Thus I have heard... From: "Eaton T. Fores" Date: 13 Mar 1999 00:00:00 GMT One day, noise spoke, desiring enlightenment: > I need to know what are the symptoms of benzo addiction > and withdrawal, so I can see if that's what's happening > to me. > > I am very sick, I ran out of all my pills early this week > and wasn't expecting to have a problem. But I cannot eat > or sleep (seriously... 3 days now with no sleep and a > small bowl of curry and one sandwich) and I feel utterly > putrid. Plus I'm going completely lunatic again. my head is > like lightning flashes, I hear sounds that aren't there. > Worst of all is my stomach. Putrid. Horrible. It feels > so god-damn bad, I want to vomit but I feel I have neither > the strength nor the tolerance for pain. > > I need to know, does it sound like bennie withdrawal, or > an illness? [The Blessed One then spoke:] Following is a good description of withdrawal from low to moderate doses of benzos: > I cannot eat or sleep (seriously... 3 days now with no > sleep and a small bowl of curry and one sandwich) and > I feel utterly putrid. Plus I'm going completely lunatic > again. my head is like lightning flashes, I hear sounds > that aren't there. Worst of all is my stomach. Putrid. Horrible. > It feels so god-damn bad, I want to vomit but I feel I have > neither the strength nor the tolerance for pain. Does that sound like you? It should, since it was just copied out of your post. Sweating and tremulousness, along with an exaggerated startle response (i.e., the phone rings and you almost jump to the ceiling) are also common symptoms. The definitive test for whether you are in benzo withdrawal is this: take an ordinary dose of a benzo on an empty stomach. If all of your symptoms magically disappear within an hour, then it's benzo withdrawal. The best way to deal with this is to use a long-acting benzodiazepine (like Librium [chlordiazepoxide] or Tranxene [clorazepate]), adjusting the dose to be equivalent to what you were on, following this off-the-top-of-my head equivalency scheme: 1mg Xanax = 10mg Valium = 15mg temazepam (Restoril) = 2mg Ativan = 25mg Librium = 15mg Tranxene Add up the total daily dose of whatever you were taking, turn it into the equivalent Librium or Tranxene dose using the above information, then take half of that amount twice a day (every 12 hours, e.g., 8:00am and 8:00pm). Example: if you were taking 1mg of Xanax four times a day, then take 50mg of Librium every 12 hours. Don't expect to "feel" anything from the benzo except relief of withdrawal. You made need to adjust the Librium or Tranxene dose upward *a little bit* until the symptoms of benzo withdrawal are controlled. At this point, you're stabilized. Once you're stable, stay that way for two days. Then reduce the dose by 10 to 20% a day every three to five days, depending on how comfortable you are. This should be almost painless. If you go to a doctor and tell him that you've become dependent on benzos and want to taper off of them, and only ask for Librium (which no one wants for recreational purposes), you will probably get it. If you have health insurance, this will go on your record, and end up on your MIB (Medical Information Bureau, sort of to your health information what TRW and the other credit reporting bureaus are to your financial health), which may come back to haunt you (i.e., you may not be able to buy life insurance or something). Best to seek out a GP not related to your health insurance and pay him or her in cash. IMO, it's worth spending the $50 or $75 or whatever an office visit costs to keep your private business private. =================================== From: "Eaton T. Fores" Date: 07 May 1999 00:00:00 GMT C L drew near to the Blessed One and asked: > i've been taking valium and xanax habitually for almost 10 years > now. Now the valium hardly works for me anymore, but the xanax > do nicely. i've had some horrible detox experiences that have > lasted 2 weeks or more. Does any one know anything about benzo > detox and is there any other kind of med. that can help with the > detox. thanks. The solution to dependence on short-acting benzos is to switch to a long-acting benzo and then gradually taper off the dosage over a period of a month or so. Stabilize yourself on Librium or Tranxene twice a day (every 12 hours, that is), substituting 15 mg Tranxene or 25 mg Librium for each 1 mg of Xanax per day you were taking. So, if you were taking 10 mg of Xanax a day, take 250 mg Librium per day, as 125 mg every 12 hours. Then decrease by 20% of the original dose every week until you're off of it. Remeron can help the anxiety and insomnia of Xanax withdrawal somewhat, but there really is no non-addictive drug that can smooth the withdrawal, and if you try to stop without using some kind of sedative, you run the risk of having seizures, which can kill you. Go with the Librium technique, it's pretty painless. =================================== From: "Eaton T. Fores" Subject: Re: Daily Xanax useage -risky? Date: 28 Jul 2000 00:00:00 GMT Moonunit62, too, adressed the Exalted One: > Gotta bunch of [Xanax] and like it. However, I'm up to about 6-8 Mg > per day now, and notice some tolerance for it. What should I max to for > daily dosage? > > My supply won't last forever. Am I in for it? Maybe weaning down is > the answer as my supply dwindles? I've heard about seizure withdrawls and > other horror stories. How long have you been taking it for? This is a significant factor in the degree of dependence that will develop. Six to eight milligrams a day is beyond the normal range for anxiety, but within the normal range for panic disorder, and far below what some people take as self-medication. But eight mg a day for a year can produce a very serious dependence. On the other hand, I've seen people take over 100 mg a day for years. Their detox took half a year. In any case, the best strategy for getting off Xanax is to substitute chlordiazepoxide (Librium) for the Xanax, 25 mg of chlordiazepoxide for every 1 mg of Xanax, divided into two doses and taken every 12 hours. After a week of stabilization on this, you can being to taper off the Librium, which you will find *much* easier than tapering Xanax. Decrease *very* slowly; it may take a couple of months to entirely detox. Don't make dosage adjustments more than once a week. Librium comes in 25, 10, and 5 mg capsules, so it's pretty easy to follow the tapering schedule. Start by assuming your highest dose of Xanax (8 mgs), since you're probably lying to yourself about how much you really take. The following schedule should work: Take the Librium every 12 hours. 11:00 am and 11:00 pm are good times. Week 1 (stabilizing): 100 mg Librium (four 25mg capsules) every 12 hours Week 2 (begin taper): 80 mg Librium (three 25 mg capsules + one 5 mg capsule) every 12 hours Week 3: 75 mg Librium (three 25 mg capsules) every 12 hours Week 4: 60 mg Librium (two 25 mg capsules + 1 10 mg capsule) every 12 hours Week 5: 50 mg Librium (two 25 mg capsules) every 12 hours Week 6: 40 mg Librium (four 10 mg capsules) every 12 hours Week 7: 30 mg Librium (three 10 mg capsules) every 12 hours Week 8: 20 mg Librium (two 10 mg capsules) every 12 hours Week 9: 15 mg Librium (three 5 mg capsules) every 12 hours Week 10: 10 mg Librium (one 10 mg capsule) every 12 hours Week 11: 5 mg Librium (one 5 mg capsule) every 12 hours Week 12: 5 mg Librium (one 5 mg capsule) ONCE A DAY Week 13: one 5 mg capsule EVERY OTHER DAY. Week 14: discontinue all drugs You should have no withdrawal symptoms at all with this regimen. Don't expect to "feel" anything from the Librium, you won't. You'll need a doctor willing to give you the 25, 10, and 5 mg capsules who doesn't insist that you go to inpatient detox. =================================== From: "Eaton T. Fores" Date: 11 Oct 2000 00:00:00 GMT On one occasion, Gregor18 opined in the presence of the Blessed One: > 60 mg is a large dose [of Valium]. I don't really agree. 600 mg is a "large dose." 60 mg is just a little more than the maximum recommended dose. You still have to carefully taper, though. With benzos, if you've been taking them a long time (more than two or three months), you need to be very careful about tapering even if you've been taking a *small* dose (like 20 mg Valium per day). The ordeal will not be fun. With *really* large doses, calling it a "nightmare" is an understatement. Even with ordinary doses, trying to get off of these drugs if you're addicted will rank as one of the worst experiences of your life. I should point out that not everyone gets addicted. However, if you're reading about this on adh, you're addicted. I completely agree about the substitution of a very long acting benzo (I personally think that Librium, Tranxene, and Klonapin, in that order, are the best to taper with). The starting dose should be sufficiently high to keep you comfortable -- the standard "benzo equivalency" charts are not right in this regard, especially with regard to Xanax -- you need a higher dose of, say, Librium, than they'd suggest. I also think that the taper should be done *incredibly* slowly. You shouldn't expect to get off of Valium in two weeks or a month. It will take two or three months. If you try to speed it up, you will end up so anxious that you'll go right back to where you started from. =================================== From: "Eaton T. Fores" Date: 31 Oct 2000 00:00:00 GMT Then BENZOBOY called upon the Blessed One: > I called on you,ETF, for advise on the chem stand point of my detox. > I am up to 20mg of Xanax a day. ETF, was hoping you would know the W/D > sevarity. Or what I can take besides another benzo to detox. At 20 mg Xanax a day, you could have quite a habit. How long have you been taking such a high dose? The approach to this is always the same. First, switch to a long-acting benzo. IMO, Librium (chlordiazepoxide) and Tranxene (clorazepate) are the best. Some people swear by Klonapin (clonazepam) for tapering, but I personally think that you want a low-potency benzo for this. Use 25 to 40 mgs Librium for each mg of Xanax you had been taking, or 15 mg Tranxene. In either case, spilt the total daily dose into 4 equal doses, to be taken every six hours. Wait three or four days at the starting level until its clear that you're stabilized. You should feel no effect from the substituted benzos at all, but you should also feel no withdrawal (although you'll probably still have trouble sleeping). If you can feel the substituted drugs, you're taking too much. You can try Benadryl for sleep (you'll need 50 to 100 mgs); this helps some people, but not others. Once you're stable on a four times a day dose, then begin to reduce it very, very gradually. For a 20 mg/day Xanax habit, don't expect to take less than two months to get off of it. Every five days or so, bump down the dose targeting this two-month goal. You may need to go even more slowly at the very end. If you try to speed it up, you will just end up right back where you started from, because you'll end up getting a panic attack and then eating the whole bottle. Don't bother trying to substitute barbs, unless it's phenobarb, and even then, the long-acting benzos are a far better idea. A barb habit is worse than a benzo habit. If at any point you feel like you're going to jump out of your skin, stop the taper until you're stabilized again. It takes a long time and is not easy. Good luck, and I'm sure plenty of us will be here if you feel the need to insanely rant at 4:00 am or something. =================================== From: "Eaton T. Fores" Date: 01 Nov 2000 00:00:00 GMT Hey man, you think we could put the General Benzodiazepine Detox Procedure in the FAQ? It's getting tedious to explain it to someone else almost every day. It sure qualifies as a Frequently Asked Question. Oh, and for all you benzo-heads out there: to compute the approximate number of times you're going to do this procedure, subtract your age from 80, and then divide the resulting number by two. Or you could just be reasonable, like Samson, and regard them as an excellent source of dietary hydrocarbons ... that is, if you can keep the dose from increasing without end. -- ETF