Alcohol Alcohol to benzo conversions for tapering purposes?

[Bleaney]

I've just done a quick 'Google' on the subject above, and all the threads I've seen so far suggest that there is no simple or straightforward conversion ratio. I understand that the substances are very different, and that it's like comparing apples and oranges, and that the way alcohol affects the brain and GABA is a lot more complicated.........

However........

I do know that sometimes severe alcoholics are switched to diazepam for their detox, so there must be some sort of pragmatic, real world, basic conversion guidelines that these detox centres use. Does anyone know what these guidelines are?

My issue is that I have been using benzos plus a quantity of whisky in order to be able to fall asleep at night. I don't really want the thread going off into a tangent as to why I did that, although I am fully aware that it was a bad idea.

I don't believe myself to be an alcoholic, although I have definitely formed an unhealthy dependency on relying on alcohol to help me fall asleep. For several reasons, the time has now come to taper down, and I've seen advice suggesting that in cases where a person has been using benzos plus alcohol, it's best to quit the alcohol before benzos in these cases. So this is what I am doing and plan to continue doing.

I had been consuming well over 3 double whiskies plus 1 single (plus benzos) for too long. I am gradually reducing down by a measure of 1 single whisky per night and plan to continue that rate of reductions until I run into problems falling asleep. At that point I may wait for my body to adjust and catch up, or temporarily increase my benzo dose slightly, if the adjustment does not happen for a very prolonged period.. This is where I am coming from with this question on this thread.

I'm not sure if I've posted in the correct subforum, but if anyone has any input other than calling me an idiot, that would be appreciated.

It's gone well so far over the first few nights, and I'm now down to 2 doubles. I know it won't be able to reduce much further before I begin to encounter issues with falling asleep and staying asleep. So some very rough equivalence guideline would be helpful. I know they are not the same, which is why I have mentioned all the caveats, hopefully to head off some of the responses whic might have been along those lines.

 

[4meSM]

It doesn’t seem like you’re physically dependent on alcohol at the moment, and you’re only drinking at night, right?
Can you provide more details regarding your benzo use ? Which benzo(s) and at what dosage? Do you exclusively take them at night for sleep or during the day as well? Those are pretty important details in this context.

You might be able to cut the alcohol completely without having to increase your benzo dose. With the main issue being having a harder time falling asleep, as opposed to wide spectrum withdrawal. Switching to a more hypnotic benzo at night time may solve this issue.
Although it also depends on whether you just became used to alcohol+benzos for falling asleep, or whether you had severe insomnia before.

 

[negrogesic]

I believe the general guideline is something like 5mg of diazepam for every 10g of alcohol (which is one drink), but this formula is rarely used in practice and is moreso symptom driven.

The thing is, drinking modestly only at night (like you're describing) shouldn't produce a physical dependency that necessitates benzodiazepines. True physical dependency to alcohol develops only when one acheives a sustained and steady blood alcohol level (which occurs when one drinks regularly throughout the day and night). So no real need to accommodate a handful of drinks a night with a benzo. You might have difficulty sleeping at first but this is distinct from true alcohol withdrawal. The alcohol used to sleep would indicate that you may have had difficulty going to sleep before using the alcohol to induce it. If you are trying to get off of benzos I wouldn't dig yourself in a deeper hole by taking more just to accommodate the absence of a few drinks of alcohol. Maybe try 1.5g of agamatine + 1.5g of beta-alanine to induce sleep, or etc.

 

[Snafu in the Void]

I do know that sometimes severe alcoholics are switched to diazepam for their detox, so there must be some sort of pragmatic, real world, basic conversion guidelines that these detox centres use. Does anyone know what these guidelines are?

Alcohol is a little different than other medical detoxes. It's not really about conversion, and more about eliminating the potential for withdrawal and seizure, with the minimal dose possible.

A typical detox gives you approx 30-40/15-20/10/5/5 mg of diazepam, and you're done by day 6... for someone drinking 20+ drinks per day. Sometimes they will add a barbiturate if you have a history of seizures.

2 doubles, or about 4 units of alcohol, is not an amount that will produce any significant withdrawal. It's possible you may sleep just fine, and you might be psyching yourself out.

REM sleep actually rebounds when you quit, unless of course you're experiencing significant withdrawal aka glutamate rebound, but that won't happen from 4 shots.

Speaking from experience as an alcoholic, I often sleep just fine if not better from cold turkey sleep, again assuming significant withdrawal is not a factor. I routinely go from 14 drinks to 0 and experience negligible withdrawal. Maybe a bit of depression, anxiety, and headache-- but I sleep just fine.

But to attempt to answer your question, as little as 5mg of diazepam would be more than enough to sleep, and honestly may be overkill. I'd consider just trying to sleep without anything and see what happens, you might be surprised. Entirely possible you will sleep better without 4 shots than with them.

 

[Bleaney]

Thanks for the replies.

Yes I do only drink of an evening and night time. My sleep has been intermittently problematic over the years, but has tended to eventually right itself whenever I've got myself into similar predicaments over the years, and have ended up quitting whatever I was using to help me sleep.

I'm currently using 1.5mg of clonazepam mainly at night. I also use it for social anxiety as well as insomnia but as I'm currently out of work I have almost zero social anxiety right now as I mainly don't have to be social. I only use it one day a week in the late afternoon for the one day I currently do something that would otherwise set off my social anxiety.

I'm planning to use the opportunity of being out of work to reduce my benzo and alcohol consumption.

Thanks also to @Snafu in the Void for the informative additional info..

It seems that my alcohol consumption isn't as bad as I thought it was, although my current amount of 4 shots is about half of what I was using a few days ago. I also have 1/3 to 1/2 to 3/4 of a bottle of wine with my evening meal, but I'm not really counting that at the moment, as it's not much of a concern right now. Also my benzo consumption is also relatively low, so hopefully I can make some good progress with this taper over the next few weeks / months.