Is milk ok for liquid taper?

Hi

Many buddies are disappointed when they learnt that with few exceptions (Ex: Oxazepam) most benzos are not soluble in water. Due to its characteristics, the use of water is neither good to dissolve nor to suspend benzos in a solution. Next reaction is trying to substitute water (as solvent) with something else, for instance alcohol, milk, fruit juice, compounded solution...But does the new solution work and how well does it work?

If you swallow the same dose of benzo in dry tablets or dissolved in Vodka, in milk or suspended in compounded solution, is the quantity of benzo absorbed by your body not the same? A Cartesian mind would say that provided the quantity of benzo remains the same, swallow it under which ever form does not matter, the efficacy would remain unchanged. At first sight it seems pretty convincing but there's perhaps something else.

Let's take the example of benzos dissolved in milk, dairy or vegetarian like almond milk. The fat in the milk has the capability to dissolve benzo and in the final solution benzo ingredient is uniformly distributed within the volume. When you drink your dose, it rapidly transits from the mouth where the slightly acidic saliva combines with milk and starts to break it down. When you swallow the milk, it travels down the esophagus into the stomach. The pyloric sphincter separating the stomach from the small intestine closes to force the milk to remain in the stomach and be digested by stomach acid. Gastric juices in the stomach come then into the game to break down the milk further and kill any living bacteria. Then the pyloric sphincter opens and the stomach sends the processed milk into the small intestine, where nutrients are absorbed. The small intestine is ideal for absortion work as it presents a much larger surface area for absorption compared to the stomach.

During the time it passed in the stomach environment, milk has been submitted to the churning action of the stomach muscles that physically crushes and mixes the food combined with the acids and enzymes for the chemical breakdown of food. Since benzo can’t move into the small intestine immediately, this considerably reduces the absorption of benzo into the bloodstream.

What happens when alcohol is used as solvent instead of milk? Most alcohol absorption into the body happens in the small intestine. The solution will rapidly transit by the empty stomach, where it leaves behind a small quantity due to the acid environment, to finish into the small intestine where it is absorbed into the bloodstream with minimum loss. From a dose viewpoint, this is the method that preserves most of the initial quantity.

What happens when the stomach is NOT empty? If one drinks benzo solution with food in the stomach, the solution will be considered as part of the food and together with existing food will be retained and processed in the stomach until it is ready to pass to the small intestine. Its efficacy will defintely reduce following this treatment. The same principle applies when the solution is a viscous compounded solution or a thick fruit juice taken right after to "wash". They will be both considered as food and will undergo the same treatment as food. To further clarify the different ways our digestive system treats "solid" food and "liquid" food, let's take the example of people who drink alcohol with empty stomach vs during a fatty meal. Actually the way the meal is processed by our stomach can reduce the peak blood alcohol concentration (BAC) up to 50% relative to that produced when alcohol is consumed on an empty stomach. This is why it is easier to get drunk with the same quantity of alcohol when the stomach is empty.

Another point is that many of the medicines need protection from the harsh stomach environment, which could lower the effects, damage or at worst destroy them before they get a chance to work. Medicines must get where they need to go to do their work, without being lost in other areas of the body. Tablets, capsules, liquids, powders, suspensions, injections, and enemas are some of the key delivery modes to get the medicines into our bodies so they can do their jobs. The coating placed on tablets and capsules is a means of managing medication within the body. In case of benzo, by its consistency and formulation the coating allows delayed release in the small intestine. By breaking and dissolving those tablets to prepare our solution, the coating is destroyed together with other excipients as binders, disintegrators ... The more time the ingredient remains exposed in the "hostile" stomach environment, the more vulnerable it becomes to loss of efficacy.

It is not seldom to read posts from buddies reporting reduction of effects, placebo effects, cold turkey effects...when going from tablets to solution. To minimize those effects a few points to pay attention to:

- Alcohol used as solvent will preserve most of the benzo quantity

- Milk, compound solutions will induce loss of the benzo quantity in a measure more or less important ranging from 5-10% to large absence of effects that might induce withdrawal symptoms

- Dose taken with empty stomach will be better absorbed than with fatty meal.

Hope it helps.

I do not understand this post.

There appears to be some contradictory info here about using full fat milk for liquid titration, but I’m not sure if I’m reading that or not.

When I first joined BB, liquid titration with milk was the “way to go” if someone wanted to do liquid titration. And then I noticed later on that many people were using the scales to microtaper.

Now I notice that numerous folks use alcohol (vodka) or PG more often than milk. Well, I don’t know many of the people here on BB now, but it appears that the liquid titrators are using vodka, everclear, or PG.

At the bottom of this post are those “tips.” Yes, I would agree that taking your titrated Benzo on a basically empty stomach probably works best in spite of disclaimers to the contrary. I really think people do whatever they want though, and I realize you are posting about optimal results.

It’s the 2 tips before that I’m wondering about. Are you saying that using alcohol for titration is superior to using full fat milk? I would appreciate clarification here. Thanks for any further explanation.

Hi Intend to be off

First thank you for taking the time to read and comment.

When I first joined BB, liquid titration with milk was the “way to go” if someone wanted to do liquid titration. And then I noticed later on that many people were using the scales to microtaper.

What I have been witnessing from the moment I joined one year ago is that there have been always 2 main ways buddies go for micro taper: the seemingly easier Dry Cut and the Liquid Taper. I do not have the same feeling as yours about a clear evolution from liquid to dry taper. But perhaps it was the case before I joined? Nowadays I would hesitate to say which method is more used than the other. Perhaps Dry Cut?

Now I notice that numerous folks use alcohol (vodka) or PG more often than milk. Well, I don’t know many of the people here on BB now, but it appears that the liquid titrators are using vodka, everclear, or PG.

Humm! I wish it was the case! Although alcohol, PG are recommended by knowledgeable people in the BB, I continue to see buddies using milk. In many other cases milk is where newcomers immediately redirected their attention to when they learnt that water is not indicated. For some reasons, alcohol is not well seen even at a quantity that would make any detection by taste difficult.

Are you saying that using alcohol for titration is superior to using full fat milk?

YES! Definitely.

I would appreciate clarification here.

In the digestion process milk is considered as a food in all aspects. The moment it goes to the stomach the mechanical and chemical work from the harsh environment of the stomach start. During this activity, benzo that would be best absorbed in the small intestine, will be exposed and loose consequently a portion of its potency. When the processed milk is ready, the passage between the stomach and the small intestine opens. The remaining benzo flows together with the processed milk to the small intestine where nutrients and benzo are optimally absorbed by the vast surface of the small intestine.

When alcohol based solution with dissolved benzo goes to the stomach, especially when this one is empty, it is considered as a specific liquid food and does not require as much of "attention" from the stomach work. The lapse time it transits in the stomach is minimized and so is the loss. It does not have to undergo the "silly" treatment reserved for solid food that is the cause of the loss. The example of drinking alcohol at empty stomach vs stomach with food just shows that should alcohol be treated as solid food then the result will be different and up to 50% of its inebriant effect can be lost. Now if you replace in the example the word "alcohol" with "benzo-dissolved-in-alcohol" then it is possible to explain why in certain cases buddies felt a drop of effects passing from tablets to milk-based solution or compounded solution from pharmacy. This phenomenon is known and you can find many interesting writings on the web, frequently under the topic: Reduced bioavailability.

Hope I partially answered your questions.

Thank you for this interesting post.  I have not been on the forum in a while as I started to titrate using whole milk and for the most part have not had problems.  This week is the first really bad time I am having.  I started at 1 mg and am down to close to .50 mg.  Is it to my advantage to stay with whole milk? 

Thank you

Hi Brooklyn1998

I started at 1 mg and am down to close to .50 mg

If milk has been working so far, there is no reason why it does not continue to work. What is your current taper pace? How long did you take to get from 1 mg to 0.5 mg?

Hi Jim Hawk.

And thank you again for your reply.

Yes, I have belonged to BB for awhile now, and I have seen the progression from liquid tapering to using the dry cut with scales. To be fair, I did spend most of my time on the now archived Klonopin Klub #1, and the first people I met there were doing liquid titration with milk. It did become a huge Support group, and as people joined, more began to use the dry cut with scales.

I did not want to try it because I was satisfied with the milk taper, and I have read that the pill itself does not necessarily have the drug itself spread equally throughout the pill. Therefore it was possible that a person could be making these micro cuts and cutting off mainly fillers, binders, and excipients, and not the drug itself. There is no question, however, that it works for many.

I have also read that consistency in tapering is as important as accuracy. I also personally feel that the brain becomes accustomed to the procedure one uses, and for me personally I felt physically better by sticking with my process. By that I mean I did not experience w/d sx much at all, but several side effects I experienced with K stopped completely.

I had a lapse of time where I was not reading BB much due to a variety of circumstances. My husband and I spent many months having to put a new roof on our house, and then I was forced to switch to another generic K which required I hold on the tapered dose I was on and allow time for adjustment. This has happened to me several times, and has made tapering difficult as I could not “get on with it.”

As far as alcohol not being well received, many members that I know of (I’m not knowledgeable about hardly any new ones) have been told that alcohol works on the same GABA receptors and prevents their up-regulation. I realize we are talking a very small amount of alcohol here, but nevertheless the stigma of using alcohol persists.

I do understand (after giving it some thought after posting) that the milk titrated Benzo goes through the digestion process as milk is definitely food as you say. And if one uses the alcohol by itself on an empty stomach, it will quickly be picked up, after rapid processing in the digestive system, and quickly enter the blood stream. I have felt this effect myself after drinking a small amount of wine on an empty stomach (before this Benzo business). I have never been much of a drinker, but a 4 oz. glass of wine would cause me to feel somewhat intoxicated quickly. It was not a feeling I liked at all.

When I began the titration process, I took my tablets in milk for over 30 days, and I never felt that drop in bioavailability at all. I cannot explain that, but it nevertheless happened that way. Most likely, if I did try the alcohol titration now, the amount I withdraw would be more than I’m used to even though the syringe would indicate the same amount, and I could possibly feel w/d sx strongly.

I will just say that I had a very troubled cross from Xanax to klonopin due to total lack of knowledge by my first pdoc. She had no idea what she was doing, and I had to figure this out on my own. Well I’ve added in a lot of my own history here. Nevertheless, it’s a good thing to question and ask for information.

Thank you again for your explanation and reply.

Hi Brooklyn1998

 

I started at 1 mg and am down to close to .50 mg

If milk has been working so far, there is no reason why it does not continue to work. What is your current taper pace? How long did you take to get from 1 mg to 0.5 mg?

 

I started 2/1/2018 and go down in increments of .50 ml.  When I was dry cutting and got to .50mg k i had a similar issue with anxiety/ocd breakdown.  Today I took extra by a removing 48 ml out of 120 ml, instead of where I was at which was 52.50ml out of 120 ml.

Hi Intend to be off

When I began the titration process, I took my tablets in milk for over 30 days, and I never felt that drop in bioavailability at all. I cannot explain that, but it nevertheless happened that way.

There might be a few reasons. One is that the dose you were taking was more important than what you needed and despite the loss it was still enough to avoid symptoms. Another reason could be that the loss in your case was insignifiant because of your personal metabolism or because your doses were taken with empty stomach and that accelerated the passage to the small intestine thus keeping the loss limited.

if I did try the alcohol titration now, the amount I withdraw would be more than I’m used to even though the syringe would indicate the same amount, and I could possibly feel w/d sx strongly.

You won't! You would actually withdraw more but in the same time your organism would absorb more too.

Hi Brooklyn1998

go down in increments of .50 ml

I fear I lost the count . What is the concentration of your solution? How many tablets do you dissolve in 120 ml? What solvent do you use? Is 120 ml the solution you have to prepare each day?

Sorry if I ask so many questions. That would help me to get an idea on the optimal way to taper the last 0.5 mg.

Thanks Jim,

I am using 2ml vodka / 1mg diazepam left over night.

I then dilute this with water to a total of 80ml so it is easy to split in to the 16 doses that last four days.

I presume diluting the alcohol is not causing any problems?

Hi Ajusta

I presume diluting the alcohol is not causing any problems?

You do everything correctly. Not only will it not create any problem, water is NEEDED to make up the solution with the right concentration after benzo has been dissolved by alcohol.

Going further down in the taper, what's next after the 80 ml?

Hi Brooklyn1998

 

go down in increments of .50 ml

I fear I lost the count . What is the concentration of your solution? How many tablets do you dissolve in 120 ml? What solvent do you use? Is 120 ml the solution you have to prepare each day?

 

Sorry if I ask so many questions. That would help me to get an idea on the optimal way to taper the last 0.5 mg.

Oh sure, thank you!

So I use 1mg K tablets, dissolve one into 120 ml of whole milk.  I then take out in increments of .50 ml.  I basically have almost reached the half way point of removing 60 ml but I started to have tremors, headache and bad anxiety this week so I decreased the amount I am taking out if this makes sense.  Prior to that I felt so good, and actually felt like I was being liberated in a way from the K.

It is all based on a spreadsheet I got from here by Canuck.

I am very sensitive to medication and medication changes in general. 

Thanks for any thoughts you have.

Hi Brooklyn1998

A quick calculation showed that by reducing recently 0.50 ml over 60 ml (by itself represents 0.5 mg of Clonazepam), you are tapering at a pace of about 12% every 14 days (0.5 / 60 * 100 * 14). Comparing to the general recommendations to reduce between 5-10% every 10-14 days you are at the fast end of the range.

When you first started the taper with 120 ml, the pace was 6% every 14 days (0.50 / 120 * 100 * 14). Going down further with the fixed reduction quantity of 0.50 ml you are increasing this pace. Since you seem to reach a threshold where symptoms start to kick in, I would like to suggest to come back to the initial pace. Instead of removing 0.50 ml, remove 0.25 ml as from now. It would lower your taper pace back to 6% every 14 days (0.25 / 60 * 100 * 14) when symptoms were still manageable.

Hope things improve.

Hi Brooklyn1998

 

A quick calculation showed that by reducing recently 0.50 ml over 60 ml (by itself represents 0.5 mg of Clonazepam), you are tapering at a pace of about 12% every 14 days (0.5 / 60 * 100 * 14). Comparing to the general recommendations to reduce between 5-10% every 10-14 days you are at the fast end of the range.

 

When you first started the taper with 120 ml, the pace was 6% every 14 days (0.50 / 120 * 100 * 14). Going down further with the fixed reduction quantity of 0.50 ml you are increasing this pace. Since you seem to reach a threshold where symptoms start to kick in, I would like to suggest to come back to the initial pace. Instead of removing 0.50 ml, remove 0.25 ml as from now. It would lower your taper pace back to 6% every 14 days (0.25 / 60 * 100 * 14) when symptoms were still manageable.

 

Hope things improve.

 

 

That makes sense.  Thank you for your help and understanding my numbers-i am not a number person and i am particularly loopy with them right now.

Thank you so very much!  It is hard to express in words how much truly...thank you

Hi Ajusta

 

I presume diluting the alcohol is not causing any problems?

You do everything correctly. Not only will it not create any problem, water is NEEDED to make up the solution with the right concentration after benzo has been dissolved by alcohol.

 

Going further down in the taper, what's next after the 80 ml?

 

Thanks Jim!

Not sure atm because symptoms are v.bad so need to hold for a bit and see what happens.

I expect what i’ll Do once I can is slowly reduce the amount from 5ml/dose until it is approaching the point where I can use 6 instead of 7 pills/ 4 days make that up in to 8ml and start again at 5ml/dose.