Long time, infrequent benzo patient needs advice.

[[st...]]

Hey folks, my first post here, so please forgive if I supply too little info. I read the guidelines for the forum so want to be conservative as to not make a mistake my first day here.  
Brief history: 25 years ago I was initiated on benzos(Ativan 2mg twice a day) in an ER after 8 days of no sleep and 400 calories a day due to an acute anxiety condition showing up unexpectedly.(no history before that.)  I was sent to a country doctor(nearest to me) who simply kept me at that ER dose for nearly 4 months until I told him I simply could not function and was sleeping nearly 18 hours a day. I switched to a mental heath professional who immediate said that dose was never supposed to be carried over from ER to a daily maintenance script(way to high) and immediately swapped me to diazepam(for half life an secondary and tertiary metabolites reasons).  8 painless months late I was free of benzos.

At some point about a decade after that, circa 2010 I began to consume alcohol as a previous life long non drinker.  But something about alcohol(whiskey) and the way it had the nearly same effect on my brain as benzos, lead me down a dark path of binge drinking followed by short term Librium or diazepam based medically assisted inlatient detox.(The 3-7 day type most counties out west offer). This cycle would repeat 7 times until I finally had enough and after a particularly dangerous hospital visit, quit drinking once and for all. I had reached a point where that last “medically assisted detox”  started with a prescribed/ER night 1 dose of 110mg diazepam, dropping very quickly to 40mg during the first week. Down to 20mg/day buy the 3 week mark. The remaining “detox” was actually a diazepam taper that ran about 8 months to slowly back my brain off of both the high dose EtOH and more so the high dose diazepam they had to use to prevent seizures. I was successful and in 2017 completed the entire process and never looked back. (No booze, no benzos) 

 

My question for the forum:  2 weeks ago I was faced with what can only be described as every man or fathers worst nightmare.  Within 24 hours I was back to 25 years ago with a complete inability to sleep, eat and after a few days to a week I could not function nor think rationally/normally. (And the dangerous “micro-napping” returned.
 

8 days ago, a very good friend, who knows my history intimately came to my home and after seeing me gave me a choice, take a couple left over alprazolam .5mg he had, or take a ride in the ambulance to ER, again. I cannot express the fear I have of going to an ER and having a doctor completely over medicate me again, leading to another year lost to Benzos and a Benzo taper.  I took 2mg,2mg,1mg,1mg,1mg,1mg,1mg,1mg alprazolam/xanax for the last 8 days. (10mg alprazolam/Xanax total over the 8 days) 

I would like to get opinions on if I will face withdrawal in not taking any more. I realize the stress and pain of what cause me to take them may likely return(and could even be a tad bit worse), that I can manage, what I don’t want to do is get to a point where I need to go back over to diazepam for a long taper. I’ve never had such a short/targeted use pattern with benzos so I have no reference for what to expect after 8 days at the above mentioned dosing.  
Any and all opinions or experiences with this type of short term use would be Greatfull appreciated. 🙏.  NOTE: (I take no other substances, illicit or not, not even caffeine nor nicotine anymore) 
 

-Stone
 

[[Pa...]]

Hello stonevapor, welcome to BenzoBuddies,

Its good to hear you've been drug and alcohol free for so long, I've been down that road myself and it makes life so much harder.  I'm sorry to hear you're back in distress but please don't be concerned about your one/two time use of .5 mg Xanax.  If it was indeed only two .5 mg tablets, I believe you're going to be okay and won't face withdrawal.  Taking it any longer will send you right back down though, you're likely kindled and can expect to reach tolerance soon with much worse symptoms.  Its just a theory at this point but I happen to agree with it.  Kindling - Benzodiazepine Information Coalition (benzoinfo.com)

We're glad you found us, many of our members describe what you've endured, you'll find understanding here. 

[[st...]]

47 minutes ago, [[P...] said:

Hello stonevapor, welcome to BenzoBuddies,

Its good to hear you've been drug and alcohol free for so long, I've been down that road myself and it makes life so much harder.  I'm sorry to hear you're back in distress but please don't be concerned about your one/two time use of .5 mg Xanax.  If it was indeed only two .5 mg tablets, I believe you're going to be okay and won't face withdrawal.  Taking it any longer will send you right back down though, you're likely kindled and can expect to reach tolerance soon with much worse symptoms.  Its just a theory at this point but I happen to agree with it.  Kindling - Benzodiazepine Information Coalition (benzoinfo.com)

We're glad you found us, many of our members describe what you've endured, you'll find understanding here. 

I wanted to repost my current past 8 day use pattern as I believe we may have miscommunicated. 
From my post “ I took 2mg,2mg,1mg,1mg,1mg,1mg,1mg,1mg alprazolam/xanax for the last 8 days. (10mg alprazolam/Xanax total over the 8days) 

Each of the 2mg, 2mg, 1mg, etc represents the amount I used that one day. So 2 on Monday, 2 on Tuesday, 1 on Wednesday 1 on Thursday and so forth for 8 days. (Today is that 8th day I took 1mg) 

aside: I do believe and have been told by medical professionals that due dosing error early on and high doses for EtOH detox I should expect kindling. 
 

With this use pattern made a bit more clear do you still feel I’m “safe” from a “hard Benzo detox”?  I struggle to think 8 days for a total of 10mg alprazolam would leave me any worse than a rough nights sleep or two. 🙏

[[op...]]

Stonevapor,

It sounds like you got some really bad news (you say you were faced with a man's worst nightmare). Is this why you believe your w/d symptoms came back? Did the xanax over the eight days ameliorate the symptoms? I'm just a bit confused about the effect they have had on the reason you took them in the first place.

That's a fairly high dose of xanax to be on for a week. To give you an idea, Dr. Ashton proposed that 1mg of xanax = 10 mg of valium. If you're feeling stable now, you might want to do a fast taper off as you may be approaching a point of dependency. I would think you could do a faster taper since you've only been on for a week, and get off them quickly. But my question is: How are you going to deal with your symptoms once you're off the xanax? It sounds like you need some emotional support - do you have someone you can talk to who can help you find non-drug ways to deal with your symptoms?

openroad

 

[[Pa...]]

I'm so sorry stonevapor, you were quite clear in your original post, I just totally missed it.  I agree with @[op...], I feel you may need to do a rapid taper and possibly expect some symptoms.  How are you feeling, has going from 2 mg to 1 made a difference in this?  Are you experiencing interdose from going to 1 mg?

[[st...]]

7 hours ago, [[P...] said:

I'm so sorry stonevapor, you were quite clear in your original post, I just totally missed it.  I agree with @[op...], I feel you may need to do a rapid taper and possibly expect some symptoms.  How are you feeling, has going from 2 mg to 1 made a difference in this?  Are you experiencing interdose from going to 1 mg?

First, Thank you so much for responding. With  @[op...]

1) I felt that the first 2 nights dose of 2mg each night. (Taken 1mg one hour apart based on acute anxiety symptoms) was appropriate and took care of all of my symptoms, though I still struggled to sleep more than 4 hours.  
 

2) Dropping from 2 to 1 mg day 3 caused no withdraw nor negative side effects of any kind. In fact, I felt I actually slept a bit better. This could also be due to the initial shock of this event in my life subsiding. 

3) I have zero inter dose withdraw. 

NOTE: I will hit the 24 hr mark of NO alprazolam I’m about 7 hours and I feel no Benzo withdraw at all. (…I am keenly aware of what Benzo WD does to me, even so mush as to have learned to tell the difference between diazepam WD and rebound anxiety. My body has a very predictable reaction to Benzo WD. Very predictable. 

[[st...]]

14 hours ago, [[o...] said:

Stonevapor,

It sounds like you got some really bad news (you say you were faced with a man's worst nightmare). Is this why you believe your w/d symptoms came back? Did the xanax over the eight days ameliorate the symptoms? I'm just a bit confused about the effect they have had on the reason you took them in the first place.

That's a fairly high dose of xanax to be on for a week. To give you an idea, Dr. Ashton proposed that 1mg of xanax = 10 mg of valium. If you're feeling stable now, you might want to do a fast taper off as you may be approaching a point of dependency. I would think you could do a faster taper since you've only been on for a week, and get off them quickly. But my question is: How are you going to deal with your symptoms once you're off the xanax? It sounds like you need some emotional support - do you have someone you can talk to who can help you find non-drug ways to deal with your symptoms?

openroad

Thank you so much for the detailed response. I can’t tell you how amazing it is to chat/get advice from folks with experience and knowledge of Dr. Ashton’s Manual. Her work quite literally saved my life 25 years ago when there was little to no help available. (Even Rehabs would not take patients like me back then.) As I did with  @[Pa...]’s questions, I will post my answers here in a list form so that it might clarify things and be easy to read.
 

1) I received some life changing and truly terrible news that triggered my acute anxiety reaction.  I remained in an acute anxiety state for 6 maybe 7 days, honestly it starts to blur together.  I consumed a max of 4-600 calories a day, no sleep, stomach consuming itself, change in body oder(random I know but it’s part of what happens to me), constant fight/flight response, as it gets close to a week of this I have less consistent memory as I’m never really awake nor asleep. Micro-napping set in that last day before my friend stepped in. This was my Acute Anxiety rearing it’s ugly head not withdrawal symptoms. (I had had no benzos up to this point. Last bezo use was successful diazepam taper close to a decade ago.) 

 

2) Night “8” we’ll call it, is the first night I took alprazolam and did so with the friend/accountability partner right there. I took 1mg at 9pm, waited 60 mins, then based on continuing symptoms took 1mg more for total of 2mg that first night. The alprazolam worked as intended, I was finally able to eat a substantial amount, and was thankful for the 4 hours sleep I got.   
 

3) Night “9”, my second night taking alprazolam was a literal carbon copy of night 8.  I took 1mg again at 9pm and again waited 60 mins before taking a second 1mg. Again, with 2mg onboard the alprazolam worked as intended and I was able to eat, actually interact with my fiancé and again was thankful for about 3-4 hours sleep.  
 

NOTE: From my story above I’d say it’s pretty clear I’m an addict. I’m deep in recovery, but an addict none the less. I use the term “works as intended” above to denote that the alprazolam took care of my anxiety but I was in no way “high”, felt no “euphoria”, nor did I feel that addict need to reach for more. The dose also made me feel close to “normal”, as opposed to when I would say, use a high dose of diazepam to get “high” or chase oblivion. I would also note I had my friend and fiancé there both those first two nights, and she is in control of the meds. (I ask her to keep/hide them) 

Night “10”, my third night taking alprazolam, I took 1mg and it took care of my symptoms the same way the 2mg had done the 2 previous nights so I took no more. I felt NO difference from dropping from 2mg to 1 mg. The 1mg gave me the same relief, allowed me to eat, and I actually slept nearly all night that night.  
 

Nights “11-15”, my 4th trough 8th night taking 1mg. 9pm every night, fiancé next to me checking symptoms at one hour mark. Again the alprazolam worked as intended, I was not in anyway “high” or “low”.  It simply took away the anxiety/panic/irrational fear/stomach issues and allowed me to function. Having been though what I have in the past with Benzos and EtOH including 3 successful Ashton Manual based tapers. The concepts of HALF-LIFE, ACTIVE METABOLITES, GABA/GLUTAMATE BALANCE and all the other little caveats of bezo family use never truly leave my mind at a time like this and begin to creep in and cause more and more anxiety as the number of days I use the medication gets higher. This is when I reached out to you all here. 
 

1) How I plan to deal? 2 weeks out now,(7 days pre bezo, 8 days on, I feel like the initial shock and anxiety has subsided significantly.  In addition to the “meds” I’ve been able to speak at great length with supportive family as well as a 2 separate social workers(one addiction one a family counselor) with whom I went to university decades ago and have maintained friendships with. I am NOT alone. I am NOT isolating.(the first red flag for anyone who knows me.) I actually credit my family and friends, some I didn’t know were such good friends, with helping me get though this. They have really been amazing. I set up times and speak with 2-3 folks a day as well as speak with one of the two counselors every other day. 
 

TODAY/NOW: This evening will be 24hrs no alprazolam. If I take it, it would be day nine. With the use pattern being, 2,2,1,1,1,1,1,1 milligrams over the previous 8 days. I have ZERO knowledge or history with short use pattern with fast taper. (I only know that fast tapers do not work for long term bezo patients with physical addictions) Everything I know about tapers comes from the Aston Manual, and I focused on her successful long term, diazepam based tapers.(which worked every time for me.) 

Finally: I hope I’m not breaking any rules of the site to ask that if yourself @[op...]or @[Pa...] might be able to direct me to this “fast taper” you’ve mentioned, be it here in BenzoBuddies or elsewhere? (I have a digital copy of the Ashton Manual) Is there any way you could drop me a link or show me where to find the info on a fast taper for alprazolam?(trusted sources are nigh impossible to find on benzos) My first intent is to simply not take anymore, and from everything I’ve read and you alls responses, I feel like I’m not “past the point of no return” where I would need a diazepam taper. I don’t even feel close to that point honestly.  

Thank you for your attention @[op...]and @[Pa...] . I hope that I answered any and all questions that would help you to better understand my situation. I can’t tell you how much I appreciate you both. 
 

-Stone

 

 

[[op...]]

10 hours ago, [[s...] said:

Thank you so much for the detailed response. I can’t tell you how amazing it is to chat/get advice from folks with experience and knowledge of Dr. Ashton’s Manual. Her work quite literally saved my life 25 years ago when there was little to no help available. (Even Rehabs would not take patients like me back then.) As I did with  @[Pa...]’s questions, I will post my answers here in a list form so that it might clarify things and be easy to read.
 

1) I received some life changing and truly terrible news that triggered my acute anxiety reaction.  I remained in an acute anxiety state for 6 maybe 7 days, honestly it starts to blur together.  I consumed a max of 4-600 calories a day, no sleep, stomach consuming itself, change in body oder(random I know but it’s part of what happens to me), constant fight/flight response, as it gets close to a week of this I have less consistent memory as I’m never really awake nor asleep. Micro-napping set in that last day before my friend stepped in. This was my Acute Anxiety rearing it’s ugly head not withdrawal symptoms. (I had had no benzos up to this point. Last bezo use was successful diazepam taper close to a decade ago.) 

2) Night “8” we’ll call it, is the first night I took alprazolam and did so with the friend/accountability partner right there. I took 1mg at 9pm, waited 60 mins, then based on continuing symptoms took 1mg more for total of 2mg that first night. The alprazolam worked as intended, I was finally able to eat a substantial amount, and was thankful for the 4 hours sleep I got.   
 

3) Night “9”, my second night taking alprazolam was a literal carbon copy of night 8.  I took 1mg again at 9pm and again waited 60 mins before taking a second 1mg. Again, with 2mg onboard the alprazolam worked as intended and I was able to eat, actually interact with my fiancé and again was thankful for about 3-4 hours sleep.  
 

NOTE: From my story above I’d say it’s pretty clear I’m an addict. I’m deep in recovery, but an addict none the less. I use the term “works as intended” above to denote that the alprazolam took care of my anxiety but I was in no way “high”, felt no “euphoria”, nor did I feel that addict need to reach for more. The dose also made me feel close to “normal”, as opposed to when I would say, use a high dose of diazepam to get “high” or chase oblivion. I would also note I had my friend and fiancé there both those first two nights, and she is in control of the meds. (I ask her to keep/hide them) 

Night “10”, my third night taking alprazolam, I took 1mg and it took care of my symptoms the same way the 2mg had done the 2 previous nights so I took no more. I felt NO difference from dropping from 2mg to 1 mg. The 1mg gave me the same relief, allowed me to eat, and I actually slept nearly all night that night.  
 

Nights “11-15”, my 4th trough 8th night taking 1mg. 9pm every night, fiancé next to me checking symptoms at one hour mark. Again the alprazolam worked as intended, I was not in anyway “high” or “low”.  It simply took away the anxiety/panic/irrational fear/stomach issues and allowed me to function. Having been though what I have in the past with Benzos and EtOH including 3 successful Ashton Manual based tapers. The concepts of HALF-LIFE, ACTIVE METABOLITES, GABA/GLUTAMATE BALANCE and all the other little caveats of bezo family use never truly leave my mind at a time like this and begin to creep in and cause more and more anxiety as the number of days I use the medication gets higher. This is when I reached out to you all here. 
 

1) How I plan to deal? 2 weeks out now,(7 days pre bezo, 8 days on, I feel like the initial shock and anxiety has subsided significantly.  In addition to the “meds” I’ve been able to speak at great length with supportive family as well as a 2 separate social workers(one addiction one a family counselor) with whom I went to university decades ago and have maintained friendships with. I am NOT alone. I am NOT isolating.(the first red flag for anyone who knows me.) I actually credit my family and friends, some I didn’t know were such good friends, with helping me get though this. They have really been amazing. I set up times and speak with 2-3 folks a day as well as speak with one of the two counselors every other day. 
 

TODAY/NOW: This evening will be 24hrs no alprazolam. If I take it, it would be day nine. With the use pattern being, 2,2,1,1,1,1,1,1 milligrams over the previous 8 days. I have ZERO knowledge or history with short use pattern with fast taper. (I only know that fast tapers do not work for long term bezo patients with physical addictions) Everything I know about tapers comes from the Aston Manual, and I focused on her successful long term, diazepam based tapers.(which worked every time for me.) 

Finally: I hope I’m not breaking any rules of the site to ask that if yourself @[op...]or @[Pa...] might be able to direct me to this “fast taper” you’ve mentioned, be it here in BenzoBuddies or elsewhere? (I have a digital copy of the Ashton Manual) Is there any way you could drop me a link or show me where to find the info on a fast taper for alprazolam?(trusted sources are nigh impossible to find on benzos) My first intent is to simply not take anymore, and from everything I’ve read and you alls responses, I feel like I’m not “past the point of no return” where I would need a diazepam taper. I don’t even feel close to that point honestly.  

Thank you for your attention @[op...]and @[Pa...] . I hope that I answered any and all questions that would help you to better understand my situation. I can’t tell you how much I appreciate you both. 
 

-Stone

Stone,

In my understanding, there is no "fast taper" format. The general idea is that if you've only been on a week, you do a fast taper and just get off. This is NOT advice I'm giving, per se. Just what I've seen other folks do. It's not scientific. I imagine you would go down to half a mg for a few days, then a quarter for a few days, then step off. If you get bad withdrawals, you will need to recalibrate and go slower. But most folks would say to just get off it as fast as you can w/o a lot of w/d sxs. I'm thinking of you and wishing you luck and so sorry for the bad news and the fear that came with it.

openroad

[[st...]]

Thank you @[op...], that all makes sense. I’ll be paying close attention to my body and follow the concepts you mentioned above. (Doing my best to just not take anymore) This seems very similar to what used to be called “chipping” where I’m from.  Again, Thank you for your time and input. I’ll post progress here as I get though this.