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flunitrazepam/rohypnol and zolpidem taper


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Hello,

 

Seeking advice on the following taper.

 

1) Started taking 2mgs of flunitrazepam and 10mgs of Zolpidem on July 5th 2021.

 

2) Started tapering the flunitrazepam on Aug. 28 2021

date: Aug. 28 2021

dose reduction: 1/8 reduction (of 2 mgs)

length of time holding dose: 7-10 days

 

3) Reach 1mg - continue taper

1/8 of new dose (1 mg)

length of time holding dose: 2 weeks

 

went from as follows: 1mg - .875 - .75 - .625 - .50 -.375 - .25 - .20 - .18 - .15

4) Dec. 27 (local time)

current dose: .15mg

 

Possible course of action going forward:

.15 - .12 - .09 - .06 - .04 - jump

2 weeks at each dose?

 

Using gemini 20 scale to weigh my cuts.

 

Main current symptoms: anxiety, muscle tension, headaches (recent symptom), exhaustion, poor sleep (4-5 hours a night)

 

To date, symptoms have been sometimes rough but, so far, I have remained functional (touch wood). 

I know I am in a bit of a rush because I have two drugs to taper but such is my fate. My rationale is that my 6 week use of 2mgs (not short-term use but relatively short-term use?) suggests a somewhat faster taper may be possible. 

 

I understand (now) it may have been better to taper the zolpidem first due to short-half life. However, the benzo rohypnol really spooked me, and on local medical advice (Japan), I decided to taper it first. 

 

My questions:

 

1) Anyone think I should hold the rohypnol in place and try to taper the Zolpidem now?

 

 

2) Do current symptoms mimic the withdrawal symptoms that will manifest after jumping off a drug (or is there no way to tell)?

 

3) Based on the above, would anyone be willing to recommend a taper plan for the rohypnol going forward (next cut amount, hold time)?

(I understand, in the end, it is up to me to decide however, I would like to get other opinions as I hope not to get this wrong)

 

4) I understand the recommended jump off dose for diazepam is .5, so that would make my jump off dose .015. Is this correct?

 

5) Does anyone have advice on how to taper zolpidem and still get enough sleep to survive?

 

 

Any advice/comments etc. would be very welcomed.

 

Thank you!

 

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Hi Agoura Success,

Congratulation on all your progress tapering; I hope you are still able to meet your basic functionality needs. I do not think that there is any strong correlation between "relatively short-term use" and rapid taper success; everyone's neurology is different depending on a myriad of factors, and I think this makes every taper different, irregardless of duration of use.

 

1) Anyone think I should hold the rohypnol in place and try to taper the Zolpidem now?

If you have the medication available to do so, I suggest holding on flunitrazepam until you're feeling more stable, and then slow tapering the zolpidem to elimination. I think it's better to taper any shorter-acting benzos first; zolpidem in particular has caused many buddies significant challenges in their recovery.

 

2) Do current symptoms mimic the withdrawal symptoms that will manifest after jumping off a drug (or is there no way to tell)?

This is a common belief and I think it might be true that the symptom intensity maintained during a slow taper may continue and then abate gradually during acute (post-taper). However, I suspect that overly rapid tapers may have the potential for increased symptom intensity during acute, perhaps due to the lack of skill-building and the stress on the nervous system caused by this approach.

 

3) Based on the above, would anyone be willing to recommend a taper plan for the rohypnol going forward (next cut amount, hold time)?

My opinion is to eliminate the zolpidem first. I also think it might be a good idea to stabilize on your current flunitrazepam dose for a week or two before beginning the z-drug taper.

 

4) I understand the recommended jump off dose for diazepam is .5, so that would make my jump off dose .015. Is this correct?

No, not according to Dr. Ashton. Her benzo-equivalency chart has 1mg of flunitrazepam equivalent to 10mg of diazepam. So 0.5mg diazepam would be 0.05mg flunitrazepam.

(https://www.benzo.org.uk/bzequiv.htm)

 

Also jump doses, such as the 0.5mg diazepam Dr. Ashton often uses in her example slow taper schedules, are not necessarily optimal quit doses IMO. Some buddies have apparently benefited from jumping at higher doses (I think someone recently raved about their 6.5mg diazepam jump), while many others taper much lower than 0.5mg diazepam equivalents, sometimes as low as possible with their current tapering method.

 

I personally think that it's beneficial to go as low as is reasonably possible before quitting, to minimize the neurological shock of this last step. But while I often advocate for a percent-based slow taper schedule for more symptomatic consistency, I think a quantity-based reduction schedule may work better at the very end of a taper; by quantity-based reductions taking the dosage as low as possible doesn't need to necessarily be a long drawn-out affair.

 

I think Bob7 for example, took his last 0.125mg of clonazepam down to 0.001mg clonazepam by 0.001mg quantity-based reductions over 124 days. Again, everyone is different.

 

5) Does anyone have advice on how to taper zolpidem and still get enough sleep to survive?

Well, I think you can do a lot better than just survival sleep; I have had weeks on 2hrs or less per day of sleep and it's disturbing but survivable. But I think sleep is a very important part of healing, so one of my personal functionality goals while tapering is 8+ hours of sleep every day.

 

The easiest way to mitigate your dependence on zolpidem might be to replace it with flunitrazepam via a short-to-long benzo crossover. This would consist of a series of week-long steps whereby you substituted your current zolpidem dose with the Ashton-equivalent of flunitrazepam. It looks to me from the chart linked above that 10mg zolpidem is equivalent to 0.5mg of flunitrazepam. So depending on your zolpidem tablet size, you could create a number of crossover steps and once weekly replace a portion of your zolpidem dose with its flunitrazepam equivalent; after a month or so you'd be done with zolpidem and have only flunitrazepam to taper.

 

Even with a crossover, I think getting adequate sleep will depend a lot on skill-building (see the Insomnia board, top pinned post for some tips and attitude suggestions) and also perhaps slowing down your taper rate. I also like low-dose (<1mg/day) melatonin once-a-day at bedtime, for which I find a liquid form easiest to dose (1 drop = 0.1mg).

 

I hope this helps. Let us know if you have more questions.

Every step is forward. :thumbsup:

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1) Anyone think I should hold the rohypnol in place and try to taper the Zolpidem now?

 

 

Hi Agoura Success,

 

I believe I mentioned in your introductory thread that I felt tapering the Rohypnol first was probably the best choice for you since you've been tapering since August but slownsteady is correct, we typically suggest tapering the shorter acting drugs first. 

 

I'd like to let you know my experience with Ambien/Zolpidem, I stopped it cold turkey 14 months after I stopped taking Klonopin and my withdrawal was short lived and fairly uneventful.  I had insomnia of course and some terrible nightmares when I did manage to fall asleep but in a matter of a couple of weeks, I recovered.  I'm not advocating stopping the Zolpidem cold turkey but I'm not sure crossing over your Zolpidem dose to Rohypnol is the best suggestion.  I'd hate to see you increase your Rohypnol dose if your Zolpidem taper could be similar to mine.

 

I guess I've never been a fan of crossing over from a z-drug to a true benzodiazepine like Professor Ashton suggests in her manual, a true benzo scares me more than a z-drug but that's just my experience talking.

 

Pamster

 

 

 

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Thank you to slownsteady and Pamster for replying to my post. It is lonely being out here and even lonelier when no one replies to your posts! 

 

slownsteady,

 

I am very sorry to read that you won’t be posting on the tapering boards. I am new to this process and in very real need of the support and wise guidance and counsel you can provide. I hope you will reconsider because there are many, many people here who can benefit from your wisdom.

 

Despite your advice to consider holding the rohypnol and trying to taper the zolpidem first, I think I will continue with my current course and try to remove the rohypnol first. I intuitively dislike the idea of effectively updosing the rohypnol (maybe it's not technically considered updosing...).  I agree with Pamster, the true benzo scares me more even though I am plenty scared of the zolpidem as well.... I set a course and I hope to set it through.

 

Regarding jump dose, that was an error on my part; I meant .005 not .015.

 

About sleep, of course I would love to get 8 hours, or even 6 or 7. That is the reason I got on these pills in the first place. I've been practicing a number of relaxation techniques and meditation for months now and have definitely seen results in terms of relaxation but my sleep hasn't improved. In fact, as I reduce the rohypnol it has gotten a bit worse.  The way I see it, this is kind of a chicken and egg problem as I don’t think my sleep will really improve until I start healing from these pills.  I have had a lack of sleep for months now and it is my biggest issue. I haven't been able to thread the needle of improving my sleep while also tapering the rohypnol. I've been stable at 4-5 hours for months now and my brain is utterly exhausted. I want to both continue my taper and get more sleep. Can I have both? I've sacrificed sleep up until now to continue with my taper of rohypnol and, despite the considerable pain already involved, I am prepared to continue.       

 

Question:

 

Any impressions on my taper speed and amount? As I mentioned, I am using the gemini 20 scale to weigh my cuts. It is getting a bit tricky as I get lower. The pills where I live don’t come smaller than 1mg and each weighs 0.104 g (0.25mg = 0.026g). I'm at 0.14 now (8 days and counting) and plan to go down to 0.12 maybe in a few days depending on symptoms.

 

Current symptoms mainly include unpleasant headaches, hand tingling/numbness, anxiety and of course poor sleep. My anxiety seems to have lessened as I've reduced the rohypnol or perhaps I have just become better at managing it. I also have wobbly/shaky legs which I think is connected more to worry and fear than from the medication... 

 

Question:

What do you think about the relative merits of water titration or using something like a gemini 20 scale to do a direct micro taper as I am doing?

 

Question:

Is it possible to taper zolpidem via water titration?

 

Question:

Is it okay (or not recommended) to take pain relievers for headaches (Tylenol, Paracetamol etc.) while tapering? 

 

slownsteady and Pamster,

 

I want to reiterate that I truly appreciate your replies and I very much hope you will be kind enough to continue to correspond with me on this thread in the future. You are lifelines for me. 

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Hi Agoura Success

 

I'll give you my opinion on some of the questions you've asked.

 

 

About sleep, of course I would love to get 8 hours, or even 6 or 7. That is the reason I got on these pills in the first place. I've been practicing a number of relaxation techniques and meditation for months now and have definitely seen results in terms of relaxation but my sleep hasn't improved. In fact, as I reduce the rohypnol it has gotten a bit worse.  The way I see it, this is kind of a chicken and egg problem as I don’t think my sleep will really improve until I start healing from these pills.  I have had a lack of sleep for months now and it is my biggest issue. I haven't been able to thread the needle of improving my sleep while also tapering the rohypnol. I've been stable at 4-5 hours for months now and my brain is utterly exhausted. I want to both continue my taper and get more sleep. Can I have both? I've sacrificed sleep up until now to continue with my taper of rohypnol and, despite the considerable pain already involved, I am prepared to continue.       

 

 

In my taper I have accepted that insomnia is just going to be part of withdrawal and something I cannot control. My sleep is erratic. Like you, I am tapering despite not being able to settle into a set pattern of sleep. If I have to wait for my sleep to stabilize, I'll probably never get off these stupid pills. I am very hopeful though that sleep will return once I'm off the pills.

 

Question:

Is it okay (or not recommended) to take pain relievers for headaches (Tylenol, Paracetamol etc.) while tapering? 

 

This is very individualized in my opinion. From what I see on the forum, each person reacts differently to different meds, supplements, foods etc. In my own case, I have used these specific headache painkillers you mentioned without problem. If you want to try it, I would suggest you start with small quantities to see how your body responds.

 

In terms of your Zolpidem tapering questions. I don't have enough knowledge to help you there, but I can give you pointers if you want to do your own searches. We have a Z-drug Withdrawal Support Group and you can look at this thread or ask the individuals who are/have tapered this drug for first hand experience.

 

Another way to do more effective searches on the BB site is explained here: http://www.benzobuddies.org/forum/index.php?topic=251991.0

 

I hope this helps somewhat.

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If you need help with math let me know.

 

I just typed up my opinion for various taper methods, I will cut and paste here:

 

For liquids, there are two general options:

(1) If you are ok with using about a teaspoon of Vodka to make a solution, let me know and we can talk.

(2) If you want to avoid all alcohol, then here is the best instructions I have ever seen:

 

For Dry Cutting, I like a 3 step approach:

(1) Get as far into your taper as possible using a pill splitter and reducing by 1/8 of a pill for each reduction.  Then hold for two weeks or until your symptoms are tolerable, whichever is longer.

(2) When you can no longer do item 1, buy a scale.  Just break up the pills into tiny bits and weigh on the scale to get your dose.

(3) When you get so low in your taper the scale no longer measures well, then see my website:  https://benzodrytapermath.com/

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Thank you jelly baby and Bob7 for your replies.

 

I have just moved from 0.14 down 0.12mgs of flunitrazepam.

I was at 0.14 for 9 nights. To reiterate:

 

July 5, 2021: Started at 2mgs

August 28, 2021: Started tapering

2 - 1.75 - .15 - 1.25 - 1mg - .875 - .75 - .625 - .50 -.375 - .25 - .20 - .18 - .15 - .14 - .12

(current as of Jan. 5, 2022)

 

My hope is to taper as follows:

 

.09 - .06 - .04mgs - (maybe one more step down?) - jump

2 weeks at each dose? 10 days if symptoms tolerable? 

 

Does anyone think this taper is too fast? If so, why?

 

 

Bob7 mentions "tolerable" symptoms. My symptoms are unpleasant but tolerable. This is my rationale for moving on to the next step in my taper.

 

As I asked in my original post, is there any reliable information on whether current symptoms foreshadow withdrawal symptoms that manifest after jumping off? (slownsteady replied to this question but I would love to hear from others as well.)

 

 

Thanks Bob7 for your info. on tapering. I prefer to stay with dry cutting and I am using the approach you outline up until step 3. The Gemini 20 does seem to weigh down to 0.001 with reasonable accuracy. I think I can weigh the jump dose using the scale. Is this correct?

 

Thank you jelly baby for your advice on searches. Much appreciated.

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Bob7 mentions "tolerable" symptoms. My symptoms are unpleasant but tolerable. This is my rationale for moving on to the next step in my taper.

 

As I asked in my original post, is there any reliable information on whether current symptoms foreshadow withdrawal symptoms that manifest after jumping off? (slownsteady replied to this question but I would love to hear from others as well.)

 

 

Unpleasant but tolerable is actually the rationale we suggest using when deciding to reduce, or we say functional, it doesn't mean feeling good but able to accomplish daily tasks.

 

In my experience reading posts on the forum I've seen members who have a difficult taper experience a difficult post taper.  I don't believe this means the person will become protracted (recovery taking longer than 18 months) but there can be a fairly intense acute stage which we define the time immediately after jumping. 

 

 

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Since you indicate you have only been on benzos since July, I think you are ok to try a "quick" taper.  The thought here is, the longer you are tapering, the longer you are on benzos.

 

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  • 2 weeks later...

Thank you jelly baby, Bob7 and Pamster for your replies.

You guys are lifelines for me!

 

To refresh memories about my situation.

 

1) Started taking 2mgs of flunitrazepam/rohypnol and 10mgs of zolpidem on July 5th 2021.

 

2) Started tapering the flunitrazepam/rohypnol on Aug. 28 2021

date: Aug. 28 2021

dose reduction: 1/8 reduction (of 2 mgs)

length of time holding dose: 7-10 days

 

3) Reach 1mg - continue taper

1/8 of new dose (1 mg)

length of time holding dose: 2 weeks

 

went as follows: 1mg - .875 - .75 - .625 - .50 -.375 - .25 - .20 - .18 - .15 - .12

length of time holding doses (between 1mg and .10mg): 10 - 14 days

 

Presently: Jan. 15, 2022 (local time)

Note: Held at .12 mg for 10 nights, felt stable so moved down to .10mg yesterday

current dose: .10mg (1 night and counting)

 

My plan going forward: .08mg - .06mg - .04mg - jump

 

Using Gemini 20 scale to weigh cuts but starting to get dicey. 

 

Main current symptoms: still horrible sleep (4-5 hours a night), anxiety, muscle pain/tension, headaches.

 

Lack of sleep has been terrible. Other symptoms have been tolerable. So far I have remained functional and working. 

 

I haven’t really had any major/noticeable new symptoms during my taper so far. Anxiety seems to have lessened a bit (or maybe I am just better able to accept/manage it). I have been taking a couple of Chinese herbs for 6 weeks which may be helping…

 

As I mentioned, I still have zolpidem to remove.

 

Questions:

 

Am I in danger of having my cumulative cuts catch up to me?

 

If I am functional, should I continue?

 

Any additional comments etc. would be much appreciated.

 

Thank you!

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You have made it this far, you might as well continue to zero.

 

As long as you hold for at least 2 weeks or until your symptoms are tolerable (whichever is longer), I would not worry too much about cumulative effects at this point.

 

Remember, anxiety is the enemy.  It impacts sleep and most of your symptoms including muscle pain and headaches.  Try to find ways to reduce stress in your life.  Meditation on youtube is good.

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Questions:

 

Am I in danger of having my cumulative cuts catch up to me?

 

If I am functional, should I continue?

 

Any additional comments etc. would be much appreciated.

 

Thank you!

 

There is always a chance that your cuts could catch up with you. There is also a chance that it wouldn't. That's why benzo withdrawal is so frustrating as there is no one size fits all. The only way you'll know is if you continue cutting. I would say the good thing is you are aware this could happen and if you notice an increase in the intensity of your symptoms/new symptoms you should consider a hold.

 

If it puts you more at ease, you could hold your cuts for 2 weeks rather than 10 days? That would give your brain maximum time to adjust to the cut.

 

Good luck and well done on your progress!

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  • 4 weeks later...

Thank you very much to Jelly Baby, Bob7 and Pamster for your replies to my posts.

 

I am still out here and continuing with my taper. I am now at .06 mgs of flunitrazepam. 

I am listening to my body and basing my cuts on how I feel (in short, not good but functional).

 

No symptoms have gotten worse. Having said that, the chronic sleep deprivation I am dealing with is, of course, horrible and a kind of torture.

Because I started taking these "stupid pills" (as JellyBaby so accurately calls them) for insomnia I accept that it it unrealistic for my sleep to get better as I taper off.

 

Sometimes I make a cut after 2 weeks, sometimes after 10 days. 

 

Bob7,

 

You suggested holding for at least 2 weeks or until symptoms are tolerable (whichever is longer). I have gone a little bit faster at times but I have been functional so far. I am 5+ months into this taper and symptoms have been tolerable. This is my rationale for my taper speed.

 

At the risk of putting the cart before the horse, I also would welcome any advice on when I may start tapering the zolpidem.

How will I know when I am ready? 

How will I know when I have recovered from the rohypnol?

Is there a general timeline for how long I have to wait before starting the taper of a second medication?

 

Like so many, many others here I am trying to balance patience with a desperation to get off these pills. 

 

Thank you all for your support and replies!

 

Best to all!

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Agoura Success,

 

You are almost done.  0.06 mg of flunitrazepam equals about 0.03mg of Klonopin.  When I was at 0.03mg of klonopin, it took one month to finish my taper. 

 

So keep it up.

 

My thoughts about zolpidem - you are so close to the end of your benzo, it seems to make sense to stay on zolpidem until your reach zero flunitrazepam.  Then start a zolpidem taper with a new journal.

 

I want to share.  For me, once I was off benzos, it was my generalize anxiety disorder which predicted my sleep quality.  I have reasonable good sleep most nights.  But if anything is happening the next day which gives me anxiety, my sleep is terrible.

 

I am 3 years off benzos.  Now I get by most nights fine. For emergencies I take a Lunesta but never more any 2 days in a row.  Benadryl works good too.  But never more than 3 or 4 days in a row.

 

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Agoura Success,

 

You are almost done.  0.06 mg of flunitrazepam equals about 0.03mg of Klonopin.  When I was at 0.03mg of klonopin, it took one month to finish my taper. 

 

So keep it up.

 

My thoughts about zolpidem - you are so close to the end of your benzo, it seems to make sense to stay on zolpidem until your reach zero flunitrazepam.  Then start a zolpidem taper with a new journal.

 

I want to share.  For me, once I was off benzos, it was my generalize anxiety disorder which predicted my sleep quality.  I have reasonable good sleep most nights.  But if anything is happening the next day which gives me anxiety, my sleep is terrible.

 

I am 3 years off benzos.  Now I get by most nights fine. For emergencies I take a Lunesta but never more any 2 days in a row.  Benadryl works good too.  But never more than 3 or 4 days in a row.

 

Again, thank you Bob7!.  This sums my sleep at this point too!  I plan a long wind-down in the evening with no phone calls or stimulating media viewing.  When one doesn't have benzos to resort to then managing their days and evenings better becomes so important.  I always appreciate your input!

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Thank you very much to Jelly Baby, Bob7 and Pamster for your replies to my posts.

 

I am still out here and continuing with my taper. I am now at .06 mgs of flunitrazepam. 

I am listening to my body and basing my cuts on how I feel (in short, not good but functional).

 

No symptoms have gotten worse. Having said that, the chronic sleep deprivation I am dealing with is, of course, horrible and a kind of torture.

Because I started taking these "stupid pills" (as JellyBaby so accurately calls them) for insomnia I accept that it it unrealistic for my sleep to get better as I taper off.

 

Sometimes I make a cut after 2 weeks, sometimes after 10 days. 

 

Bob7,

 

You suggested holding for at least 2 weeks or until symptoms are tolerable (whichever is longer). I have gone a little bit faster at times but I have been functional so far. I am 5+ months into this taper and symptoms have been tolerable. This is my rationale for my taper speed.

 

At the risk of putting the cart before the horse, I also would welcome any advice on when I may start tapering the zolpidem.

How will I know when I am ready? 

How will I know when I have recovered from the rohypnol?

Is there a general timeline for how long I have to wait before starting the taper of a second medication?

 

Like so many, many others here I am trying to balance patience with a desperation to get off these pills. 

 

Thank you all for your support and replies!

 

Best to all!

 

I think you're doing a great job listening to your symptoms and adjusting your taper accordingly. There are really no set time frames for starting your second taper. I suggest you just follow your gut. If it were me, I would probably take a month's break before starting the new taper just to give my body some time to recover. But I understand sometimes the patience is in low supply and we just want to get on with it.  :laugh:

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Thanks so much Bob7, Kate08 and jelly baby!

 

Hope you are all well.

 

It's so strange that, even though I don't know any of your real names, I've never seen your faces nor heard your voices, it is so comforting, even inspiring, to have you all out here in the ether supporting us all. I know there are so very, very many others who feel the same...

 

Bob7,

 

Your signature mentions you take Magnesium for sleep and in a personal message you explained it was Magnesium glycinate. Can I ask the dosage? 100mgs? 150? 200? Do you take it every night?

 

I don't intend to start taking it anytime soon as I don't want to interfere with my tapers but I'm interested for future reference.

 

Thanks again to you all!

 

 

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