What is the Best Way to Get Off a Benzo?
A noted journalist in Canada who was a two pack a day cigarette smoker tried and failed many times to quit the tobacco habit. When he was diagnosed with a life-threatening lung disease he entered a residential detox and quit smoking within weeks. He later said the method really wasn't that important — that he could have stopped smoking standing on his head with a carrot in his ear if he really had wanted to. The difference now was that he had no choice.
What Are You Really Asking?
There is a lot of discussion about what method works “best” in terms of getting off benzos. But the question people are really asking is “what method will not make me suffer too much” or “what method is easy.”
People have successfully and permanently stopped using benzos by going cold turkey or being withdrawn in a few weeks at a short term detox (not advised but it has been done), by designing slow reductions off a benzo (very hard with most benzos), by using valium substitution (the Ashton method) or by other methods like micro-tapering which dilutes the drug and reduces the dose by a tiny amount each day.
More Than One Way…
Some people have used combinations of approaches. In the past year I have been contacted by a number of people who started their taper by micro-tapering but then found they got stuck at a certain point until they switched to valium substitution. Others have tapered slowly and then gone to a residential facility to taper the last few milligrams. Others have tapered down, become frightened, gone back up, gone back down and then gone back up until they finally break through and finally get off. Others never do fully withdraw even after trying to taper using various methods. There is no “one way” to do it and for most people it is a bit “messy.”
After observing all these methods, the successes and the failures here is what I think.
- Getting off benzos is very hard and can feel like the most difficult thing you have ever done — for MOST people, no matter what the method.
- Be wary of what you read on the internet (lol) because the “ease” of getting off may be exaggerated by some fellow victims. Remember everybody has a completely different reaction to withdrawal. Some people have one or two symptoms — others have dozens.
- Don't ever stop using benzos abruptly. This can be life threatening and certainly will be traumatizing. It is also likely to fail because symptoms will be intolerable. For some people withdrawal is a 4/10, for others it is a 100/10. You are not a freak if you have dozens of symptoms — that is normal.
- Short-term residential detoxes are inappropriate for benzo withdrawal no matter what the staff or fancy brochures may say (in my opinion). Benzo withdrawal typically takes weeks and months and is best done at home with the proper information, support and comfort measures.
- The best methods understand and take into account proper equivalences and they don't rush things. A slow taper is a safe taper and is much more likely to succeed.
- Many physicians even addictions specialists try to make reductions that are far too large. Remind your doctor that it is not the speed at which you get off but STAYING off that is your goal.
- Don't stretch out the taper too long or “wait till you feel better” between reductions during a longer term tapers. The longer you take the more risk there is that you won't finish. Set a schedule and try to keep to it, no matter what.
- Consider the evidence base for the tapering method. To be frank there isn't research that compares the different success levels of types of tapers. Only the Ashton valium substitution method has a real evidence base gathered from patients at a withdrawal clinic she directed for 12 years. This and her other extensive published experience is the ONLY evidence we have for successful tapering. With support and information she achieved a success rate of 90% and my experience reflects this too. Hundreds of thousands of people have successfully used this method although she would be the first to say that someday something better might come along.
- Micro tapering works for some but we only have anecdotal information about it. I look forward to the evidence and know it has worked for some.
- Don't get too worked up about the method. It is better to find a method and be consistent. If you are flailing around and trying different things you are more likely to have problems.
- Don't give up if you don't succeed the first time — many people try and fail before eventually succeeding. The people who succeed are not exceptional people — they are scared and human just like you.
More on how to survive withdrawal in posts to come!
Updated: December 6, 2012