Harm Reduction Tapering Plan Mega thread - community project

[Colmes]

i know the standard for medical benzo detox is to switch the user over to valium but i thought your infor with % and mg one should prob taper with for minimal discomfort on the first page was great but should maybe contain similar information in regards to maybe a couple, atleast one other popular benzo (xanax. if not others like k-pin. i mean u dont need on for every benzo but the big three, maybe dig 4-5; ie ativan, temazepam)

my 2 cents

Alright i'll try and answer some questions.

Assuming of course you are legally on benzos (you being anyone), first step is to get off of benzos like Xanax, Ativan I know is short acting, ) and ... temazapam isnt used for long periods of time - I think the limit is one month in the U.S.? Thats what my doctor said - I always thought it was just illegal. Clonazapam (klonopin) is also a long acting benzodiazapine, but not as long acting as diazapam (valium). That being said, if you've been on clonazapam for years, that would probably be the one you'd taper with.

What im trying to say is, you (again, you being anyone) can't taper off of benzos using fast acting benzos such xanax, or ativan (temeazepam I dont think really is ever considered) - and i will quote this bit of info regarding ativan


"The likelihood of dependence is relatively high with lorazepam compared to other benzodiazepines. Lorazepam's relatively short serum half-life, its confinement mainly to the vascular space, and its inactive metabolite results in interdose withdrawal phenomena and next-dose cravings. This may reinforce psychological dependence. Because of its high potency, the smallest lorazepam tablet strength of 0.5 mg is also a significant dose reduction"


Certain benzos are just better for tapering than others. A medicines half-life does not reflect on how long its therapeutic effect is - but rather - how long it remains detectable in your body (Think smoking a lot of pot, and having it be in your system for 30 days).

I'm just a psychopharmacology student. I know a good deal about medications, but there are definitely other opinions out there, and people much more knowledgeable about actual benzodiazapine titration / what medications can aid / and what to expect life to be like.

 

[Pegasus]

^Well, just to add to the idea of tapering off with clonazepam, I will mention that I did it and it wasn't too difficult (besides the horrible trembling), although I did go really slow. Professor Ashton mentions that clonazepam can be especially hard to withdraw from and even goes as far as to recommend compounding pills with very small reductions in clonazepam, but I'm sure this would only be for a very small percentage of people who have been on for considerable time. All this said, I still believe diazepam is superior for tapering purposes, but think it's worth a mention that a clonazepam taper was workable for me.

Edit- I'll add a rough timetable of how I withdrew from clonazepam, for the crucial part, at least. It wasn't difficult for me at all except for the period of time after dropping under 0.5mg/ day.

To get to 0.5mg/ day, I dropped by 0.25mg every 10 days or so from 1.5mg/ day. This was relatively easy, and I found that I was still having substantial effects on my anxiety (and sobriety for that matter) all the way down to around 0.5mg and slightly below that, even. Once I got to 0.5mg a day, I started decreasing by 0.125mg every 10 days or so (0.125mg = 1/4 of a 0.5mg tablet), until I was just taking the 0.125mg every day. From there, I started gradually placing days in between taking my 0.125mg. For example, I would take every other day for a week, then every third day, then every fourth. By this point, the amount of clonazepam in my system was miniscule and I was facing the majority of the w/d symptoms already, but I believe the reason they never got too intense was because there was always a tiny amount of clonazepam in my system. When I finally stopped taking clonazepam altogether (0.125mg every fourth day was the lowest I went), I had no perceivable withdrawal symptoms whatsoever.

Like I said, it worked very well for me, but I know everyone is different. In this case, I would have certainly switched to diazepam to taper if it was possible, but my sources for benzos were all illicit, and thus, my options were limited. I'm sure there are others in this situation, and this is for them, in the hopes that it works as well for them as it did for me.

 

[Colmes]

^Well, just to add to the idea of tapering off with clonazepam, I will mention that I did it and it wasn't too difficult (besides the horrible trembling), although I did go really slow. Professor Ashton mentions that clonazepam can be especially hard to withdraw from and even goes as far as to recommend compounding pills with very small reductions in clonazepam, but I'm sure this would only be for a very small percentage of people who have been on for considerable time. All this said, I still believe diazepam is superior for tapering purposes, but think it's worth a mention that a clonazepam taper was workable for me.

Edit- I'll add a rough timetable of how I withdrew from clonazepam, for the crucial part, at least. It wasn't difficult for me at all except for the period of time after dropping under 0.5mg/ day.

To get to 0.5mg/ day, I dropped by 0.25mg every 10 days or so from 1.5mg/ day. This was relatively easy, and I found that I was still having substantial effects on my anxiety (and sobriety for that matter) all the way down to around 0.5mg and slightly below that, even. Once I got to 0.5mg a day, I started decreasing by 0.125mg every 10 days or so (0.125mg = 1/4 of a 0.5mg tablet), until I was just taking the 0.125mg every day. From there, I started gradually placing days in between taking my 0.125mg. For example, I would take every other day for a week, then every third day, then every fourth. By this point, the amount of clonazepam in my system was miniscule and I was facing the majority of the w/d symptoms already, but I believe the reason they never got too intense was because there was always a tiny amount of clonazepam in my system. When I finally stopped taking clonazepam altogether (0.125mg every fourth day was the lowest I went), I had no perceivable withdrawal symptoms whatsoever.

Like I said, it worked very well for me, but I know everyone is different. In this case, I would have certainly switched to diazepam to taper if it was possible, but my sources for benzos were all illicit, and thus, my options were limited. I'm sure there are others in this situation, and this is for them, in the hopes that it works as well for them as it did for me.

Interesting feedback - I know, diazapam is choice #1 for titration. However, two questions for you;

1. Since your source was illicit, did you use clonazapam for recreation? or genuine anxiety (have you ever been to a therapist and been diagnosed with anxiety, does it interfere with your life etc...? This can have a major impression on the condition of the patient after tapering off fully. Anxiety for some comes back on twice fold - literally making life almost impossible to be productive in (benzodiazapine withdrawl syndrome)

2. How long were you on them? 1 month? 4 months? 4 years? This has such a huge impact on your ability to taper. If you were on them for 2-3 months - well yes, it is going to be difficult when tapering - but your risks for seizures wont be the same, your rebound anxiety wouldnt be as bad as if you have been on them for years - as over time, year by year, it changes your brain chemistry. When you quit - I think the amount of time you took the medication plays a major role in the amount of time it takes for you to feel okay again.

Lets be logical, doesnt my last sentence apply to any recreational-addicting drug? Nicotine, speed, opiates,dissociative;s, alcohol etc etc

 

[Pegasus]

Regarding my largest experience with the subject:

1) Yes, I was diagnosed for anxiety, but the line is kind of blurred between recreation and general usage. That isn't to say I didn't genuinely have anxiety, because I certainly do; it's just that I took more than necessary at times.

It's really hard to qualify how I used benzos. I'd often like to take them before going out and being social, but really that goes for a few other drugs, too. I think the similar thread between the drugs is that I prefer to interact with people when intoxicated.

2) I was on for approximately one year of daily dosing, and a good six months before that of dosing maybe 1/2 of the days. I took alprazolam for all of the first six months and started phasing in clonazepam right at the beginning of that year of daily dosing.

The length of time addicted is certainly a huge variable in the degree of the addiction, as is the strength of the dose. This said, I believe the key differences in the type of tapering needed between the two is going to be time. Moving my dose down wasn't too difficult for me at the rate of 0.5mg per decrease, but it would likely be difficult for someone who has been on for longer and at a lower dose than me. For these people, the answer seems to be that the decrease needs to be smaller to avoid much of the discomfort.

 

[Colmes]

Regarding my largest experience with the subject:

1) Yes, I was diagnosed for anxiety, but the line is kind of blurred between recreation and general usage. That isn't to say I didn't genuinely have anxiety, because I certainly do; it's just that I took more than necessary at times.

It's really hard to qualify how I used benzos. I'd often like to take them before going out and being social, but really that goes for a few other drugs, too. I think the similar thread between the drugs is that I prefer to interact with people when intoxicated.

2) I was on for approximately one year of daily dosing, and a good six months before that of dosing maybe 1/2 of the days. I took alprazolam for all of the first six months and started phasing in clonazepam right at the beginning of that year of daily dosing.

The length of time addicted is certainly a huge variable in the degree of the addiction, as is the strength of the dose. This said, I believe the key differences in the type of tapering needed between the two is going to be time. Moving my dose down wasn't too difficult for me at the rate of 0.5mg per decrease, but it would likely be difficult for someone who has been on for longer and at a lower dose than me. For these people, the answer seems to be that the decrease needs to be smaller to avoid much of the discomfort.

Well you certainly were on them long enough to feel the hurt - glad you were able to taper off. How long would you say (truly) it took for you to feel as close to "100%" as you could feel, after taking your final dose?

 

[Pegasus]

^I felt nearly 100% as soon as I quit. (Maybe 85% ) As I was describing in the section of skipping days between doses over the last few weeks, most of the w/d symptoms came in this period. Once I quit, I did not have any perceivable negative feelings or attitudes, and only minimal headaches and tremors (hard to say that those were necessarily from w/d, honestly). Once off, I also began exercising much more intensely and got in pretty good shape, so around a month after the last dose, I felt really great overall. It's hard to say what the extent of the withdrawal during that month was, but it certainly wasn't debilitating in any way. More than anything, it was just my mood that seemed to brighten over time.

Oh yeah, the withdrawal's effect on anxiety... I should mention that, I guess! IME, I didn't really get noticeable rebound anxiety, though some old anxiety patterns have seeped back into my life over time. I feel more in control of them for the most part, though I still avoid many situations that I know to be stressful. I can't really say how much this is due to the benzo usage.

 

[Colmes]

^I felt nearly 100% as soon as I quit. (Maybe 85% ) As I was describing in the section of skipping days between doses over the last few weeks, most of the w/d symptoms came in this period. Once I quit, I did not have any perceivable negative feelings or attitudes, and only minimal headaches and tremors (hard to say that those were necessarily from w/d, honestly). Once off, I also began exercising much more intensely and got in pretty good shape, so around a month after the last dose, I felt really great overall. It's hard to say what the extent of the withdrawal during that month was, but it certainly wasn't debilitating in any way. More than anything, it was just my mood that seemed to brighten over time.

Oh yeah, the withdrawal's effect on anxiety... I should mention that, I guess! IME, I didn't really get noticeable rebound anxiety, though some old anxiety patterns have seeped back into my life over time. I feel more in control of them for the most part, though I still avoid many situations that I know to be stressful. I can't really say how much this is due to the benzo usage.

Thanks for the reply, sounds like you got out of the situation arguably pretty lucky. Just considering seizures, death, and the withdraw syndrome, which can last up to a year or more, didn't occur. Well, its nice to hear you got your energy back, I miss having as much as I used to.

 

[Pegasus]

^I would definitely agree that it was arguably pretty lucky. However, I do believe the very slow rate of tapering, especially over the last 0.5mg clonazepam, helped considerably. I've had withdrawals before from only a few months of usage that I remember being much worse, with considerable rage and insomnia. I didn't taper those times like I did this one, though!

 

[Colmes]

^I would definitely agree that it was arguably pretty lucky. However, I do believe the very slow rate of tapering, especially over the last 0.5mg clonazepam, helped considerably. I've had withdrawals before from only a few months of usage that I remember being much worse, with considerable rage and insomnia. I didn't taper those times like I did this one, though!

aye, A lot of times, when people want to quit a drug they want to QUIT

like throwing away your ciggarettes, never buying an oxy again, getting off benzos doesnt give you that luxury of "well, at least i'm off them" - so yeah, long and arduous taper, especially the last .5mg of kpin ;]

 

[HighonLife]

Alright i'll try and answer some questions.

Assuming of course you are legally on benzos (you being anyone), first step is to get off of benzos like Xanax, Ativan I know is short acting, ) and ... temazapam isnt used for long periods of time - I think the limit is one month in the U.S.? Thats what my doctor said - I always thought it was just illegal. Clonazapam (klonopin) is also a long acting benzodiazapine, but not as long acting as diazapam (valium). That being said, if you've been on clonazapam for years, that would probably be the one you'd taper with.

What im trying to say is, you (again, you being anyone) can't taper off of benzos using fast acting benzos such xanax, or ativan (temeazepam I dont think really is ever considered) - and i will quote this bit of info regarding ativan


"The likelihood of dependence is relatively high with lorazepam compared to other benzodiazepines. Lorazepam's relatively short serum half-life, its confinement mainly to the vascular space, and its inactive metabolite results in interdose withdrawal phenomena and next-dose cravings. This may reinforce psychological dependence. Because of its high potency, the smallest lorazepam tablet strength of 0.5 mg is also a significant dose reduction"


Certain benzos are just better for tapering than others. A medicines half-life does not reflect on how long its therapeutic effect is - but rather - how long it remains detectable in your body (Think smoking a lot of pot, and having it be in your system for 30 days).

I'm just a psychopharmacology student. I know a good deal about medications, but there are definitely other opinions out there, and people much more knowledgeable about actual benzodiazapine titration / what medications can aid / and what to expect life to be like.

While i appreciate the time and attention you payed to my post. the reason why i did it was not for my own benefit. i am not addicted or dependent on benzos. your info is good but my reason for posting was that i felt that the info i asked about should be on the first page with all the other info.

im not trying to be rude, and i do appreciate your reply but my post was basically a critique of the OP and not so much a question for myself. i dont think as many people who will look at the 1st page and 1st post will go on to read through the first couple pages so that is why i say that

anyways thanks all

 

[Colmes]

While i appreciate the time and attention you payed to my post. the reason why i did it was not for my own benefit. i am not addicted or dependent on benzos. your info is good but my reason for posting was that i felt that the info i asked about should be on the first page with all the other info.

im not trying to be rude, and i do appreciate your reply but my post was basically a critique of the OP and not so much a question for myself. i dont think as many people who will look at the 1st page and 1st post will go on to read through the first couple pages so that is why i say that

anyways thanks all

oh sure, np - thats why I said (you - as in anyone) not specifically just you. Just trying to help BL if I can

 

[subox1]

tapering suboxone

So I have been on suboxone for about 2 years now. I have been doing 2-3 mgs a day intranasally. I have recently been forced to quit this habit due to various reasons. I recently attempted to quit without tapering. I did my last 2 mgs in 2 doses over 2 days and then began to detox. After about 40 hours I was feeling like shit and I broke down and asked my friend for 2 mgs to attempt some sort of rapid taper in an effort to ease the withdrawals.
I did about .5 mgs last night at about 7 pm. Today I did about .25 mgs around noon and another .25 mgs at about 11 pm. I am currently down to about 1 mg of sub left. What do you guys recommend for a tapering schedule for my remaining 1 mg? I would like to do this with the least amount of w/d's possible. Am I wasting my time? Should I have just toughed it out after making it 40 hours or will this rapid taper really help? How long should I expect the worst of the w/d symptoms to last? Thanks in advance for your response.

 

[Pegasus]

^Personally, I'd definitely use that last 1mg and just do a tiny bit like you have been whenever you start having bad w/d symptoms. The withdrawal is so drawn out with bupe that quitting all at once is likely going to be a long and unpleasant process. 1mg is a decent amount actually, and it will certainly help make your withdrawal more tolerable. Just use as little as possible and stretch it out as long as you can. Good luck.

PS- I did the exact same thing as you, except my original dose was slightly smaller. It wasn't pleasant, but I imagine it would have been much worse had I not been able to do a rapid taper like this.

 

[Pegasus]

Okay i've been using diazepam sporadically since early december 2009 using anywhere between 2.5 mg to 30 mg per day. However even though i have not taken a dose every day i know that 3/4 day breaks are no good due to the very long half-life of the drug.

Annoyingly this past 7 days i've had a nasty flu like bug called norovirus & have taken about 40mg since then just to give me some comfort & help me rest- the last 2 days i've had about 10mg in divided 2.5 mg doses. Now i am quite ashamed of myself as i think i may have swan into the deep end where i will suffer. I know rebound effects can be an issue, i have 10mg in my bathroom that has been there for ages as a real emergency type insurance.

My general questions are if it is okay for me to stop cold turkey? & is 6-8 weeks of 2/3 day a week use enough to put me in the physically addicted class?

I'm fully aware that alot of people have it worse 7 this is small cuttings but i'm really just trying to reduce harm to myself physically & mentally.

Thank you everybody in advance & no negatives please.

I don't know how this post was missed... Anyways, it's good that you were only taking for 2-3 days a week because the daily dosing is generally where you are going to have problems. This said, diazepam lasts forever in your system and may have never cleared out completely between doses. In this case, you may have some minor w/d symptoms (maybe like trouble falling asleep, minor agitation, etc.), but they shouldn't be too bad IMO. You have that one 10mg tab, and you can probably split that in half and take that on two occasions if you are having trouble. Hopefully, though, it won't be too bad at all.

 

[subox1]

Cool thanks bollweevil. Yeah that is what I am attempting to do. It is amazing how the smallest bit of bupe will keep me from w/d so I am just trying to do the smallest little amount whenever I begin to feel a bit sick.

 

[SteveVe]

Hydrocodone tappering program...thoughts for me

I had been taking 50mg+ hydrocodone for the last few years. I was going through some personal issues, but I think most of those have been resolved. The hydrocodone did a good job with that emotional pain, and know that has just become part of 'my day.'

Over the weekend I cut my dose in half to 22.5mg (6 days so far)

Physically I feel fine, but I do 'miss' it. I have felt like drinking more alcohol.

How long would you stay at 22.5mg before further reducing it? Is a month too much time?

Is there less risk staying at 15-22.5 forever or will I be at risk--there might be medical reasons why I want to do this? Should I really try to get to 0? I usually have good self control, but I have to admit that these cravings are different than alcohol.

Any suggestions on a tappering program?

Any suggestions on what to do when i have actual pain and really do need the medication? Any tricks people have used out there?

Thanks.

 

[HighonLife]

at 50mgs im assuming you dont do CWE's?

APAP everyday for a few years is gonna take its toll on your liver

try not to drink more alcohol. i know its hard but its for the best

i dont think you would have much of a prob cutting that 22.5 in half within another week.

there is less APAP risk if u stayed at 22.5 forever but could you? i mean i doubt u feel good off half your dose, will you be able not to increase it?

are you a pain patent? IE you gets your hydros RXed?

i would maybe suggest smoking pot first before using hydrocodone in the event of some pain but i know not everyone gets bud that is good for pain (indicas/indica dominant hybrids etc) but it is def worth a shot initially

also u could try ibuprofen n the like

i think if u go slowly ur taper should be next to unnoticable, asside from the obvious psychological aspect

anyways good luck

 

[sixpartseven]

I'm going to merge this into the Tapering Plan Megathread.

 

[Suboxone]

Starting at 8mg twice daily Suboxone, here's my taper:

I began by waiting about two days until I started to feel sick. I dosed myself with (1/4 pill) 2mg, followed by 2mg a half hour later. I realized at that point I wasn't sick, I was able to hold myself on 4mg and feel fine.
I started at 4mg sublingual in the morning and 4mg insufflated at night for a week.
Then down to (1/3 of a pill) ~2.6mg a pill, sublingual in the morning and ~2.6mg insufflated at night for a week.
From there I switched to (1/4 of a pill) 2mg twice daily, after a little over a week of this I was able to do any ROA and feel good. I noticed if insufflated or IV'd, I could feel the high (IV felt pretty damn good).

I'm glad I was able to taper down this low so painlessly. Now I feel NO anxiety, depression, nausea, constipation (woot! no constipation!!!). I really do feel like a new person. I don't know why, but I felt every side effect of this drug at 16mg/day. It fucking sucked.

I'm debating on tapering lower but I am planning on staying on the Suboxone until the end of the school year.

 

[Suboxone]

Any suggestions on what to do when i have actual pain and really do need the medication? Any tricks people have used out there?

Thanks.

I was in your position. I was doing so many pain killers that I would run out before my next script so I had to do heroin. You should quit while you're ahead, otherwise who knows where you'll end up.

The pain is unbearable at times. I just have to deal with it because if I go to a doctor and get painkillers or go get dope on the street, I pretty much forfeit my life.