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Tapering: Difference between revisions
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Substances with long half-lives (like [[diazepam]]) are preferable to shorter-lasting ones (including [[alprazolam]] and [[lorazepam]]) because the latter are eliminated fairly quickly, resulting in its blood concentrations fluctuating instead of smoothly declining gradually. Tapering off of substances with short half-lives generally require taking multiple dosages per day and users will likely experience withdrawal symptoms between doses. Diazepam is the most commonly used drug for tapering off of [[benzodiazepines]] or [[alcohol]] because it has a half-life of 200 hours.<ref name="benzo">CHAPTER II: HOW TO WITHDRAW FROM BENZODIAZEPINES (aka The Ashton Manual) by Professor C Heather Ashton DM, FRCP | http://www.benzo.org.uk/manual/bzcha02.htm</ref> To avoid withdrawal symptoms when switching over to a longer-lasting one, users should factor in potency differences between the substances. | Substances with long half-lives (like [[diazepam]]) are preferable to shorter-lasting ones (including [[alprazolam]] and [[lorazepam]]) because the latter are eliminated fairly quickly, resulting in its blood concentrations fluctuating instead of smoothly declining gradually. Tapering off of substances with short half-lives generally require taking multiple dosages per day and users will likely experience withdrawal symptoms between doses. Diazepam is the most commonly used drug for tapering off of [[benzodiazepines]] or [[alcohol]] because it has a half-life of 200 hours.<ref name="benzo">CHAPTER II: HOW TO WITHDRAW FROM BENZODIAZEPINES (aka The Ashton Manual) by Professor C Heather Ashton DM, FRCP | http://www.benzo.org.uk/manual/bzcha02.htm</ref> To avoid withdrawal symptoms when switching over to a longer-lasting one, users should factor in potency differences between the substances. | ||
===Tapering schedule examples=== | ===Tapering schedule examples=== | ||
[[File:Taper3.png|250px|thumbnail|right|This chart from [http://www.benzo.org.uk/manual/bzsched.htm#s3 the Ashton Manual] is an example of a slow taper from 6mg alprazolam daily with a diazepam substitution.]] | |||
The overall schedule of the taper should be determined on an individual basis, depending on many factors including one's initial dosage, length of use, and specific substance used as well as its potency, duration of action, and half-life. | The overall schedule of the taper should be determined on an individual basis, depending on many factors including one's initial dosage, length of use, and specific substance used as well as its potency, duration of action, and half-life. | ||
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*Reducing one's daily dose by 25% each week | *Reducing one's daily dose by 25% each week | ||
More detailed examples of tapering schedules for various benzodiazepines can be found on [http://www.benzo.org.uk/manual/bzsched.htm the Ashton Manual]. These can be used as a reference when designing one's own tapering schedule. | More detailed examples of tapering schedules for various benzodiazepines can be found on [http://www.benzo.org.uk/manual/bzsched.htm#s3 the Ashton Manual]. These can be used as a reference when designing one's own tapering schedule. | ||
===Emergency tapering=== | ===Emergency tapering=== | ||
Emergency tapering can be done if one does not have the time or enough of the psychoactive substance to attempt a slow, planned taper. In this method, users stop their drug use until the onset of withdrawal symptoms and then dose very small amounts every hour until the symptoms are tolerable. Redosing should only be done when withdrawal symptoms become intolerable. Since [[benzodiazepine]], [[alcohol]], and [[barbiturate]] withdrawals are the most dangerous drugs to experience withdrawal from and can cause seizures and death in severe cases, it is recommended that users seek treatment at a medical facility or hospital in an emergency situation. | Emergency tapering can be done if one does not have the time or enough of the psychoactive substance to attempt a slow, planned taper. In this method, users stop their drug use until the onset of withdrawal symptoms and then dose very small amounts every hour until the symptoms are tolerable. Redosing should only be done when withdrawal symptoms become intolerable. Since [[benzodiazepine]], [[alcohol]], and [[barbiturate]] withdrawals are the most dangerous drugs to experience withdrawal from and can cause seizures and death in severe cases, it is recommended that users seek treatment at a medical facility or hospital in an emergency situation. | ||