Recent studies show that long-term use of benzodiazepines is correlated with serious memory deficits, falls, dependence and other health problems. Once this information sinks in, some benzodiazepine (BZD) consumers, suddenly want to come off their medication. Many do not have the information they need and some believe they can simply stop the medication as easily as they started it.
BZDs can appear to be tiny pills and often patients are told they are on ‘small’ doses. What they don’t understand is that abruptly stopping this class of drugs can be life threatening, no matter the dose. Many agencies and researchers warn that cold turkey from even a ‘small’ dose is linked to extreme rebound symptoms and other severe symptoms such as psychosis, hallucinations, homicidal and suicidal ideation and seizures. While some feel this is a reasonable price to pay to get off the drug, what they do not understand is that a cold turkey or rapid detox can cause severe and protracted withdrawal symptoms that can disable someone for months or even years. For many, the withdrawal does not end once they are off the drug.
Unfortunately, many rehab facilities and some physicians underestimate or are not educated on how severe rapid discontinuation can be. Addiction based approaches simply do not offer the proper support and time frame required to assist patients in safely tapering and recovering from a BZD associated disability. There have been warnings and more appropriate suggested guidelines for decades that have been largely ignored.
Researchers in the UK have been warning about Benzodiazepine Withdrawal Syndrome (BWS) since the 1980’s when Professor Heather Ashton ran a detox clinic to test her tapering method. protocol and to study BWS. Since that time the Ashton taper guidelines have been used by thousands of patients to successfully withdraw from their benzodiazepines. This protocol calls for an adjustable tapering schedule that is dictated by the patient. On average it can take 10 months to slowly withdraw from a benzodiazepine in this way. In most cases, insurance companies will not pay for more than a 3-10-day stay in a rehabilitation facility that is ill-equipped to handle the complexities of BWS. A slow withdrawal rate using a taper protocol like Dr. Ashton’s can significantly reduce the probability of severe withdrawal symptoms and / or in having a protracted withdrawal syndrome.
The British National Formulary issued new guidance for slow withdrawal of BZDs in 2013. They advise to follow a slower taper schedule similar to Dr. Ashton’s and one that is flexible to the individual patient’s needs and comfort. They also recognize the different needs between short-term patients and long-term, dependence and addiction. Another recommendation was not to add additional medications during the withdrawal and recovery phases to an already fragile nervous system. Poly pharmacy, or the addition of more medicine (including phsyciatric medication), is common practice in many rehab facilities.
One of the world’s leading authorities in benzodiazepine pharmacology, Professor Malcolm Lader, emphasizes time and again the need to adopt a slower rate of taper in general when it comes to benzodiazepine discontinuation. Not only can slow tapering save patients from disability and death, it can also aid in successfully, permanently staying of off benzodiazepines and at the end of the day, isn’t that the goal?