BIC percentages vs. Ashton percentages?

Like many who are looking towards the light at the end of the tunnel, I've been eyeing the end game of my taper in advance. (I realize and accept that I need to be flexible and adapt to circumstances.)

 

When I say "Ashton percentages", I'm looking at stages 26-36 of Ashton's Schedule 3 taper here https://www.benzo.org.uk/manual/bzsched.htm#s3

 

The cut from 10mg Valium to 9mg is 10 percent, but obviously the subsequent cuts are larger. I assume that many people have succeeded with this schedule? I realize some of us need a gentler taper via smaller cuts using different methods.

 

So my main question is, how does one reconcile this from the Benzo Info Coalition? https://www.benzoinfo.com/2017/10/09/benzodiazepine-tapering-strategies-and-solutions/

 

Problems with Available Benzodiazepine Milligrams

How does one accomplish a 10% reduction every 2-4 weeks from potent benzodiazepines such as Ativan, Xanax and Klonopin that are not available in very small dosages? For some, substituting the original benzodiazepine in a stepwise fashion over to Valium and making small reductions per the Ashton method is very successful.

 

In other words, the "Ashton method" does not use 10 percent reductions when you read the end of the withdrawal schedule, Valium 10mg to zero.

 

In short: are cuts from Valium 10mg, 9, 8, 7, 6, 5, 4, 3, 2, 1, (0.5), 0 still considered small reductions?

 

I'll note that I haven't had insurmountable problems during my taper (not saying it has been easy). I'm just trying to understand what I read.

 

Thank you

Good for you checking on this!

I was fooled by the Ashton schdule and did a fast taper off my 2.5mg valium crashed big. It says a few weeks from 2mg to zero which is basically ct from my 1 month use. You can find many ppl had to taper much slower that that, like over a year or even more. I believe for ppl who are very sensitive, 10% rule should be applied all the way to the end.

 

 

Understood.. I don't dispute that all sources are saying "do what works best for you, take it slowly if needed".

 

It just seems like the text contradicts itself there. I realize the limitations of dry cutting, etc., and I just want to understand what I'm reading. Yes, people sometimes use micro-cutting or titration to get doses other than what appears in Ashton's taper schedules. Because everyone responds differently.

 

But the taper schedules themselves are not necessarily out of date?

Start slowly, listen to your body and take what it tells you very seriously.

 

Wish I had done that and never read Ashton or any withdrawal sites so when muscles started to get bad thought was normal when for me it isn’t as is why was on Benzos.

 

Should have trusted my body and stayed on them.

Both are valid.  Remember, at this time, we do not know how any one person will be affected by any one approach to a taper.  Which is why there are so many variations.  It's confusing when you are looking to start.

 

Even Dr. Ashton recommends the "patient centric approach".  And if you are a poor metabolizer, you may want to start lower on your cut.  The Mayo Clinic now offers a test for this as part of their GeneGuide:  https://www.mayoclinic.org/mayoclinic-geneguide

 

1.  Start low and slow - think turtles.  It's easier to start lower cut and slower, and ramp up, than to start high and go down when the symptoms get too high.

 

2. Try an approach that feels right for you.  Keep a journal.  You'll realize soon enough if it's not working (withdrawal symptoms  are too much, dry tapering or liquid is a PITA, etc).

 

3.  Start a DBT or CBT program - you'll find free stuff online.  These will help with the symptoms ,as well as learning to listen to what your body is trying to tell you.

 

I started with a dry taper, 2% cut and hold, then moved to a liquid micro taper.  I wish it was as easy as do XYZ  - and if you are polytapering off several drugs, uuuugh .

If you look at my signature, you will see that I have pretty well followed the Ashton taper schedule. I found it to work well. I started off cutting .5mg about every 12 days. From 5 down to my current 0.5 mg I have cut .5 mg per week and found that works well. I have side effects but I just get on with it - they lessen as time goes on. Ashton says complete healing happens after we are off the benzos and I expect that is so.

Hi MessedUp,

 

I was replying to the OP.  Glad the percentages are working out for you.

 

BB

It is more useful to think of dose reductions in terms of percentages when at larger doses, and the amount cut in terms of milligrams at lower doses. However, most benzodiazepines are not available in low enough doses to allow some benzo (dependent) patients to taper down (using percentages) to a dose where discrete cuts to dose (set reductions to dose) can occur without undue withdrawal effects. For this reason, Ashton had her patients cross over to diazepam (Valium) because it is relatively low potency, relatively long half-life, and being available in relatively low doses.

 

So, you might well ask yourself, why is OK to switch to discrete cuts at low doses? Well, at larger doses, much/most of your overall GABA regulation has been taken over by your use of benzodiazepine. So, for given percentage reduction in dose will have corresponding effect upon GABA receptor functioning. However, assuming that you have followed a sensible taper regimen (or initiated your taper from a relatively low dose), the benzodiazepine is having a much smaller effect upon GABA functioning. So, for a given reduction to dose, it will have a much smaller effect on your overall GABA functioning. Put it like this, if your dose was just a single molecule of benzodiazepine per day, and you then quit, this would equate to a reduction of 100% of dose. Clearly, it would be ridiculous to think of the reductions in such terms at low doses. 1mg of Valium has relatively little effects upon GABA functioning, so quitting from 1mg to zero will have relatively little effect. (I am not meaning to suggest that some people do not experience any difficulties - I am only trying to drive home the point of looking to the overall picture. Obviously, people vary).

 

Further, given Valium's relatively long half-life value, the corresponding reduction in blood levels from a reduction to dose occurs over many days (even a week or two) - Valium has some 'in-built' tapering properties. For this reason, it is unusual for people to need to resort Valium tapering strips, compounded formulas or table-top 'titration' methods.

 

For the vast majority of people, there is no reason to be concerned about making 1mg reductions to your diazepam (Valium) dose at the end of your taper. Most people manage just fine with it.

Thank you.

 

I updated my profile so my taper history is a little more clear. I'm in the middle of my taper. I realize Ashton didn't reasonably expect patients to calculate crazy specific small doses and that's why the Valium chart looks like it does. I guess this thread was my musing "can this work, these larger percentages?"

 

Black Betty, I started my taper already and am "eyeing" the end game. I'm learning to be patient. I have a counselor and I'm not sure how much help they are at the moment but I like the option of talking to them about my taper. I did email them some literature on benzo recovery.

 

I'm tapering Klonopin and dose once a day now, 9pm-ish. I'm lucky in that I was in good physical shape when I started my taper, no other drugs, etc. My highest dose was 1.25mg per day and I drank occasionally 1 drink a day on certain days, which I've stopped.

 

Colin, if I had to guess I would say my brain is working better since I started tapering, i.e. normal dreams and more normal sleep compared to when I was taking 1.25mg or even 0.75mg Klonopin per day, better able to function on an emotional plane (but math takes me longer when I have withdrawal symptoms), more hopeful about the future, etc.

 

I'll reread the comments again and consider my plan. Thank you so much.

 

 

Hi haveagreatday,

 

Yes, people can and do experience positives during withdrawal too. It is not unusual to experience a lifting of fog as your dose lowers. I am glad to hear that it is not bad all for you.

 

Good luck.

I did ok with Ashton taper. Had to hold for awhile because of life events. I switched over from .5mg klonopin to 10mg valium. But I had an easy time for the first 80%.

 

I am now at 2mg down from 10mg. But this cut was only 10% of the CURRENT dose and it hit my a lot harder that the previous of 1mg each drop. I'll be doing microtapering the rest of the way. The last 20% is supposed to be the worst. And I was given good advice to hold at least 2 weeks before reducing the dose if you do a cut and drop taper. I'd rather spend the time tapering with minor wds than rapid withdrawal and months of bad wds

Thanks, and I'm glad you're taking your time and doing fairly well. I'm open to longer holds. I think Colin answered my main question which was "why is it ok to have such large percentages".

 

Good luck to you!