Feel free to ask any and all benzo questions here

[Raven]

No problem at all!

The Ashton method is a slow switch to diazepam (or other long-acting, high mg/dose benzo) then a slow taper of 1-3mg every few weeks. All of the basic and somewhat detailed informations can be found here: http://www.benzo.org.uk/manual/

Tapering off to zero is honestly a REALLY bad idea unless you're treading familiar territory. To totally taper even a relatively low dose of benzos safely can take a year. The best way to look at it is this: if you were consistently on 1mg of lorazepam and were to stick to the Ashton method and taper 2mg of diazepam every other week, you'd be down to 5mg of diazepam in 5 weeks. 5mg of diazepam is roughly equivalent to 1mg lorazepam so you'd be down to .5mg when switching back.

I'm not sure if it was this thread or somewhere else or if it was you I brought it up to but have you considered doxylamine succinate? It's essentially a better antihistamine sleep aid than diphenhydramine. Failing that, might i suggest midazolam? That would have to be a small dose to avoid next day grogginess (~5mg) and it's fairly short acting but it's effective. There's also lunesta which I have no experience with but I've heard that it's much better than the z drug it's an isomer of (zopiclone).

Oh and as for tolerance, its only temporary. I've used the Ashton method several times to keep my alprazolam tolerance in check.

I'm not so sure about the full specifics of the Ambien/Ativan question to be totally honest. If I were in your situation I'd most likely alternate each one with something to potentiate the Ativan (if I were to choose to stay with those two) for at least a few weeks before switching to something else. I'm not you obviously so I domt know if that's an option but I would likely try to go 2 nights on one each alternating for a bit before a switch or taper as well but that's just me. Whatever your body lets you do, try it out. Youll have some sleepless nights for sure but tapering and particularly your awful situation (sorry to hear this is all injury induced as well) don't leave you a lot of options that I can think of.

Bowser:
If I was not a Newbie here with limited privileges, then I would surely be sending you some style points for all the work you have put into this thread! Thank you for your detailed replies; full of personal experience and well written.
I don't want to pretend to be speaking for anyone but myself. However, I think that my situation will apply to many. The only benzo script I have is for Ativan. I have, however, chosen to use diazepam and alprazolam on my own (because they work!). I have no script and I manage these medications completely on my own.
Given the inherent risks associated with obtaining medications via my chosen method, and based on the complete absence of sympathy I anticipate that my Primary Care Physician will convey to me in the event that my medication supply is disrupted, what do you recommend that I have on hand in terms of medications so that I can work my way through an emergency taper on my own? Should I always have a substantial supply of diazepam on hand so that I can fall back on an Ashton Model taper in the event that my alp supply is disrupted?
Raven

[Bowser]

Hey, Raven!

Thanks for the kind words. Honestly, I just enjoy helping where I can. Sometimes I ramble but I'll eventually get to where I'm going ahahaha. Too many people have entered and left my life (usually unexpectedly) due to pharmaceutical complications and I figure hey, I learn new things every day so why not put at least some food for thought out there for people who only have "SWIM" sites for answers and would like a bit more. I was actually in the same position as you a while back. You are correct in your assumption of lack of sympathy but you can expect at least a bit of ass-covering if the past couple of years are any indication.

To elaborate slightly: I was on 2mg klonopin 3x daily for GAD, insomnia and agoraphobia. I knew nothing of benzos at the time, just that the klonopin fixed everything my SSRI didn't. I now know the doctor was a well known pill pusher and I believe is now in prison but that's something else entirely. Anyway, I lost the job that gave me insurance that I was able to visit Dr. Pusher with. I ended up going into what started my background in pharmaceuticals with a less than reputable company and having some kind of garbage insurance that allowed me only the finest in sleazy, back alley physicians allowed to practice here. First few months were fine. Then out of nowhere Dr. Clueless informs me "it's a miracle i'm still alive and haven't overdosed on Klonopin yet" and will no longer prescribe me Klonopin. Oh no.

By now I've learned a bit about various narcotic classes and (of course) read up on the meds i'm on. I knew that since I'm not a recreational drug user and don't drink that there is virtually no way I'm going to overdose on a script that was 2 years old at that point. I did, however, know the withdrawal was potentially fatal. Heated argument, him kicking me of his office and a trip to the place's head MD threatening to sue the practice to hell and back if I went through even one minute of withdrawal symptoms due to the negligence of a 90 year old doctor (who was only still practicing to keep himself in his well known prostitute addiction... ew) and he wrote me a script for 1 0.5mg tab every 12 hours. In these past few years though I've noticed an uptick in doctors that realize benzo dangers so most will halve your dose for a few months. I mean... it's something at least.

Sorry for rambling. My point is this is what led to my discovery of the Ashton method. I firmly believe that this is the singular reason I'm still here. I immediately turned to IOPs and bought what I thought was an absurd number of tablets. It ended up being JUST enough to complete my taper down to .5mg of Klonopin.

So long answer short, yes, by all means stock up if you believe this to be an eventuality. Just remember to cycle through them and make sure to check with the provider that the expiration is a decent amount of time in the future. I'm not going to state this definitively but VERY FEW drugs become dangerous after expiration. I'm not going to say that diazepam is one of them. I'm also not going to mention that the US military among many others have done innumerable tests and studies to determine safety and potency of prescription drugs and found that diazepam is part of the 90+% of medications tested that are perfectly fine up to and including fifteen years past manufacture date (oops, mentioned that). If you're willing to wait, one of the posters on this site offers a few thousand DAZ 10s for an UNBELIEVABLE price from the country he gets a lot of crap about the shipping speed from.

Not a doctor, blah blah blah, ask yours. You know the drill, Sir (and/or ma'am). And of course, don't eat expired meds. Unless... you know, the apocalypse or something of that nature. I'd rather be cleaved in two by some sort of demonic something or other than deal with zombie apocalypse situations with full blown agoraphobia.

[Bowser]

As previously and repeatedly stated, this isnt meant to replace the advice of an MD. Which I again am not. I agree that it's not a one size fits all area, it's barely a one size fits two or more area. I can take almost any benzo and know what to expect. Then I'll take an Ativan and have incredible anxiety, rage and violent outbursts. I can take 4mg of Klonopin and not get any result at all but 1mg of xanax will put me to sleep. Is everyone like this? No. Not at all and I never implied I expected anyone to be the same.

In my op I flat out stated these answers aren't derived from anything more than anecdotal evidence and observations of those close to me and my own personal experience. I'm not including medical studies because I won't go into that territory and studies can and are regularly refuted. Anecdotes and experience are more relatable and in my opinion (like everything else here) more accurate than a .PDF of a confusing series of tables and things like peak plasma levels during a menstruating rodent's average Tuesday afternoon.

Anyone that's going to attempt the Ashton method needs to read the materials thoroughly and speak to their doctor. You're correct, there is the problem of half life. I've not addressed the ACTUAL undertaking of the method imtentionally because it differs from person to person and from an ethical and, depending on area, legal standpoint, I would need 6-12 more months of schooling and testing that I have neither the interest or desire to complete to represent anything I'm saying as anything other than "hey, I've been to benzo hell and it's not pretty. Here are some directions in which you should look to see if any of this fits your particular situation or may help you in any way."

Yes, there are flaws and variations as with anything. This is also probably the only solution for many, many people. I credit it with quite literally saving my life. I'm not calling it the unicorn of benzo dependence or a miracle cure. Even using the Ashton method with no deviation... it isn't fun. Tapering off of anything isn't a trip to the theme park. It's a little slice of hell, i'm the first to admit that. Is it better than a potentially fatal, cold turkey most general practitioners will suggest (and by that I mean force upon the patient)? Most certainly.

[Bowser]

Hey erol34,

If I were tapering short acting meds without a switch (which I have done but it's not something I enjoyed) I'd go with the old "take a small chunk out of the pill every few nights" method. If you really are set on it and know the risks (namely in your case, rebound insomnia) then 0.5mg or even 1mg in a month shouldn't (but COULD) be much of a problem. There's an inherent risk with any kind of benzo taper but your situation is rather unique.

The alternating only really serves to see how your body reacts to it and make sure that it's capable of handling the switch. To answer your other question, zolpidem works on and in much the same way as benzos on the same (GABA) receptors. In theory a total cutoff of Ativan COULD result in nothing at all of note different with the zolpidem taken into consideration. In practice it would be dangerous as hell. If your intent is to come off of one or more narcotic medications, you could ask your doctor about gabapentin. It's something of a longshot that they would be willing to switch you over but there's always a chance and it's worth asking. Some doctors are only too happy to try non narcotic medications if you bring them up, particularly to treat things associated with a head injury, but I'm guessing that since this IS the result of a head injury they've already tried that route with you. As I said, though, there's always a chance.


Shmokey- I wouldn't use it for insomnia for any real duration of time. Tolerance rises quickly and day to day anxiety can pop up out of nowhere between doses. As I've suggested to other posters, doxylamine succinate can be bought OTC in most places and can be a huge benefit to most people. Store brands are cheap and if you're in the US then they can be purchased on Amazon for $10-$12 for around 200 under the brand Kirkland. As I said before (possibly to you? Sorry, a lot of benzo/sleep questions) doxylamine works the same way benadryl does just much, much better. I just checked a few Amazon listings for doxylamine and with almost 1,500 reviews that drug has a pretty constant 4/5 rating.

There's also melatonin which CAN BE extremely effective but usually isn't. This is solely the fault of pill poppers that don't follow instructions. Where melatonin ASSISTS in sleeping, it doesn't actually put you out the way sleeping meds or benzos do. It's actually used to regulate circadian rhythm disorders. The way it works, essentially, is by signaling the brain that it's getting dark out and to be prepared to sleep. That is to say that if you work a night shift, blinds and curtains need to be closed and things need to be very dark for as long as possible after taking the pill. It also can't be taken any time like most people think. It should be taken 1-2 hours before sleep, sometimes a bit longer if 1-2 isn't working and you're actually taking them late in the day.

Ome more point about melatonin - the dose is all wrong. The companies that make most brands know this but they also like the fact that to most people, "more is better" in the way of active ingredient. A couple of years ago we ran a sleep study with traditional sleep remedies vs modern medications. The melatonin actually fared very well, better than some well known narcotic sleep agents, ONLY IN LOW DOSES. People were given various doses of various compounds. What we ended up finding was that people who took the most easily accessible melatonin from a drug store or supplement shop (2-5mg) actually got less quality sleep than people that were taking 125-300mcg doses.

I hope that helps and if not, id be happy to answer anything at all with other suggestions. Oh. One last thought regarding melatonin (pill form or natural, internally produced): Google "light therapy." This can also be beneficial with practice and following the guidelines but even I am not long-winded enough to go into detail here haha. That is unless you'd like me to explain further. As was my mantra when I was a teenager "i'm up for anything, just let me know when"

[barq2]

Hi Bowser,

This is a really interesting thread. My background is psychology, so that touches some of the issues you have raised (plus my ex was a pharmacist). Anything I post is done in a personal capacity. I cannot diagnose people on this forum - sorry.

My background... Long history of depression and anxiety (GAD). As I've grown older I have more coping skills for depression and take St Johns Wort as a preventative measure. The anxiety hasn't got better and that is partly due to my career demanding more of me. SSRIs and TCAs have not helped. A doctor put me on diazepam to help deal with side effects from citalopram. This was to be short term until things settled down. You can probably guess what happened... years later I am still on diazepam but not citalopram.

The interesting thing is that I have kept my dose low. Very early on I discovered the addictive properties and have done everything to resist increasing. Over six years I have crept up from 5mg to around 10mg of diazepam (or equivalent when taking other benzos). Doctors are generally surprised it is this low. Last year a new doc told me that when I mentioned the length of time he had been expecting me to be on hundreds of mgs, so in that respective I have been fortunate.

I know about the Ashton method for tapering, but my high stress job and various life events mean there is never a good time to cut down. You have commented to others about switching benzos and doing partial tapers to keep tolerance low. Should I be switching out to something else? Bromazepam works well for me, but are you advocating switching *pam for *lam? Is there anything I should be adding to my diet or supplements that would help me stay at my 10mg plateau, and then maybe taper downwards? I honestly find the idea of zero very scary. Diazepam works very well for me, so how long can I maintain 10mg before I am so tolerant that it is at best placebo and at worst mild withdrawal?

if I were to search for and post a study linking frequent small dosage vs infrequent moderate dosage stating that the former was more likely to lead to dependence and/or addiction, I could find a study stating the exact opposite with another quick search and then a third stating the risks are, for all intents and purposes, identical.

I take your point, but isn't this where you would search for a systematic review or meta-analysis?

Z-drugs - I was interested that you are basically fairly anti z-drug on the basis of poor quality sleep. In your view are some better/worse than others? Could you be more specific about the changes to sleep? Do you mean less REM or something like that? How does this compare to hypnotic benzos? I was a bit worried about sedating antihistamines due to the possible link with dementia.

Phenibut - Never taken it, but heard many stories about people on massive doses. In your view, how does it compare with baclofen? Given some people are using this to make them indifferent to alcohol (albeit with mixed success), are those individuals going to end up on ever higher doses of baclofen? Keep in mind people using for alcohol generally need a high dose to start with 100-300mg.

Sleep - Any opinion on 5-HTP as a sleep aid? I am on SJW, so wonder about the potential for serotonin syndrome, but I would guess the odds are pretty low. What do you reckon? I struggle getting to sleep, but the real killer is waking at 3am.

Sorry for all the questions, but thanks for giving up your time and knowledge.
All the best, barq

[Bowser]

Hey barq, i'm sorry I haven't answered, my actual job, at-home work and a problem in my wife's family that resulted in needing to find a last minute flight for her back to her native country all snowballed into a huge pile of garbage of a week for me. The things airlines make you do in order to buy a nonstop ticket to eastern Europe are pure evil in the most malicious of ways.

As I type this, I've totaled 6 hours of sleep in 3 days so I'm literally doing this in the first free few minutes I've had in a while. If you don't mind, I can't wait to delve into your questions (and please, don't ever apologize; "too many" is not a phrase i'll ever use in regard to questions) but I'll write up my response and post when I wake up from what I'm sure will be the best sleep I've had in months. Again, apologies but frankly, i'm not even positive this post is coherent. Anyway, have a great day/night and I'll be looking forward to talking with you once I address everything you've brought up. - Bowser

[barq2]

Hey barq, i'm sorry I haven't answered, my actual job, at-home work and a problem in my wife's family that resulted in needing to find a last minute flight for her back to her native country all snowballed into a huge pile of garbage of a week for me. The things airlines make you do in order to buy a nonstop ticket to eastern Europe are pure evil in the most malicious of ways.

As I type this, I've totaled 6 hours of sleep in 3 days so I'm literally doing this in the first free few minutes I've had in a while. If you don't mind, I can't wait to delve into your questions (and please, don't ever apologize; "too many" is not a phrase i'll ever use in regard to questions) but I'll write up my response and post when I wake up from what I'm sure will be the best sleep I've had in months. Again, apologies but frankly, i'm not even positive this post is coherent. Anyway, have a great day/night and I'll be looking forward to talking with you once I address everything you've brought up. - Bowser

Have a good sleep!

I know how awful sleep deprivation is. The other week major movie was being shot along the block from me and all night they were filming stunts of a car chase with LOUD machine gun fire. This went on for four nights. It was interesting at first, but as I become more an more sleep deprived I could hardly function. Your grammar is holding up quite well

Seriously though, no hurry at all. None of my questions are urgent. Just whenever you feel like it.

Hope your wife's family situation is ok.

All the best,
barq

[Raven]

Hey Bowser:
Here is another question for you (or anyone else who cares to share pertinent information). What is the best way to store this type of med for say a time period exceeding 6 months? My theory is that any med. that can be so effective at such a small dose must be fairly volatile. I abide by the normal cool and dry storage methods, but since stockpiling is essential to prevent big problems when supply disruptions occur, what other measures should be taken to maintain product quality during extended storage periods? Thanks.
Raven

[barq2]

Hey Bowser:
Here is another question for you (or anyone else who cares to share pertinent information). What is the best way to store this type of med for say a time period exceeding 6 months? My theory is that any med. that can be so effective at such a small dose must be fairly volatile. I abide by the normal cool and dry storage methods, but since stockpiling is essential to prevent big problems when supply disruptions occur, what other measures should be taken to maintain product quality during extended storage periods? Thanks.
Raven

Benzos like diazepam are quite stable. If kept cool, dark and dry then diazepam can still be fine 10-20 years after the expiry date. (Confirmed by a pharmacologist I know.)

To help keep nice and dry, consider sachets of silica gel (you can buy them cheaply on ebay). After a while they can be dried out in a microwave, but Google for advice on this - I don't want you blowing up your kitchen!

I know one person who keeps their blistered diazepam in a fridge (approx 5 deg C). I would worry about that because any sudden changes of temperature could cause condensation.

Would be interested in other opinions and experiences.

[Drainyou94]

Anyone ever had naze -2 they were in blisters of 10 2mg clonazepam ,or msj 2mg clonazepam came in a glass bottle never opened qgot to break the seal was surprised to see they had an imprint white msj on one side and the 4 break mark like the Roche has on the back of thers and the last is called clonax-2 made by the same company that makes Etizest concern I think it's called thoes are 2mg also anyone tried any of these what was the best one out the 3?