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Tapering Questions about my Xanax taper (and Suboxone taper)

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Enough999

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Oct 19, 2016
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I have a question about my sub taper. I'm stable at 3 mg Xanax right now and have a psychiatrist appointment tomorrow. I'm hoping he can help with tapering office of this. As for the opiates, I can't play around with them. I did a classic quick taper using subs, 4 mg day 1, 3 day 2, 2 for 2 days, 1.5 for a day, 1 for 2 days, .75 for a day, .5 for 1 day, then insufllated around .3 yesterday and today. Should I be in the clear? I didn't feel bad when I woke up. Should I feel any opiate withdrawals tomorrow? I have work tomorrow and about 2 mgs left but if I'm in the clear I'm flushing it. What do you guys think?

Sorry if I've been posting the same stuff everywhere but I'm concerned of what's to come. I have a question about my sub taper. I'm stable at 3 mg Xanax right now and have a psychiatrist appointment tomorrow. I'm hoping he can help with tapering office of this. As for the opiates, I can't play around with them. I did a classic quick taper using subs, 4 mg day 1, 3 day 2, 2 for 2 days, 1.5 for a day, 1 for 2 days, .75 for a day, .5 for 1 day, then insufllated around .3 yesterday and today. Should I be in the clear? I didn't feel bad when I woke up. Should I feel any opiate withdrawals tomorrow? I have work tomorrow and about 2 mgs left but if I'm in the clear I'm flushing it. What do you guys think? I don't want to see my psychiatrist kicking, and don't want to be on subs for any long period of time. Any input is much appreciated.
 
Last edited by a moderator:
I'm finally seeing a psychiatrist for the first time tomorrow and want help tapering off Xanax. Any advice in what to say?
 
So you've been taking buprenorphine for 11 days now? What opioid were dependent on before starting with the subs? Is the Suboxone prescribed?

When you see your doctor please considering letting them know that you are currently finishing a buprenorphine taper to get off opioids. Also consider putting off beginning a taper off of alprazolam until you have stabilized in your newfound sobriety and abstinence from opioids. I believe you hinted at in kickin's tapering thread about your desire to get off the alprazolam.

You brain and body will be going through serious changes over the next three to six months with your abstinence from opioids. Best not to make it any harder on yourself in your question to remain abstinent from opioid use.

If and when you choose to taper off alprazolam, really, really push to get on a longer acting benzo. Ideally your psychiatrist will prescribe the class benzo tapering medication, the longest acting commonly available benzodiazepine, diazepam. If he isn't familiar with the Ashton Manual, educate him (print it out and go over it with him - or make sure he checks it out on his own - but ideally you'd ensure this by doing it with him in the session). If he is too stuck up to see that diazepam is the ideal benzo taper medication, at least get him to put you on something like clonazepam that is still much longer acting than alprazolam.

Using alprazolam to get off alprazolam taper wise is like using heroin to taper off heroin. It is possible, but very problematic and very difficult, given how short acting both substances are.

Good luck! Try and take your time; try and be gentle as opposed to pushing yourself to hard: You have the rest of your life to recover (literally) from the harms you've experience associated with your substance use.
 
Enough999 said:
I'm finally seeing a psychiatrist for the first time tomorrow and want help tapering off Xanax. Any advice in what to say?
Click to expand...

That's good advice. Don't be surprised if the doctor tries to get you into rehab instead of tapering you himself. There is a lot of liability in taking on an already addicted patient who wants a taper.
 
Rehab is out of the question, I would never be able to get the time off of work. As for the bupe taper, it was to come off of a 2 week run, I was using h every other day to help with the Xanax withdrawals. I've been tapering Xanax if awhile now, down from 8 mgs to 3. I also have a legitimate prescription. I plan on not mentioning my recent opiate relapse just to avoid the rehab suggestion. I figured I would just tell him that I want off the Xanax. I feel no euphoria from it but I'm definitely dependent on it. If rehab was an option I would take it just get a break from all of my daily stressors but I support myself and couldn't get the time off/insurance coverage. I just don't want to botch this appointment I've been waiting for so long.
 
I was hoping that since I've already began to taper on my own, he might not be as opposed to helping me along.
 
Enough999 said:
Rehab is out of the question, I would never be able to get the time off of work. As for the bupe taper, it was to come off of a 2 week run, I was using h every other day to help with the Xanax withdrawals. I've been tapering Xanax if awhile now, down from 8 mgs to 3. I also have a legitimate prescription. I plan on not mentioning my recent opiate relapse just to avoid the rehab suggestion. I figured I would just tell him that I want off the Xanax. I feel no euphoria from it but I'm definitely dependent on it. If rehab was an option I would take it just get a break from all of my daily stressors but I support myself and couldn't get the time off/insurance coverage. I just don't want to botch this appointment I've been waiting for so long.
Click to expand...

If your tapering alprazolam led you to return to opioid use that ended up necessitating a buprenorphine detox, you REALLY need to consider two things:

  1. Put your taper off alprazolam on hold until you are more stable and have more support.
  2. Get your alprazolam switched to diazepam.
With diazepam, if you really needed to, you could continue on with your benzo taper, just at far more realistic, reduced rate - a rate FAR less likely for you to need to self medicate due to discomforts related to your benzo taper with opioids or other substance. You could go down on diazepam, the best benzo taper drug known to man, according to the following schedule:

Starting at 30mg diazepam (the equivalent to 3mg alprazolam), reduce your dose by 1mg until you are off. That would take a year or more, yes, but it would be infinitely less uncomfortable, more forgiving and more manageable than simply using alprazolam to taper off (plus it would be a lot easier to manage the dosage decreases themselves and maintain stability on a single dose a day).

Look into the Ashton Manual, the best guide for benzo tapers out there: http://www.benzo.org.uk/manual/
 
mid Xanax taper, seeing pdoc tmw, advice?

I apologize for the redundant posts, but I finally have a psychiatrist appointment tomorrow and don't want to get turned away or told to just "go to rehab." I've come too far in my taper, going from 8 mgs to 3. I know the outcome of this appointment is, ideally, a switch to a longer acting benzo. I don't want to say the wrong thing and am wondering if I should leave my past opiate abuse out of my history as anything documented on it was in another state? Does anyone have any advice on what to say, or what not to say? Has anyone been in the same boat? Again, sorry for the redundancy, it just took a long time to get this appointment and my general doctor told me he doesn't usually prescribe Xanax and probably won't write me another script let alone a different one, so I can't rely on him, nor did he seem to know much about tapering (literally told me to just taper myself). This is my last chance to get help from a professional, because I know the lower I go the harder it will be without something longer acting. Any advice is beyond appreciated and a big thank you to BL for all of the support.
 
I definitely plan to mention the Ashton manual tomorrow, because I know the lower I go the harder it's going to get. And I don't want to use discomfort as an excuse to use my DOC. I just wish I had a script for this, you know? I'm so afraid of saying the wrong thing. I'm hoping that by telling him I want off instead of more will work in my favor.
 
Obviously I've mentioned this to my regular doctor who on my last visit increased my dose, then told me he doesn't usually write scripts for psych meds so will no longer be doing so (he wants me to get them from a shrink and from what I heard in the waiting room he seems to be under some kind of investigation) and suggested to "taper myself" if I wanted to discontinue. Wtf?
 
Find yourself a new doctor ASAP and explain your position. MAKE him give you three referral that take your insurance and don't have a huge waitlist. He is legally obligated to do this. Sounds like he isn't the most legit doctor out there and just want you out of his practice for whatever reason. HIGHLY UNETHICAL. I am so sorry you find yourself in this position. No wonder you're stressing!

And btw, there is nothing wrong about needing to self medicate, if you do. IMO it is better not to suffer needlessly when there is stuff around that you know will help. Of course that must be balanced by finding ways to do so without leading to a situation like this where the substance use you engage in to self medicate ends leads to causing more harm than help than that of the taper.

Your doctor legally cannot just tell you to taper and drop you as a patient before ensuring you are provided with three reasonable referral to doctors who can and are willing to take you. Don't play that card with him unless ABSOLUTELY necessary as it'll almost certainly make him entirely adversarial and confrontational with you, leading to even worse treatment than you are already receive. However, if absolutely necessary, I have found it useful to remind treatment providers of your legal rights as a patient and their legal duties as a licensed treatment provider. It is the very last card you'd want to play though, only if you feel you have exhausted all your other options with him.

Get those referrals!
 
Update: after a pricey copay and an hour of dissecting my life, I was told since I've been on Xanax for months rather than years, I don't "need" to be switched to a longer acting benzo. I've been told to decrease by .5 a week (starting tonight) and report back in 3 weeks. And I was given Zoloft which, from what I've read, I probably shouldn't even touch until this taper is over. I can't afford anymore copays, detox is not an option. Looks like I'm in it for the shitty ride. And a lot of Unisom. Any advice at all, again, is much appreciated. Back at square one, except minus the copay...I'm pretty frightened right now to be honest.
 
And I think my biggest fear is going right back to the needle. The junkie in me is screaming at me, telling me I'd have a much easier time if I just went back. Even though coming off smack led me to the benzos to start with. My mind is split down the middle and I've been flipping a coin for the last twenty minutes. I pray That I fall asleep before I make that phone call.
 
Enough999 said:
I'm finally seeing a psychiatrist for the first time tomorrow and want help tapering off Xanax. Any advice in what to say?
Click to expand...

First off, DO NOT attempt to detox from Suboxone and Alprozolam at the same time. Both compounds really pack a punch in regards to symptoms.

Be honest with your Dr. and ask for Diazepam or Clonazepam to taper off with.... To give you a cookie cutter program I would start with 2mgs of clonazepam a day (1mg upon waking and 1mg 12 hours lateR) and stay on that until you stabilize and then decrease 0.25mgs every month or whenever you are ready.
 
I was honest and asked for both. He refused and told me to taper off of the Xanax
 
Yes, I think that's too much. Actually I just posted the same response to the same question on cj's thread.

Is there any room for negotiation with this doc?
 
Thanks for your responses. It was my first time seeing him so we don't have much of a relationship yet where I think I could negotiate. I was considering just doing .25 a week myself and on my next visit explaining it was too much. Thing is, I was able to cut at .5 every 5 days to get to 3 mg. Then I used being uncomfortable as an excuse to use smack. So in theory I can do this and function, but I'll have an excuse to use. Do you think that me being on it for months instead of years is why he's so confident about this? He's not the first doctor to suggest the exact same taper, Ive phoned other doctors and even paid for an online consultation where they recommended the same thing. Then I read these horror stories and think "no way." Can my length on it be contributing to the faster cuts being recommended?
 
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