, sweating, hallucinations,
depression and craving. You may also notice behavioural changes such as withdrawal from social
activities, secretiveness, stealing of money, visits to different Doctors and extreme defensiveness
when questioned or confronted.

Benzos detox and treatment must take place under the close supervision of a trained Medical Doctor
and nursing staff. It is possible to have a severe reaction if Benzos are suddenly withdrawn.
Medically assisted detox ensures that the process is safe and thorough, and comfortable for the
person concerned.

Thereafter a non-judgemental treatment process will assist in determining how the dependency
began and address the underlying triggers that developed the dependency, along with learning
coping tools and strategies to maintain abstinence.

If you or your family member are struggling with a dependency of any kind, contact us for a free
assessment. Tel: 021-7617348 or email

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How do I know if I or a loved one is an alcoholic?

How do I know if I or a loved one is an alcoholic?

We often perceive an alcoholic as a down and out person living on the streets begging for money for booze.
However, some of the ‘best’ alcoholics I know are high functioning CEO’s and professionals.

So what does an alcoholic ‘look like’?

We now call someone who is struggling with alcohol as having an alcohol use disorder which may be mild,
moderate or severe depending on the number of symptoms that are being experienced. Have a look through the symptoms below. Anyone meeting any two of the 11 criteria during the last year can expect a diagnosis of an alcohol use disorder.

 Had times when you ended up drinking more, or longer than you intended?
 More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
 Spent a lot of time drinking? Or being sick or getting over the aftereffects?
 Experienced craving — a strong need, or urge, to drink?
 Found that drinking — or being sick from drinking — often interfered with taking care of your home or
family? Or caused job troubles? Or school problems?
 Continued to drink even though it was causing trouble with your family or friends?
 Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order
to drink?
 More than once gotten into situations while or after drinking that increased your chances of getting hurt
(such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
 Continued to drink even though it was making you feel depressed or anxious or adding to another health
problem? Or after having had a memory blackout?
 Had to drink much more than you once did to get the effect you want? Or found that your usual number of
drinks had much less effect than before?
 Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble
sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things
that were not there?
If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms
you have, the more urgent the need for change.
Some questions to ask yourself:
 Do you or your loved one drink more than 3-4 drinks per day?
 Do you or your friends and family ever joke that you or your loved one is an alcoholic?
 Has the GP flagged that your or your loved one’s liver is in in distress?
 Do you or your loved one need alcohol in order to relax or sleep?

Heavy drinking is very risky for your body and emotional health. Liver disease, cancer and heart disease are all
linked to heavy drinking of alcohol. Depression and anxiety are also linked to heavy drinking.

Contact a professional for an assessment if you or your loved one’s drinking is cause for concern.
Ixande undertakes free assessments.

Please contact us on 021-7617348 or email

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When Love Becomes Addictive

Relationship addiction is otherwise known as love addiction.  The same behaviour that we see in substance abuse addicts or alcoholics is evident in the behaviour of love addicts.

These behaviours are focused on obtaining the hearts desire – not necessarily love and affection but the emotional high that is obtained in the early stages of a romance, and are totally compulsive in nature.  We see a continual preoccupation and obsession with the fantasy of a new relationship.  Control over usually restrained behaviours begins to slip away and as a result negative consequences begin to emerge.

Much like other addictions the obsession engages the love addict for much longer and more intensely that meant to.  Cutting down on the obsessive behaviour is not possible and the behaviours take up a lot of time and at the cost of home and work.  Love addicts continue to engage in their behaviours despite the problems that it causes in relationships with others and takes the place of engaging with other important work, social or recreational activities.  It can even lead to the love addict being put in danger and lead to physical and mental problems such as depression or anxiety.  The high of engaging in a romantic fantasy or relationship becomes ever more difficult to reach (tolerance).  Even feelings of cravings or withdrawals can become apparent when not engaging in the problem behaviours.

Whilst the rush of new love and emotional and physical attachment is a healthy and normal facet of human behaviour – when it is repeatedly sought after to achieve the ‘high’ or to avoid emotional discomfort it can become a serious problem.

So what does this behaviour look like?

Adam is not able to sustain an intimate relationship.  He fixates on one particular person and obsessively attempts to engage in a relationship with that person.  He uses multiple methods to achieve his goal, choosing his work place and social activities to ensure contact.  He obsessively abuses social media in order to track the person’s family and social life.  He has twice been caught hacking into other peoples social media accounts and has an outstanding restraint court order for invading privacy.  He engages in fantasy about the potential relationship and becomes highly anxious and depressed when he does not make headway.  No sooner than he obtains some sort of response from the person involved – whether positive or negative he quickly switches his attention elsewhere.  And so the cycle continues.

Carla is an attractive woman and finds it easy to enter into relationships.  She flings herself into the partnership mistaking the intensity and intimacy of a new sexual relationship for long lasting love and starts planning her future accordingly.  Her every moment is filled with obsessive and controlling thoughts and feelings about her new partner.  Her sense of self and self worth quickly becomes tied up with the other person.  She gives up all her other activities, friends and social life to focus on ‘the one’. More often than not the new partner quickly draws away fearing the intensity of Carla’s behaviour leaving Carla devastated as yet another relationship fails.  On the rebound she places herself in dangerous situations just to be able to hook up with someone new.  Her friends make her promise to stay single for a while but she can never stick to her good intentions.


Like all addictions it is usually easy to identify the vulnerability of the addict towards these behaviours.  Inadequate attachment and nurturing as a child, poor sense of self and low self esteem, poor role models, trauma and societal conditioning all contribute towards an unconscious drive to seek out the love ‘high’.

If you or a loved one find themselves caught up in a pattern of addictive behaviour in love and sex relationships help is at hand.


If you or a loved one are struggling with addiction please contact or phone +27(21) 7617348.

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“Tik” – are You Meth dependent?

Methamphetamine is a man made central nervous system stimulant.

Dependency on Methamphetamine (commonly known as ‘tik”) develops as a result of the impact of regular use of Meth on the brain.  The Meth passes through your body to the brain where it causes the neurons to transmit unusually large amounts of the natural neurotransmitters (norepinephrine and dopamine), which then prevents the normal re-uptake of these brain chemicals.  The release of this neurotransmitters results in a short lived powerful euphoric effect and increase in energy and feeling of invulnerability.

Meth is highly addictive and can quickly move from occasional use to compulsive use.  Two of the indications of dependency are tolerance and withdrawal.

Tolerance is the increase need for more Meth in order to achieve the same high and is due to the change in brain chemistry.

Withdrawal is the presence of physiological symptoms as a result of not using Meth.  These symptoms make it very difficult to stop the use of Meth.  They include:

  • Anxiety
  • Depression
  • Anhedonia (inability to feel pleasure)
  • Irritability
  • Lack of energy
  • Sleeplessness
  • Teeth grinding
  • Mood swings

Other symptoms of Meth dependency include:

  • Loss of appetite and weight loss
  • Severe tooth decay
  • Respiratory problems
  • Permanent heart, liver, kidney, lung damage
  • Brain damage including inability to give attention, make good judgements, problem solve, poor memory, movement issues, poor impulse control and loss of contact with reality
  • Panic and psychosis
  • Bizarre or erratic behaviour
  • Criminal and violent behaviour

Recovery from Meth addiction is possible with the required help.  Firstly detox needs to take place.  A place of safety and medical assistance can ease the challenging withdrawal symptoms.  Within a few days sleep and eating patterns can return to normal.

Adherence to a 12 Step recovery programme can provide the daily support and changes necessary to support abstinence.

If you or a family member are struggling with addiction please contact or phone +27217627348.

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Schizoaffective Disorder

Schizoaffective disorder describes a condition that includes aspects of both schizophrenia and a mood disorder (either major depressive disorder or bipolar disorder).

Scientists are not entirely certain whether schizoaffective disorder is a condition related mainly to schizophrenia or a mood disorder. However, it is usually viewed and treated as a hybrid or combination of both conditions.

Schizoaffective disorder can be managed, but most people diagnosed with the condition have relapses.

A few definitions:

Schizophrenia  is a brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others.

Depression  is an illness that is marked by feelings of sadness, worthlessness, or hopelessness, as well as problems concentrating and remembering details.

Bipolar disorder  includes cycling mood changes, such as severe highs (mania) and lows (depression).



The symptoms of schizoaffective disorder may vary greatly from one person to the next and may be mild or severe. They may include:


  • Poor appetite
  • Weight loss or gain
  • Changes in sleeping patterns (sleeping very little or a lot)
  • Agitation (being very restless)
  • Lack of energy
  • Loss of interest in usual activities
  • Feelings of worthlessness or hopelessness
  • Guilt or self-blame
  • Trouble with thinking or concentration
  • Thoughts of death or suicide


  • Being more active than usual, including at work, in your social life, or sexually
  • Talking more or faster
  • Rapid or racing thoughts
  • Little need for sleep
  • Agitation
  • Being full of yourself
  • Being easily distracted
  • Self-destructive or dangerous behavior (such as going on spending sprees, driving recklessly, or having risky sex)


  • Delusions (strange beliefs that the person refuses to give up, even when they get the facts)
  • Hallucinations (sensing things that aren’t real, such as hearing voices)
  • Disorganized thinking
  • Odd or unusual behavior
  • Slow movements or not moving at all
  • Lack of emotion in facial expression and speech
  • Poor motivation
  • Problems with speech and communication




Scientists don’t know the exact cause of schizoaffective disorder. Things that may be involved include:

Genetics (heredity): Someone may inherit a tendency to develop schizoaffective disorder from their parents.

Brain  structure and function: People with schizophrenia and mood disorders may have problems with brain circuits that manage mood and thinking.

Environment: Environmental things — such as a viral infection, bad relationships, or highly stressful situations — may trigger schizoaffective disorder in people who are at risk for it. How that happens isn’t clear.

Schizoaffective disorder usually begins in the late teen years or early adulthood, often between ages 16 and 30. It seems to happen slightly more often in women than in men. It’s rare in children.

Because people with schizoaffective disorder have a combination of symptoms reflecting two separate mental illnesses, it is easily confused with other psychotic or mood disorders. Some people may be believed to have schizophrenia, and others may be believed to have just a mood disorder. As a result, it’s hard to determine exactly how many people actually have schizoaffective disorder. It’s probably less common than either schizophrenia or mood disorders alone.


There are no laboratory tests to specifically diagnose schizoaffective disorder. So doctors rely on a person’s medical history — and may use various tests such as brain imaging (like MRI scans) and blood tests — to make sure that a physical illness isn’t the reason for the symptoms.

If the doctor finds no physical cause, he may refer the person to a psychiatrist or psychologist. These mental health professionals are trained to diagnose and treat mental illnesses. They use specially designed interview and assessment tools to evaluate a person for a psychotic disorder.

In order to diagnose someone with schizoaffective disorder, the person must have periods of uninterrupted illness and, at some point, an episode of mania, major depression, or a mix of both, while also having symptoms of schizophrenia. The person must also have had a period of at least two weeks of psychotic symptoms without the mood (depression or bipolar) symptoms.


Treatment for schizoaffective disorder includes:

Medication : Some of the medicine a person needs depends on whether they have symptoms of depression or bipolar disorder, along with symptoms that suggest schizophrenia. The main medications that doctors prescribe for psychotic symptoms such as delusions, hallucinations, and disordered thinking are called antipsychotics.  Many antipsychotic drugs have value in the treatment of schizoaffective disorder.  For mood-related symptoms, someone may take an antidepressant medication or a mood stabilizer such as lithium. They often will also take an antipsychotic medication.

Psychotherapy : The goal of this type of counseling is to help the person learn about their illness, set goals, and manage everyday problems related to the disorder. Family therapy can help families become more effective in relating to and helping a loved one who has schizoaffective disorder.

Skills training: This generally focuses on work and social skills, grooming and self-care, and other day-to-day activities, including money and home management.

Hospitalization: Psychotic episodes may require a person to be hospitalized, especially if he/she is suicidal or threatens to hurt others.


Can You Prevent Schizoaffective Disorder?

No. But if someone gets diagnosed and starts treatment ASAP, it can help a person avoid or reduce frequent relapses and hospitalizations and help decrease the disruption to the person’s life, family, and friendships.


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Cannabis and Work

Cannabis and Work

With the Constitutional Court judgment on 18th September 2018 effectively legalizing cannabis, some questions can be asked around Labour Law.
Jan du Toit, a Senior Consultant with SA Labour Guide asks the question, “Does the fact that one will have the right to private consumption of cannabis imply that employers will have to amend their policies and disciplinary codes?”

Cannabis is a psychoactive drug derived from the Cannabis plant. The main psychoactive part of the plant is tetrahydrocannobinol (THC). Cannabis can be used by smoking, vaporizing with a ‘bong’, within food or as an oil extract. Cannabis is a depressant drug, which means it slows down messages travelling between your brain and body.

The physical effects of cannabis is an altered state of consciousness – a general change in perception of time and space, heightened mood (euphoric and sociable), increased sensitivity to taste, sight, smell and hearing, impaired coordination and concentration, decrease in short term memory, decreased motivation, increased pulse and heart rate, dilated and blood shot eyes and at times negative experiences like paranoia and anxiety.
Long-term effects of cannabis use are widely debated but include dependency, damage to heart and lungs, the reproductive system, and adolescent brain development. There is evidence of a link between schizophrenia and cannabis use.

Cannabis oil is used to combat a wide variety of different illnesses such as effects of cancer treatment, pain relief and epilepsy.

Cannabis can be detected in urine for a few days (occasional user) or longer than a month (chronic user). This means that a joint smoked on a Saturday night at a party may be detectable in the urine on a Monday morning – despite the effects of the cannabis having probably worn off.

So will it be permissible for employees to have cannabis in their system when they present for work?
The General Safety Regulation 2A of the Occupational Health and Safety Act, requires that an employer may not allow any person who is or who appears to be under the influence of an intoxicating substance, to be allowed access to the workplace. Neither may an employer allow any person to have intoxicating substances in his or her possession in the workplace.

Jan du Toit suggests that this means that the legislation of private cannabis use is probably not a defence for a positive urine test of cannabis at work.

Cannabis – what the Constitutional Court did not say

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