Benzodiazepines: the good news and bad news, right? I mean, if you’re being knocked-around by anxiety, they can bring quick relief. But, of course, there’s that huge multifaceted downside. Is it time to say good-bye?
Benzos are schedule IV controlled substances, not recommended for use beyond two to four weeks. That said, prescribing them comes with the responsibility of providing an exit strategy.
Naturally, I drove right to the pharmacy and waited for the fill.
How well I remember the euphoria not long after chucking-down the first tablet. Absolutely, I felt a massive sense of, well, lightening. And I said to myself, “So this is what living is supposed to feel like.” Really, the feeling was akin to the buzz from drinking those first couple of beers (in the very old days).
Well, I did just one .25’er daily for two years and decided I no longer wanted to head for my briefcase first thing every morning. So I quit.
But it isn’t always quite that easy, is it?
Benzodiazepines: Way Popular
I put together a list of anxiety meds on drugs.com. It included brand, generics, and OTCs. Of the twelve most popular, seven were benzodiazepines (benzos).
Here they are in order of popularity: Xanax, clonazepam (Klonopin), alprazolam (Xanax), Ativan, lorazepam (Ativan), Lexapro, Buspar, buspirone (Buspar), Valium, hydroxyzine (Vistaril), diazepam (Valium), Cymbalta.
Do you use any of them?
Benzodiazepine Information Coalition
If you’re ready to say good-bye to benzos, or know someone who is, I came upon a great resource: Benzodiazepine Information Coalition (BIC).
BICs mission is to advocate for greater understanding of the potentially devastating effects of commonly prescribed benzos, as well as prevention of patient injury through medical recognition, informed consent, and education.
They’re the real-deal, people.
Benzodiazepine Tapering Strategies and Solutions
Among the many valuable resources on the BIC site is a blog with some great articles. I’d like to feature one of the pieces, “Benzodiazepine Tapering Strategies and Solutions.”
Now, the article, and my highlighting, provide some very detailed info regarding benzo tapering. Understand, I’m presenting it within the context of resource info, not direction and recommendation. Please chat with your medical professional, okay?
So here are 10 highlights…
- Benzos are schedule IV controlled substances, not recommended for use beyond two to four weeks. That said, prescribing them comes with the responsibility of providing an exit strategy.
- Patients who aren’t able to successfully withdraw from a benzo in a few weeks may forfeit years of their life to an unsuccessful taper. So it’s imperative that docs and patients are educated about available methods of tapering.
- A common taper method is to instruct the patient to cut a pill by 1/4 weekly. This leads to a completed taper in some four weeks. But many researchers, docs, and patients would consider a four week taper too rapid. Indeed, it’s been found to be ineffective for 32-42% of long-term benzo users.
- Although there are other options available to patients and docs, the general guideline is not to exceed a 5-10% reduction in current dose every two to four weeks. But keep in mind, some benzos aren’t designed for gradual reduction.
- When considering switching to a longer-acting benzo, conversion can be tricky. Professor Heather Ashton’s Benzodiazepine Equivalence Table offers a guide of average conversions. Of note, this guide, as well as assorted charts and doc opinions, can significantly vary.
- Regarding meds to assist with a benzo taper, BICs experience from thousands from online support groups indicate many patients withdrawing from benzos develop multiple sensitivities to other medications, which seem to aggravate withdrawal symptoms. That means with a sufficiently slow, patient-led taper, additional meds are typically not necessary.
- Those who dose at regular intervals are more likely to successfully complete a benzo taper because they don’t experience severe “drops” throughout the day between doses that make discontinuation intolerable. These symptoms are commonly referred to as “interdose” withdrawal.
- The Ashton Manual is likely the best known “cut-and-hold” method in the benzo community. It has a 90% reported success rate, but still may be too fast for many patients to taper comfortably. Also, many patients can’t tolerate Valium, which the Ashton Manual requires. The Valium recommendation is based upon it coming in a much smaller dose and having a longer half-life than other benzos.
- Dry-tapering is a popular method because of convenience and feelings of intimidation regarding other methods. It involves using a pill-cutter or scale and shaving-off a pill in compliance with a taper plan. Tapering Strips, a newcomer to the cessation market, is worth a look-see.
- Liquid titration is a method known in the online support community. Simply, the patient makes a homemade suspension in water or milk. A pill is either crushed or allowed to disintegrate in, say, 300 mls of liquid. One ml is removed from the suspension and discarded, the rest ingested. More and more mls are reduced and discarded each day until nothing’s left.
So there you have 10 article highlights, but there’s so much more. You’ll find a link to the piece at the end.
That’ll Do It
Maybe you’ve been doing the benzodiazepine good news/bad news thing for a while. And maybe the downside has convinced you they’re really not worth it anymore.
Is it time to say good-bye? You really can do it, you know. And there’s plenty of easily accessible help available.
If you want off, get busy…
Be sure to read the full article on the Benzodiazepine Information Coalition site. And while you’re there, take the time to check-out what they have to offer. Impressively empowering.
There are numerous benzo articles here on Chipur. Just enter benzo in the search box. And let’s not forget about the hundreds of Chipur mood and anxiety disorder-related titles.