Benzodiazepines are known as “anxiolytics” and are listed as a schedule IV controlled substance. Given that they are not recommended for use beyond 2-4 weeks, a benzodiazepine prescription comes with the inherent responsibility of providing patients with an exit strategy. There are those who are fortunate and will have little problem withdrawing from a prescribed benzodiazepine no matter what method of discontinuation they follow. Others, no matter how much they desire to withdraw may experience debilitating mental and physical withdrawal effects. It has been said that benzodiazepines are more “difficult than heroin” to withdraw from.
While it is unclear which patients will be able to successfully withdraw from a benzodiazepine in a few weeks, what is clear is that those who cannot may lose years of their life to an unsuccessful taper. It is imperative that doctors and patients are educated about the available methods of tapering. The methods discussed here have been developed through clinical experience and by the thousands of survivors who have successfully completed a benzodiazepine taper.
The Problem: Prescriber Common Practice
One common method is to instruct the patient to cut the pill by 1/4 weekly. With this method the patient will be finished tapering in approximately 4 weeks. While some view this as a gradual reduction, many experienced researchers, physicians and patients would consider a 4 week taper to be too rapid. Research has shown that symptoms of dependence are due in part to GABA receptor alteration. Four weeks is often not enough time for these receptors (which are located throughout 70% of the brain and body) to repair, leaving the patient with intolerable symptoms. In fact, this rapid tapering method was found to be ineffective for at least 32-42% of patients who are prescribed benzodiazepines long term, with 90% experiencing withdrawal symptoms.
There are many instances of patients developing a protracted withdrawal syndrome and even seizure disorders from rapid tapers of this nature. Slower, more gradual dose reduction can reduce the severity withdrawal and the risk of protracted acute withdrawal syndrome or PAWS which can last anywhere from 18-24 months or longer.
Patients who are dependent may also have become so severely sensitized to benzodiazepines that even minute fluctuations in dosage can cause terrible suffering. Cutting pills that are not scored to evenly distribute the medication into 4 equal parts exacerbates the severity and fluctuation of symptoms throughout a taper.
Another commonly prescribed method of tapering requires the patient to continuously remove one of the daily doses throughout the week, over the course of several weeks until all doses have been removed. This protocol presents the same problems as with the 1/4 dose reduction per week method. Benzodiazepine Information Coalition has observed throughout years in online support groups representing thousands of patients that this approach more often than not causes a cluster of disabling mental and physical symptoms, which persist for months or years. Additionally, skipping doses means even greater drug serum level fluctuations, instead of a slow, steady decline of drug serum levels often leading to unnecessary pain and suffering.
Tapering Methods
There are many effective tapering approaches for cessation of benzodiazepines. Because benzodiazepines don’t come in dosages for easy cessation, nearly all require manipulating the dosage through some method, be it cutting with a scale, liquid or compounding.
Ashton Manual
The Ashton Manual is probably the most well known cut-and-hold method in the benzodiazepine community. While it has a 90% reported success rate, it may be too fast for many patients to taper comfortably. Additionally many patients cannot tolerate Valium, which is what the Ashton Manual requires.
The Ashton protocol recommends using Valium (diazepam) to taper because it comes in much smaller doses and has a longer half life than the newer, shorter acting benzodiazepines. For example, while Klonopin (clonazepam) has a medium half life, the smallest dose available is 0.125 mg, and Xanax (alprazolam) has a short half life, the smallest dose is .25 mg. While these may seem like small doses, when one considers it’s equivalence to diazepam, 0.125mg of Klonopin is actually closer to 2.5 mg of diazepam, .25 mg of Xanax is about 5 mg of Valium.
Ashton also recommends tapering no more than 5-10% every 2-4 weeks. This means that, on average, a taper will take about ten months or longer, depending on the patient’s starting dose and individual response. As with any recommended guideline it is important to remember that the patient should be allowed to dictate the rate and pace of their taper depending on their individual response to dose reduction. If symptoms are severe and/or disabling, per Ashton, the taper may be suspended for a few weeks until symptoms subside. Oftentimes this resolves the problem and the patient may then resume their taper. It is not uncommon for benzodiazepine tapers to take longer than one might expect due to individual responses. Per Ashton, it matters little whether it takes 6 months or 18 months (or longer) in those who have become dependent due to long term, as prescribed use of benzodiazepines.
While Ashton recommends Valium due to it’s long half-life for tapering, other guidelines recommend staying on the originally prescribed benzodiazepine if withdrawal symptoms are tolerable. As with any new medication introduced, there is a risk of adverse reaction. Some patients do not respond well to Valium. Substituting a longer-acting benzodiazepine can take weeks to adjust before patients can begin or resume their taper. This adds more time to what is already perceived as a life-altering and very consuming project. Since benzodiazepine usage and withdrawal often creates numerous complex symptoms, it can be difficult to know if someone is suffering from an adverse reaction to new medication, or is simply symptomatic due to the neuroadaptations caused by long term exposure to benzodiazepines.
Dry Tapering
This is a popular method due to convenience and initial intimidation of other methods. It involves using a pill cutter or scale and shaving off a pill following a taper plan. There are various methods for dry tapering, including micro-tapering and larger cut-and-hold tapers.
Tapering Strips
A newcomer to the cessation market is Tapering Strips by Dr. Groot. These can be ordered from the Netherlands. Availability varies by country. These strips can have a faster taper rate than recommended by Dr. Ashton. We recommend, if utilizing this option, to consider stabilization strips to slow the taper to 5-10% per month maximum.
Micro-Tapers
Online support communities have developed systems of “micro-tapering” to help distribute medication evenly throughout the day in order to avoid interdose withdrawal symptoms. Micro-tapering uses small daily reductions that add up to a 5-10% overall reduction every month. Daily micro reductions also help to avoid the physical and mental turmoil that larger weekly reductions may create for those who are very sensitive. Keeping track of dose reductions usually requires a daily log, or for some, the use of a spreadsheet.
Dry Micro-taper
Some patients micro taper with a scale removing a small amount, such as 0.001 to 0.003 per day or every few days. This method is initially complicated to many, but videos and resources are available to explain it.
Liquid Micro-taper
Oral diazepam solution (Roxane Laboratories) can be a valuable tool in micro-tapering and comes as a stock 5mg/5ml (1mg per ml) solution. Using a syringe, patients can, for example, measure 0.1 mg less of the total dose every day or every 3 or more days. (Of course how much is reduced depends on the individual response of the patient, their starting mg’s and rate of desired reduction). For those who cannot tolerate oral diazepam solution, or cannot tolerate diazepam at all, a prescription for a liquid compound of the patient’s benzodiazepine can be used.
Suspending vehicles such as “OraPlus” or even almond oil based compounds can be made with crushed pills or the stock powder form of most benzodiazepines. Most compounding pharmacists will have access to a database that will allow them to choose the appropriate suspending agent for each specific benzodiazepine. Liquid compounds in some cases, make it easier for the patient to control the rate of taper and require very little work on their part compared to other tapering methods. If a compounded suspension of a benzodiazepine has been decided upon, it is recommended that a compounding pharmacist associated with the International Academy of Compounding Pharmacists or the Professional Association of Compounding Pharmacists be used due to their extensive knowledge and access to databases which allow them to properly prepare consistent compounded suspensions in the appropriate suspending vehicle.
Finally, there is the method known in the online support community as “liquid titration.” Some patients may not tolerate compounded liquids due to multiple factors such as intolerance to the suspending vehicle and/or inconsistencies in the preparation of the compounded suspension. Others may have a difficult time finding a doctor who is willing to prescribe Valium or a prescription for a compounded suspension of their current benzodiazepine. Many who have found themselves in this predicament have successfully tapered on their own by making a homemade suspension in water or milk. A pill is either crushed or allowed to disintegrate in, for example, 300 ml’s of liquid. One ml is removed from this suspension and discarded, the rest is ingested. More and more ml’s are reduced and discarded each day until nothing is left. This method is less difficult than it sounds and many have successfully tapered on their own using this method.
Tapering Strategies
Recommended Taper Rate
As mentioned before, it is often difficult to taper medications that are not designed for gradual reduction. The general guideline is to not exceed a 5-10% reduction of the current dose every 2-4 weeks.
Conversion Rates for Benzodiazepines
Another tricky aspect of switching to a longer acting benzodiazepine is conversion. Ashton created a guide of average conversions. This guide, as well as other charts and individual physician opinions can vary wildly. However, unlike opiates, drug equivalences are not studied or mandated by the FDA and every body will be different.
Medications to Alleviate Withdrawal Symptoms
Other issues that should be taken into consideration are the use of other medications to assist in the tapering process such as antidepressants, anticonvulsants, antihistamines and antipsychotics. Currently, there are no FDA-approved medications to alleviate the symptoms of withdrawal. Benzodiazepine Information Coalition’s experience from the thousands of people in benzodiazepine online support groups have found that many patients withdrawing from benzodiazepines develop multiple sensitivities to other medications which seem to aggravate symptoms of withdrawal. With a sufficiently slow, patient-led taper, additional medications are usually not necessary.
Problems with Available Benzodiazepine Milligrams
How does one accomplish a 10% reduction every 2-4 weeks from potent benzodiazepines such as Ativan, Xanax and Klonopin that are not available in very small dosages? For some, substituting the original benzodiazepine in a stepwise fashion over to Valium and making small reductions per the Ashton method is very successful. Some even utilize a jewel scale and razor blade for more accurate dose reductions. However, even these seemingly small cuts can be problematic, particularly for children and adults with seizure disorders. While Valium has the longest half life of any benzodiazepine, it must be remembered that the first metabolites break down after only a few hours. Sensitive patients may benefit from evenly dividing their dose and taking it 2 or 3 times per day.
Dosing Multiple Times Per Day
Those who choose or are required to taper using a shorter-acting benzodiazepine may find it particularly helpful to take their dose several times per day, depending on the half life of the medication. For example, patients taking Klonopin may benefit from dosing 3-4x per day, whereas those taking Ativan may need to dose 4-5x per day. Some patients on Xanax may require 5-6 doses per day just to maintain steady serum levels. Patients who dose at regular intervals are more likely to successfully complete a benzodiazepine taper because they do not experience severe “drops” throughout the day between doses that make discontinuation intolerable. These symptoms are commonly referred to as “interdose” withdrawal.
Can I go from Klonopin straight to volume without having any withdrawal symptoms
am I gonna be ok? I went from 8mg of Xanax and klonopin to going straight to 4mg (been prescbribed 7 years) but I oddly feel fine as of day 2 today…
To anyone that reads/comes across this knows that there are very few support groups for benzo recovery. I as well as others know a POSITIVE support group is needed. I myself started the Ashton Method and currently at stage 5. I know my meds pretty well, however I do know there are people out there that know more and have successfully gotten off them period! I’m tired of living a life with no support and want other to talk to. That being said I know I’m not alone. I can set up a website etc… just need enough willing people. Plz email me at [email protected]
After all this hell I want to be helped and help others.
Hi Susi, ive been taking lorazapam for several years and have decided to take the CBD oil route to get off of them . Its been a week and i have taken the Lorazapam 0.5 every other day and the CBD oil the second half of the day or 3 times a day when not taking the lorazapam. I was also taking mertazapine at night. I threw it in the garbage about a month ago and never looked back, it never worked! Anyway after a few days i felt a little anxious in between doses of CBD oil(maybe withdrawel)but it goes away as the day goes on. Its still too early to see if long term withdrawel is an option . I hear so many scary situations about withdrawel and how it can be damaging to your health. But what is the alternative? A life time of side effects? Increased dosage is no longer helpful for me taking this medication, it doesnt help anymore. I,m not guarenteeing anything but so far so good. P.S. My sister is a naturapathic doctor and she is behind me 100% . Let me know what you think and how your doing, Rich D.
Hi Richard, I have been taking Klonopin for over 7 years. I put myself down to one mg. a night since before 2014. I have never had any side effects from quitting any type of medication. I even quit smoking cold turkey with zero problems. The instructions my doctor gave was take half the dose for 4 days and then stop. Long story short, I stopped suddenly! Ended up with most withdraw symptoms that I’ve read about minus seizures and bowel problems. I went back to doctor and they gave me half mg dose for 5 days, so with my medication, that gave me 10 days of med. dr said that should work. I’m on day 5 and have started feeling increased anxiety again. I’m not taking anything for anxiety or depression right now . I have appointment soon and plan to ask for antidepressant. I need something for the reason I was taking it to begin with. I’ve been drinking Chamomile tea to help the nerves. I was curious about CBD oil for this.
I had been taking Xanax 0.5mg for some 20+ years… It’s a short acting benzo so more difficult than other benzos to wean off.. – My GP decided to wean me off them with Valium,10mg.. – Because Valium comes in 2mgs, it is a lot easier to wean off the Valium.. – Also, Valium is longer acting, thus stay in your body for a long time… – Anyway,, I am totally off the Xanax,, down to 6mgs of Valium, and doing very well.. – Some asked at the beginning of the comments, why take people off a benzo when they have been taking it for decades, and that the dose is low.. – Well at 70 you can still manage alright, but in another 10 years form now, your gait, might start being affected, where you could need a walker,, and your chances of getting dementia are increased by like at least 50-75%.. – I am 64 and I decided to stop taking these horrible drugs as they will definitely affect you sooner than later.. – Anne
I am 64 and have been on benzo’s for 10 years. From 10 mg valium and 2×1 mg Xanex I am now tapering to 2 mg valiym per day. Good luck to you! Would be good to support each other if you would like 😉
Did you go straight from Xanes to an equal amt. of Valium, or did you simply replace one dose at a time of Xanex with Valium until you were only taking Valium.??
I also tapered even though I only took 2.5-5 mg a day but for 10 years. My question is when do you jump off the taper and how are withdrawals then ? I went off at 2 I thought was dose and 34 days off I’m still jonesing hard enough to think I need to go back on and taper again. Hate to go thru this hell again though but don’t want to drop either.
Scott:
Why would “jumping off” be accepted?
If you were tapering by 0.25MG of Valium at each reduction step, why would you suddenly change that dosage reduction ( cut) to 0.5MG? This is what “jumping off” is. Jumping represents a sudden C/T when the jump is larger than the accustomed cut. Of course a major increase in the syndrome will follow.
This effect is still referred to as “protracted withdrawal”. Protracted withdrawal is not a different condition. It is an incomplete withdrawal.
Of course the originator of the idea of jumping off also maintained that healing doesn’t begin until the taper is ended. Neither claim has any supporting evidence.
Another unfortunate claim is that jumping is fine because a dose of 0.5mg Valium can have no therapeutic effect. While that dosage may not have any of the five therapeutic effects, Quite clearly it has a sixth effect. That effect is keeping withdrawal symptoms at bay.
There is a procedure to prevent that protracted effect which is present in all versions of the cut and hold method.
Go to YouTube type in crazycanuck follow his method he uses clonazeoam I use diazepam I’m on 4 mg/ day using this method. Follow his videos he has 4 videos watch them all then do it it’s very simple, make sure you’re knowledgable in using spreadsheets or get someone to do it for you it automatically calculates your reductions don’t forget if you start to experience some with drawl you hold at that point until your body recovers it’s a very easy painless process listen to his videos he’s been off for 15 months with zero side effects .
Go to YouTube and watch the video crazycanuck he has three videos he does a micro taper using clonazepam I’m on diazepam and I’m using his method it’s actually not his method it was someone else’s but several people have used us it’s better than the Ashton manual it’s micro tapering using homogenized milk please watch this video he has been off of his 1 mg one mg Clonazepam for 15 months and has had zero with drawl symptoms
Hi, I was on 10 mg of Valium at night for about 10 weeks , how long should it take to taper off? I am down to 2mg over a month time period, I feel flu like,, No t sure what to do?
Thanks for your in put
I would love to start a support group! I’m utilizing the Ashton Method and currently on stage 5.
Plz email me
[email protected]
I am also 64 and have been on Xanax about 7 years. My doctor switched me from the regular tablets to the ER version. I’m on the lowest dose, .5 twice a day. Now I’m supposed to switch to Valium so I can taper.
Can anyone tell me how that switching went ? I went from a total daily dose of Xanax of 1.65 immediately to a total of 1 when I changed over to all extended release. It was a very rough couple weeks, and that’s all I have to compare this to.
Rachel – I am in the beginning of a taper …. Lorazepam to Valium. This is second “doctor” I am dealing with. I live in Central Coast CA….any suggestions?
Linda
Hi did he take you from Xanax straight to volume and did you have any withdrawal symptoms I’m currently on klonopin and want to changed it valium so I can eventually weaning down off of it
I have been taking Xanax about a year… I gradually worked up from doing it on the weekend about .5 mg to taking up to 2 mg a day for about six months ….I have reduced myself to .25 mg and I would do that every two weeks I felt a little uncomfortable but I’m dealing with it so far … I read in the Ashton report about the diazepam or valium and also read that it’s an antidepressant as well as anti-anxiety and anticonvulsant so I started taking that to help with the withdrawals coming off of the Xanax . I only have a weeks left of .25 mg of Xanax and I’m almost done. My question is now how do I taper off of the Valium or diazepam. . That I’ve only been taking about a month since I got into the .25 part of my tapering schedule for the Xanax . I cannot afford to miss work or have seizures or anything of that nature and I only have about 6010 mg diazepam left.. Any advice would be appreciated I was wondering if I should cut the 10mg valium with a pill cutter in 4 ..25 mg pieces and reduce that .25 mg every two weeks as well . Any advice would be much appreciated please I would like to keep this confidential and no I cannot go back to the doctor to get more medication
Go one line and google THE ASHTON MANUAL for proper dosing and all info about the Withdrawel symptoms!!!! You cannot just stop fast or you’ll go crazy! Make sure you can get enough Valium to stop slowly as needed!!!!! The Valium is just as horrible to stop but u just have to go slow !!!!
Hi I been taking Lorazapam for 2, 3 years now and decided it not doing the right thing anymore. My next step..CBD oil! Ive been taking my meds every other day and taking CBD oil in between. I had some nervous moments with anxiety (maybe withdrawel) but so far so good. I get worried when i hear about having to take a long term withdrawel but these are doctors who wont change. I,m not saying there wrong but my only out in my Mind is CBD oil. It,s very promising to see what ailments it has cured or aleviated. Arthritis(yes it helped me with that) alzhiemers, PTSD opiod withdrawel kidneys, liver, depression, anxiety and 50 + more. It is discovered that our bodies are equipped with CBD receptors that react to CBD oil in which they improve the performance of our functions in our body, our brain and many metabolism functions. AlsI am also 68 years old and i,m tired of the drug companies getting over and making us more sick! Rich D.
Why do people have to completely be benzo free to have a happy, productive life. I’d rather be on 1/4 mg Klonopin daily and feel good, than not to have it and feel like committing suicide. The withdrawal sickness is beyond description. At 70 years old, does it really matter if I take my 1/4 pill daily? It’s not like I’m going to live for another 10 or 15 years. Let people who are dependent and NOT requiring an increase in medication live a normal life without outside interference.
You’ll develop tolerance to even this 1/4 of your drug. What will you do then? If the withdrawal issues end in, say, 6 months, think of quitting imo.
Carol, your point is very much in accordance with Ashton’s opinion: Anyone who is currently happy taking benzodiazepines should never be forced off the drug. This is a personal decision. It is not known who can or cannot successfully come off of benzodiazepines. 10% of Ashton’s 300 or so patients were unsuccessful and she does state that suicides have been reported in the literature. Most certainly suicides are reported in every benzodiazepine internet support group. Every individual who decides to come off of benzodiazepines or any other psychotropic must factor the risks versus the benefits and make their own decision.
Thanks Mary you are so right, everyone is differant. However it hasnt been helping in the last 6 months so i,m leaning on CBD oil. Please read my last responses to other comments. Thanks Rich D.
You can become tolerant to this Drug and have to keep going up on it for it to help you anymore. You can’t keep going up.
I have been taking Teva clonazepam for 23 years at 2 mg. Daily. Teva no longer sells the medication, and the substitute made by another company makes me feel worse. I would like to know more about tapering, as I have no understanding of how to do this correctly.
Hello
I’m confused. I’m at 8mg valium. When cutting 10% every 2 weeks it starts off looking like this:
8
7 – 12.5%
-.7
6.3 – 10%
-.63
5.67 – 10%
-.567
5.10 – 10%
-.510
4.59 – 10%
-.459
4.13 – 10%
How does one get to each of these odd sized doses?
I appreciate your help.
Dave
One of the major problems covered here is dosing preventing safe withdrawal: https://benzoinfo.com/2018/02/06/why-currently-available-benzodiazepine-dosages-prevent-safe-withdrawal/
Some suggested ways can be found here: https://benzoinfo.com/2017/10/09/benzodiazepine-tapering-strategies-and-solutions/
Thanks for the info. Do you have info with specifics answering my question above. How do I dose fir instance 5.67?
And Dr Ashton’s drops on her schedules aren’t 5-10%. If I’m not mistaken. Still trying to find a plan to drop 10% every two weeks from 8mg valium. The numbers I come up with are 5.67,4.13 etc. hope I’m being clear.
It’s explained on tapering strategies page. You need a 0.001 g scale or a compound.
Dave it shouldn’t make a difference until you are almost done with the taper and then just maybe. if you are tapering from 10mg just cut 0.5mg every 2 weeks until 5mg then cut .25 until. 2mg. The worry about smaller cuts, but you’ll be 805 done by then.
That taper rate suggested by Yoman is too fast and it does make a big difference.
Yo
That’s way tooooo fast . Perhaps you don’t have sensitivities to taper . Please reconsider your amounts and references.
I know this is old message, but it may help others.
If you bought a cheap milligram type scale off ebay, you can cut up the pills and weight them, so when 5.67mg is needed just weight it out….
I have gone through this and I used a compounding pharmacy to take my pills and powderize them and suspend them in a liquid, it was real easy to dose out even 0.05mg! Due to the fact that the solution I got was very “watered down”, it was done using a syringe. For example 100cc of liquid may contain 10 mg of drug, so taking 1cc or 1cc/100cc would mean you took 1/100 of 10mg of drug or 0.1mg, then when you need to taper even less get 100cc with 5mg of drug and then each cc has 0.05mg…. its very accurate this way!
No do you not follow that 10% rule that’s BS the Ashton manual is OK but it’s not for a lot of people. If you want to do this successfully go to YouTube and type in crazycanuck Watch all four of his YouTube videos and follow his method he was taking 1 mg of clonazepam which is equal to 20 mg of Valium he’s been off now for 15 months now and he has had zero with drawl symptoms this allows you to make microdose in reductions if you do start to feel some type of with drawl symptoms you hold at that point I am following his method and it’s better than the ashen manual remember don’t use the percentage use the ML method please watch his videos I tried the action manual it took me a year to get off of my Valium and then on the 15th Day I started to have severe withdrawal symptoms I had to be reinstated now it’s going a lot better zero with drawl symptoms following the crazycanuck method.
My primary doctor just packed up and closed his office.Stopped taking my insurance anyway.Have went to 2 different new doctors that accepts my insurance. None would fill my prescription for Klonopin 0.5 mg once a day?? Been taking same dosage for 6 years.. Now I’m out with no where to turn?? Want to taper off this crap,but nobody wants to help?? Any advice?? I know there getting heat to quit prescribing this stuff ?? Shouldn’t they at least help you taper?? Not cold turkey?? So much for the oath they take??Sure could use some help?? Can’t keep taking off work driving from doctor to doctor to refill this crap so I can taper off of it!!!
How awful. Check out our resources https://www.benzoinfo.com/resources there’s support groups and doctors willing to help patients taper on there.
Thank you!! I will..
BIC. There are no Drs listed for where I live which is CT🙁 Can anyone help??!!
Hi. I also live in CT and need to find a doctor to assist me taper. Just wondering if you found one yet?
When either of you find one please let us know if they’re reasonable and willing to be listed! https://www.benzoinfo.com/doctors/
I had one dr. In CT who supported my taper many years ago but knew nothing about how to do it. I followed the Ashton Manual but it did not work. As a PhD in Biopsychology as of June 2019 I know of no drs. in CT who supervise a taper. I even tried a “detox” facility in Florida who didn’t know what they were doing. BIC resources list a few drs. in a few states but none in CT. 😥
Is there any way to force someone to taper off the klonopin, as my nephew has been hospitalized over 3 times in the past two months, he is now in matc, ordered sectioned by a judge. I’m sure he is suffering severe withdrawal symptoms, hallucinations, paranoia, rage, lost 80 lbs in six months, and more, our family is hoping the treatment center will taper him, because he is acting psychotic, but he is in such denial, and so stubborn, his life is in shambles, he is suicidal also. Currently he is prescribed suboxone and klonopin, but he cannot manage his own meds as he is out of his mind. He has been prescribed Xanax adderall, adavan, Valium, and other meds for over 15 years. We’re at a loss on how to help.
My doctor has now prescribed Clonazepam in liquid form, so I have more options and the ability to reduce at 10% a week as suggested in the Ashton Manual.
Right now I’m trying to stabilize after reducing my morning dose from .25MG to .125MG on May 24, then reducing my evening dose just one week later on May 31 from from .25MG to .125MG; so I updosed my evening dose back to .25MG on June 5… so I’m loosely giving myself 3 weeks to stabilize continuing using the Clonazepam tablets before transitioning to the liquid Clonazepam the week of June 25… probably on June 28. Even after speaking with the pharmacist I have some questions as now I have more options as it seems.
Do I stay at the current morning and evening dosages and do the liquid equivalencies (morning 3.3 mL, evening 6.7 mL), which is 10 mL a day… or do I make it simpler (as stated by the pharmacist) and just take 5 mL in the morning and 5 mL in the evening?
Also, going forward, when I do my weekly 10% reductions, do I do an evening reduction one week, then a morning reduction the next week, etc.; or do I reduce the morning by 5% and the evening by 5% (as stated by Jim) so both are reduced by the same amount each week?
In addition, the pharmacist said he went over my list of current medications and said he believes I would have reduced withdrawal and anxiety if I used CBD Oil — he brought this up; he said he recommends trying it at 1 mg doses as needed. He also recommends using L-Theanine at 200 mg, 2-3 times a day for anxiety and withdrawal symptoms. He said the amount I’m getting from drinking decaf green tea is minute. Thoughts and insight on this are greatly appreciated.
L-Theanine will not help, and more likely to hurt. Some people have success with CBD oil, some are worsened by it. Check out the resources at https://www.benzoinfo.com/resources
L-theanine hasn’t helped me, personally, during any type of taper be it sedatives or cannabis. It’s not necessarily a stimulant, but it seems to make my inner voice sort of hammer on and on in deep focus, and I really don’t want to be focusing inward so much for hours. People are different though and may not notice anything, or it might help them get into the right place, you won’t know until you try it, and if you can, trial a very small test in very small portions. With pills, breaking off a small piece (if not time released!) or pouring out some powder from a capsule is a good way to go. I like that for supplements/vitamins/herbs in general since I’ve had mostly bad reactions that I wouldn’t otherwise have outside of withdrawals. With that being said, with everything being on the fritz things could go any direction, any time it seems. Sometimes I’ve found myself to like foods or doing certain things which were the total opposite of what I preferred before. It’s a reminder of how powerful and intricate we are inside down to a microscopic level.
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On CBD… TL; DR: CBD has helped me on all the major fronts (sleep-regulating and quality, pain, anxiety, nutrient absorption), just give it time and trial hemp CBD products. Be prepared to spend $30-100+ on some products, but for me, they’re completely worth it and may be helping me get through this third taper and very possibly the last.
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I tried only hemp CBD, to ensure no ingestion of THC since I’m quite sensitive to THC at this time. After some trials for the last 3~ months, I have found significant relief on 3 major levels. First of all, I want to say in the beginning when I take anything new, I tend to get anticipation anxiety in general, so this can sometimes skew the results in the start. Take that into consideration if you do feel some anxiety come up and try to work through it if you can with breathing and reassuring yourself you’re safe and will be okay. If not, at worse, you can wait it out or see a doctor but you will probably already be able to calm down by the time your name get’s called in the waiting room and you could just be laying in bed or relaxing at home for all that… CBD is best used consistently, letting it build up in our system for at least two weeks to get a better gauge on if this is something you find helping you. CBD first noticeably helped me with sleep. I felt like I had something I could take to relax that wasn’t going to cause adverse effects, a new dependency, and is working naturally WITH my body, actually helping to guide it to natural homeostasis. I would suggest looking up the role the endocannabinoid system in the body plays…it’s about as complex and spread out as our GABA receptors, which this also will not tamper with. Some things like chamomile even are gabaergic, being it won’t help the GABA receptor recover as it too is acting as an uptake regulator continuing the cycle of your brain is dependent on something else to regulate GABA. No beuno. Not only could I nod off without feeling like I needed a benzo before bed, the sleep was SOLID, like, 8 hours of deep quality sleep. I looked it up and it turns out it does improve the quality of sleep, so not just sleep, but deep healing type of sleep. I know many people have insomnia going through the taper, and I’m not on the lowest end yet or off, but I don’t see why this wouldn’t be of help on some level as opposed to nothing. It’s not going to knock you hard like a Seroquel or something, it just feels subtle, yet natural. Whew, moving on, pain. There is so much weird pain ranging from weird nerve signals to aches of inactivity or the pains that come with depression and being in such a horrible slump in life. You might not be eating the best so your inflammation is up. Prior injuries or arthritis is compounded. It took me some time to notice the pain management qualities. I’ve tried products ranging from the tincture drops, pure concentrate pastes (both raw and decarbed CO2 extraction), pure isolate, CBD ediles, and Plus brand CBD oil capsules. I personally avoid coconut/MCT oils as they can upset my stomach and be stimulating. I aim for a pure form, the concentrated paste (nothing added), and if drops, I go with just hemp oil and CBD hemp infusions, as long as there’s no coconut I’m good.
So far the best way for me is taking the Plus CBD capsules, 15mg each. This gets all the way through my body and I noticed, finally, CBD is the ONLY thing to ever cut through nerve/neuropathic type of pain. I take 1 when I wake and don’t take too much because I can get a bit too tired by noon and need a nap which messes with my sleep schedule. I must say though if I do mess up on my sleep I can usually fix it in a day or two easily with extra CBD. Extra won’t hurt once you’re on a solid regimen with no negative effects. If anything I just get more tired, but that’s preferred to pacing around in panic and wanting to crawl out of my skin. So that’s sleep, and pain, two very big complaints during taper. Then we have the elephant in the room, anxiety. So far it’s something I have felt take a panic attack from a 9 to a 4 in a couple of minutes with some belly breathing. For these occasions, I use the sublingual method with the drops or paste. It works well for on the spot anxiety pangs, it won’t knock you down but you will notice it’s better than nothing at all. It seems to mostly keep things balanced, but not 100% and I couldn’t expect that during a benzo taper. No other medications have helped and often make things worse, but CBD is like that missing supplement that is natural and so safe compared to other pharmaceuticals that could worsen or cause NEW symptoms. Ugh, enough with the psychiatric drugs already. Some extra bonuses I discovered were it helps me to stay calm and cool. I have quite a temper, especially around PMS time, and mood swings with tapering. On CBD I rarely yell, my partner noticed as well. Just realized it one day like, I haven’t been infuriated by some stupid thing in 2 weeks straight. For me that’s big, huge, and such a relief for others I’m sure. Finally, not to say this is it with the miracle stuff, but, if you didn’t know, benzos block nutrient absorption, among other things. I am skinny, but booooy did I waste away on klonopin. I could feel my body falling apart, I felt 80 years old, I’m 30. I was prone to injuries and couldn’t do as much at work at one point. I could just feel that unhealthy feeling where I felt so frail no matter how much or good I ate. With CBD, and incorporating more vitamins gradually, I feel less frail. I feel stronger and I looked it up, guess what? CBD increases nutrient/mineral absorption! It’s a miracle supplement for this situation on many levels. You may not feel it take away all of your troubles, but wow, I haven’t found something natural, that covers so many bases, in a way that is so beautifully harmonious. CBD products are not cheap, but they are 100% worth every penny you can scrounge up. They may be cheaper than some other alternatives, snake oils, and nutraceuticals and DVDs etc… I’m not wasting my time with anything else at this point. I feel CBD may have not only offered me a life raft out of this pit of hell, but a new way to manage my anxiety going forward.
Hi. I have heard of using the CBD as well….actually your post is the only thing i have read that actually gives me hope. Im a single mom and i really think this would make my taper easier. I have heard of it but im at a loss as to where to buy it or how to buy it and what brand? Please help me with that information. You would be saving a life. Thank you
So this was 9 months ago? Did u make thru your taper? And how are u now?
I have tried CBD Oil even with THC as well as L-theonine and they did nothing to help me. Resources listed by BIC are very very sparse.
Mark. If you go to benzo.alwaysdata.net you’ll find a different methods of tapering.one is liquid. With the help of your farmacist you can put the numbers and you have the option of what percentage you want to reduce or qty. The good thing is that you can produce a spreadsheet where you can reduce daily (most recomended)you can figure also if you want cut and hold. Have a look is going to help track your progress. Im in the same bote like you. Im at 0.375 of clonazepan and is getting tougher to cut the pills. So im switching to liquid and tappering daily reduction. Not stated yet. Kind of anxious how it will go. But ill do my best to get rid of this poison. Let me know how it goes.
How are you doing miguel
I was put on Valium at age 15 approx. I am now 66yrs. I tried to withdraw many times,many years ago…with groups, it was cold turkey then but I was younger, however, I always felt tapering slowly was better.
I suffered fits and ended up in hospital only to be…..yes, you guessed correctly, put back on Valium again.
I currently take 10mg daily to keep withdrawal at bay. I feel after so many years it is deeply ingrained in my body and mind. Is it worth the protracted withdrawals? I have made attempts to wean off SSRIS but have suffered greatly with rebound depression. The withdrawals themselves , I was able for [although I had to keep saying to myself, this is not you, this is the tablets].
Hi, I was once put on upward of 10 1mg Ativan per day by a bad doc. I have PTSD & Major Depressive Disorder as well as a host of physical ailments-including post cancer-all physical since this event-the doctor decided he wasn’t going to refill my prescription, so I knew it wouldn’t be good but I just went with it. On 3rd day with no sleep I woke or began to full on hallucinate. I saw people in the trees around my house with long guns shooting into my home & no one would listen to me & get down. I kept closing the blinds & running from place to place then my mind would think,”Oh theres a window right there, they can see me. Or I’d be in the pantry huddled down & think, Oh the bullets can pierce this wall.” This went on for so long-during which time the war in Kosovos was going on & I saw refugees walking down my road with donkeys & children & I had them all come into my yard & stay & I gave them all my clothes then everyone got disentery & there were rivers of stool running thru my yard. One night a husband & wife with their children came to me in my room & asked if I could let them hide in the attic & I told them to use the shower & then I’d show them how to get into the attic. I went in & turned on the shower & put down towels & fresh clothes & sat on my bed & waited for hours while the water ran. Finally after several hours I lightly knocked on the door but no one answered so I said “are you okay?” there still was no answer so I told them that I was coming in & I opened the door. The room was empty but was full of steam & the shower running. I saw the clothing there & towels & pulled back the curtain to the shower & no one was there. I pondered it & thought, “Oh they went into the attic thru the ceiling! So they are safe.” Then I went outside where the men refugees hog tied me & hoisted me into the air naked & all began raping me. I looked towards my house & saw my son there with all of his friends so ashamed & blaming me for this mess. I felt worthless & horrid confused & frightened. I wound up back inside & the shooting began as the police had come & chased all the refugees out of the property & the shooters came back. I continued to run from place to place & my sons best friend who’d been over nearly everyday was there & this was into it’s second week. He looked at my partner & asked, “Hey how long are you going to let this go on?” He meant me & my bizarre behavior as he’d get popsicles out of the freezer & I’d run & take them from him mumbling poisoned. I kept screaming & pleading with everyone to please get down or they’d get shot. But no one listened or they laughed about it. Finally my partner talked me into going to the ER after my sons friend said that & I was worried how we’d get to the car without getting shot or my son getting killed when we left. But I trusted him & ran to get into his truck covering my head. As we started to go to the hospital I saw my son in a car headed towards the house & screamed for my partner to stop him. He just blew me off that my son would be fine then I looked back & saw the entire house explode as they’d shot the propane tank. I was screaming then as we got on the road to the hospital I looked at my partner & he looked like one of the shooters exactly & I opened the door & tried to jump out but he grabbed my arm just as I was going out. We got to the hospital & I saw the shooter raping a nurse on the lawn where we’d parked & as they were doing intake I saw him approaching the doors to the ER. I ran into the ER & into a room (I used to work there) I blockaded the door with equipment because those people behind the curtains were shooters too. The nurses knew me from work before & pounded on the door begging me to open it & I kept asking how do I know it’s really you and not the shooters? Finally I let one of them in. An old friend. I told her in a moment of clarity about the Ativan dosage & what had happened then I’d snap right back into the hallucination. She asked me to leave the door opened & I told her why I couldn’t & she went to call crisis who came over & interviewed me & didn’t believe me & just thought I was psychotic but gave me a 1mg Ativan which didn’t help. Then I again blocked the door as they called all of the local hospitals to see if they had a place for me but every hospital refused to admit me saying I’d destroy their facility-only one 3+ hours south of me said they’d take me but it’d take multiple ambulance transfers to get me there. During the ride I thought we were being put in protective custody & we’d all be reunited in Texas. However I remember arriving at a facility strapped down & explaining what was happening & why in another moment of clarity only to be injected with a ton of heavy psych meds & I remember nothing until the day they took me out of the watching room & allowed me in the day room with my hands shaking so uncontrollably I couldn’t feed myself. I found out later from their notes that for nearly 2 more weeks I was in that room being watched day & night as I “literally tried to climb the walls”-their words. I was abandoned their by my partner who kept my child & wound up their for 2 months as I had no one & no where to go. Those hallucinations were so real that they still haunt me the smells the sounds the memories are so real. Then I was in 2 bad car accidents & got Breast Cancer as well as a broken jaw spine injury & head injury & was put on a ton of various meds including 140mg of Oxycontin & 600 4X’s a day of Gabapentin, 25mg hydroxyzine 4X’s a day, 25mg of promethazine 4X’s a day, Baclofen, Valium 5mg at bed, Lunesta highest dose at bed, plus 3 1mg Klonopin a day with a host of other meds. I stopped taking 1 of the Klonopin because I didn’t need it with the Valium at night & never missed it. Then I went into Heart Failure due to my labs being all over the place & fully coded but was revived. There I asked them to cut my pain meds as far as they felt they could safely & they told me I had to take the Klonopin wether I wanted to or not but that they were stopping the Valium & cut my pain meds in 1/2. Since then I have stopped all the other meds except now am down to the last 5mg of Oxycodone & was skipping the morning dose of Klonopin as I didn’t feel like I needed it until I changed my pain med schedule & cut the 5mg in 1/2 taking 1/2 in a.m. 1/2 in p.m. then with the 2 Klonopin 1mg each at bed & 1 25mg Metoprolol for migraines I couldn’t sleep for 3 days & got the worse headache I’ve ever had & couldn’t stop it. So I think I shouldn’t be trying to get off both of them at the same time so I started to take the 1 5mg Oxycodone w/2 1/2 mg Klonopin & 1 25mg Metoprolol so I could sleep but I went into a rage the night I started this before I started it. I punched a window, tried to put my head thru a window, tried climbing out a window when it was below zero, smashed everything I could screamed FUCK YOU! Over & Over & Over until I lost my voice. Then I went into my room & took the meds as described above & slept until 9:24 that morning this past Monday. Then I decided on Tuesday because I was still in a rage & not behaving normally that I should take 1/2 or .5mg of Klonopin around noon but I don’t think I should be taking the rest all at night but am terrified of getting another out of control Migraine. Do you have any advice for me? I am trying to get my life back & when they took the valium away I was in a rage for 2months & lived in the woods in my car alone so as not to hurt anyone or myself although all day I looked for a tree to hang myself on with the noose I’d made off of youtube. Please give me a hand & help me I don’t want to be in a hospital but want to get off this crap & have already had the wearwithall to get off of so much of it. Oh-I did see pain management & they said I had to stop the Klonopin but needed the huge amount of pain meds & their plan was to take a mg away every 3 days so I’d be off of the Klonopin in a bit over a week-I knew that was nuts as I’d just finally come home after the Valium fiasco. Hence my fear of even bringing this up to my doctor or anyone other than the person I live with. I just want life back! Please! Thanks, Bonnie
Honestly, and I am not an expert, but it seems to me that a detox facility or a hospital might be necessary to see you through a detox. That is just my view though. Good luck!
Usually they’re not of help, but harm people. https://benzoinfo.com/2018/04/20/why-prescribed-benzo-patients-shouldnt-go-to-detox-or-rehab/
That did not work for me and Benzo Info.com made up of experts strongly advise against it and since I had first hand experience with a detox facility in Florida (Longview) which only severely further traumatized me!!
Can you please supply me with this information as I am attempting a volume taper and not doing very well at all at this moment I feel like I am dying and don’t think I can make it. Thank you in advance for any information
Hi Lily, Thank You for the information. I will look into it. I got off the narcotic meds easily but then getting off of this garbage has been very challenging especially once I realized the danger my current Dr was putting me in back in Jan. & Dec. when I’d had several appointments cancelled upon arrival at the office & as I was leaving to get to the appointments. Then in July I saw my Dr & he assured me he had called in the prescription & I reminded him that I didn’t need it until the end of the month. He acknowledged this & said it wasn’t a problem until the end of the month came & I called the pharmacy to refill the script. The pharmacist said they’d never called it in & he would fax them & I should call them. I called & left them a message…waited till next day & called the pharmacy…still no prescription & I’m now out of the medication (Klonopin). The pharmacist told me he’d fax them again & to call them again. I called again & let them know about the situation & that I was out. The following day I called the pharmacy & still no prescription again they told me to call the Dr’s office again. I called & now it’s 3 days without medication. I was going with a friend who’d had cancer then to radiation treatments, when I got home I called the pharmacy & was told still nothing. The following day on 4th day the “nurse” called me & said it was called in earlier in the month but because I’d not picked it up it disappeared. This struck me as very strange so I thought I’m calling the pharmacy to see if this is true. The pharmacist was very upset & said to me, ” Listen, they are being super unprofessional. If they’d called that prescription in it wouldn’t vanish for 6months. It’s not a script that need a new one each time.” He asked me if I was going to be home because this was very concerning to him & psychosis can develop as I all too well know so he said he was calling them & would call me back as soon as he spoke to them. I was supposed to go with my friend again to radiation so I told him this & he said to stop on the way home. While at the hospital with my friend I became very sick & lost control of my bowels. When we went back to go home we stopped at the pharmacy & my friend went in to get my prescription for me because I wasn’t feeling well at all & hadn’t slept in days, with bad diarrhea. When my friend went into the pharmacy he was told by the pharmacist the the Dr’s nurse told him that I’d called too many times & was an annoying patient as well as ranting about me for over 20min. He didn’t want to share with my friend all they’d said about me but he thought they were very unprofessional but that he had gotten a “verbal” prescription finally from the nurse. Fast forward this week…I’ve been fighting for 2+ months with the practice which is tied to the local hospital. Yesterday I was having severe heart symtoms & had asked that this “nurse” not call me for any reason or escort me to appointments as I didn’t want to have to play nice when I knew what she’d said & done to my. Then the staff had her call me to tell me to go to the ER. I hung up shaking & sick…3 min later a 2nd nurse called & started an argument with me about the prescription after I was just told to go to the ER for heart symptoms. She 1st told me it was filled & disappeared. I explained that my insurance wouldn’t have filled it early for one thing and that the pharmacy leaves messages on the phone when a script is filled & how long you have to pick it up but this never occurred. She then said it was given to a female pharmacist & named her 1st name. I told her a male got the prescription straightened out for me not a woman. This arguing & upset lasted over 15 min until I hung up the phone on her. Then an administrator called & I went over everything that has happened over the past year & she said the there was a notation in my record that it was called in on the 17th of July which was also a false notation as well as a lie because I didn’t even call the pharmacy until the 19th & it wasn’t until the 22nd in the afternoon that it was finally okay’d by the office thanks to the pharmacist. I stressed to the admin. the repercussions of this for me…the seriousness of holding this over my head & making me go for days without the meds. She kept saying that she didn’t understand-“You did get the prescription right?” I told her eventually but not until going without it for almost 5 days. Then she told me the nurse was not the one who said these things except it was because the nurse told me the same lies as the pharmacist and the administrator was told. I was totally humiliated as well as my mental health put in jeopardy & now I don’t trust them at all & do not want to be on any medications for fear it will be used against me. I have in the past 2 yrs developed substantial MS symptoms & now know I’ve had them for nearly 20 yrs with no diagnosis due to just having symptoms treated while no-one was trying to see why these things are happening to me. I’d been feeling a ton better & every time I cut the benzo I felt better & slept better & I am now down to less than 1/2 a 1mg tablet & hoping my recurrence will begin to subside so I can get off the rest & use a natural med for the symptoms. If anyone has any tips for me please tell me I really appreciate all of your help & caring! Take Care-from 3mg down to less than 1/2 now!!!!! Just keep plodding forward folks,,,life is so much better without this in my system & though it’s not pleasant & has been a challenge I got off of 140mg of Morphine & Oxycodone as well as the blood pressure med & most of the Klonopin that I was on without the help or support of any one but you guys! You can do it if I have…I promise! Hang in!
How are u doing these days?
Bonnie, this post is over a year old. I hope your okay by now. Your partner was an A-hole for abandoning you. The Dr who cut you off cold-turkey 10 mgs ativan should be charged with attempted manslaughter as your lucky you survived. Your brain was damaged from that incidence. I’ve been on benzos for 7 years. A Dr reduced me from 4 mgs Xanax to 2 mgs and within a week added 2 mgs klonopin. He’s kept me year at .50 Xanax since my auditory hallucinations start 24 hours after last dose so now I’m on 5 mgs valium daily equivalent to .25 mg xanax. I’ve landed in psych wards twice for trying to commit suicide. Yeah i was discovered breathing about twice a minute and by a miracle I was found on time. Im sorry but you’ve been let down by the medical community. Don’t go to a detox facility for benzodiazepine withdrawal. They don’t wean patients long enough and it can cause brain damage that takes years to heal. My Dr considers them in-humane as many just rip you off meds and monitor your vitals in case you stroke out. Pish. So even with my history of suicidal depression, Dr shopping, failed urine screens (I’ve been difficult) my Dr still wants me in control of the length of time it takes to come off meds. We know our bodies the most. Sadly some of us are more sensitive to the effects of withdrawal and benzos are dangerous to cut off without tapering properly. Im saying this because I want people to know there are Dr’s who care and won’t allow you to suffer needlessly. My Dr saved a patients life after one Dr cut her off klonopin CT and the E.R Dr refused to help saying he wouldn’t support her addiction. She’d NEVER taken more than prescribed or abused meds. Physical dependence and addiction are seperate. Though I’m both. The E.R Dr wrote her off, sent her home and told her husband the withdrawal could kill her but he wouldn’t contribute to her addiction by writing a script. So just go home and die?? Hypocritic oath VS Hippocratic. My Dr wrote the script and helped her wean off. He also is the Dr who doesn’t judge opiate addicts and prescribes meds to safely withdrawal. Don’t let Dr’s dismiss your concerns. Its our bodies and we need to be our own advocates or find a friend who can advocate for us. Get a new Dr if your current one won’t help. I hope your doing well
Hi Rachel,
I appreciate your candid thoughts on this. I call doctors: Whitecoated Assasins. What NO ONE talks about is that the process of taking anti-depressants and anti-anxiety drugs is that it up-regulates the receptors for the hormone/neurotransmitters that it affects. Therefore, when you wean of the durgs the setpoint for the body expecting Serotonin or GABA or other chemistry is extremely high, so when you fall below that setpoint those excessive numbers of receptors are crying for more that then often pushes the person to take more drugs instead of weaning. That that does is raises the genetic upregulation of receptors so that now you are in a deeper hole then before starting the wean. This is Romper Room biochemistry yet I have never seen any ‘professional’ address this because they want patients for life. Well for as long as the person lives if they don’t kill themselves. Since I am not a doctor I cannot offer any solution to the downregulation of those receptors other than to say that Ashton says that GABA really isn’t the target so supplementing with that is not helpful. Added to the fact that GABA has some influence on growth hormone so it can affect someone with cancer. The strategy would be to find the hormone/neurotransmitter/amino acids specific to the drug damage and use that as a transition from the poison to life-molecules and allow PLENTY of time for those receptors to downregulate on their own so that you can lower and/or quit the poison with the least amount of distress. Anxiety as defined by the Ancient Chinese was to hold your breath. It is hypoxia. If you read the warnings on Valium it says it can cause respiratory depression. That sounds like the drug causes the thing that caused the problem in the first place. It also says it shouldn’t be taken over three weeks. For those who have suffered for decades then you call for charges on what I would call premeditated murder using chemical warfare agents is simply logic that you could teach to a third grader. All my best.