Have I scuppered my Medically supervised Benzo taper?

To cut a very long story short, around 2 weeks ago I was admitted to my local hospital due to extreme Benzo withdrawal symptoms, I have abised Benzos for around 4 years, doses ranging into the thousands of mg's of Diazepam in a night and other Benzos (Alprazolam, Temazepam) over the course of a weekend. Yes I am very lucky to be alive! Anyway just over 3 weeks ago I quit cold turkey after a heavy Alprazolam binge, I've withdrawn from Benzos cold turkey many times so I thought I knew what I was in for - severe anxiety, irratability, Insomnia, auditory and visual hallucinations, twitches the list is endless.

But this time was so severe I thought I'd lost the plot and there was no coming back, as well as the above I was suffering paranoid delusions, I thought people were trying to break into my house to rob my house and take my family hostage, I even rang a friend to come and help. I had so many nights without sleep, the line between concious, unconcious and subconcious had been wiped away. I basically didn't know what reality was! I lost all my motor skills, I couldn't put hand to mouth, brushing my teeth or having a shave was out of the question. I had to get my mother to feed me and give me fluids through a straw. I lost all basic function as a human being, the times I did manage to crawl to the bathroom my brain couldn't work out how to use a toilet, so on more than one occassion I wet myself.

Anyway enough of the background (Even though there is plenty more to tell that escapes my memory now) although I do remember believing that the nurses in the hospital were trying to kill me. Anyway after 5 and a half days in hospital I was put on a 30mg per day regime of Diazepam to be reduced by 2mg every 1 -2 weeks, and also at the same time I was put on 150mg Pregablin per day for the first week increasing to 300mg per day on the second week and then finally increasing to 600mg per day for the forseeable future until my G.P decides to taper off the pregablin. I had my first appointment with my G.P yesterday (since I left the hospital last Wednesday) My G.P suggested reducing my dose of Diazepam by 5mg after the first 2 weeks on 30mg per day (I currently take 6 x 5mg Diazepam per day - 5mg morning - 5mg afternoon - 5mg early evening - 15mg night time. which will be next Wednesday 9th October and then after that I am not sure of her plans. I'm happy to taper as fast as possible as I plan to go travelling (I quit my job and was meant to be starting my travels 2 days ago but now all this has happened and I don't think travelling the world whilst tapering from Benzos/Pregablin is the best option)

My problem is (self inflicted once again) as soon as I arrived home from hospital I went on a 6 day binge of Oxycontin, using 200 - 240mg per day in one dose. Now having been addicted to Oxy in the past and withdrawinfg from this many time I expect to be in for a rough ride, I last used 240mg Oxy on Monday 30th September and I started to feel a bit ruff last night (Wednesday 3nd Oct) So may I stress I have not abused any of my prescribed Diazepam as I truely want them out my life for good. But in my Opiated withdrawal desperation I search my room for anything that can help and I come across a stash of Benzos, alsorts, Diazepam, Temazepam, Alprazolam, Diazepam etc and in my desperation to ease my Opiate withdrawal I take 3mg Alprazolam and 80mg Diazepam, it did ease the withdrawal and I also smoked a joint of Hash which is something I do very rarely.

Would this one off binge derailed my taper?

I feel the need to dose again, I'm literally aching all over and feel like I'm jumping out of my skin all at once! I do realise this is mainly due to the fact that I binged on Opiates for the last 6 days so I can expect at least another week of these symptoms to varying degrees, I also realise I'm still in Benzo withdrawal which will most likely last months or years due to my level of abuse.

I guess many of you may tar me with the brush of a hopeless junkie but that is truely not the case, I have so much good in my life, I have a family who are literal saints who give me all the love and affection one could ever ask for, I have an amazing bunch of friends, I have worked in good long - term full time jobs all my working life (I'm now 34) I have always had a roof over my head, food on the table, I have never wanted for anything (except maybe a love life) But that's another story! 

Thanks for any replies or to anyone who took the time to read what I have written.

My first suggestion is to get rid of all the extra meds in the house except the ones you are being prescribed right now. Too much temptation. Next is to immediately go back on your prescribed med schedule. It is going to be a bit ugly for a while, so you may have to hold at the current dose for a number of weeks. You're probably going to have to explain this to your doctor, but if you get rid of the other drugs, he may cut you some slack since you are offering up a display of sincerity in getting yourself out of this mess. Dumping the other meds looks like it may be crucial right now for you, and also accepting that you're in for some discomfort is also important for you to be in the right frame of mind to get through this. Once things settle down, then start a sensible taper and stick to it as closely as possible, holding when you need to. Don't beat yourself up. This happens. It's what you do next that counts.

I should also add: If your symptoms come crashing back as bad as what sent you to hospital - the paranoia, psychosis, etcetera, then you may have to go back to square one. I don't know how your body is going to react to all this, but if you start getting psychotic symptoms again, please seek medical help.

Hiya Pete!  The more you go on benzo binges, the more you will become dependent on them and will find the aftermath of each binge is increasingly unpleasant.

Yes, your recent benzo binge will have derailed your taper.  If you were just starting to binge, it would not have derailed by much (you could perhaps measure it in days or perhaps weeks).  However you are a regular benzo binger, so the period of readjustment after derailment will be longer (measured in weeks).  There no real way of telling exactly how long because that depends on so many factors.

You may want to consider getting on a regular daily dose of benzo which is tolerable and this may be higher than the dose you are now on.  Diazepam takes a week or two to build up to full strength so you need to allow for that.

Then after holding on a fixed dose for a month or so to allow for your body to adapt, start to taper the diazepam slowly.  Your doc's suggested rate of taper seems rather fast but, who knows, you may be one of the lucky people who can go that quickly although the odds are against it.  Personally I wouldn't taper any faster than Ashton suggests and in my own case I would probably aim for something like half her suggested rates.

Obsid has mentioned some ways to avoid giving in to the desire to binge.  If you continue to binge you are going to find it much harder to taper if you finally do attempt it.

Good luck.

@[Br...]

The hospital doctors and my G.P have thid golden rule where they can't give me more than 30mg per day! The medical community here in Coventry, United Kingdom are almost cluelsss when it comes to Benzodiazepine withdrawal.

Ive tried tomention Ashton to then but no of them have heard of her, not even the psych people! Talk about frustration!!!!

@Braban.

 

The hospital doctors and my G.P have thid golden rule where they can't give me more than 30mg per day! The medical community here in Coventry, United Kingdom are almost cluelsss when it comes to Benzodiazepine withdrawal.

 

Ive tried to mention Ashton to then but no of them have heard of her, not even the psych people! Talk about frustration!!!!

Hi Pete!  Maybe the hospital docs and your doc are following the BNF dosing suggestion which says:  "By mouth, anxiety, 2 mg 3 times daily increased if necessary to 15–30 mg daily in divided doses".  I guess that's possibly because you haven't told them the full story and so they are treating you like a regular patient rather one that has almost dined out on impressively large quantities of 18 different benzos obtained without prescription.

Perhaps you need to approach the local addiction service.  You can walk in and self-refer.  They will inform your GP because of the need for joint working.  They don't usually take on patients who have become dependent on prescribed benzos but if you mention your 18 benzo and oxycontin binges enabled by independent sourcing, then it's much more likely they would take you on.

One difficulty you currently face is finding what dose to settle on.  As I mentioned, diazepam takes a week or two to build up to full strength.  This means if you start with a dose of diazepam which makes your symptoms tolerable within a day or two then by the end of two weeks the level of diazepam in you will have crept noticeably higher and this will create an unnecessarily longer taper.

@Braban.

 

The hospital doctors and my G.P have thid golden rule where they can't give me more than 30mg per day! The medical community here in Coventry, United Kingdom are almost cluelsss when it comes to Benzodiazepine withdrawal.

 

Ive tried to mention Ashton to then but no of them have heard of her, not even the psych people! Talk about frustration!!!!

 

Hi Pete!  Maybe the hospital docs and your doc are following the BNF dosing suggestion which says:  "By mouth, anxiety, 2 mg 3 times daily increased if necessary to 15–30 mg daily in divided doses".  I guess that's possibly because you haven't told them the full story and so they are treating you like a regular patient rather one that has almost dined out on impressively large quantities of 18 different benzos obtained without prescription.

 

Perhaps you need to approach the local addiction service.  You can walk in and self-refer.  They will inform your GP because of the need for joint working.  They don't usually take on patients who have become dependent on prescribed benzos but if you mention your 18 benzo and oxycontin binges enabled by independent sourcing, then it's much more likely they would take you on.

 

One difficulty you currently face is finding what dose to settle on.  As I mentioned, diazepam takes a week or two to build up to full strength.  This means if you start with a dose of diazepam which makes your symptoms tolerable within a day or two then by the end of two weeks the level of diazepam in you will have crept noticeably higher and this will create an unnecessarily longer taper.

I actually not only stressed as forecefully (Yet politely) as I could of my levels of abuse. Even my family (Who know everything) told the doctors the severity of my abuse. Over the course of the last few years I've kept a diary of my drug use which my Mum presented it to the medical staff in the hospital (Who looked confused) I have a feeling they didn't believe what they were reading in diary and must of thought I was lying because what I was taking was not posssible so therefore it must be a lie.

At my worst I was taking 300mg of Xanax (Alprazolam) or 3000 - 9000mg Temazepam or 1000mg or so of Diazepam, alongside Oxycontin doses ranging from 20mg in the beginning upto 400mg at my worst, much of the time I would be taking with Benzos. I told all of this to all the hospital staff over and over, but to no avail. I told them how much and of what I had used, I even gave them my diary which had the vast majority of twhat doses and at what times I was takinghe drugs and

but they shown no interest. They insisted on a maximum of 30mg per day Diazepam and the Pregablin which dose is due to rise to 600mg per day as of Tomorrow,

Unfortunately my G.P does not have much knowledge in this field so she refered me to addiction centre where I would attend regular meeting with my key worker, and because my use was so erratic, sporadic, extreme but also because it had no pattern I was a hard case to nail. Which after 2 years of regularly attending the local addiction centre nothing was ever done, no taper put into place, no referal to a detox centre as they are only funded to send Opiate addicts and alcoholics to detox. My G.P, local hospital nor my local drug treatment centre will prescribe more than 30mg per day.

I think because even at that low dose it has kept my hallucinations, paranoid delusinos, psychosis and reduced my risk of seizure.

Many thanks for your kind advice and support 

I actually not only stressed as forecefully (Yet politely) as I could of my levels of abuse. Even my family (Who know everything) told the doctors the severity of my abuse. Over the course of the last few years I've kept a diary of my drug use which my Mum presented it to the medical staff in the hospital (Who looked confused) I have a feeling they didn't believe what they were reading in diary and must of thought I was lying because what I was taking was not posssible so therefore it must be a lie.

 

At my worst I was taking 300mg of Xanax (Alprazolam) or 3000 - 9000mg Temazepam or 1000mg or so of Diazepam, alongside Oxycontin doses ranging from 20mg in the beginning upto 400mg at my worst, much of the time I would be taking with Benzos. I told all of this to all the hospital staff over and over, but to no avail. I told them how much and of what I had used, I even gave them my diary which had the vast majority of twhat doses and at what times I was takinghe drugs and

but they shown no interest. They insisted on a maximum of 30mg per day Diazepam and the Pregablin which dose is due to rise to 600mg per day as of Tomorrow,

 

Unfortunately my G.P does not have much knowledge in this field so she refered me to addiction centre where I would attend regular meeting with my key worker, and because my use was so erratic, sporadic, extreme but also because it had no pattern I was a hard case to nail. Which after 2 years of regularly attending the local addiction centre nothing was ever done, no taper put into place, no referal to a detox centre as they are only funded to send Opiate addicts and alcoholics to detox. My G.P, local hospital nor my local drug treatment centre will prescribe more than 30mg per day.

 

I think because even at that low dose it has kept my hallucinations, paranoid delusinos, psychosis and reduced my risk of seizure.

Hiya Pete!  You certainly have taken some crazy doses in the past and your benzo receptors must have been hit hard. 

Maybe the professionals think you used to take high doses but they may say as you are no longer in absolute crisis you're now okay on lower doses like 30mg diazepam.  In fact once you have shaken off your recent opiate binge you may find you don't need a whole lot more than 30mg diazepam and may be able to tolerate the withdrawal symptoms until your body heals enough for 30mg to be sufficient for you.  This could be a few months.

The addiction centre sounds like the right place to be.  Maybe another GP referral stating your wish for a supervised outpatient withdrawal would help.  For your part, you may need to persuade them you will not indulge in benzo/opiate binges in the way you did when you were previously under their care.

You can search for experiences with pregabalin (and the similar gabapentin) in this forum.  Some people say it helped them but, in my own case, I wouldn't expect too much from it and would manage without it if possible because it can complicate the situation and sometimes make it worse.