doctor support with titration taper

hi, everyone. i have been taking benzos since 2003 for insomnia and live with cfs (diagnosed in 5/08). i transitioned from 2 mg klonipan to 20 mg valium at bedtime to be able to off more easily. after trying to withdraw over several weeks by splitting pills and having terrible seizure-like results, i decided (armed with the knowledge of someone who is tapering this way) to do water titration, on a 150 day schedule. my problem is finding a prescriber  new insurance has made me need a new primary care doctor (who prescribes my valium), and i've tried three. all of them have suggested that i split pills, suggesting that it would be hard but that it was what i had to do. when i have been unwilling to do what has already hurt me, quitting very quickly, they have called me an addict and tried to make me feel ashamed.

the doctor i was talking to today had no knowledge of water titration. he gave me a prescription for my valium, and said i would be taking less because of the titration. when i explained that i wouldn't need less medicine, but would instead be drinking less of the same solution, he acted really skeptical and treated me like a criminal. he said he would only prescribe the medicine one time only. when i got out, i noticed that it was a prescription for two weeks worth, refillable once.

i have been on these meds for five years, on the advice of doctors the whole time, and being treated with such suspicion and disrespect when i am making very painful and difficult efforts to go off (good lord, switching to valium was hard enough) is really hard. i know these drugs are often abused, but i have never abused a substance in my life. how can i explain to doctors that i need to create me own water titration schedule, that i will need the same amount of the drug for the duration and that i may need to adjust the schedule myself? i'm sure by this point, i must not seem happy with doctors, and it must come across. i find that they treat me much, much differently when my male partner accompanies me. the doctor today was talking babytalking to me. i am an adult and an informed consumer. i am so mad right now. i don't like being pressured to do what i know are bad things to my body. one doctor didn't even KNOW that valium is easier to get off. he questioned the doctor who switched me's competence, saying, "what good was it just to get you hooked on something else?" the ignorance and disrespect is hard. it would be one thing if i didn't know i had 150 day, possibly more, taper ahead of me. i need access to meds and physician support. if anyone has any advice on finding a doctor who isn't a benzophobe or unaware, please let me know.

thanks.

Don't know where you are located but please check out http://www.benzodocs.com to see if there is one in your area.

I'm so sorry you are having to deal with such ignorance. It saddens me no end every time I read a story like this. It's hard enough getting off this poison without being treated like a criminal and drug addict. If we are drug addicts, it's they who created the situation, not we. It's called Iatrogenic Addiction. Dictionary Definition: "caused by the diagnosis, manner, or treatment of a physician."

I hope you find someone. Please keep us posted.

Tony

Hi Violetta,

Welcome to BenzoBuddies.

Substitution of meds is not at all unusual. It is true that doctors, on the whole, are ignorant of the advantages of substituting for, and tapering with Valium. I must say, few people need to use titration when tapering from Valium, so long as they are using 2mg tablets - what dose are your tablets? If you do need to titrate, either because all you can obtain is larger dose Valium tablets, or you have the 2mg tablets and need to titrate anyway, I will help you with a titration schedule. As you appear to be struggling with a taper, you will need more than 4 weeks worth of tablets though.

i transitioned from 2 mg klonipan to 20 mg valium at bedtime to be able to off more easily. after trying to withdraw over several weeks by splitting pills and having terrible seizure-like results, i decided (armed with the knowledge of someone who is tapering this way) to do water titration, on a 150 day schedule.

Hi Violetta - I'm sorry you're having a tough time.  I wanted to point out something I noticed about your dosage - according to the frequently-cited Ashton Manual's benzo equivalency chart, (you can see it <a href=http://www.benzo.org.uk/bzequiv.htm>here</a>) 2 mg Klonopin is equivalent to 40 mg Valium.  So in moving to 20 mg Valium, you may have effectively cut your dose in half without meaning to - and just doing that, not to mention withdrawing from that point, could certainly cause some unpleasant results.

colin, could you suggest a direct taper with valium? as atalanta said, i did accidentally halve my dose due to the bad advice of my doctor (2mg klonipan to 20mg valium rather than 40mg valium, as ashton suggests). i think i will have my rheumatologist handle presccribing, because he told me that he uses benzos and helps people get off them. i think he's much more attuned to my symptoms than the random pcp's i've been seeing. and a nicer doctor in general. i didn't think about just having him handle things until my partner suggested it last night.

thanks so much for your support everybody. it is so ironic that doctors have been telling me to take these drugs for five years and i've only encountered bad treatment when i voice that i'm trying to get off them.

HI Violetta. As I understand, you are on 20mg valium. What mg pills do you have?

Since the recommended safe taper rate is aprox 10% every couple of weeks, an initial reduction of 1 or 2mg would be feasable to start. This is doable if you have 2mg pills. At some point in your taper, these cuts can be reduced to .5mg.(1/4 pill) 

Now, if you only have 5mg pills, I would say to cut that in quarters(1.25mg each) and reduce by a quarter pill every week or two.

I"m not sure what kind of cuts you were doing and having such a hard time with. It sounds like you only have 10mg pills?

Hopefully your rheumatologist can write you a continuing script. And ask for 2mg pills, that way you can direct taper all the way down.   

Hi,

You should be fine if you follow Eljay's suggestion. You will need to get those 2mg tablets though.

If, in the unlikely event that you cannot make small enough cuts when tapering using 2mg Valium tablets, we can sort a out a titration schedule. You should be fine tapering something like 1-2mg from a dose of 20mg Valium. As you reduce your dose, you will need to reduce the size of your cuts though. This is why the 2mg tablets become so important as your taper progresses.