These tips that have been reported by patients. They are not meant to serve as medical advice. These are general guidelines as there are always exceptions.
It is important when seeking assistance with your taper to learn on your own what a safe taper entails. Please read Tapering Strategies and Solutions for more information.
Check out our Doctors List.
See our latest video 10 Tips to Find Medical Help with Benzodiazepine Cessation from Dr. Christy Huff
Be aware of the common prescriber pitfalls in cessation:
- Designing an arbitrary, overrapid taper
- Inaccurate or overrapid conversion to a longer lasting benzodiazepine (See Ashton Manual Equivalence Tables and Diazepam Crossover Schedules)
- Oversized reductions (see Why Currently Available Dosages Prevent Safe Withdrawal)
- Overrapid taper rate (greater than 5-10% per month of current dose)
- Add-on medications interfering with GABA
- Check our doctor list. We have compiled a list of those that may be able to assist in a taper. The list is composed of either volunteers to join or professionals who received positive feedback from other patients. Being on this list does not mean they will be fully educated on deprescribing. It does mean they will likely be open to following a taper you design. They normally will not be able to help with any protracted issues post cessation.
- Most doctors are undereducated about benzodiazepines in general. Temper expectations. Patients frequently find that they have to do most of the work to successfully get off their benzodiazepine. Many doctors will engage in sudden cessation, refer to detox (we oppose detoxes) or demand strict adherence to an arbitrary, overrapid taper. This behavior is frequently found in doctors over-focused on deprescribing. These types of doctors tend to be younger. With more updated training than some doctors, they have learned benzodiazepines are dangerous, but not that cessation can also be extremely dangerous when attempted under any condition.
- Psychiatrists and addiction specialists are, counterintuitively, often not educated about benzo harm, slow cessation, severe withdrawal effects, benzodiazepine withdrawal syndrome, microtapering or protracted withdrawal risks. These specialties tend to misdiagnose withdrawal symptoms as new mental illness and prescribe more psychotropics.
- Medications like gabapentin, lyrica, clonidine, buspar and antidepressants can create their own physical dependence and withdrawal issues, and interfere with GABA and healing. They also lack evidence for cessation. The British National Formulary guidelines advise against these medications for benzodiazepine cessation.
- Consider more than just M.Ds. Osteopaths have the initials D.O. after their names (in the US). They are sometimes more inclined to help as they are trained differently. Functional medicine doctors, or the like, may be similarly trained and helpful. Some Nurse Practitioners (NP) and/or Physicians Assistants (PA) may be more open minded to new information.
- Consider the original prescriber, GP or family doctor. They already have a relationship with the patient and may be more flexible.
- Get a referral! Call the local compounding pharmacy and ask for a recommendation. They may know what medical prescribers in your area have prescribed compounded liquid benzodiazepines for other patients to use in tapering. Ask a therapist. Join online benzodiazepine support groups and ask around about your area. These groups can be very large and nearly everyone in there has a prescription from someone.
Before Your Appointment
Get educated first. Be sure you have absorbed as much information as possible and have a good idea of what taper you wish to try. Read Tapering Strategies and Solutions. Join Beating Benzos on Facebook and ask for a free taper plan.
Be prepared to discuss your plan.a. If asking to crossover to Valium, it is critical that you understand why Dr. Ashton recommends the Valium taper as many doctors are resistant to prescribing it. (Valium has a much longer half-life than most other benzodiazepines, allowing for a ‘smoother’ taper AND is delivered in 2mg, 5mg, and 10 mg doses, as well as manufacturer liquid formulations, making it possible to make smaller reductions). You will also need to be familiar with the crossover equivalents, etc., which can be found in the Ashton Manual. An Ashton based online conversion tool can be found here.
If you wish to taper directly off of the benzodiazepine you are currently taking, as opposed to crossing to Valium you can cite the British National Formulary guidelines.
Bring visuals. Consider:
a. The Ashton Manual
b. Tapering Strategies and Solutions
c. Withdrawing Prescribed Benzodiazepine Patients Pamphlet
d. BNF guidelines
To avoid overwhelming your prescriber, only highlight and print only the parts they may find relevant.
Keep it brief and easy to understand.
a. Appointments are short. Medical professionals do not want to hear a long story as they are very pressed for time
b. Approach the prescriber loaded with all the knowledge you can, but keep your presentation simple and precise.
Have your suggested taper schedule ready and appear confident about it. This indicates to your doctor that you are serious about this, that you have a plan, and that they don’t have to come up with one for you (as they might not know how).
Stay on topic. Avoid getting hostile or angry or upset. Don’t overreact. If the doctor says something you don’t like, listen and state your objection firmly but nicely. This is not the time to go on a rant about how dangerous and horrible these drugs are! Also, if you mislabel yourself as addicted as opposed to physically dependent, the doctor will probably treat you like an addict (with suspicion, refusing to prescribe or assist you). If the prescriber seems hesitant, offer to come in weekly or monthly. Be willing to take a drug screening. This will often calm the prescribers fears about prescribing Valium or other benzodiazepines.