What is the BuddiesGuide?

It is important to understand that the BuddiesGuide is intended as a guide only, not a bible. The Community will help you plan your taper schedule, but you alone are in charge of your withdrawal. We hope to introduce you to the main withdrawal methods and options available, make you aware of possible advantages and pitfalls associated with particular withdrawal methods, and lend you moral support during your withdrawal and recovery. Our hope is that by being better informed, you can begin to take control of your benzodiazepine dependency, and experience few problems during your withdrawal.

We welcome feedback, suggestions, and submissions for additional material to The BuddiesGuide. The BenzoBuddies Forum has an area dedicated to member participation for expanding the Guide, and for corrections where relevant. We consider member input to the Guide both important and invaluable.

Introduction

BenzoBuddies hopes to help those who are thinking of quitting, are quitting, or who have already quit benzodiazepines. Total recovery can take some time, so even of it has been months or longer since you took your last benzo, you will find a sympathetic ear here at BenzoBuddies. If you are fully recovered and would like to write about how much things have improved for you since quitting benzos, we would love to read your words of encouragement and support. It is important for those still recovering to know that it really is worth the effort; things do improve.

There are very good reasons for you to be thinking about quitting benzos, as long-term benzodiazepine use can result in some serious health problems. Benzos are highly addictive, they dull the mind (benzo-fog or cog-fog), and they are a danger to your general health. You can expect benzodiazepines to stop being effective in the treatment of insomnia within a few weeks, ineffective in the treatment of anxiety after some months, and even the anticonvulsant effects of benzodiazepines can be limited to a few months or years. The official recommendation is that, under most circumstances, benzodiazepines should be prescribed for no more than 2-4 weeks.

The afore mentioned trend towards becoming ineffective is termed "tolerance" and results in a number of possible problems. You may feel the urge to increase your dosage. This may alleviate the issue in the short term; however, you will one day face tolerance again at this new higher dose. It is plain to see that this situation is unsustainable, and at some point you will have to face withdrawal as the only option left to you. Alternatively, you may suffer "Tolerance Withdrawal". This is the very difficult situation in which you continue with your medication as usual, but you experience withdrawal symptoms. Again, an increase in medication may well alleviate these symptoms, but it is unlikely to last. You will eventually find that you have no real option but to withdraw from benzos completely.

Tolerance: how we become dependent

As mentioned previously, "tolerance" is a term used to describe the situation where your original effective dose becomes ineffective. For your medication to again be effective, you must do one of two things: either you supply your body with an increased dose of medication, or you must perform a taper - break - reinstatement program. In the first situation, your doctor would need to prescribe a higher dose of your benzodiazepine. This will result only in a temporary fix. At some point in time, your new higher dose will again become ineffective. Perhaps yet another increase in dosage will be suggested - where will it all end? In the second situation, you must taper off your benzo, take a break, and then reinstate your medication. Even if you were to attempt and accelerated withdrawal, break, and reinstatement program, it could still take months to complete. And the end result will be the same, at some point in time you will be faced with tolerance once more. Do you again go through this kind of program? Sooner or later, if you are to lead a normal life, you must withdraw completely. You can put an end to the vicious cycle that tolerance begins; you can make the decision to withdraw sooner rather than later.

You should also consider that more doctors are becoming aware of the problems and dangers associated with protracted benzodiazepine use. They are beginning to realise that they owe it to their patients to help them taper off benzos. However, there will always be doctors who do not truly understand the issues surrounding benzodiazepine withdrawal. These doctors may force their patients to withdraw at a rate they cannot tolerate. All doctors have a duty of care, and it will become more evident (as it is only a matter of time before there are successful lawsuits) that they risk being sued if they continue to blindly prescribe benzodiazepines, against best practice, and without regard to patients long-term interests and health. It is going to become increasingly difficult to find a doctor that will prescribe these meds for insomnia, anxiety, and panic. Take control of your health now; it is never too late! It is your body!

Tolerance Withdrawal

The term "Tolerance" describes the situation where your brain has become accustomed to the action of the benzodiazepine and will now need more of the drug to maintain the same degree of action. It is a well-known fact that if you take a benzodiazepine on a regular basis and for an extended period of time, you will at some point experience tolerance. (Read the previous section, above, for more about "tolerance").

When you experience tolerance, you may begin to suffer from symptoms of withdrawal. You have not actually begun to taper off the benzodiazepine, but your body signals say that you are. Because your brain has developed a tolerance to the drug and is requiring more to produce the same effect, and because you have not increased your dose to keep up, your brain sees it as less than adequate, in essence withdrawing from the necessary dose of the drug to maintain action.

The symptoms of "Tolerance Withdrawal" can be confusing. Often one will assume that their condition is simply getting worse. Most doctors do not inform their patients that once they achieve tolerance they may start to experience symptoms of withdrawal, or even that such a problem can occur. But then again, it would seem that many doctors themselves are unaware of this potential problem.

If you begin to experience Tolerance Withdrawal, your doctor may decide that you should undergo a battery of tests, as both they and their patients are usually unaware of potential Tolerance Withdrawal problems. It is not uncommon for MRIs, CT scans, blood-work and numerous other tests to be carried out. While it is always prudent to check out new symptoms, if the symptoms are the result of Tolerance Withdrawal, the patient is left with a "we found nothing to explain your symptoms" result. This is certainly good news in terms of your general health, but can leave you questioning your own sanity: "How can I be feeling so awful and yet nothing is wrong"?

The usual course of action by a doctor is to simply increase the dose of the benzodiazepine, possibly add a second benzodiazepine, or perhaps even add another medication to the mix such as an antidepressant. This may be a temporary "fix" for the problem, but inevitably tolerance to the new dose will again be achieved, and you will most probably once more face symptoms of withdrawal. You can again up your dose and perpetuate this vicious circle, or you can choose to stabilize your dose and begin a proper withdrawal taper. - Which sounds better to you?

Protracted Withdrawal Syndrome

It is first important to understand that, generally speaking, a syndrome is not a disease, per se. Rather, it is a collection of symptoms associated with a particular condition where the causal mechanism is unknown. If you have read the withdrawal symptoms list above, you will be familiar with the possible effects associated with benzodiazepine withdrawal. If these withdrawal symptoms continue for some months after you have finished your taper, then your symptoms can be said to be "protracted"; this does not mean permanent! Therefore, Protracted Withdrawal Syndrome (PWS) is just a label to indicate that you have not been lucky enough for your withdrawal symptoms to have cleared up (or largely cleared up) within some weeks or a few months of your having taken your last dose of a benzodiazepine.

PWS is characterised by a group of symptoms that are assessed clinically (not by blood tests etc.). Because the cause for these protracted symptoms is not understood, and these symptoms go on for some time, then the term "PWS" is appropriate, but actually not very helpful. Some of us take longer to get better; it would be a mistake to think that you have another disease - PWS is not a disease! It is probably better to think of PWS as "protracted withdrawal symptoms", because that is exactly what they are!

Page Contents

• What is the BuddiesGuide?
• Introduction
• Cold Turkey - Danger!
• Tolerance: how we become dependent
• Side Effects
• Tolerance Withdrawal
• Withdrawal Effects
• Protracted Withdrawal Syndrome

Shoutbox

Today at 05:33:36 AM Beeper - G'Nite, Buddies! Have a good Night/Day. Today at 03:38:35 AM xanax_slave - doc wont give me enough valium to get me through! ?? Today at 03:10:44 AM beachrose - Thanks so much Beeper!  Today at 03:09:30 AM Beeper - I'm REALLY happy now. : : Today at 03:08:39 AM Beeper -  Beachrose is Free at Last! Today at 02:42:08 AM beachrose - Hey Beeper- doing great!  How about you? Today at 02:22:13 AM Beeper - How you doin'. beachrose? Yesterday at 09:52:01 PM Beeper - Welcome to BenzoBuddies, lucy!  Yesterday at 08:14:07 PM timber - happy b-day everyone Yesterday at 02:42:45 PM eljay - Happy Birthday Mikey!!

Stepping-Off! The step-by-step approach to being benzo-free!
Step No.	No. of tabs.	Percent cut
!BENZO-FREE!
0.5	1/8	50.00%
1	1/4	50.00%
1.5	3/8	25.0/33.3%
2	1/2	33.33%
2.5	5/8	16.7/20.0%
3	3/4	25.00%
3.5	7/8	12.5/14.3%
4	1	20.00%
4.5	1 1/8	10.0/11.1%
5	1 1/4	16.67%
5.5	1 3/8	8.33/9.09%
6	1 1/2	14.29%
6.5	1 5/8	7.14/7.69%
7	1 3/4	12.50%
7.5	1 7/8	6.25/6.67%
8	2	11.11%
8.5	2 1/8	5.56/5.88%
9	2 1/4	10.00%
10	2 1/2	9.09%
11	2 3/4	8.33%
12	3	7.69%
13	3 1/4	7.14%
14	3 1/2	6.67%
15	3 3/4	6.25%
16	4	5.88%
17	4 1/4	5.56%
18	4 1/2	10.00%
19	5	9.09%
20	5 1/2	8.33%
21	6	7.69%
22	6 1/2	7.14%
23	7	6.67%
24	7 1/2	6.25%
25	8	5.88%
26	8 1/2	5.56%
27	9	10.00%
28	10	9.09%
29	11	8.33%
30	12	7.69%
31	13	7.14%
32	14	6.67%
33	15	6.25%
34	16	5.88%
35	17	5.56%
36	18	10.00%
37	20
EXPLANATION to the Stepping-Off table

Tip

Think positive!

Your brain doesn't filter out negatives. So if you are thinking, "I don't want to feel anxious," your brain is getting the message, "I want to feel anxious." Instead, think, "I want to feel calm." Your brain gets the message! Think positive!