Benzos Can switching between different benzos prevent tolerance or WD?

[VisceralChems]

I have a friend who is curious if switching between xanax, klonopin, and lorazepam will help stop any form of dependence and ultimately WD?

P.S. Low doses, just fairly frequent (once daily).

 

[Lorne???]

Absolutely not. All benzo's work via the same mechanism, so tolerance to one benzo carries tolerance to all. And once your addicted, your body really doesn't care which benzo, it just needs one of them.

However, if you abuse one benzo in particular, you will build a "special" tolerance to that specific benzo(and perhaps similar benzo's, in the same family) but you will still be tolerant to all benzo's, but slightly more so to your BOC.

But get physically dependent upon benzo's is pretty difficult, however if you take them every single day, regardless of dose, inevitably tolerance/dependence will set in, but it could honestly take a while.

 

[VisceralChems]

Thank you for the response, that was the assumption, but wasn't quite sure. Use has been long term (3-4 years), but frequently breaks are taken with no craving or WD. At low doses, how often is typical (I realize everyone is different) for physical dependence to set in? (Currently going through opiate detox and needing them more frequently than typical)

 

[Lorne???]

Well it obviously varies among people/BOC, and quite dramatically at that.

Can you please tell me what benzo(or benzo's) that you primarily take? And at what dose? I know it likely varies, but give me your typical regimen.

The pharmacology of the different benzo's is extremely variable, so your BOC is quite important.

 

[VisceralChems]

For first two to three years, 1mg - 1.5mg lorazepam ~5 days week. This was definitely BOC until efficacy decreased.

Recently, new Dr (moved to new state) decides she doesnt like lorazepam and changes me to clonazepam. Scripted for .75mg, but usually takes .5mg, and sometimes less. Use has increased over the past several months from a couple times a week to almost daily. On occasion, xanax is supplemented for the clonazepam depending on when scipt is filled, but rarely as that is definitely not BOC.

 

[jeng1128]

You can't switch Benzos to get no wd. You can switch the Benzo with a longer half life & diazapam helps with that. I used it to get off a heavy(10-15 bar/day habit for a good year,& although it was a 21 day detox(inpatient ) it worked.

 

[Lorne???]

I don't know why people are always saying to switch to diazepam. It is extremely fast acting, with a very short duration of action. The reason why Valium dt's are generally mild is because diazepam itself is very mild. I mean 10mg diazepam = 0.5mg alprazolam(Xanax) or 0.5mg clonazepam, or (roughly) 1mg lorazepam.

But I assure you coming off of high dose diazepam can be quite Intense. What people don't understand is that half-life and duration of action are not mutually exclusive.

In the case of diazepam, it has a long half-life, yes, however it's duration of action is notoriously short. This is because diazepam is rapidly redistributed from the CNS to other parts of the body. In contrast, lorazepam, which has a shorter half-life is actually longer acting, as it's lower lipid solubility means it takes longer for it to reach a sufficient concentration in the CNS, but once it's there, it lingers a good while.

But my point, is that diazepam hits hard and fast, and wears off quickly, which are the hallmarks of an addictive substance. However, it is more mild than your typical benzo's of abuse.

Personally, I think lorazepam is a good benzo to taper down with, but seeing as that is your BOC, it might not be a great idea!!! But, it's slow onset and long duration of action make it ideal for that purpose, and lends itself to a milder detox.

 

[VisceralChems]

For the record, I have never experienced, in all my years of fairly regular use, any sort of physical withdrawal or addictive craving with benzos. I used to use them recreational, but only due to access and lack of interest in other alternatives (I don't drink), and now mostly only use when needed. The problem is I am finding I need them quite often given current experiences, and thus I am trying to avoid what I am going through with opiates, so trying to gauge where to draw the line between need / want / and prevention.

 

[VisceralChems]

Personally, I think lorazepam is a good benzo to taper down with, but seeing as that is your BOC, it might not be a great idea!!! But, it's slow onset and long duration of action make it ideal for that purpose, and lends itself to a milder detox.

Significantly better than Clonazepam? Because that is my current RX, and currently has more efficacy due to my history with lorazepam...although maybe that is the point?

 

[Lorne???]

Clonazepam is also an excellent benzo for tapering, in fact, once it reaches steady state it is just an excellent benzo all around. But with clonazepam, you either live it, or hate it.

In your case, it doesn't sound like you want/need a taper though. But exactly what are you asking? If your worried about dependence, it won't happen unless you are taking them every single day. Once that happens, it is inevitable.

You have to watch out for clonazepam, though. It is HIGHLY potent, and has a very long half-life. And with chronic administration, it is even more potent, and it has a longer duration, due to it accumulating. Literally taking even 1mg of clonazepam per day will lead to dependence, and even coming off of 2-3mg can be quite awful.

If you are trying to avoid dependence, not using everyday is obviously key. However, coming off of opioids, it sounds like you might actually need the benzo's right now. And unfortunately, clonazepam is MUCH more effective when taken daily.

I mean, it is simply not a PRN medication. If you are going to take clonazepam, it needs to be taken every day. It doesn't mean you have to take a large dose every day... You could literally take 0.75mg daily, and then sometimes take an extra 0.5-0.75mg, AS NEEDED.

If you do not want to take benzo's every day(or 5-6daus a week, at least) switch to something fast acting. In that case, diazepam could be perfect. Alprazolam is also an option, being right between those two.

But really, if your going to take them, you need to find the right regimen. I'm sorry your doctor "hates" lorazepam, that is just silly, since it's a helluva lot milder than fucking clonazepam.

Anyway, I'll be here if you have any more questions

 

[pregab_the_way]

However, if you abuse one benzo in particular, you will build a "special" tolerance to that specific benzo(and perhaps similar benzo's, in the same family) but you will still be tolerant to all benzo's, but slightly more so to your BOC.

.

Yes that's true. I abuse Temazepam ( as it's the easiest to get for me ) and I can do stupidly high doses with nothing, where as Lorazepam will knock me out with an equivalent dose.

Benzo addiction sucks. if your not already dependent on them, avoid using them to often.

 

[Lorne???]

Dude, I just realized you are the same person from the other post! Sorry, I wasn't paying enough attention, trying to multitask.

This changes things a bit. Look, you can only deal with one problem at a time. And frankly, if your not stabilized with buprenorphine AND clonazepam, your PHYSICAL dependence is worse than I thought.

Look, it is obviously not a good idea to replace one addiction with another, but you mentioned insomnia. I have had insomnia since I was a child, sleep is now almost impossible without a high dose of opioids in my system, and or benzo's.(which I now rarely take) so I feel for there. For now, I would focus on your buprenorphine taper, and make this a second priority. Just try to keep the benzo use to a minimum. Really though, I think a fast acting benzo might be better for sleep. But for now, I would stick with low dose clonazepam, like 0.5-1mg per day. Note that clonazepam is twice as potent as your BOC, and more so with chronic use, so 1ng clonazepam=2mg lorazepam.

But if you keep it in your system, you can occasionally take an extra 0.5mg, or even 0.25mg to help with anxiety/sleep.
But like I said, focus on bupe, it is generally (much) easier to taper with benzo's, and you have more options.

 

[VisceralChems]

Dude, I just realized you are the same person from the other post! Sorry, I wasn't paying enough attention, trying to multitask.

This changes things a bit. Look, you can only deal with one problem at a time. And frankly, if your not stabilized with buprenorphine AND clonazepam, your PHYSICAL dependence is worse than I thought.

No worries . Yes, I pretty much cant sleep right now without them, but even half a .5mg clonazepam can put me to sleep, so Ill keep using until I fix this other issue, and them stop the Benzo for awhile to give them a rest.

 

[hfa]

But get physically dependent upon benzo's is pretty difficult, however if you take them every single day, regardless of dose, inevitably tolerance/dependence will set in, but it could honestly take a while.

All I have is anecdotal evidence, but I would disagree that getting physically addicted to daily benzo use takes a long while and is difficult.

I'd say it's the exact opposite. It is very easy and takes only a short while to be physically dependent on benzo's. 1 - 2 weeks is sufficient with daily use to suffer some sort of withdrawal.

I don't know why people are always saying to switch to diazepam. It is extremely fast acting, with a very short duration of action. The reason why Valium dt's are generally mild is because diazepam itself is very mild. I mean 10mg diazepam = 0.5mg alprazolam(Xanax) or 0.5mg clonazepam, or (roughly) 1mg lorazepam.

But I assure you coming off of high dose diazepam can be quite Intense. What people don't understand is that half-life and duration of action are not mutually exclusive.

In the case of diazepam, it has a long half-life, yes, however it's duration of action is notoriously short. This is because diazepam is rapidly redistributed from the CNS to other parts of the body. In contrast, lorazepam, which has a shorter half-life is actually longer acting, as it's lower lipid solubility means it takes longer for it to reach a sufficient concentration in the CNS, but once it's there, it lingers a good while.

But my point, is that diazepam hits hard and fast, and wears off quickly, which are the hallmarks of an addictive substance. However, it is more mild than your typical benzo's of abuse.

Personally, I think lorazepam is a good benzo to taper down with, but seeing as that is your BOC, it might not be a great idea!!! But, it's slow onset and long duration of action make it ideal for that purpose, and lends itself to a milder detox.

Yea, I was always under the assumption that Diazepam is the longest-acting, and that Lorazepam was the shortest acting; however, the opposite is true:

"The use of diazepam is limited by its rapid redistribution out of the CNS. The duration of action of diazepam is approximately 20–30 minutes. Pharmacokinetic studies of lorazepam have shown it has an elimination half life of 13 hours. Lorazepam has a much longer duration of action than diazepam and has an equivalent onset of action."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1725554/

So Lorazepam would actually be the best for tapering

 

[VisceralChems]

All I have is anecdotal evidence, but I would disagree that getting physically addicted to daily benzo use takes a long while and is difficult.

I'd say it's the exact opposite. It is very easy and takes only a short while to be physically dependent on benzo's. 1 - 2 weeks is sufficient with daily use to suffer some sort of withdrawal.

I don't doubt that this is true for some people; however, it has not been my experience in the past (with lorazepam). I had often gone several consecutive weeks, and never had any sort of physical or mental dependence when suddenly stopping for any length of time. But that is just me, so I appreciate hearing other people's experience, because maybe I am a lot closer to my threshold than I know.