Tapering

TaperingIf you have received conflicting advice about tapering, don’t let this confuse you. Despite claims that some tapering protocols are more successful than others, people who have used similar methods can have varying results - ranging from good to challenging. The worst accounts are from those who either stopped abruptly or rushed their tapers. But once you wean off gently and slowly under medical supervision, decide the pace at which you will proceed, and keep the mindset that you can and will succeed, you will find that coming off your medication is attainable.

There are different recommended methods for tapering, some of which are successfully used. For anyone who has taken the drug long-term, it is advisable to not rush the process. The schedules must be flexible and reduction rate should be based on your withdrawal reactions and intensity of symptoms. For short-term users, tapering over very long periods will prolong the period in which the receptors remain down-regulated.

The Ashton Manual recommends the use of diazepam (Valium) to taper off other benzodiazepines because it is more slowly eliminated from the body. Diazepam comes in liquid form and in doses of 10 mg, 5 mg and 2 mg which makes it easy to make very minute reductions in doses.

If you have decided to discontinue taking your medication, there are a few factors which will determine the duration and pace of your taper and how well you are likely to cope:

• If you are on a high dose, you will take longer to withdraw. The drug will be reduced in very small increments periodically in order to allow your body to readjust to the new doses at each stage of reduction.

• The tapering schedule should be used only as a guide. If you require a longer period to taper, you can discuss this with your doctor and adjust it accordingly.

• Many people use razor blades or the milk or water titration method to make the smallest possible cuts. It is believed that the smaller the cut, the gentler it is and the easier it will be for your central nervous system to adjust.

• Drugs differ in potency. If you are on a highly potent one you will need a longer time to reduce.

• Your personal circumstances, overall general health, the stressors in your life, stamina, support available and previous experience with drugs, if any, may also influence how you cope and determine the pace at which you can realistically taper.

If you are faced with additional stress such as a bereavement, admission to hospital or other crisis while tapering, it is acceptable and in some cases necessary to remain on the same stage of the withdrawal for a longer period. It is also important to avoid increasing the dose at this time, if possible. Once your circumstances are more settled, a further reduction in dose can be made.

You will need the cooperation of your doctor. If using the substitution or any other method, she or he will also be prescribing the medication required and will also be supervising your taper.

Having a support system in place is best. It would be good if you had a reliable family member or friend who is willing to learn about your medication and withdrawal. It is extremely important that you set the pace for your taper and not feel rushed to complete it or have anyone pressure you into weaning off quicker than you’re comfortable with. You can do it.