Does anybody really get out in the Ashton timeline?

I'm starting to despair a little. I'm currently transitioning to 10mg Valium from 1mg daily of Ativan. My intention is to follow the Ashton method which would put me benzo free in 10 to 20 weeks. However, everywhere I look on this board I see people starting from a similar spot who are taking a year or years to get free. I can't fathom that now. I applaud all who make it in any time frame and I know it is one day at a time but I can't even have a glass of wine with dinner right now without misery at night. I'm hoping the Ashton plan isn't a pipe dream but nothing I've seen on this forum has given me reason to believe otherwise. How many people can actually hit that mark?

I hope my post doesn't come across as too negative. I really do understand the severity of this problem and that it is probably not smart to become invested in a calendar approach vs a "how I feel" approach. I'm just truly curious if there are percentages to back up the success rate of the Ashton taper schedules. I admittedly have only sampled a small section of this forum but even in the success stories section I couldn't find anyone who matched the Ashton schedule. There is an abundance of hope in these forums. I don't want to take away from that. I'd just like to know if Ashton is a bit unrealistic.

I can see you're overwhelmed by the prospect of a long taper, but you need to understand that what Professor Ashton came up with was a guide.  She gave us what no one else did, and we're grateful for it because no one before her and not many since her have given us the tools we need to taper from these drugs.  No two people are alike, so no two journeys off of benzo's is either, it has to be about individual choice.

 

You can design your taper anyway you want to, you can stick to what Ashton recommended, slow it down or speed it up.  Most here found that they needed to listen to their symptoms in order to remain functional so they hold for longer periods, or reduce in smaller amounts.

 

I know you'd like to get this over with as soon as possible, but it doesn't work like that.  You can speed up your taper, but your brain still has healing to do long after you're off the drug.  You can go slow, live our life while tapering and hopefully the real healing begins when you're off the drug.  Or, taper quickly, be miserable and non-functioning and your brain still has recover once the drug is removed.

 

We're the worst case scenarios here, you may not have the trouble we do, but I feel it's important for me to stress to you the possibility of what you may be facing.  And as for finding success rates here on following the Ashton method, you won't find them, we don't have any way of tracking that kind of information.

 

One last thing, glad you're staying away from the wine, as you've found out, it affects the same part of the brain as benzo's, so it can make life miserable.

 

 

 

 

Of course, you are correct. Thanks for the words of reason and encouragement. My natural inclination would be to push as hard as I can to get through this but I can see now that isn’t going to be the smart course. It’s difficult not to feel betrayed by my doctor who put me on these and to not feel like part of my life has been taken from me. I’ll get through this though. Will need positivity, exercise, guidance and maybe some therapy but I’ll get there. Thanks!

I know it's discouraging sometimes but first thing is use this website for information and inspiration. Stay away from the stories, for the most part, or you will be terrified. Most people who post are having a really bad time. I don't think that's the norm. 

 

I used the Ashton method from 10mg to 2mg. I held for 2 weeks then dropped another mg each time. Not too difficult at all. There were a few times I had to hold do the life circumstances but not because the withdrawals were bad. However at 2 mg I slowed the taper way down with a recommendation from a really good pharmacist to take the last 20% with smaller drops and more time in between. I dropped from 2mg to 1.8mg and hit a wall. Not a bad one but it kept me from doing anything for about 2 weeks. I'm SOOOOOO glad I listened to him. That was only 10% of my current dose and if I had done a full 1mg drop I would have been in trouble.

 

People can say "but it takes too long". But time is going to pass whether you taper or not.

 

 

The main reason I decided to come off of it was because I no longer needed it. The second is because I'm terrified that one day I'll get a provider will say they won't prescribe it anymore and yank me off of it. I'd rather go at my own pace now than in the future at someone else's whim. It may not be like that now but it's not long, I think, before it's going to be the next opioid crises and no one will prescribe it. When that happens, OMG all those hundreds of thousands of people who will have to go through rapid tapers. I'd rather not be one of them.

 

You'll go through periods of despair, I know I do. I want to be off it NOW. But when I start feeling that way I stop myself and realize I have to slow down to  minimize the withdrawals.

 

Try and get comfortable with the idea that it may take longer than 20 weeks. You might be fine at that pace but prepare anyway.

 

  Be patient and be kind to yourself. There is no rush. It takes as long as it takes.

 

I'm starting to despair a little. I'm currently transitioning to 10mg Valium from 1mg daily of Ativan. My intention is to follow the Ashton method which would put me benzo free in 10 to 20 weeks. However, everywhere I look on this board I see people starting from a similar spot who are taking a year or years to get free. I can't fathom that now. I applaud all who make it in any time frame and I know it is one day at a time but I can't even have a glass of wine with dinner right now without misery at night. I'm hoping the Ashton plan isn't a pipe dream but nothing I've seen on this forum has given me reason to believe otherwise. How many people can actually hit that mark?

 

Hi Seemam3,

 

I'm relatively new to BB, and just chiming in here because I relate to your question and I think it is similar to one I've had about the Ashton taper.  I started off by using her schedule for a Valium taper from a relatively low dose (12mgs at most) of Valium.  As you know it us a guideline involving a set rate of dose reduction every 1-2 weeks  (versus percentage decrease).

 

It is my impression that since Ashton's schedule was first published decades ago, more awareness has resulted in a general acceptance of recommendation to slow the taper down, especially towards the end.

 

You may have read that some indicate a 10% (or less) decrease of the previous dose every 1-2 weeks.  This results in less 'drastic' changes for our bodies to adjust to e.g. a drop at the end from 1mg to .5mg is a significant 50% decrease, versus a drop earlier on from 10mg to 9mg (10% decrease).

 

The way I see this is 'sliding down'' (gradually reducing the percentage of dose), versus 'jumping down' off levels that are each equally steep.

 

It seems that many people (myself included) experience worsening symptoms towards the end of the taper, at Ashton's schedule rate. For me that was when I was between 2mg - 1mg of Valium.

 

While I believed (come hell or high water) I would find a way to endure the symptoms if necessary, I simultaneously didn't want to compromise my overall recovery by doing that.  I received messages from BB that suggested 'taking it slowly'.  I came to understand that the symptoms might be a signal that my taper was unnecessarily fast.  I didn't want it to be unnecessarily protracted either!

 

I didn't notice on BB that those who were doing a slower taper were necessarily having a better or worse time of it during taper or afterwards, e.g. compared to reports I've read from individuals who followed Ashton's taper to the end. But at the end of the day I understand it does come down to what feels suitable for each of us individually.

 

When I noticed a wall of full-on symptoms after getting to about 1.5 mg of Valium, I made a decision to reduce the rate of my taper accordingly, and stray from Ashton's schedule at that point. 

 

I came to see that slowing down my taper might provide the benefit of 'cushioning' my system while my impaired neurological processes needed support through the process of restoration towards (homeostatic) balance.  I think if my symptoms hadn't worsened when they did I wouldn't have felt I had much reason to slow down my taper.

 

I personally am glad that I heeded the suggestion to slow down in response to the appearance of symptoms that were extremely unpleasant, to say the least.  I feel lucky that the worst of these diminished when I altered my course, and I find my current symptoms debilitating but tolerable.  I also notice improvements and I use these to help gauge the rate of my taper and proceed at the current rate. 

 

A difficulty I had in reducing the percentage dose of Valium was that a 2mg Valium tablet is not easy to reduce accurately into fractional doses (I could manage splitting it in half to 1mg, but quarters to get to .5mg became inconsistent and anything after that was an incalculable crumble.  There are ways of managing this (on BB).

 

I was fortunate to be able to access liquid diazepam (in New Zealand) and I use a 1ml syringe to very gradually reduce my dose at much lesser rate than indicated in Ashton's schedule for Valium taper. 

 

The liquid part of my taper started when I was down to 1mg of Valium on 13th Nov 2019 and I am feeling 'on track' to finish my slide to zero mg in 4 days time.  It will have taken me a total of 9 weeks to slide off that last 1mg.

 

Nine weeks ago that felt like a ridiculously long time to reduce from 1mg (though some would think it's quick).  Nearly nine weeks later it has felt like the right move.  In the duration I have learnt a lot more about the ways that Benzos have impacted my physiology and that understanding has also really helped me through this process. 

 

Glad you found BB.  I wish you all the very best with your taper :-).

 

 

 

 

 

Thank you Mobykal and Agentic, I can only speak in generalities because I don't have first hand experience tapering, but the two of you dropped by with incredibly useful information gained from personal experience. 

 

I just love peer support, this is how it's supposed to work. 

This post has been incredibly valuable for me as well.  Peer support at its finest, and I loved Mobykal's "time is going to pass whether you taper or not". 

Also Angenic - your suggestion of switching to liquid valium at 1mg.  We have that here in Canada.  I think I'm going to try that soon.   

And Pamster........daily, you give me such hope.... I am in awe of your tremendous service.

This site is my toolbox and lifeline.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Seeman3,

 

Pamster is right: the Ashton Manual is essentially a set of guidelines, and Prof. Ashton was quite clear on this when she wrote it: it is not a rigid method, it has to be adapted to each patient.

 

Some individuals are driven by withdrawal symptoms, i.e. they will adjust the pace of their taper to minimise withdrawal symptoms; others are driven by timeline: those individuals place less importance on the withdrawal symptoms, perhaps because their symptoms are not as severe or they can afford to be not fully functional for a while (i.e. they are off work, on leave, have no family responsibilities, have someone who can look after them throughout the withdrawal process, etc...?).

 

Prof Ashton did highlight that the slower the taper, the lower the risk of protracted withdraw symptoms. This is particularly important for those who have been on those medications for a long time. What does a "long time" mean is not clear to me. Perhaps more than 6 months? Who knows... Again, it depends on the individual, the ability of their central nervous system to recover quickly, etc.

 

For what it's worth, I have been tapering off zopiclone (a z-class drug similar to benzodiazepines) at a constant rate equivalent to 0.625mg of valium/diazepam per week. There have been days when it was tough and I really wanted to updose/give up. But I received great support from people on this forum and soldiered through the process, sticking to my dose. This meant a few nights without sleeping or sleeping very little, etc. Then again, as you can see from my profile below, I have not been on those nasty medications for too long (refer to the "long time" discussion in the paragraph above) - and I am not out of the wood yet!

 

So, hang in there. You're not on your own, you will make it through and you will be better.

I can see you're overwhelmed by the prospect of a long taper, but you need to understand that what Professor Ashton came up with was a guide.  She gave us what no one else did, and we're grateful for it because no one before her and not many since her have given us the tools we need to taper from these drugs.  No two people are alike, so no two journeys off of benzo's is either, it has to be about individual choice.

 

You can design your taper anyway you want to, you can stick to what Ashton recommended, slow it down or speed it up.  Most here found that they needed to listen to their symptoms in order to remain functional so they hold for longer periods, or reduce in smaller amounts.

 

Pamster really nailed it with her post.  You can adjust the taper to best suit yourself and adjust it to a rate that you can handle and try to minimize discomfort.

 

Dr. Ashton herself later concluded that a slower rate than what she had originally wrote about in her book might be better for most people. In a paper that I believe she wrote in 2005 she concluded that a slower rate might be better for most people.

https://www.benzo.org.uk/amisc/ashdiag.pdf On p. 4 under the heading of "Therapeutic dose users" she wrote:

 

"Benzodiazepine dosage should be tapered gradually since abrupt withdrawal, especially from high doses, can precipitate convulsions, acute psychotic states and other severe reactions (Table 3). The recommended rate of tapering for patients on therapeutic doses of benzodiazepine is withdrawal in steps of about one-eighth to one-tenth of the daily dose every 1–2 weeks."

 

Perhaps of interest/relevance?  BMA = British Medical Association.  Dated November 2013. Do we have members who can verify this and/or provide a link to the “amended text” referenced?

 

BMA - Slower sedative withdrawal recommended

https://www.bma.org.uk/news/2013/november/slower-sedative-withdrawal-recommended

 

Slower sedative withdrawal recommended

 

Gold-standard advice for slower benzodiazepine withdrawal has been issued following a warning from the BMA.

 

The association was concerned that patients with long-term addictions could suffer conditions such as confusion, toxic psychosis and convulsions under existing schedules.

 

As a result, the BNF (British National Formulary) published revised recommendations on the prescription medication last week.

 

Previous best practice advice stated that doses could be reduced by about an eighth – ranging from a tenth to a quarter – every fortnight. In practice, this often meant doctors and clinics were withdrawing patients at a rate of 25 per cent every two weeks.

 

A BMA meeting on addiction to prescribed medicines earlier this year agreed there was compelling evidence for change, leading then BMA board of science chair Averil Mansfield to write to BNF managing editor Rachel Ryan.

 

In her letter, Professor Mansfield maintains: ‘Our concern is that for long-term users of benzodiazepines this rate of withdrawal is too rapid and many patients experience significant discomfort as a result. This is both in terms of severity of their symptoms and the time it takes to recover.’

 

The letter supports an earlier plea for change from Newcastle emeritus professor of clinical psychopharmacology Heather Ashton and several addiction charities.

 

The revised guidance by Professor Ashton, a world-renowned expert on benzodiazepine withdrawal, stresses the importance of longer withdrawal schedules for long-term patients.

 

It includes:

 

* A new emphasis on withdrawal at a flexible rate that is tolerable to the patient

* Differences in tapering needs for short- and long-term users

* Recommendations to avoid the addition of new drugs during withdrawal

* A link to Ashton’s manual Benzodiazepines: How they work and how to withdraw.

 

The amended text has been approved by the Joint Formulary Committee, under whose authority the BNF is published. The group comprises representatives of the BMA, Royal Pharmaceutical Society, UK health departments, the Medicines and Healthcare Products Regulatory Agency and a national guideline producer.

 

I'm starting to despair a little. I'm currently transitioning to 10mg Valium from 1mg daily of Ativan. My intention is to follow the Ashton method which would put me benzo free in 10 to 20 weeks. However, everywhere I look on this board I see people starting from a similar spot who are taking a year or years to get free. I can't fathom that now. I applaud all who make it in any time frame and I know it is one day at a time but I can't even have a glass of wine with dinner right now without misery at night. I'm hoping the Ashton plan isn't a pipe dream but nothing I've seen on this forum has given me reason to believe otherwise. How many people can actually hit that mark?

 

Dr. Ashton had to come up with a one size fits all protocol for a problem that no one else had addressed. Considering that, she did an amazing job helping many people get off of benzodiazepines.

 

If she had set up schedules that lasted years, however, no one would have taken her seriously or she would have possibly scared people off from even attempting to taper off of these drugs. People generally unfamiliar with these drugs will have a hard time wrapping their heads around the need for such slow tapers.

 

Even she said that a time limit should not be set on tapering. It doesn’t matter if it takes 18 weeks or 18 months.

 

Success is a relative term. A lot of people can get off quickly but will face many months of uncomfortable withdrawal. They are successfully off of the drug but is that what you really want?

 

10% is the guide that is given here because that is a safe tapering rate to start off with. You can either speed up or slow down from there. Because the people here have had mostly negative experiences with tapers, first or secondhand, that is a reasonable suggestion. The bottom line is that none of us know what will happen if you decide to taper off given the Ashton timeline.

 

Since this place is causing you despair I would advise you to maybe take a break from this site for a bit. Either that or take what you have learned here and put together a plan to get off of these drugs and then move forward from there.

 

I know I was very overwhelmed by all of this when I stumbled across this site two years ago. It took me almost six months to muster up the courage to start tapering. A lot of my fears from that time have proven to be unfounded for the most part.

 

I thought I would be in constant misery during my taper. That hasn’t been the case at all. I’ve been tapering for 18 months and I feel better than I did when I started tapering. I made plans to possibly take a leave of absence from work. I haven’t missed one minute of work because of my taper. I thought about buying adult coloring books just so I could have something quiet to do during the inevitable sleepless nights ahead. I haven’t had one sleepless night since I started tapering.

Thank you so much Confuseduser and Libertas, for the info and links:

https://www.benzo.org.uk/amisc/ashdiag.pdf

 

I have been looking for this information for some time (updates to Ashton's original schedule) but I hadn't managed to find it in the places I looked.  I read there were updates on the Benzodiazepine Information Coalition website, but didn't manage to find it there.  So thank you for your posts. 

Much appreciated.

I tapered using the Ashton method from June 2019-Dec2019 - 6 months to w/d from 10mg valium. It is possible. Many people think they can taper without w/d symptoms if you go slow enough. Maybe that works for some but it seemed to just draw out an already painful process. I had tolerance w/d so that wasn't going to be me. I took to heart Ashton's advice to grit my teeth and continue cutting every time that I didn't feel worse. If I had waited to feel better, I may have been waiting forever and I do not want to make a life out being in benzo w/d.

Every one is different. There is a lot of "go slower" on this forum. Find what you can tolerate and just get on with it.

Following this topic.

 

I think I expected to feel worse during my taper than I have felt, and the biggest challenge so far has been fear. I feel accomplishment when I think of how few pills I've "used" compared to my past usage. But this isn't a race! Nobody wins a prize for sticking to a schedule.

 

I agree with the poster who said to take a break from BB or from the internet, if it seems to trigger your fears.

 

Best wishes to everyone.

I'm starting to despair a little. I'm currently transitioning to 10mg Valium from 1mg daily of Ativan. My intention is to follow the Ashton method which would put me benzo free in 10 to 20 weeks. However, everywhere I look on this board I see people starting from a similar spot who are taking a year or years to get free. I can't fathom that now. I applaud all who make it in any time frame and I know it is one day at a time but I can't even have a glass of wine with dinner right now without misery at night. I'm hoping the Ashton plan isn't a pipe dream but nothing I've seen on this forum has given me reason to believe otherwise. How many people can actually hit that mark?

 

Dr. Ashton had to come up with a one size fits all protocol for a problem that no one else had addressed. Considering that, she did an amazing job helping many people get off of benzodiazepines.

 

If she had set up schedules that lasted years, however, no one would have taken her seriously or she would have possibly scared people off from even attempting to taper off of these drugs. People generally unfamiliar with these drugs will have a hard time wrapping their heads around the need for such slow tapers.

 

Even she said that a time limit should not be set on tapering. It doesn’t matter if it takes 18 weeks or 18 months.

 

Success is a relative term. A lot of people can get off quickly but will face many months of uncomfortable withdrawal. They are successfully off of the drug but is that what you really want?

 

10% is the guide that is given here because that is a safe tapering rate to start off with. You can either speed up or slow down from there. Because the people here have had mostly negative experiences with tapers, first or secondhand, that is a reasonable suggestion. The bottom line is that none of us know what will happen if you decide to taper off given the Ashton timeline.

 

Since this place is causing you despair I would advise you to maybe take a break from this site for a bit. Either that or take what you have learned here and put together a plan to get off of these drugs and then move forward from there.

 

I know I was very overwhelmed by all of this when I stumbled across this site two years ago. It took me almost six months to muster up the courage to start tapering. A lot of my fears from that time have proven to be unfounded for the most part.

 

I thought I would be in constant misery during my taper. That hasn’t been the case at all. I’ve been tapering for 18 months and I feel better than I did when I started tapering. I made plans to possibly take a leave of absence from work. I haven’t missed one minute of work because of my taper. I thought about buying adult coloring books just so I could have something quiet to do during the inevitable sleepless nights ahead. I haven’t had one sleepless night since I started tapering.

 

I second everything you said.

Seemam, it is important to realise that each individual's body is so different that unfortunately it is pretty hard to make predictions about how long each taper will take. In a way, you are very fortunate that you have realised that Ashton's protocol might not be for everyone early on in your taper. I was told to avoid the internet early on and kept pushing on with Ashton when in my situation it didn't work. You are at least aware at this point that the measure of success isn't necessarily how fast you get off, but that you keep trying and remain as functional as possible. As I've said, Ashton didn't work for me. However, this was because I had actually been on benzos and successfully discontinued many times before I got stuck without realising that this led to me becoming more and more kindled. I am also autistic and believe I have always had physical problems to do with GABA/glutamate imbalance. For you, that might not be the case. It depends on your individual genetics, your pattern of benzo use, which benzo you are on and for what. My advice is treat the Ashton Manual as a general outline but if you feel that the cuts are getting too hard don't feel like it's giving up if you slow down. Lots of people have success with it and they aren't always the ones posting on here. All the best, Malwina

Hi,

 

I have been doing a taper that is faster than the Ashton Manual because of my own circumstances and having no real choice about it. The important thing is that you *are* doing a taper, which means that you will be on the right path before the changing rules surrounding benzos cause problems for many people. So everyone on here is struggling, yet it is a struggle in the right direction.

 

When I first started reading on this site, my goal was to find out "how will it go"? I could find no certainty that I would be okay. Then I let go of the idea that anyone could gaze into a crystal ball and predict it for me. I let go of the idea that there could be a model taper found anywhere.

 

Then I started focusing on success stories, but sometimes even those alarmed me. If the time frame seemed long to me I would wrongly interpret everything as "After 475 Years of Hell, I'm Finally Feeling a Smidge Better."

 

Removing a layer of anxiety was to not read posts about how people are feeling at some specific point during or after their taper, hoping or dreading that I will match that. What restored my courage was to seek help in forming a plan, even if that plan fell through. No one has ever made me feel like I did something wrong or that I would suffer dire irreversible consequences.

 

The only person that is handling this wrongly is my doctor (but not her nurse practitioner, who has been amazing). I am still looking for a different doctor, but even if I don't fine one, there are still plenty of equally amazing people here who will help me work with what I've got.

 

Liz

I had a thread here about this http://www.benzobuddies.org/forum/index.php?topic=234565.0

 

It's understandable that people seek and analyze info. I had a doctor tell me I could get off 1mg Klonopin in 8 weeks, 0.125mg reduction per week. This was the doctor that put me on Klonopin but not the one I see now. Even if I was willing to endure the 8 weeks plus aftermath, I'm terrified to get protracted symptoms. And that doctor knows that I work full-time.

 

It's just insane.

Thanks Libertas for that link! I will be sending it to my "rapid taper doctor" when this is over. Even if she messed things up for me, perhaps her nurse practitioner will read it and be able to handle things better for future patients. That could relieve a lot of suffering for people, so thanks again for sharing that!

 

Yes, haveagreatday, this IS insane! I read your other thread. I also worry a lot about protracted withdrawal. Sometimes it has consumed my thoughts and the symptoms only drive those thoughts further into the ground of all my worries.

 

I'm glad that you are under the care of a new doctor. It's really stressful when the prescribing doctor is uninformed or is unwilling to be informed. It sounds like you will now be in good hands.