Titration Measurement Tip

[[Bi...]]

I have been using the following method:  I have a bottle that holds 100ml.  I add 100 ml water and a pill.  When the pill dissolves I remove the percentage amount for that day in mls.  Then I add an equal amount of clean water back in.  I draw 4 doses from the 100 ml bottle, so each dose is always 25ml.  This way I don't have to calculate my dose amount.  Works well for me and I thought I'd share as I don't get the impression that most are doing it this way.

 

Bilbo

[[Be...]]

Sounds interesting. I mix my dose up at the time I need to take it but that's just because I have a fear of the drug losing potency over time (which isn't really grounded in any knowledge).

[[Ho...]]

I use to draw out my cut and then shoot it back into the empty 100ml cylinder for measurement.

[[...]]

I use to draw out my cut and then shoot it back into the empty 100ml cylinder for measurement.

Smart

[[...]]

I have been using the following method:  I have a bottle that holds 100ml.  I add 100 ml water and a pill.  When the pill dissolves I remove the percentage amount for that day in mls.  Then I add an equal amount of clean water back in.  I draw 4 doses from the 100 ml bottle, so each dose is always 25ml.  This way I don't have to calculate my dose amount.  Works well for me and I thought I'd share as I don't get the impression that most are doing it this way.

 

Bilbo

 

I completely don't understand.

[[Be...]]

I think it saves figuring out how many mls you need at each dosage point, since the answer is always going to be 25 mls (I'm assuming four doses). You would, of course, still need to calculate or know how many mls you are starting with before adding back in the water to get to 100 ml.

 

I probably just made this more confusing.

[[Bi...]]

Benzo3, you have it right.

 

By adding clean water back in, I never have to calculate how many mls to drink.  It is always 25.  I made a spreadsheet in which I just enter the "toss" amount and it calculates percent drop from amount at beginning of titration in ml, also same value in mg, and percent drop from previous cut.  Since I am using the 1 ml/day method right now, the actual cut as a percentage of total daily dose (in milligrams) is always increasing very incrementally, and the spreadsheet shows that increase.

 

I use a 100 ml jar for the days doses because I figure the less glass surface area exposed that can hold particles the better.  I don't split the doses into individual containers because of losses and inaccuracies in dividing and transferring the liquid.  I also use a graduated oral syringe to draw toss amount and doses throughout the day, and the stuff goes straight into my mouth.

 

Benzo3, I have not noticed any decrease in potency even after mixture sits for two days.  I might be wrong, and should ask a pharmacist, but since these drugs are insoluble in water I think they will remain unchanged unless there is a quality of the water used that might break down the drug.  But this is only conjecture.

 

Anyway, not saying my way is the best way, but it is working for me and wanted to share.  I have reached the 13 ml reduction mark over a 15 day period.  It seems if I need to hold, it's only for a day.  I can't wait for this to be over!

 

Bilbo

[[An...]]

Benzo3, you have it right.

 

By adding clean water back in, I never have to calculate how many mls to drink.  It is always 25.  I made a spreadsheet in which I just enter the "toss" amount and it calculates percent drop from amount at beginning of titration in ml, also same value in mg, and percent drop from previous cut.  Since I am using the 1 ml/day method right now, the actual cut as a percentage of total daily dose (in milligrams) is always increasing very incrementally, and the spreadsheet shows that increase.

 

I use a 100 ml jar for the days doses because I figure the less glass surface area exposed that can hold particles the better.  I don't split the doses into individual containers because of losses and inaccuracies in dividing and transferring the liquid.  I also use a graduated oral syringe to draw toss amount and doses throughout the day, and the stuff goes straight into my mouth.

 

Benzo3, I have not noticed any decrease in potency even after mixture sits for two days.  I might be wrong, and should ask a pharmacist, but since these drugs are insoluble in water I think they will remain unchanged unless there is a quality of the water used that might break down the drug.  But this is only conjecture.

 

Anyway, not saying my way is the best way, but it is working for me and wanted to share.  I have reached the 13 ml reduction mark over a 15 day period.  It seems if I need to hold, it's only for a day.  I can't wait for this to be over!

 

Bilbo

[[os...]]

I use to draw out my cut and then shoot it back into the empty 100ml cylinder for measurement.

 

Problem here is that cylinders and syringe amounts differ... cylinders are almost always out by as much as 4mls... which seems crazy but if you took a 10ml syringe and filled it 10 times and squirted it into a cylinder, you can bet i won´t read as 100mls.

 

Use syringes to measure is the most accurate way.

 

Oscar

[[Be...]]

Oscar. I did just that once, and, yes, it was short by about 4 mls or so. However, that would be 4 mls over 100 or 0.4 mls over a ten ml syringe. I'm actually thinking it is the syringe that is off.

[[Bi...]]

"Problem here is that cylinders and syringe amounts differ... cylinders are almost always out by as much as 4mls... which seems crazy but if you took a 10ml syringe and filled it 10 times and squirted it into a cylinder, you can bet i won´t read as 100mls.

 

Use syringes to measure is the most accurate way."

 

The way I see it, as long as one measures in the same way every time, it's good.

 

Bilbo

 

[[Me...]]

It is a good idea to calibrate whatever you will use to measure, if that is how you are doing it.  So to calibrate, (using the same syringe that will are using to adminsiter or discard your cut) take that and move the same number of mls over to the other measuring device.  Use room temp water.

 

Then when you have carefully filled the second container, then take a permanant pen and then mark the line where you have calibrated your other vessle.  It might be close to the marking, but probably off just a  little bit.  But then you are calibrated and then you can just use a dropper or sryinge to make up the final volume as long as you use the same syringe.

 

I change my syringe each week because there is potential for blockage in the needle and markings fall off, etc, so then I would recalibrate the second vessel to the new syringe.

 

Another trick.  Use clear nail polish to coat the markings from 0 to 2 mls and then then don't come off with rubbing as easy, but you only got one chance to do it.  A quick swipe and then the markings last longer.

[[...]]

Sorry, bb I get what you were saying now. It's actually quite simple.

 

And for some reason the amounts I syringe in aren't available by the fourth time I attempt to syringe out.

I guess some milk gets lost on the outside of the syringe or something?

[[Me...]]

There is waste.  I lost the last bit too, but when I took it, I think it was actually more concentrated due to the way I felt the next day.  I think the moisture evapourates over the week.

 

I finally got a script for the pharmaceutical grade 1 mg/ml solution and now I just use one syringe and the same solution so it is way easier now.

 

It sure did take a lot of convincing my pdoc to do that!

 

I told him that I just couldn't handle the withdrawal cycles.  I told him that most of my symptoms are Valium toxicity so as I approach "stabilizartion" I get sicker, then feel bettter when I take less for a few days.

 

I said I had to use my respite care for my son (send my son to a foster family) to go to medical appointments and couldn't subject my son to my withdrawal cycle so I started to titrate and cut back 2% every day and it was so effective that I cut half of my instant release mood stabilizer too, because I just don't need it, I am settled enough at night that I can sleep with half the dose.

 

I was much more coherent in the second visit, so he asked, " has anyone else done this before (daily reductions)?"

 

I said that I read lots of peoples success stories on the internet and even though it is anecdotal, it has helped a lot of people and the Ashton Manual was writtten in 1965 and even though it is evidence based, I have unique withdrawal symptoms so I thought it was worth a try and even if it was only 8 days so far AND I am still on YOUR schedule, it will just be a little extra work for me to do daily reductions but I can't handle the biweekly withdrawal. I get my supplies from the harm reduction needle exchange.  Besides, I have a kid who needs respite care because I go soo crazy and I hate being disconnected from him for another four to five months!

 

So he finally agreed to give me 30 mg of Valium in solution (which is the equilivent of 4 full daily doses!)  He counts out my pills, so I don't have much chance to take it slower if I wanted too.  But so far so good, I haven't needed to do any stabilizing doses.

[[bl...]]

I'm still using teaspoons, but that won't work when my dose is smaller. For now, it's okay. I agree with trying to keep down how much medication sticks to the side. A light rinse of water, and close looking, then drinking, after the non-divided dose is drunk seems to do well. I'll be reminded of this tomorrow since I've been holding but am about to taper again from 2.25 mg to 2.18 mg Xanax daily -- this dose should hit me a day after begun for two days max. Then be okay for two days. Then I will keep tapering at this rate for a while. When my summer break comes, I will definitely push it a bit harder again. By then, I may need a syringe.

[[Me...]]

My syringe has 0.1 ml markings and I could probably measure as accurately as 0.02ml, but I reduce about 0.2 a day and today I took 7.1 mg so I don't bother with that yet (in science, they call the 3rd significant digit.)  Ideally, 3 significant digits are ideal, but for tapering, I'd think at least 2 is important, That is, say 1.2 mg or 12 mg, like that.  But if you are using teaspoon, you won't be doing bettter than 1 significant digit, too inaccurate! 

 

A harm reduction place will give you as many syringes (ask for large bore needle) as you want, free, no questions asked, although if you say you are using it to make small cuts in your dose to get off of a drug, then they will be quite happy to keep you supplied.

 

Good luck!

[[...]]

Yeah, some liquid does go missing over the course of a few days. I've switched to this weird ora-plus gel and I hope that helps. I would love to have one of those pre-mixed solutions.  More hassle  but probably way more worth it in the end.

 

Also I can't believe the Aston manual was written in the 60's. How can people say there is good up to date research when this is still the leading reference.

[[bl...]]

In the 60's? The version I see is from 2002 with a 2011 update? Her most recent work was published in 2007? Are you certain it was the 60's?? That's from before when most of the benzos she refers to were invented?

[[...]]

Right. It would had to have been updated to include the latest drugs. Good point.

How many benzo takers does it take to screw in a light bulb? Meaning I need help piecing things together.

[[bl...]]

Right. It would had to have been updated to include the latest drugs. Good point.

How many benzo takers does it take to screw in a light bulb? Meaning I need help piecing things together.

 

 

[[Me...]]

Ashton ran a clinic in 1965 and then observed those patients so she treated a lot of patients and they did well.  If you go to a clinic to do a slow taper, food is provided, daily support, etc. I am sure with the numbers, her method could still be considered the gold standard. 

 

But the Wd symptoms and toxic effects of Benzos are quite different for individual people.  So when they do studies , they do something called "control for..." so if anything that was less than usual turned up (and it could be a sX that made it difficult to complete the WD) then the subject can be excluded from the study.  So then you get a large number of people (subtract the excluded patients who probably failed) and then you get a validated method that doctors can use confidently to ruin your unique situation.

 

Anyway, she treated a very large number of people and her work would continue to be reviewed by grad students (most likely) but unlikely challenged because she doesn't run a clinic any more.  And not many scientist who develop a validated method will turn around and say, perhaps I was wrong and not especially the graduate students who just want to get their medical degree and get on with it.. so of course the Ashton Method will stick around. 

 

It takes a huge amount of opposing medical evidence to change an existing evidence based model... HUGE... Usually it is impossible to fund anything that opposes the current state so researchers tend to study the status Quo to continue to receive finding.  This is just the way scientific study works!  It is supposed to benefit 98% of the population but they can define the population anyway they want when they do the study, so it could exclude individuals for any reason if it is difficult to match a non-treated person with the same reason.  It's possible that there were no woman or older people in the study because in those days, the hormonal fluctuations would need to be "controlled" so all females were excluded. It is possible that smokers were excluded, you just never know.  Often an exclusion criteria is whether they finished the entire program or quit and the quitters were excluded if they quit too soon.

 

So is the Ashton method going to work for 98% of females?  That can't be verified, as I don't know who she excluded or included in her study.