Help! Complicated, going down from 40mg of valium to ???

Hi:

I just detoxed from alcohol --- 5 days.  Started at 200mg of librium (about 80mg of valium?) and now down to nothing.  Was drinking way too much --- maybe 15 drinks a day.  I have been on valium for 28 years --- 10mg (when drinking a lot of alcohol) to 40mg a day.  I never abused it.  Of course, the detox center wanted me to get off of valium, too.  I was given a 14 say prescription on release for klonopin.  Starting at 1mg and tapering down to "0" by day 14.  This is to take the place of the valium. 

(I have an appt with an IOP center (in the U.S.) rep. for a 2-3 month rehab follow-up.  I'm sure they'll expect me to be off of benzos fairly quickly.)

Is 14 days of klonopin enough to "taper" off of 28 years of fairly heavy valium use?  Especially since I have just given up alcohol.  How does 1mg of klonopin (for, at most, a week) compare to 10-40mg of valium?  Why is a klonopin taper better than a valium taper?  Is it smart to stop taking alcohol and valium at the same time?  It strikes me as asking for a lot from both a physical and pyschological point of view.  Also, what would be wrong with staying off alcohol now and, perhaps, starting a slow valium taper in, say, 3 months?  Especially since alcohol is/was by far my bigger problem. 

If the valium/klonopin "taper" does not work, and I'm still benzo dependent, I will almost surely revert to alcohol to deal with it.  This would be a disaster.   

Any thoughts?  I have limited time due to the expectation that I stop valium now. 

P.S.  No anti-siezure medication.             

Hi, kestrel.

Welcome back.  I can address a few  of your questions.  There will be more people here throughout the day so check back from time to time.

I can't imagine why the center switched you from valium to klonopin.  Valium is the benzo of choice to taper off from since it stays in the body longer.  Here's a link to the Ashton Manual which is the gold standard for coming off benzos.

http://www.benzo.org.uk/manual/bzcha01.htm

Some people print out information from this manual and give it to their doc so they can crossover to valium and slow taper from there.  If you did okay on valium, that would be the way to go if possible.

Coming off the klonopin in 14 days is NOT a good idea.  We usually recommend reducing your dose about 10% per 7-14 days to start and then speeding up  or slowing down depending on how you are feeling.  It is possible to successfully taper off of klonopin and many docs do switch xanax and ativan users to it because it lasts longer than they do in the body which makes for a smoother taper.  It's nearly impossible to cut just 10% from a 1 mg pil, though, unless you go the liquid titration way.  I noticed you posted on the Titration board so I wonder if you are alredy thinking of doing that?  Take a look at our Methods section for more information:

http://www.benzobuddies.org/buddiesguide/methods

If you are able to continue with the benzo and get off the alcohol first, that's probably the best way to go.  There are many reasons not to consume alcohol while taking benzos and it can really mess up a taper.  I remember seeing other members here who decided to take 3 months to get clear of alchohol and then tackle the benzo.  Since alcohol is a bigger problem for you, it makes a lot of sense to kick that first.

What do you think?

Hi Kestrel,

Although it is true that we tend to recommend that people taper at about 10% of their dose every 7-14 days as a starting point, some can taper a lot faster. There is no way of knowing if you have not tried tapering before. I do think that that being forced to taper off 1mg in two weeks is unacceptable though. Some people can manage it, but we tend not here from such people around here, so it is hard for us gauge how the average person will fair, never mind an individual. In your shoes, I definitely try to get some more Klonopin, and allow for a two month withdrawal as a minimum. You might well be able to finish tapering before then, but unless you've tried tapering similarly in the past, there is no way to know. Two months to taper off 1mg Klonopin probably would be still considered a moderately fast taper around here, so you can see my concern over a two-week supply. The fact that you have just detoxed from alcohol only makes this bigger task than it would have been anyway.

What size pills have been prescribed? Assuming you have the 0.5mg pills, and you have 28 of then (0.5mg x 2 x 14), you could make this stretch out for a month anyway - which helps. Since you would be tapering, you average dose (from 1mg down 0mg) is 0.5mg per day. So long as you don't waste any of your pills, they should last 28 days. Start tapering immediately, and see you doctor about a further prescription.

Hi:

Thanks for the quick replies.  My thought is to begin a valium withdrawal (not klonopin --- why muddy the waters and switch to a shorter-half life med?) in three months. 

Last week, alcohol was 98% of my problem and valium 2%.  Now, I'm off alcohol.  Hopefully, for good  --- I tried once before but made the mistake of having ONE drink on a date.  Moreover, the underlying reasons for drinking did not disappear and a substitute "coping" mechanism was not in place. 

And please remember I'm going from 40mg of valium for 28 years, not going from 1mg of klonopin for two weeks.  Moreover, getting off the alcohol (15 drinks, say) probably means my CNS depression was greater than that provided by 40mg of valium.  200mg of librium did seem to work for me for the 5 day period --- so maybe I was at the equal of maybe 80mg of valium a day --- or more.     

I have seen that book on the internet and it is excellent.  It seems to suggest a 6 - 9 month taper for me. 

What is with these detox centers?  Why move off so quickly as long as one is moving in the right direction and not kiling oneself with tapered drugs?  Or maybe I don't know what I'm talking about?       

I have seen that book on the internet and it is excellent.  It seems to suggest a 6 - 9 month taper for me.   

 

What is with these detox centers?  Why move off so quickly as long as one is moving in the right direction and not kiling oneself with tapered drugs?   Or maybe I don't know what I'm talking about?         

They apparently don't know and insurance will only pay for a short stay.  Probably a high volume business, too, with so many docs prescribing benzos.