Intro

[[Jo...]]

Hi. I've been taking .5 mg of Lorazepam 1-2 times a day for 3 years. I'm about to have a tonsillectomy, and I've been prescribed liquid Hydrocodone/Acetaminophen, to take afterwards for pain. I'm concerned about the possible interactions of these drugs, so I'm considering not taking the Lorazepam while I recover. I will ask the doctor about this before surgery, but I'm wondering if anyone has any experience with this type of situation.

[[ma...]]

Hello  JoeSmith    Welcome to BenzoBuddies!. 

 

Please don’t stop Lorazepam cold turkey, it can be dangerous.  Benzodiazepines need to be tapered slowly. The suggested taper rate is 5/10% every 10/14 days. You may want to familiarize yourself with the Ashton Manual. It is a great resource for information about benzos and how to withdraw.

 

Here is a link to the manual: : Professor Ashtons Manual 

 

We have a wonderful community of caring members. They have been through all aspects of benzodiazepine use and withdrawal, and will share their experiences with you.

 

Sorry I don’t have any experience with  Hydrocodone/Acetaminophen but I am sure one of our more knowledgeable members will . I found this thread about hydrocodone, not sure if it will help.  If you use the search you might find more on these meds. 

 

Lortab (Hydrocodone) in withdrawal

 

You might like to check out the other meds board: Other Medications Board

For tapering advice General Taper Plans   

 

For support with any symptoms you may have post here: Withdrawal Support

 

If you would please be so kind as to add a signature (history of meds/doses etc) it will help members give you relevant advice.  This link will show you how to do this Create a signature

 

If you have any questions let us know.

 

Welcome aboard

 

Magrita

 

[[Mo...]]

Hi Joe,

if you stop taking the Lorazepam you might be in for a horrible surprise.

please talk to your Doctor, tell him you are a long term Benzo user, he should

know that these meds are serious buisness.

 

wish you good luck with your operation, hopefully when you've recovered you will come back

and decide tapering off this crap, Benzos are meant for short term use (3-4 weeks ),

anything longer is irresponsible for a Doctor to prescribe.

 

Glad you have joined us, take care.

Claudia.

[[Jo...]]

I talked to the doctor, and we ended up postponing the surgery.

 

To give some more background on my situation, I've had this prescription for almost exactly 3 years. The initial situation was a severe case of gastritis, which triggered severe panic attacks. I thought I was dying, felt like I was going to pass out, thought I was having a heart attack, etc. All of the classic panic attack symptoms. Episodes of gastritis flare-up would always trigger the most severe panic attacks, but I also was having them at times when my stomach wasn't bothering me as much. I lost 30 pounds in about 6 months.

 

The gastritis has slowly improved, but it's still a lingering concern. The panic attacks have slowed down. I would not have been able to get through it without the Lorazepam. For the first six months, I could barely drive because I so often had panic attacks behind the wheel.

 

There are underlying issues of stress and anxiety aside from health issues that I've recognized as contributing factors, although the stomach problems were very real, and remain a real concern.

 

Over time I found a routine to get all of this under control, which includes healthy eating, vitamin supplements, regular warm baths with Epsom salt, and (obviously) Lorazepam. I'm also on Nexium and occasionally Carafate, but I don't know that those are relevant to this discussion.

 

The prescription I've had has not changed over three years: Two .5 mg tablets per day, as needed. In practice, I've only had one or two months where I've even come close to taking that much. However, I have been taking it routinely. I got into a habit of taking one .5mg tablet in the morning after waking up, as a preventative measure. On days where I have a high amount of stress and/or feel a panic attack coming on, I will take the second tablet. On many other days, I don't take any more after the one in the morning.

 

I've been keeping track of how much I'm taking precisely the whole time, and it averages to around .6-.8 mg per day. I've never taken it lightly, because I'm aware of its addictive properties, but I have read enough to know that this is a relatively small dose. I have no doubt that I have some level of dependency, but I have not abused the drug. There has been no escalation in my use of it, or craving for it over the course of three years. I usually don't take it before sleep, and I have no problems sleeping, even though the last dose was often 16 hours earlier, first thing in the morning. I've gone over 48 hours without taking any, because I simply forgot and didn't feel the need for it.

 

I still occasionally feel panic attacks coming on, and I've found that it is not related to how much I have or haven't taken the drug. It's always caused by stressful events and circumstances in life, just as it was initially triggered by a health issue.

 

Unfortunately, my life has not become less stressful, and I was having panic attacks before I was prescribed the drug. So if I taper off, I have no way of knowing whether I'm experiencing withdrawal, or merely the return of the problem the drug was prescribed to deal with. Maybe there's no difference.

 

I get the impression that a lot of people are prescribed these drugs for general stress and anxiety or insomnia, and they escalate how much they're taking over time. I was having severe and continuous panic attacks, and this type of drug was the only thing that helped. As I said, my intake of it has remained steady and has not increased. I don't crave more, or need more to get the same effect.

 

With all of that said, I recognize that stopping it "cold turkey" may be a bad idea. Which is why we ended up postponing the surgery. I need a responsible plan for tapering off, but I also feel that I could go a bit more quickly than someone taking a much higher dose.

 

I have a pill cutter that I bought for this purpose, but I don't think I can shave 10% off of a .5mg tablet, which is already tiny. I was thinking more in terms of cutting a pill in half, taking one half twice a day for a week, then taking a half a pill in the morning for a week, then maybe every other day. That's a ballpark idea given to me by a nurse.

 

Looking at the Ashton site linked above, the smallest dose withdrawal schedule, with Valium substitution, is 3mg per day. I'm already taking a little more than 1/6th that amount. I doubt that I need to go on Valium to get off of Ativan, but I will take any advice available from people who have experience.

 

 

[[Mo...]]

I'm glad you spoke to the Doctor, postponing the surgery might have been a wise decision.

Here is a short overview about tapering, which might help.

http://www.benzobuddies.org/forum/index.php?topic=9522.0

 

Ativan support group.

http://www.benzobuddies.org/forum/index.php?topic=44903.0

 

wish you good luck .

[[Ch...]]

I talked to the doctor, and we ended up postponing the surgery.

 

It should be okay to take pain medication temporarily while taking Lorazepam, unless your doctor says there's a reason why not.  I took a hydrocodone/acetominophen pain reliever after surgery with no negative effects.

To give some more background on my situation, I've had this prescription for almost exactly 3 years. The initial situation was a severe case of gastritis, which triggered severe panic attacks. I thought I was dying, felt like I was going to pass out, thought I was having a heart attack, etc. All of the classic panic attack symptoms. Episodes of gastritis flare-up would always trigger the most severe panic attacks, but I also was having them at times when my stomach wasn't bothering me as much. I lost 30 pounds in about 6 months.

 

The gastritis has slowly improved, but it's still a lingering concern. The panic attacks have slowed down. I would not have been able to get through it without the Lorazepam. For the first six months, I could barely drive because I so often had panic attacks behind the wheel.

 

There are underlying issues of stress and anxiety aside from health issues that I've recognized as contributing factors, although the stomach problems were very real, and remain a real concern.

 

Over time I found a routine to get all of this under control, which includes healthy eating, vitamin supplements, regular warm baths with Epsom salt, and (obviously) Lorazepam. I'm also on Nexium and occasionally Carafate, but I don't know that those are relevant to this discussion.

 

The prescription I've had has not changed over three years: Two .5 mg tablets per day, as needed. In practice, I've only had one or two months where I've even come close to taking that much. However, I have been taking it routinely. I got into a habit of taking one .5mg tablet in the morning after waking up, as a preventative measure. On days where I have a high amount of stress and/or feel a panic attack coming on, I will take the second tablet. On many other days, I don't take any more after the one in the morning.

 

I've been keeping track of how much I'm taking precisely the whole time, and it averages to around .6-.8 mg per day. I've never taken it lightly, because I'm aware of its addictive properties, but I have read enough to know that this is a relatively small dose. I have no doubt that I have some level of dependency, but I have not abused the drug. There has been no escalation in my use of it, or craving for it over the course of three years. I usually don't take it before sleep, and I have no problems sleeping, even though the last dose was often 16 hours earlier, first thing in the morning. I've gone over 48 hours without taking any, because I simply forgot and didn't feel the need for it.

 

This is enough to need to be tapered after three years of use.

 

I still occasionally feel panic attacks coming on, and I've found that it is not related to how much I have or haven't taken the drug. It's always caused by stressful events and circumstances in life, just as it was initially triggered by a health issue.

 

Unfortunately, my life has not become less stressful, and I was having panic attacks before I was prescribed the drug. So if I taper off, I have no way of knowing whether I'm experiencing withdrawal, or merely the return of the problem the drug was prescribed to deal with. Maybe there's no difference.

 

I get the impression that a lot of people are prescribed these drugs for general stress and anxiety or insomnia, and they escalate how much they're taking over time. I was having severe and continuous panic attacks, and this type of drug was the only thing that helped. As I said, my intake of it has remained steady and has not increased. I don't crave more, or need more to get the same effect.

 

With all of that said, I recognize that stopping it "cold turkey" may be a bad idea. Which is why we ended up postponing the surgery. I need a responsible plan for tapering off, but I also feel that I could go a bit more quickly than someone taking a much higher dose.

 

I have a pill cutter that I bought for this purpose, but I don't think I can shave 10% off of a .5mg tablet, which is already tiny. I was thinking more in terms of cutting a pill in half, taking one half twice a day for a week, then taking a half a pill in the morning for a week, then maybe every other day. That's a ballpark idea given to me by a nurse.

 

I would do it this way... I would try a week at .5 in the morning with no second pill and make sure I was stable at that dose.  If so, I would quarter the .5 tablet and take 3/4 of it and see how that cut goes.  If it went relatively well, I'd then cut another quarter off for a week or two and so on.

 

 

Looking at the Ashton site linked above, the smallest dose withdrawal schedule, with Valium substitution, is 3mg per day. I'm already taking a little more than 1/6th that amount. I doubt that I need to go on Valium to get off of Ativan, but I will take any advice available from people who have experience.

 

 

 

Challis 

[[Jo...]]

I feel like my situation is very minor compared to most of what I read on this forum, but this is where things stand now for me: I restricted myself to .5mg a day without any incidence at all. Now I've had a few days where I cut it in half again to .25 mg with no sense of withdrawal. I may be feeling slightly elevated stress and anxiety, but haven't had anything approaching a panic attack during this period, let alone the more severe symptoms some people report.

 

What I'm wondering is, if you're going to experience any kind of withdrawal, how soon after the last dose does it usually happen? I know that Lorazepam has a half life of 12 hours, which I assume means that 24 hours after a .25 mg dose, I have .0625 mg in my system. That is obviously a very small amount.

 

In short, I've read a lot of horror stories here, and I have yet to experience any real withdrawal myself, despite cutting the dose in half twice over a relatively short period of time. I wonder if I'm missing something that's waiting around the corner, or if I'm just lucky, or maybe not very addicted to the drug at all, despite taking it for 3 years. Obviously, when you read about things like seizures and death, you want to be extremely cautious. I just haven't felt anything beyond a little bit of low level anxiety.