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The pill method vs water titration


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Hello, thank you for your great forum...

 

I have this question...

 

When using the water titration method, is there possibility that, due to the titration process, I may, in fact (statistically), provide the body with less of the active substance than in the case of the pill method? What I mean is that, if I dissolve a 1 mg pill in the jar, some of it (even though I rinse everything down super carefully, dissolve it as best as I can, etc) could end up somewhere else (evaporation, sediment, on sides of the jar, etc, etc)? So, even if the syringe shows, let us say 0.39 mg (as in my case), in reality it could be a bit less?

 

Some time ago I switched from a pill to water titration, and made some serious mistakes. I am trying to fix them all, and I don't want to make more of them, which is why I am asking this question.

 

What is your opinion?

 

Thank you so much for your help and advice! I am suffering terribly these days...

 

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Hi BR, I'd say the answer to your question is No.  If you are rinsing well and being careful you will get the entire dose.  But even if there was some slight loss it would not matter as, from one day to the next, you are doing the same thing so the loss would only be felt once.

 

I'm more concerned about your use of water to titrate.  Although some do use it successfully generally you will be better of with a liquid that dissolves the benzo.

 

Sorry you are suffering.  What's going on?  What benzo?

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Hello, SG57, thank you for your help so much... Here's my story...

 

For at least 10 -12 months (maybe more) I have been taking Lorazepam... I did it in a very bad way... skipping days, irregularly... It would usually take 0.5 mg one day, then skipped the next. But, quite often, I would take 2, and seldom, but it happened too, 3 pills in a row... then take a one day break.

 

As I counted, I would take an average 25 of 1 mg pills for every 70 days...  So, it would be, on average, about 0.39 mg a day.

At some point I realized that it's a very bad idea... so I switched to water titration and started to take 4 even doses a day...

Unfortunately, I did one more thing I probably shouldn't have done - I reduced the dose of the benzo to 0.25 mg a day (in 4 doses) in a couple of days. I feel the reduction - the WD symptoms include anhedonia and severe anxiety... It's been 11 days since the reduction... I am now trying to figure out how I should up the dose, and to what level?  :-[

 

You mentioned "a liquid that dissolves the benzo". What would be the best do you think?

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If it's been only 11 days I'd up the dose and get yourself feeling good first.  Don't even think of tapering until you feel better.  What dose did you last feel good at?

 

As for the liquid, with lorazepam it dissolves in alcohol.  I never used lorazepam, but others do this.  Also, with a doctors script you can get liquid made for you at a compounding pharmacy.  And then there is Ora Plus which is a good quality suspension liquid.  This doesn't actually dissolve it, but it duspends it much better than water.

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I think that lorazepam is one of the benzos that doesn't dissolve well in milk.  It's pretty much insoluble in water.  It will dissolve into alcohol.  There's a study on its solubility in ethanol (as well as other solvents) here...

 

http://journals.ju.edu.jo/JJPS/article/viewFile/3219/2788

 

From what I see, you want the alcohol concentration to be above 60%, so don't use regular vodka.  151 rum should work well.  You should easily be able to dissolve the active ingredients of a pill in 1 milliliter of 151 rum.  The alcohol may affect the rate at which the drug is absorbed (I'm thinking that it may be absorbed faster).

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Thank you again, SG57... The last "tolerable" dose was 0.39 mg... I then almost immediately went down to 0.25 mg... I'm very very scared now... What do you think... how long it may take to at least start feeling some improvement?

 

I would try with alcohol... Is it safe? They always say not to drink alcohol when you take benzo (I am absolutely not questioning what you are saying here, SG57, I just don't want to make any mistakes in the state I am in now...) What is the method? The same as with water?

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Thank you, badsocref... Oh God... I got scared now... you wrote:

 

"It's pretty much insoluble in water"

 

Does this mean that in the last 11 days I have been in a WD even more severe than I thought?? If I dissolved 1 mg pill in water, how much of an active ingredient my body may have absorbed from it then... ? :(

 

 

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Thank you again, SG57... The last "tolerable" dose was 0.39 mg... I then almost immediately went down to 0.25 mg... I'm very very scared now... What do you think... how long it may take to at least start feeling some improvement?

 

I would try with alcohol... Is it safe? They always say not to drink alcohol when you take benzo (I am absolutely not questioning what you are saying here, SG57, I just don't want to make any mistakes in the state I am in now...) What is the method? The same as with water?

 

Honestly, if it were me I'd go back to .39mg and hold there until I felt better.  I would not try to tough it out at .25mg.

 

The amount of alcohol we are talking about is small enough to not interfere.  And don't worry about the insolubility in water.  The drug is still there, just not spread as evenly as we'd like in water.

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Does this mean that in the last 11 days I have been in a WD even more severe than I thought?? If I dissolved 1 mg pill in water, how much of an active ingredient my body may have absorbed from it then... ? :(

 

Very difficult to know how much med you were getting.  Insoluble doesn't mean zero, and the med may have still been suspended when you took it.  Like I said - very difficult to know.

 

Don't be scared (that won't help with anything).  What's done is done, and I'm sure you'll survive it.  You just made it through 11 days of what is likely to be a pretty significant drop in your dose.  Perhaps almost the equivalent of a c/t???  You're still inside that two-week window, so probably fine to reinstate back at a level that was working for you.  Lots of options here.  Might wish to explore those options a bit.

 

You might wish to update your signature so we can better support you (by knowing where you've been and where you are in your withdrawal).

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Thank you for your explantion, Badsocref...

 

You mentioned that it will work better in rum:

 

"You should easily be able to dissolve the active ingredients of a pill in 1 milliliter of 151 rum"

 

So, if I understand it correctly, I should first dissolve it in 1 milliliter of it, and then mix it with water, then drink, yes?

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Thank you, badsocref... Oh God... I got scared now... you wrote:

 

"It's pretty much insoluble in water"

 

Does this mean that in the last 11 days I have been in a WD even more severe than I thought?? If I dissolved 1 mg pill in water, how much of an active ingredient my body may have absorbed from it then... ? :(

 

If your drinking the whole glass of water, you are still getting the full dose.  Even though it's essentially insoluble in water, if drop it in a container of water, all the med is still there, even if it doesn't dissolve.

 

Not much different than taking a pill and washing it down with a glass of water.

 

BTW, ativan is available in a pharma-grade liquid, 2ml per mg.

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No water.  Just 151 rum.  One ml of rum is hardly anything.  A 'shot' is 25-37 mls (or 50-75 mls if I'm pouring).  :D

 

After you swallow the rum, you can wash the shot down with a little water if you wish.

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If your drinking the whole glass of water, you are still getting the full dose.  Even though it's essentially insoluble in water, if drop it in a container of water, all the med is still there, even if it doesn't dissolve.

 

True - as long as all of the med gets swallowed.  My concern is that the med may prefer the side of the glass or cup instead of remaining in the water.  Maybe not an issue if prepared and drunk quickly enough.  No concern with 151 rum.

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If your drinking the whole glass of water, you are still getting the full dose.  Even though it's essentially insoluble in water, if drop it in a container of water, all the med is still there, even if it doesn't dissolve.

 

True - as long as all of the med gets swallowed.  My concern is that the med may prefer the side of the glass or cup instead of remaining in the water.  Maybe not an issue if prepared and drunk quickly enough.  No concern with 151 rum.

 

If that's really a concern, just rinse the glass and drink the rinse water.

 

But you really don't need to be that concerned over small variations.  There will even be +/- as much as 5% variation from one tablet to another, and from one batch to another. 

 

Best alternative-Ativan Intensol Liquid.

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