Dr. Josef Witt-Doerring: What is a blind taper? Could this be a game changer?

Psychiatrist Dr. Josef Witt-Doerring recently posted this short video: "What is a blind taper? Could this be a game changer?"

 

This could be helpful, we know there is a psychological component to this process, the anticipatory aspect is challenging but finding help doing this would be tough.

I’ve read about least one of our members who did a blind taper with the help of her husband.

Yes, it would have to be done with the help of someone that the person trusts very, very much. Lots to reflect on with this idea.....

I thought about it, i got one of those 7 day pill planners. load it up with the pills and dont pay attention when i open that days pill container and just pop it into my mouth.....id never remember what day i loaded the cut in dose with if i wasnt looking right at it. Sometimes i wonder, cause last dose cut i had insomnia exactly 9 days later, and that happ exactly 9 days the cut before. Is it in my mind cause i know its day 9 after the cut? probably.

Well, the placebo effect is real. I think the doctor is talking about harnessing that. The scenario he describes would be pretty hard to take place though. manufacturing pills on a small scale is probably not economically feasible. But it would be nice!

 

I know the human body thrives on a certain amount of chaos. It needs change, challenge and variety to perform at peak levels. Even our DNA during gestation splits and then does this crazy dance and genes flip, switch and transform into a completely different human being.

 

My jeweler's scale seems pretty accurate. But sometimes it goes off the reservation and I get tired of turning it off and on, pushing the tare button and going through sit again and again. So I just take the pill when the scale says it's about where I need it.

 

I'm fully aware that what I take is different. But I've noticed my body seems to like it and not overreact when I take less.

 

I know, but it works for me!

 

 

Well, the placebo effect is real. I think the doctor is talking about harnessing that. The scenario he describes would be pretty hard to take place though. manufacturing pills on a small scale is probably not economically feasible. But it would be nice!

 

You might be interested to learn that a compounding pharmacy in The Netherlands developed the technology to produce very low dose benzodiazepine tablets several years ago.  See links below (note: the pharmacy ships to other countries).

 

In the case of the member whose husband helped her implement a blind taper, they used a pharma-grade manufacturer’s liquid and diluted it.

 

Links:

 

Tapering strip | Responsibly reducing your medicine intake

https://www.taperingstrip.com/

 

Prescribing and ordering tapering strips | Tapering strip

https://www.taperingstrip.com/prescribing-and-ordering/

 

Indeed, Libertas, Regenboog pharmacy does it. In Belgium now all pharmacies are able to help compound the pills into smaller pieces in tapering strips as well.

Hello, Cocodot.  That’s wonderful news about pharmacies in Belgium.  Can you tell us more about how this came about?  Is it a recent development?

Yes, recent change in the social security system and media campaign since February 2023. Social security now covers tapering off sleeping meds and all pharmacists can compound pills into tapering strips/capsules so no need for special compounding pharmacies. However, the maximum length your taper is in that system is one year and there's some rules on how much time to stay on which dose (with a small extension possible in case of too many symptoms). So I guess the timeframe works for non-sensitive and semi-sensitive people for sure. (Most common benzos/sleeping meds are ambien and xanax, I really ended up on clonazepam by horrible faith because normally they only prescribe that for RLS, fybromyalgia, epilepsy, etc.) Also, most of the time you have a small package of pills max 10 and you don't get these huge refills. Only older people or sick people have a continued prescription. (Again, I had no guidance and rivotril drops so I lasted months with one bottle).

 

But pharmacists can help now regardless also outside of the social security system. Then you just pay for your benzo (often only like €4) and the fee for compounding it. There's also proper manufacturer liquids available for many different benzos: rivotril, xanax, etc. Those you can get diluted to a certain extent by most pharmacies too (two pharmacies confirmed me to very reliably dilute till 1/20th of a drop)(this costs around €15 per time). 

 

For some here on benzo buddies, they'd have to taper outside of the system (including me). At least it does start to acknowledge symptoms can last longer than a couple of weeks. There's still too many local fora where people have all kinds of symptoms after tapering a benzo and ask psychiatrists whether that can be from the benzo and although many answer then "they are very addictive" they also say "after six months it's not possible to still have symptoms, it's a return of the initial anxiety disorder" 

 

It's all in an attempt to lower usage because it's bad and because both the Netherlands and Belgium score extremely high in number of prescriptions in Europe. It's prescribed way too often (even to people like me specifically stating not to want to risk habit forming/mind altering drugs, I got prescribed halcion, ambien and then rivotril, the rivotril was recommended by a therapy center and there the doctor didn't say "not to get stuck on it" or "I'll just give you something similar" so that's how my family thought it would be safe).

 

Pharmacists are trained to always explain you every med you go get (even paracetamol) (again I was unlucky they didn't say anything to save me either). This campaign is now also making them more and more involved and go from pill shops to advice centers.

Thank you so much for this information-rich post, Cocodot.

 

It sounds like Belgium is making progress toward putting supports in place to help individuals safely discontinue benzodiazepines.  Eliminating the barriers of access to appropriate dosage forms and medication cost are both encouraging signs.

 

Re: your comment that individuals on local fora are still struggling with educating their psychiatrists that it is indeed possible to experience benzodiazepine-use-related symptoms 6+ months post-cessation ….

 

Perhaps this video from Dr. Witt-Doerring might help:

 

Don't call it protracted withdrawal (it confuses them)

 

Do benzodiazepine drug labels in Belgium include a Black Box Warning similar to those in the US?  If so, that might be helpful information for individuals to share with their psychiatrists as well.  I was surprised when a well-known psychiatrist here in the US recently shared he was unaware of these warnings, despite the fact they were released in the fall of 2020.

Hi Libertas,

 

Unfortunately Belgium does not have any black box warnings, otherwise I would have noticed and not taken it. There has been more awareness about tapering and the symptoms that come with it but very rapid hospital detoxes are still very common as well. Often the word "addiction" is used also by doctors instead of dependency which is frustrating. The most common drugs prescribed are ambien and xanax and often a decent doctor warns you not to take them regularly but it's very dependent on the specific doctor. Trying to lobby written informed consent for psychoactive drugs in the new patient rights bill, the black box warning is a good idea too. Normally, a pharmacist should explain you but that's clearly also pharmacist dependent. According to the court system, doctors and hospitals carry the burden of proof of informed consent so this would actually protect both patients and prescribers.

Psychiatrist Dr. Josef Witt-Doerring recently posted this short video: "What is a blind taper? Could this be a game changer?"

 

 

I don't love this idea because my withdrawal symptoms weren't all in my head lol. Could be very dangerous. I don't trust the medical profession to correctly taper anyone, let alone blindly.

Psychiatrist Dr. Josef Witt-Doerring recently posted this short video: "What is a blind taper? Could this be a game changer?"

 

 

I don't love this idea because my withdrawal symptoms weren't all in my head lol. Could be very dangerous. I don't trust the medical profession to correctly taper anyone, let alone blindly.

 

Agreed but perhaps a loved one could help estimate. I discuss it with my new GP and parents like what my symptoms are. I did a 3% cut and waited 2 weeks and then another 3% cut and now we decided to try and wait 3 week although I'm kinda stabilized just to see how that goes. We keep track of my symptoms together but in the end it's my decision.

 

I do like how buddy @TheSunAlsoRises helps his wife tapering and so he's also involved in how much and when she cuts. But yes, it's not blind.