Author Topic: Might I be in "tolerance"?  (Read 463 times)

[Buddie]

Might I be in "tolerance"?
« on: February 15, 2022, 09:52:11 pm »
Hi BB,

I have been successful in the recent past at following Ashton's schedule, crossing from clonazepam to 300 diazepam, and am now at 3.5mg diazepam - it's been very hard, but worthwhile (It's been approximately 1 year since I began the crossover and reduction). I was even getting a few windows here and there.

Then I cut to 3.5 (from 4mg). It's been over 6 weeks now. My symptoms increased from a stable place and are not decreasing. What has been decreasing is a sense of making progress. The activities I was beginning to show interest in and even enjoy a little have ceased. I feel stuck- that's my term.

I don't know what tolerance is, but my days feel like they did before I started the process - not the actual symptoms themselves but the flow - as if I'm having a groundhog day experience and time is agonizingly slow to me. As if I am treading very murky water.

Can someone help me understand if there is a definition or description of tolerance and what types of options are available with a sense of being stuck? Even simply pointing me to where to look on BB might help.

Thank you,
Rascal
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[Buddie]

Re: Might I be in "tolerance"?
« Reply #1 on: February 15, 2022, 10:29:43 pm »
I know it's hard to determine tolerance as I know many people said their symptoms got worse when they hit the lower numbers. Here are some links discussing tolerance:

http://www.benzobuddies.org/forum/index.php?topic=9706.0

https://www.benzoinfo.com/tolerance/


Once you've read through these, can you let us know if you feel you identify with anything being said?
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Might I be in "tolerance"?
« Reply #2 on: February 15, 2022, 10:33:44 pm »
Hello, [...].  Iím sorry youíve hit a rough patch in your taper.

Here are definitions for tolerance and withdrawal symptoms from the Alliance for Benzodiazepine Best Practices (citation below):

Tolerance
The process of neuroadaptation in which use of a substance over time results in the need to increase the dose of that substance in order to get the same effect as that seen when the substance is first started.

Withdrawal Symptoms
The process of neuroadaptation in which use of a substance over time results in a characteristic group of symptoms that occur when that substance is withdrawn.

Given that your taper was going well until the last reduction you made, it sounds like you are experiencing increased withdrawal symptoms due to to a Ďtoo large for youí reduction in dose.  Your last reduction from 4mg to 3.5mg was a 12.5% reduction. 

As [...] has noted, it is not uncommon for members to discover they need to make smaller percent reductions in dose when they reach lower doses of diazepam.

Citation:
Terminology
The Alliance for Benzodiazepine Best Practices
https://benzoreform.org/terminology/
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[Buddie]

Re: Might I be in "tolerance"?
« Reply #3 on: February 15, 2022, 11:07:40 pm »
Thank you [...] and [...],

I have read the material and do not know which best describes me now. I am confused.

I have been trying to get to 3mg and then start a liquid micro taper. Thatís in part why I cut to 3.5 (although I donít like the tablet cutting process). While at 3.5mg, Iíve been working to prepare for and learn the best DLMT for 3.5. Itís been downright baffling, escalating my stress at the least. So many options. I finally landed at dissolving  2 X 2mg (so 4mg)  tablets with vodka, adding 300 ml water, and discarding 37.5ml + 1 daily. (37.5 accounting for the .5 Iíve ďwithdrawn from). 

Creating a spreadsheet to guide me has also been hard.

Whatís hardest is that I donít feel ďstableĒ enough to start to liquid taper, IF stable means ďokĒ or relatively ďtolerableĒ. I was definitely at tolerable and stable at 4mg. Hence- canít proceed to DLMT.

All this is to say I feel stuck at repetitive bad symptoms, plus stuck in my process. And Iím beginning to feel Iím getting even worse.

I hope something Iíve mentioned helps you help me- I had been so pleased with the results of my hard work and the help of BB. This week, Iím loosing the light I had begun to see (sorry for dramatics!)

Gratefully,
Rascal
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Might I be in "tolerance"?
« Reply #4 on: February 15, 2022, 11:52:24 pm »
Personally I don't think it's tolerance. When I read through the document from Colin I linked you to, this statement stood out to me:

Often, when people have hit a rough patch in their withdrawal taper they are mistakenly advised that they have developed tolerance, and must cut, to resolve the problem.

I think it's more likely that your cut was either too big this time or the numbers are just getting low and tough. The fact that you're getting stressed out over your symptoms not abating might be contributing to your situation.

I don't think you should be cutting or crossing to liquid in your current state. I think what you need is to give it more time. And I know we all get frustrated when we are "doing nothing" and just waiting it out.

You have done a tremendous job on reducing your dose. We have a member here that often says "heal more than you're cutting". I think you just need to do more healing. Please don't get discouraged. You're going to get there!
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Might I be in "tolerance"?
« Reply #5 on: February 16, 2022, 02:12:53 am »
Thank you [...],

Sounds as if staying where I am is the option your suggesting, along with a extra helping of patience and reminding myself how far Iíve come.  Am I hearing you right? 

Is there some point at which holding without change becomes unadvisable? I realize weíre all different.

Glad to hear from you,
Rascal
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Might I be in "tolerance"?
« Reply #6 on: February 16, 2022, 02:42:13 am »
Sorry [...]

I know this sucks. I've also felt stuck in my taper before.

During my last crash I held for 6 weeks before I felt better, so it makes sense for some it can take longer. If you're able to relax and not stress about this wave, hopefully you'll see some improvement. How about we work on bite size chunks? What about we give it another 2-3 weeks and you make sure you keep a detailed journal of any improvements even if it's just a 30min window? Then we re-evaluate again. I'm not saying resume your taper after this time, I'm saying let's talk about how you've been feeling. I know waiting indefinitely also causes agitation, so this way you know the topic is up for discussion again, but in the meantime, you try and relax.

Maybe [...] will weigh in as well?
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Might I be in "tolerance"?
« Reply #7 on: February 16, 2022, 03:11:45 am »
Hello again, rascal4ver.

Are your symptoms tolerable?  Are you functional enough to do what you need to get done?

If so, then I agree with [...].  Wait another 10-14 days, keep a journal (see note below), and then re-evaluate.

If not, then another option to consider is a small updose (perhaps from 3.5 to 3.75) to see if that helps.

What strength tablets do you have?  Have you talked to your prescriber about the possibility of using a combination of 2mg tablets and the 5mg/5mL oral solution to complete the last phase of your taper?

Note: You might consider rating your symptoms and functionality on a 0-10 scale each day so you can graph the results.  Graphs can sometimes reveal patterns that arenít apparent from text-only notes.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Might I be in "tolerance"?
« Reply #8 on: February 16, 2022, 03:02:57 pm »
[...] and [...],

My symptoms have been barely tolerable and recently (this week) not tolerable (meaning they are interfering with life greatly)  I concur that my frustration with wanting to move ahead is exacerbating them all. After digesting both your replies, I already feel better at the prospect of waiting, and this morning am feeling relieved.

i especially appreciate the notion of healing more than cutting, which I was experiencing at 4mg. The cut was too large.

I am meeting with my doctor today and will ask about both more of the 2 mg tablets (what I currently have and have been using- I also have remaining 5 mgs from when I was at higher doses but see no use for them now) and liquid diazepam, hoping that prescribing both will not trigger some sort of "not allowed" from controlled substances regulators. That way, I will have options at my disposal when more ready to proceed.

I was indeed very confused and frightened by the quote regarding "must cut to resolve the problem" (when believed to have hit tolerance). I'm dropping that one!

What I read about updosing opens up another can of worms either on the forum and/or in my head. If either of you have clarification about such, I'd love to hear it.

I am much better at the moment- I'd like to hug you both,
Rascal  :smitten:



Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Might I be in "tolerance"?
« Reply #9 on: February 16, 2022, 04:41:22 pm »
Just a PS to correct my initial entry- I never took 300 Valium (it was 30)- Can you imagine  :laugh:?

I suspect you suspected,
Rascal
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.