How to Taper off Benzodiazepines – 11 Secrets to Success
Thinking about trying to taper off any of the benzodiazepines and worried about the withdrawals, your anxiety and your odds of success?
Well, a poorly thought out or overly quick taper can be agonizing but it doesn’t have to go that way – a methodical and patient benzo taper makes things much more manageable.
Need some advice on how to make sure your taper goes smoothly? Well here are 11 great tips and strategies to a successful benzodiazepine taper from Professor C Heather Ashton. Oxford educated Professor Ashton is considered a leading expert on benzodiazepine withdrawal based on her experiences running a benzo withdrawal clinic over more than a decade. She is also the author of ‘Benzodiazepines: How They Work and How to Withdraw’ which is now more famously known as The Ashton Manual.
11 Tips for a Successful Benzodiazepine Withdrawal
1. Get Confident
You can do it! Millions of people have gone before you and if they can get off so can you.
2. Don’t Believe All the Horror Stories
Just because someone else had a tough time withdrawing doesn’t mean that you will too. Every body is different every use-history is different and every tapering attempt differs as well. Many people who taper very slowly experience only minimal withdrawal symptoms so don’t worry about the worst case scenarios and all those scary stories you’ve heard. Go slow and listen to your body and it’s very unlikely that you’ll experience anything so severe.
3. Talk to Your Doctor before You Start
Talk to your doctor first to make sure it is safe and advisable for you to begin tapering down. Assuming you get the green light (and if you don’t you may wish to seek out a second opinion on that) inform your doctor of your tapering plans and your estimated schedule of reductions.
Make sure your doctor knows that you will be in control of the benzodiazepine tapering schedule and that you do not want arbitrary deadlines or imposed pacing.
4. Get Support from Someone Who Understands What You’re Going Through
You’re likely going to need emotional and psychological support at some points of the tapering journey so make sure you’ve got someone in your corner who understands benzo withdrawal (or is willing to get informed) and who’s willing to be there for you when you need a helping hand.
This person can be a doctor or therapist, it can be a friend or a spouse or it can be a person or a group of people from a community support group. It doesn’t matter who it is, as long as they understand what you’re going through and are willing to help you out as needed.
5. Be Patient
If you’ve been using for a while, understand that it’s going to a take a long while for your brain and body to adapt to reductions in dosage. It is not uncommon for a tapering to take 6, 12 or even 18 months. This is OK.
6. Control Your Own Pace of Reductions
It’s your body so you’re the person who’s best able to judge an acceptable pace of dosage tapering. Don’t worry at the onset about mapping out a schedule of tapering all the way to the end. Make a schedule and follow it for a few weeks and then review and alter that schedule as necessary based on your progress and the way you’re handling the dosage reductions.
Resist outside attempts to push you to a tapering schedule that’s faster than you’re comfortable with.
7. Switch to Longer Acting Medications
If you take short acting medications, like Xanax, you may want to consider switching to a longer acting benzodiazepine, like diazepam.
Short acting benzodiazepines result in rising and falling quantities of the medication in the bloodstream several times over the course of a day and this can lead to feelings of withdrawal and/or cravings as you taper. Longer lasting benzodiazepines result in more stable blood concentrations.
8. The Larger Your Daily Dose the Greater Your Dose Reduction (It’s All About the %)
Don’t think dose reductions per mg, percentage dose reductions are much more manageable. For example, if you are dropping your dose by 5% a week and are starting off on 40mg a day of diazepam, then you would start off by reducing your daily dose by 2 mg (a 5% reduction). Once you are down to 5 mgs per day, for example, if you dropped that same 2 mgs you would be reducing your daily dosage by 40% - which is a very big drop!
9. Never Increase Your Dosage
There may be times of great stress when you really feel like you need to temporarily increase your dosage (a death in the family, for example). If you need to, it is fine to delay further reductions for as long as necessary, but you should never go back and increase your dosage once you have already done the hard work and once your brain has already adjusted to a lower dosage.
It can be very useful as you taper to learn alternative ways to handle stress, such as yoga, meditation, relaxation exercises (like the relaxation response) or deep breathing exercises. As you learn to handle stressful situations without resorting to benzodiazepines you will gain confidence in your ability to really beat this dependence.
10. Don’t Take Other Substances Which Cause Similar Effects
It does you little good to reduce your daily benzodiazepine intake by half if you simply double your consumption of alcohol, marijuana or other sedative drugs to compensate.
11. Jump off at .5mgs of Diazepam
Once you’re down to 0.5 mgs of diazepam it’s time to make the jump off to nothing. Continuing to taper after this point serves little purpose and most people find that the worry about not taking any medication is far worse than the reality of the final jump to freedom. 1
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