Tolerance vs Stabilization

Aren’t these ideas contradictory?

 

I keep reading that tolerance to benzodiazepines develops quickly yet the whole premise of taper plans seem to require stabilization. How does one stabilize without developing tolerance?

Aren’t these ideas contradictory?

 

I keep reading that tolerance to benzodiazepines develops quickly yet the whole premise of taper plans seem to require stabilization. How does one stabilize without developing tolerance?

 

" the whole premise of taper plans" is to lower your dose at a rate that approximates your body's recovery rate.

So the body can simultaneously become accustomed to a higher dose AND recover from a lower dose?

 

I’m not trying to be argumentative I’m genuinely confused.

I have been unable to stabilize. Long holds and slow taper. No windows. I was in relative withdrawal at the start. But the taper has been over a year of extreme depression and anxiety, with no real relief. Totally caused by klonopin use and withdrawal. I am on .3mg. and just microtapering to get off, accepting I was not able to taper without a lot of misery. Stabilizing, for some of us, just means survival. I am in the unlucky minority. But, I still hope to heal. Esperanza

So the body can simultaneously become accustomed to a higher dose AND recover from a lower dose?

 

I’m not trying to be argumentative I’m genuinely confused.

 

If you take a benzo for very long, you will become "accustomed" to it.  This is tolerance (NOT "tolerance withdrawal", if there is such a thing  )  Tolerance is a completely normal physiological response to the continues presence of some external substance or stimuli.  It will occur with almost any psych med, as well as many simply physical medicine/remedies.

 

When you reduce that  dosage, the body will likewise make an adjustment, and begin to return to equilibrium.  This is what we call recovery, the physiological process of adjusting a lower dose of the substance, or the absence of the substance.

Rdandy,

I think you may have wanted an answer regarding benzos, though Builder is absolutely correct in his explanation.

As I understand it,,,,,,

When I took benzos 50 years ago my receptors noticed the extra exogenous source and  down regulated. Eventually the number of receptors in action are probably minimal. It’s probable diazepam now does little for me if I ever updose. .

However if I reduce my Diazepam as I must do in due course, then I feel anxious because such receptors I have are in a shoddy state and without exogenous diazepam I feel withdrawal. Therein starts recovery as the body decides to repair the damaged receptors which frustratingly takes time.

 

There is a weird thing though, I have sometimes felt less anxious when forgetting a dose of valium, possibly because of its half life.

Please correct me folks if I am wrong

Dick

Rdandy,

I think you may have wanted an answer regarding benzos, though Builder is absolutely correct in his explanation.

 

 

 

My answer absolutely applies to benzos. 

 

Benzos are a textbook example of the  tolerance, dependence, withdrawal, and recovery processes.

Rdandy,

 

I've been confused about this same thing and I think over the years many on BB have.  I am not a long term user, but I've never been stable on a dosage either.  Back in December I did a rapid taper from about 1.2 mg average Ativan down to 0.75 in January.  I was never well or stable so I've been holding since early February, although now starting a very slow move down.  While holding I cant help worry if I'm still stabilizing or becoming tolerant as I feel things change and wax and wane.

 

I think tolerance and dependence both relate to dependence, but the words indicate a relative amount of dependence.  Tolerance seems to mean so much dependence that your dose no longer does anything such that folks need to be increased in dosage.  "Dependence" just means your body needs some level of drug to function without withdrawal.

 

My thinking is that tolerance is something that happens after a very long time of a stable dose and stable symptoms (usually none or very minor.)  Since I'm a fairly short term user and I've never been really stable and always had symptoms I feel like it cant be tolerance and is still just recovery from a messed up CNS from the rapid taper.  And if you are doing a slow taper and your symptoms start to increase, that's due to the taper going below your dependence point.  I don't think you can technically get into "tolerance" while moving down.

 

It gets confusing though since by moving down you are technically just going below the point where you would have tolerance. 

 

I think the main fear is that you will have a bad taper if you reach "tolerance".  Some folks do have a bad taper, but are not always starting from tolerance.  I think there's some mystery here about it.  It could be related to just how much healing is required in different cases, with very long term users requiring more healing and much more time moving down.