Have you changed from the cut and hold method to microtapering?

[Guest [St...]]

Thanks and right on, Colin!

 

  Praise the lord for the voice of reason!

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This is so confusing

 

I have just been and looked at the T.R.A.P forum which I know has closed, I then go to Ashton method of tapering once at 2 mg completely different methods, no wonder I am confused.

 

DD

[[Wi...]]

See this is where I get into trouble...

 

I was at 3 mg and was cutting .15 a week, so about 10 -15 % down to 2 mg.  And to be candid, it kickd my a**.  I'm prepared to deal with some discomfort and perhaps I'm one of those, like Ashtons people that Colin mentioned that were more difficult than most.  I would give my right arm if i could taper more quickly, but at the moment that simply isn't possible.  I wanted to follow Hope's example, thinking that what could 2 measly mg do after having come from so high.  Turns out for her it worked out, although I'm sure she has some s/x.  For me it hasn't.  I don't know where I'll jump and no matter where I jump from, it's going to be  higher than any other cut, but while I have great respect for Colin and Hope, in my case things are going very differently then is described here.

 

I DO notice the cuts and intensly,  but perhaps I'm an anomily.

 

WWWI

 

Hi WWWI,

 

That's a slow taper, but it is not crazily slow. If you feel you need to taper off your final few milligrams over some months, then do that. If the goal is to be benzo-free, then within reasonable bounds, it matters little how long the taper lasts.

 

0.15mg cut from 3mg is actually a 5% cut. At low doses of Valium, that is a small cut, but as I said, not altogether unreasonable in particular circumstances and for some people. If the end part of your taper takes some extra weeks than what is suggested by Ashton, this is not a big deal.

 

My aim with these posts is to help some people from following taper plans that are totally unnecessarily long (plans that last years from relatively low doses).

Colin,

 

Your point is a very valid one.  I've seen enough people able to jump successfully from .25, .5 or even 1 mg to know it's in no way unreasonable.  And it frustrates me more than I can express that I am not in that group.  It is also concerning to me that someone would attempt to patent a tapering method as it leads me to believe that they may have a potential financial interest.  Perhaps I'm wrong (or not). 

 

Perhaps the intention in the beginning, for her, was simply to help people w/d from benzos, but when they promote their solution as the optimal way, when it is abundantly clear there is no "best" way and they make the leap to patenting that solution, for me it opens the door to a serious conflict of interest and questioning if the goal is in fact to help people, or really one of self interest.  Early in my taper, I encountered this site and method, although I don't think it was as formalized.  With the limited knowledge I had then, I still found that this method didn't work for me. 

 

And despite my addled brain, what I meant by 10-15% cuts is that while I cut every week, I keep my percentages based on every two weeks percentages based on Ashton I believe, which I halve.  So at 3 mg, I was cutting 10% every two weeks. However at 2 mg, I was cutting at 15%.  The challenge for me is that my comfort zone is 3.5% weekly (7% every two weeks) and has allowed me to taper down based on that.  And even at this low dose, as I mentioned above, apparently no one told my body that I was at a low dose and could cut faster, because I still respond badly to anything that is much higher than 3.5-4% a week.  This causes me great distress for these last two mg, since this would seem to indicate that this is going to go on far longer then it already has.

 

And again I want to say I support your message.  By putting out this benzo micro taper as  the optimal method, there may be many people who take it as gospel without first determing what pace and method might actually be more to their benefit and as a result extend this process unnecessarily.

 

WWWI

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Since you have been on Valium for a relatively short time (I assume there was no other recent bezodiazepine use), I would caution you over following an overly cautious taper plan. Benzodiazepine dependency can occur in as little as a few weeks, but this is unusual. The likelihood is that you dependency is relatively low. In you shoes, in the first instance, I think I would aim to to cut by 1mg per week, but of course if you are overly symptomatic, you would adjust your taper plan to suit. (so, down to 3mg, 2mg, 1mg, and then off).

 

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You could tale 3.5mg, and make 0.5mg cuts from there. Again, though, just keep an eye on the overall taper rate - there is no point in drawing out this for longer than necessary. After all, dependency develops over time, even when you are tapering.

 

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It is not very useful to think of percentages at low does. Keep the cuts smallish, but aim to get off over some weeks rather than months.

 

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When I used to draw up titration plans for people, I'd switch to a linear (discrete cuts) at about two pills, or one pill for a very slow taper (assuming they were using the lowest dose pill available for their particular benzodiazepine). A linear taper for Valium easily might be started at a higher dose. This is the case with Ashton's schedules.

 

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Unless you already have experience that informs you otherwise, your expectation should be that you can taper off with relatively few problems.

 

Good luck.

 

Colin,  again I want to start with my extreme thanks.  I feel like yor comments are making sense out of all the noise and confusion in my head.  Thank you thank you thank you!

 

I want to comment further on my level of dependency.... Which of course is some guesses and some observation. And let's not forget that the level of anxiety provoked by the IDEA of drug dependency and withdrawals can be huge (and IS HUGE for me).

 

In general I have been having physical and psychological problems, starting before Valium, and continuing. In recent weeks I've had several people suggest I need antidepressants or whatever, which I was preparing to get.  My problems read like the forum here: insomnia, anxiety, depression, losing weight, difficulty eating, not very functional generally, depersonalization, brain mush....

 

Through my own willing ignorance I had not read much about benzos till about 3 weeks ago. When I read more,  It just all sounds so much like my situation, that I decided that benzo tolerance (withdraws fom not increasing the dose) must be going on.  And decided that reducing/ending Valium makes more sense than adding other dugs. But this also means a period of time of continuing psychological stress, possibly more than I can sustain......

 

My main focus has been on finding non-drug help.  I'm currently starting cranial electro stimulation, and neurofeedback.  I have continuing support with supplements, but this is not always so successful.

 

In other words I am suffering, and I suspect it is from benzo itself and/or withdrawal, at least in part (I suspect in LARGE part, but insomnia/ anxiety/ depression are not strangers to me.). I have no real sense of what effects are from drug vs from tolerance withdrawal.  Can't say for sure what may be "just me" vs either of those. All of which makes me want out of the drug.

 

So......I'm wondering if this falls in the "unless experience tells you otherwise expect relatively few problems" category?  To me it seems very problematic, but I don't know what would be considered RELATIVELY few problems.  I don't have tremors. I do sleep some (but not enough, it is awful).

I do think the drop from 5 mg to 3.75 was uncomfortable - suggesting dependency - but again, perhaps a matter of degree.  I was not hospitalized or suicidal.  I was more anxious and less functioning and more isolated. Took 8 to 9 days to get back to prior level (which is not a good place, just less bad.)

 

Thoughts on this?

 

I very much agree that in the grand scheme it would be better to be done in weeks not months.  I've very aware now of wanting to stop the burden of this drug. The idea of MONTHS to taper has been a huge mental burden to me. The idea of cutting 1 mg per cut seems good.

 

I also suspect I need to stop reading BB forum.  It is supportive AND extremely frightening.

 

Oh, and to confirm/clarify: I did not use benzos prior to this.  I think 4 to 5 months total. - i started at 2.5 mg and went to 5 mg. in the beginning i ddnt take it every day. On a couple of occasions took 7.5 (only 3 nights total, I think) do to extreme stress. Once took none because I fell asleep. In other words I took 5 mg most of the time, with a few deviations up or down.

 

Thank you again for each f your comments.  They are EXTREMELY helpful.

 

In some other post I talked about a close friend of mine who took 5 mg Valium for aprox 2 months, then reduced to 1/2 for a month, then went to none. She stopped a month ago and thinks it was not a big deal. I think I am not going to get off as easy as she did, but am hoping still for some middle ground, and, as you said, not dragging out this process.

 

 

[[Co...]]

I think Colin meant: Please understand, I am not telling anyone what they 'should' do.

 

Yep - typo. I've edited my post to correct the error. Thanks, Hope.

[[In...]]

I think there was some clarification on the difference between the "micro" situation and titration. Great, because there is a big difference. So perhaps, if there was confusion among members, that is clarified.

 

In regards to the time frame for this now patented method, from what I know, it can take a bit of time; perhaps 18 months or 2 years is my limited reading of that. I also read it can go faster if the person doing it can go faster. I've not added up the 7 year time. Is that in the patent?

 

In regards to "formalizing" by patenting, I think more info on this method that would have apparently been "not out there," is now "out there" by this discussion happening, but perhaps that was necessary in the need to emphasize that BB does not endorse this method. IMO, open discussion must often take place in life to come to understanding of issues.

 

In regards to the "suggestions" made in the patents contents, well it's another method, and if folks try it, and it doesn't work for them or they don't like the time involved, they are free to try something else. And is the patenter here on BB promoting this in any way? Just wondering. Or is it BB members doing that or what? I admit to actually suggesting a "micro taper" back in December to a person, actually with another member giving tons of detailed info, but I'm not ever doing that again as I forgot to add "IMO" which it really is IMO.

 

If another way works for people, well more power to them.

 

And as far as the 3 generally accepted methods here on BB, well I think they work for some, but not all. A lot of folks cannot get Valium, although that often just seems to escape the realization of many here, but it's really true. And others don't take well to it with sedation and depression. Im actually a very good pill splitter, but can only get the klonopin tab down to .0625 mgs, and that's not easy. And I'm seriously afraid to "jump" at that level as it's equivalent, I believe, to .625 mgs Valium. Others may want to try that, but I do not.

 

So that leaves titration for me, and I am going to give it a try. But I want to add that in crossing over from Xanax to klonopin, I actually did have to use those pill splitting skills. I exchanged .25 Mg X for .25 mgs K all the way up to 3 mgs K. And the last .25 mgs of exchange I had to take at 4 individual intervals of .0625 X for .0625 K all the way due to very high X affinity. And I had sx all the way. So pharmacologically speaking, perhaps the is illogical or whatever, but it's true. And 7 weeks out of that, I still have "evolving" sx.

 

Well I'm me, and no one else, so it doesn't matter what makes sense pharmacologically because it's happening. And that's my point; we do not really have the power to see those receptors and what's happening to them. If someone has sx at a very small dose, can anyone say it's psychological for sure? Do they really want to say that? I realize there's a big difference between .01 mgs of Valium and .625 Mg of Valium. But people should do or try, IMO, what may work for them.

 

Intend

 

[[Co...]]

Intend,

 

Absolutely you can use whatever method you wish.

 

I just wish to make clear that there is nothing novel or non-obvious in the patent. Apart from my more technical objections to the patent (not that important), I take issue with formalised suggestions of ultra-slow-benzo-tapers (should I trademark the term ), where the schedule might take very many years to complete.

 

As I wrote in my main post to this thread, 7 years was an extrapolation of the figures supplied in the patent. It wasn't even an extreme example, as I started from 20mg and some people take much larger doses.

 

I also take particular issue with the suggestion that people can correct errors in their dose by drinking grapefruit juice - this is potentially dangerous. Apart from the potential to boost blood levels of benzodiazepine to an indeterminable level (potentially dangerous in of itself), grapefruit juice will affect blood levels of many other concomitant medicines that might be taken, and many dose-critical drugs are potentially much more dangerous than benzodiazepines.

 

Most of the patent is open to discussion, but I will take a particularly strong stance upon any suggestion that the use of grapefruit juice for a dose correction is acceptable. It is not - it is potentially very dangerous.

[[...]]

Thank you again Colin

 

I personally also feel and I may be wrong, I usually am that being on other medication could affect ones taper w/d sxs.  Some have more than one medication that they are taking and it is all in our system.

 

DD

[[In...]]

Colin,

 

Yes, I am aware of the grapefruit precaution as I believe it appears on the literature handed out with the drugs at the pharmacy.

 

I appreciate your response to my post. Many folks here have, unfortunately, somewhat tortured benzo histories, and just don't feel well. I actually do not at all feel like myself on K.

 

IMO, people want to try newer methods than Ashton and what she still appears to advocate. She's a true pioneer, but I'm not even aware that she herself came out in favor of titration as a method. At least I've not read such.

 

Although I've read that you had said she endorsed it to you. I will never push one method over another again, but I will try something that I think could help me. The ultimate goal is to get off this stuff, and as we learn about ourselves, we do discover what does and doesn't work as well.

 

Thank you again.

 

Intend

[[...]]

This is so confusing

 

I have just been and looked at the T.R.A.P forum which I know has closed, I then go to Ashton method of tapering once at 2 mg completely different methods, no wonder I am confused.

 

DD

 

 

Hi Intend not sure if you read this.

 

DD

[[Co...]]

Although I've read that you had said she endorsed it to you.

 

If you mean Ashton regarding titration: she did not 'endorse' the method. She purely provided me some feedback to the effect that she thought my synopsis of the three methods was a reasonable assessment.

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I feel that I have to say something about leaflets, never once was I given a leaflet when I was put on my meds whilst I was in hospital. I eventually got one after I kept pestering for them.

 

One of my meds caused sxs but I was told it was not the meds, later when I was given the leaflet there it was RLS. I was not even given any information about lithium until the day I was suddenly discharged and given a purple wallet with a card and information.

 

Talking about grapefruit there was a patient who was told that he should not eat grapefruit because of the medication he was on by another patient.

 

DD

[[In...]]

Yes DD,

 

I have also found neglect of info at the pharmacy. They generally ask if I have questions for the pharmacist, but frankly, how does one even know what to ask?

 

I'm a little more practiced at this now, so I handle this well, but 10 years ago I was a "babe in the woods" with almost any medication.

 

Not a good way to be when one is taking any med, but it's really trust the doctor (human beings) and trust the pharmacist ( human beings). Education does not always imply true expertise in any one area.

 

Intend

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Thanks Intend

 

I am very friendly with my pharmacist at home and would ring and ask before taking script round, but if I told you even pharmacists have differences of opinions towards meds. Yet they are taught the same way. Sorry but I don't trust any one to many let downs for me . I personally can not believe the attitude of some that work in the medical field.

 

DD

[[In...]]

Colin,

 

Well I'll just add this in regards to Ashton and titration and I suppose her in general.

 

As I said, she is the pioneer without doubt. I guess she still prefers the pill cutting method and the Valium method. I don't know.

 

It is only my opinion, but I think she is a bit dated. Generally, research in any area moves along and more "discoveries" are made. I don't think that's really happened a lot in this area (benzos) so the real researchers have been and are the users of the drug.

 

And that's why, IMO, you (all of us) see other ways of getting off being advocated. There's exists, IMO, a true vacumn of this and it is being filled naturally on it's own by the ideas of others whether by happenstance or on purpose, by innovative persons educated or not.

 

I do not believe it will be held back, by fiat, opinion, or anything like that. Theres a need for this as these older ways just don't help everyone. And with that, I'm letting this go for now.

 

Intend

[[In...]]

DD,

 

I just saw your post about TRAP. I don't know much about them other than from what I've heard from other members.

 

I thought they were all about Ashton. I'm surprised to read otherwise. I have heard 2 things from former members:

 

1. Everyone had to cross to Valium in order to taper.

 

2. Klonopin was a "bad" drug to be on.

 

That's about it. I had a close friend here on BB who joined TRAP. She could not cross to Valium as she was paradoxical to it. So she often said she felt very supported there with her "not Valium" benzo, and made many friends. But then they closed and many came here to BB. That's really all I know.

 

Intend

[[aw...]]

My greatest ambition in life is to cut slower than everybody else. Nighty night.

 

Bart, that's easy...just hold forever. Oh, wait, that didn't work out so well last time

 

On titration: I have seen it used in a pharmaceutical context to mean adjusting the dose of a drug based on observed physiologic parameters, such as BP or serum concentration. For us, that would probably mean adjusting a reduction rate in response to observed sx. Here's an example of what I mean:

 

J Vet Pharmacol Ther. 2001 Feb;24(1):43-55. A pharmacokinetic/pharmacodynamic approach vs. a dose titration for the determination of a dosage regimen: the case of nimesulide, a Cox-2 selective nonsteroidal anti-inflammatory drug in the dog.

 

I'm sure this clears up everything...

 

Intend: I definitely see the vacuum you speak of. Many of us find the medical establishment vastly useless, so we seek support and info from each other or wherever we can find it. This vacuum will be filled by innovative persons, educated or not, as you say. It will also be filled by charlatans.

 

Aweigh

 

[[Di...]]

Since you are already following a successful method (titration), a method that works for you, why change it? Especially as you are pretty close to the end. I would just question validity of tapering off at the rate suggested by Hill. Since Hills suggests a rate slower than 100 days per 1mg Valium (at doses below 5mg/day), and you are at a dose of 2.3mg, this means it would take you more than 230 days to complete your taper. If we assume a rate of something like 200 days per milligram Valium (this would seem like a reasonable interpretation of Hill's patent), this would translate to the remainder of your taper taking 460 days (15 months) to complete. Following the Ashton protocols, you probably would be off in 3-5 weeks (though mileage will vary). It should be remembered that, on the whole, Ashton's patients were tougher cases. There should be no expectation by our members that they need to follow taper plans lasting much longer than the ones devised by Ashton for her patients.

 

If you are happy with your present system, there is no reason to go back. It is not 'wrong' to titrate Valium, it is just unnecessary (although it might be useful for those without access to 2mg Valium tablets).

 

As I explained in my main post, Valium has 'in-built microtapering'. When you make a cut to your Valium (by pill-splitting), the corresponding drop in blood levels will occur gradually (over a week or more).

 

Yes, it is perfectly possible to cut from 2mg to 1mg Valium - this is what most people do when following Ashton's schedules. Many members at BB prefer to make 0.5mg cuts at low doses of Valium - this would seem reasonable. Of course, the might make more frequent cuts if the size of their cut is halved. I just question the validity (for the vast majority of people) of titrating Valium (unless they do not have access to 2mg tablets).

 

If this slow taper plan works for you, good for you. I just wish to curtail the expectation by members that they need or should taper off very slowly (many months or years to quit a small dose of Valium). There should be no expectation of this. Most people can taper off as per Ashton or faster (though not necessarily by a typical member of our self-selecting group).

 

I would not tell you that it is taking you 'too long'. I am just trying to prevent seeds being planted that suggest that tapering off at incredibly slow rates is somehow optimal. The optimal rate of withdrawal is the fastest one that can be reasonably achieved without causing intolerable withdrawal symptoms. There will be great variability in this, but most people can taper off as per Ashton's protocols or faster. If you need to take it more slowly, so be it.

 

Hello Colin

 

Firstly I want to say that I really admire you, and am grateful for, all the hard work you and your team do with keeping BB afloat, helping everyone get through the benzo maze.

 

However, I read your posts a few of days ago, and quite frankly some of the things that you have said have been bothering me ever since. Being someone who has to speak their mind, I think I really need to point out some of the (above) quotes which are concerning me, because I believe they are a bit misleading, especially to those who are new to a benzo reduction plan.

 

I am probably considered someone who started out on a low dose (5mg valium) and I can categorically tell you that there is no way I could follow Ashton’s Method of tablet cutting. I couldn’t even do a straight tablet cut of 0.25mg from that dose. Before I found BB I tried and failed that method so many times that I was starting to feel like a complete freak, and completely desperate and hopeless as well. 

 

I doubt that I will ever try doing it again, even when I’m down to a very low dose, because quite frankly it scares the bejesus out of me, after the hell I've already been through trying to do it. When I get a lot lower I will still continue to do a daily reduction. However, at this point, who knows what the daily rate will be. Maybe it will be more or less than what I’m currently doing. I will make that judgement for myself when I get there, depending on how I feel. I don’t want to be told what kind of reduction I “should” be able to do.

 

My current dose is around 3.4mg and the only way I have gotten there is by doing a slow daily titration. I started out reducing 0.02mg per day, but found that was too much. So I then reduced that to 0.015mg. That went very well for a while, so I decided to experiment with doing a 3 day rotation of 2 days @ 0.015mg and 1 day @ 0.02mg. That also worked very well. So then I decided I’d experiment with 1 day @ 0.015mg and 1 day @ 0.02mg. However that was too much. 

 

So I’m back to the 3 day rotation plan, which works out to be roughly a 0.0166mg reduction per day. That seems to be my limit. That would work out to being around 0.25mg every 15 days. This is sort of in keeping with the Ashton Method (I think – I honestly don’t take much notice of the various “methods” – I just do my own thing). However there is no way I could actually do a tablet cut of that amount all in one go. Been there, done that. Not doing it again. The s/x are too horrible.

 

If I can keep doing this reduction it will take me at least 7 months to finish my taper, yet I’m theoretically on a “low dose”. Maybe it will take me longer, because I have no idea how I will cope on the very low doses, so yes that is “many” months. Of course there is a train of thought that some people can increase their taper once they get below 2mg, but that is by no means a definite rule, and there are a number of people I know of on BB who have had to do tiny reductions right to the very end. I'm sure they did that because they had to, not because they wanted to, or for the fun of it.

 

Yes we all know about valium’s half-life qualities, however that doesn’t mean that it automatically has an “inbuilt microtaper”. If you are doing a daily reduction, and that daily reduction is more than your body can handle, YOU WILL suffer s/x eventually. I have, and everyone else I speak to has also experienced this when their reduction rate has been too high. From my experience there is no “corresponding drop in blood levels occuring gradually over a week or more”. I will get hit with s/x at around the 4-6 day mark and I need to hold and adjust. There is nothing gradual about it at all.

 

There have been some complaints levelled at people doing daily reduction methods from those who prefer to do a cut and hold method. Supposedly we have criticised these people for doing a cut and hold method, or we've made them feel like a failure because they can’t, or don't want to, do daily cuts. We have been criticised for using the tongue in cheek term of “cut and suffer”, but the only people I’ve seen use that term have only been referring to their own experience with that method, and have not actually criticised anyone else who has preferred to use that method. 

 

I’ve personally never seen any of this “criticism”. All the people I speak with always emphasise that everyone should use a tapering method they feel the most comfortable with. Yet the inference that is being made here, from some of the things that you have said, is that daily titration isn’t necessary if you are on the lower doses, but to be very blunt, it most certainly is necessary.

 

Some people on the lower doses find it better to do a cut and hold method, but that doesn't mean that it is suitable for everyone. In fact I would hazard a guess and say that the majority of people on the lower doses find daily tapering easier to cope with, but that is not levelling any criticism at anyone on a low dose who is successfully doing a cut and hold taper.

 

To be honest, it is also quite possible that the cut and hold people who are on the higher doses, and who have also claimed that the daily reduction people have criticised them or treated them unfairly, will also find that their cut and hold method won’t work for them when they also get down to the lower doses. Time will tell with that. I honestly hope everyone can find a reduction plan that gives them few s/x, regardless of what level their dosage is.

 

I know you said a few times that people should titrate/reduce at their own rate, but then there is the return to the claim that titration of Valium "is just unnecessary". So it seems that maybe there is a bit of “reverse discrimination” of people doing a titration method. We seem to be getting told “well it’s okay to do it, but it’s not really necessary” (sorry, I’ve paraphrased you, but that's essentially what you said).

 

A lot of the people I talk to on this forum all seem to say that the Ashton Method is unsuitable for them. I think I can categorically say that no one wants to draw out their reduction any longer than necessary, but most people have to weigh up “quality over quantity”. So I think it is very misleading to say that members should be able to “expect” to follow any particular method.

 

While I agree that Hill’s method does seem to be exceptionally slow and unnecessary, Ashton’s Method isn't necessarily the “right” way either. Everyone has to find their own method, whether that be Ashton, TRAP, daily reduction or cut and hold, and no one should be told what method they “should” be able to follow, or what is, or isn’t, “necessary”.

 

Fortunately I’ve been on BB long enough now, and learned enough about my own tapering needs, to take what other people say with a grain of salt. I know how to work out my own tapering plan, and what to do if things aren’t going well. Frankly, I couldn’t care less about other people's opinions on how I should be able to taper, or about any of these specific methods, whether it be Hill’s, Ashton’s or TRAP’s. I really don't know the specifics of any of them anyway, because frankly I don’t care. I just do what I need to do to suit myself.

 

However, I am concerned that if newbies read some of the comments you have made they will get very confused about what they “should” be able to do on their taper, especially when it is coming from someone in your position. They may try to follow a method that simply isn’t suitable for them. I don’t want to criticise you for the comments you have made. However, I have seen some generalisations which aren't correct, and that concerns me greatly. Everyone has to find their own way, without being influenced by someone, they could see as being "in charge", making generalised statements which aren't accurate.

 

I would hate to see a "them and us" mentality come into play between the daily reduction people and the cut and hold people. Frankly I have seen a little bit of an undercurrent of that floating around from some people who have felt they have been "criticised" for their choices, and I'm just worried that comments like "It is not 'wrong' to titrate Valium, it is just unnecessary" is just doing what the "daily reducers" have been (wrongly) criticised of doing. It is very unfair for anyone to be told what is "unnecessary" when they are tapering.

 

[[Di...]]

Hi DD

 

Yes, you should definitely do what you feel you need to do and not take any notice of what others say you "should" do. I know you've been through a lot with your taper, and I'm sure Colin isn't as familiar with your history as some of us are. It's great to get opinions and advice from people, but quite frankly everyone's opinion is worth the same amount when it comes to the bottom line - it's worth nothing. The only opinion that matters is your own.

 

I really felt someone needed to defend those who choose to titrate on the lower doses, because they're not being brave little soldiers doing tablet cuts. It's all very well to say "It is not 'wrong' to titrate Valium", but that means nothing when the very next statement is that "it is just unnecessary". I actually find that quite condescending and frankly I'm annoyed by it.

 

As for all the Ashton's, TRAP's and Hill's of the world, as far as I'm concerned I think they all belong in the bin. Sure they're great to use as a guide to get you started on a reduction plan, but I think once you've worked out a plan you should just forget about them altogther. The only thing that should be controlling your taper is how you are feeling, not something some retired doctor has written, and which is probably now out of date.

 

A reduction plan isn't rocket science. If you don't like doing a daily reduction, you do a cut and hold, regardless of your doseage. If you don't like doing a cut and hold, you do a daily reduction. If you feel good you either stay or you try increasing. If you're not feeling okay you either hold or you decrease, and you hope that sorts out the problem. It's really pretty easy. Of course there are some unfortunate people who just never seem to feel good no matter what type of reduction plan they are using, and that's very sad.

 

Anyway, that's all you need to remember. The only method I think is worthwhile is the KISS method (Keep it simple). Worrying about percentages and trying to get too scientific about things is ridiculous IMO.

[[Ho...]]

I agree that each member should do what they feel comfortable with and I suggest each member think of Colin's comments as another guideline of sorts. Not everyone will be comfortable with it but as is true of the entire forum; you take what works for you and disregard the rest. There are, no doubt, members who have benefited from Colin's post. In fact, it was this very advice I used to finally finish my taper. If I had continued as I had planned, I'd be tapering at least 6 more months. So, just as this worked for me, it is no doubt useful for other members.

 

There are members who don't seem to be able to manage more rapid tapers. Even the smallest cut causes them to have unnerving symptoms. To those members, I would suggest you do what you can manage to do.

[Guest [...]]

 

(Hope's post was been made while I was writing this - thanks for mentioning how you were helped by this advice in your taper, Hope.)

 

Diaz Pam:

 

As for all the Ashton's, TRAP's and Hill's of the world, as far as I'm concerned I think they all belong in the bin.

 

 

This is a rather 'brave' statement from someone who previously admitted they haven't even read these materials! 

 

 

something some retired doctor has written

 

 

If you had read them you would realise that Professor Heather Ashton is not just 'some retired doctor'!

 

 

You are remarkably confident in your assertions about what is correct, considering how long you have been at the game of benzo withdrawal.

 

 

Have you read Colin's history? I did long ago but refreshed my memory the other night. I was amazed at what he had been through. I am still amazed that after all these years he still has the patience to go over the same stuff over and over, treating everyone with the greatest respect.

 

 

I believe you would probably call him one of your 'brave little soldiers'. He certainly had to come off a much higher dose than you are attempting. I think about 85mg equivalent more. I'm sure he suffered greatly. I'm sure he has done his homework over the last decade that he has been sacrificing his spare time to educate himself and help others. I'm sure he gives his opinion with alot of experience to back it up.

 

Have a read - unless it is another piece of reading you can't be bothered to waste the time on.

 

IMHO perhaps you should patent this new discovery of yours called 'KISS'. It certainly has a nice ring to it but is sadly lacking in substance I am afraid, my dear. Maybe you could get some old doctor to put their seal of approval on it.

 

All the best with it.

 

 

Colin: Sorry if I have jumped in here. I know you don't need the likes of me to defend you. I'm sure that you have had much practice over the years. It's just that I have been holding my tongue (fingers) ever since the first post today and I could not contain myself any longer. I am impressed with the struggle you had and the dedication for all these years. I, for one, respect your opinions on this matter. As I'm sure many others do. You have done the research and the prac work.

 

 

Xana

[[Di...]]

Hope - I fully agree that Colin's post should be treated as a "guideline of sorts". Unfortunately that is not how some of his comments have come across. You only need to read the ones I have highlighted to see that. I have great respect for Colin, but I was not at all impressed with the "cut and dried" manner in which he made some of his comments. Someone in his position needs to very careful about the advice and information he puts out there. The rest of us have to be very careful about not being "prescriptive", but I'm seeing a lot of that in what Colin has written. So that rule should apply to everyone.

 

Xana - Thank you for picking out a few non-relevant points to make a sarcastic issue of, and for taking some comments out of context. Also please don't tell me I've said something that I haven't. I never said I haven't read these methods. I have read them, but I said I don't take notice of them and I'm not that familiar with them because I'm not that interested in them. They're not something that I want to follow as a rule book. They are merely meant to be guidlelines, and for anyone to keep referring to them as the way someone on a low dose should taper is not correct because most people I speak with all say Ashton is something that's not suitable for them either.

 

Frankly I don't think the dosage that a person started on is at all relevant to this discussion. What Colin was referring to is what people on low doses should do, and that was what I was responding to. It is simply not fair to make a comment that people who are titrating on a low dose are doing something "unnecessary".

 

And yes, I am "remarkably confident in my assertions about what is correct" - FOR ME, which is why I made my initial post because what Colin was saying was not correct for me nor for a lot of other people.

 

I am merely trying to make the point that all these methods should only be treated as guides, and that everyone has to find what works for them as an individual. While Colin has made that point in some of his posts, he has countered it by also making assumptions about what people "should" be able to do, and I know there are a lot of people currently trying to do a low dose reduction who will disagree with him - just as I am doing, which we should all have a perfect right to do because this is a forum after all.

 

Xana, if you don't want to agree with me, you have perfectly entitled to, just as I am disagreeing with some of what Colin has written.  Like I said, I have great respect for Colin, but that doesn't mean I have to agree with him. I hope that he, and others, have respect for me and what I'm saying, even if they don't agree with me.

[Guest [St...]]

Since you are already following a successful method (titration), a method that works for you, why change it? Especially as you are pretty close to the end. I would just question validity of tapering off at the rate suggested by Hill. Since Hills suggests a rate slower than 100 days per 1mg Valium (at doses below 5mg/day), and you are at a dose of 2.3mg, this means it would take you more than 230 days to complete your taper. If we assume a rate of something like 200 days per milligram Valium (this would seem like a reasonable interpretation of Hill's patent), this would translate to the remainder of your taper taking 460 days (15 months) to complete. Following the Ashton protocols, you probably would be off in 3-5 weeks (though mileage will vary). It should be remembered that, on the whole, Ashton's patients were tougher cases. There should be no expectation by our members that they need to follow taper plans lasting much longer than the ones devised by Ashton for her patients.

 

If you are happy with your present system, there is no reason to go back. It is not 'wrong' to titrate Valium, it is just unnecessary (although it might be useful for those without access to 2mg Valium tablets).

 

As I explained in my main post, Valium has 'in-built microtapering'. When you make a cut to your Valium (by pill-splitting), the corresponding drop in blood levels will occur gradually (over a week or more).

 

Yes, it is perfectly possible to cut from 2mg to 1mg Valium - this is what most people do when following Ashton's schedules. Many members at BB prefer to make 0.5mg cuts at low doses of Valium - this would seem reasonable. Of course, the might make more frequent cuts if the size of their cut is halved. I just question the validity (for the vast majority of people) of titrating Valium (unless they do not have access to 2mg tablets).

 

If this slow taper plan works for you, good for you. I just wish to curtail the expectation by members that they need or should taper off very slowly (many months or years to quit a small dose of Valium). There should be no expectation of this. Most people can taper off as per Ashton or faster (though not necessarily by a typical member of our self-selecting group).

 

I would not tell you that it is taking you 'too long'. I am just trying to prevent seeds being planted that suggest that tapering off at incredibly slow rates is somehow optimal. The optimal rate of withdrawal is the fastest one that can be reasonably achieved without causing intolerable withdrawal symptoms. There will be great variability in this, but most people can taper off as per Ashton's protocols or faster. If you need to take it more slowly, so be it.

 

Hello Colin

 

Firstly I want to say that I really admire you, and am grateful for, all the hard work you and your team do with keeping BB afloat, helping everyone get through the benzo maze.

 

However, I read your posts a few of days ago, and quite frankly some of the things that you have said have been bothering me ever since. Being someone who has to speak their mind, I think I really need to point out some of the (above) quotes which are concerning me, because I believe they are a bit misleading, especially to those who are new to a benzo reduction plan.

 

I am probably considered someone who started out on a low dose (5mg valium) and I can categorically tell you that there is no way I could follow Ashton’s Method of tablet cutting. I couldn’t even do a straight tablet cut of 0.25mg from that dose. Before I found BB I tried and failed that method so many times that I was starting to feel like a complete freak, and completely desperate and hopeless as well. 

 

I doubt that I will ever try doing it again, even when I’m down to a very low dose, because quite frankly it scares the bejesus out of me, after the hell I've already been through trying to do it. When I get a lot lower I will still continue to do a daily reduction. However, at this point, who knows what the daily rate will be. Maybe it will be more or less than what I’m currently doing. I will make that judgement for myself when I get there, depending on how I feel. I don’t want to be told what kind of reduction I “should” be able to do.

 

My current dose is around 3.4mg and the only way I have gotten there is by doing a slow daily titration. I started out reducing 0.02mg per day, but found that was too much. So I then reduced that to 0.015mg. That went very well for a while, so I decided to experiment with doing a 3 day rotation of 2 days @ 0.015mg and 1 day @ 0.02mg. That also worked very well. So then I decided I’d experiment with 1 day @ 0.015mg and 1 day @ 0.02mg. However that was too much. 

 

So I’m back to the 3 day rotation plan, which works out to be roughly a 0.0166mg reduction per day. That seems to be my limit. That would work out to being around 0.25mg every 15 days. This is sort of in keeping with the Ashton Method (I think – I honestly don’t take much notice of the various “methods” – I just do my own thing). However there is no way I could actually do a tablet cut of that amount all in one go. Been there, done that. Not doing it again. The s/x are too horrible.

 

If I can keep doing this reduction it will take me at least 7 months to finish my taper, yet I’m theoretically on a “low dose”. Maybe it will take me longer, because I have no idea how I will cope on the very low doses, so yes that is “many” months. Of course there is a train of thought that some people can increase their taper once they get below 2mg, but that is by no means a definite rule, and there are a number of people I know of on BB who have had to do tiny reductions right to the very end. I'm sure they did that because they had to, not because they wanted to, or for the fun of it.

 

Yes we all know about valium’s half-life qualities, however that doesn’t mean that it automatically has an “inbuilt microtaper”. If you are doing a daily reduction, and that daily reduction is more than your body can handle, YOU WILL suffer s/x eventually. I have, and everyone else I speak to has also experienced this when their reduction rate has been too high. From my experience there is no “corresponding drop in blood levels occuring gradually over a week or more”. I will get hit with s/x at around the 4-6 day mark and I need to hold and adjust. There is nothing gradual about it at all.

 

There have been some complaints levelled at people doing daily reduction methods from those who prefer to do a cut and hold method. Supposedly we have criticised these people for doing a cut and hold method, or we've made them feel like a failure because they can’t, or don't want to, do daily cuts. We have been criticised for using the tongue in cheek term of “cut and suffer”, but the only people I’ve seen use that term have only been referring to their own experience with that method, and have not actually criticised anyone else who has preferred to use that method. 

 

I’ve personally never seen any of this “criticism”. All the people I speak with always emphasise that everyone should use a tapering method they feel the most comfortable with. Yet the inference that is being made here, from some of the things that you have said, is that daily titration isn’t necessary if you are on the lower doses, but to be very blunt, it most certainly is necessary.

 

Some people on the lower doses find it better to do a cut and hold method, but that doesn't mean that it is suitable for everyone. In fact I would hazard a guess and say that the majority of people on the lower doses find daily tapering easier to cope with, but that is not levelling any criticism at anyone on a low dose who is successfully doing a cut and hold taper.

 

To be honest, it is also quite possible that the cut and hold people who are on the higher doses, and who have also claimed that the daily reduction people have criticised them or treated them unfairly, will also find that their cut and hold method won’t work for them when they also get down to the lower doses. Time will tell with that. I honestly hope everyone can find a reduction plan that gives them few s/x, regardless of what level their dosage is.

 

I know you said a few times that people should titrate/reduce at their own rate, but then there is the return to the claim that titration of Valium "is just unnecessary". So it seems that maybe there is a bit of “reverse discrimination” of people doing a titration method. We seem to be getting told “well it’s okay to do it, but it’s not really necessary” (sorry, I’ve paraphrased you, but that's essentially what you said).

 

A lot of the people I talk to on this forum all seem to say that the Ashton Method is unsuitable for them. I think I can categorically say that no one wants to draw out their reduction any longer than necessary, but most people have to weigh up “quality over quantity”. So I think it is very misleading to say that members should be able to “expect” to follow any particular method.

 

While I agree that Hill’s method does seem to be exceptionally slow and unnecessary, Ashton’s Method isn't necessarily the “right” way either. Everyone has to find their own method, whether that be Ashton, TRAP, daily reduction or cut and hold, and no one should be told what method they “should” be able to follow, or what is, or isn’t, “necessary”.

 

Fortunately I’ve been on BB long enough now, and learned enough about my own tapering needs, to take what other people say with a grain of salt. I know how to work out my own tapering plan, and what to do if things aren’t going well. Frankly, I couldn’t care less about other people's opinions on how I should be able to taper, or about any of these specific methods, whether it be Hill’s, Ashton’s or TRAP’s. I really don't know the specifics of any of them anyway, because frankly I don’t care. I just do what I need to do to suit myself.

 

However, I am concerned that if newbies read some of the comments you have made they will get very confused about what they “should” be able to do on their taper, especially when it is coming from someone in your position. They may try to follow a method that simply isn’t suitable for them. I don’t want to criticise you for the comments you have made. However, I have seen some generalisations which aren't correct, and that concerns me greatly. Everyone has to find their own way, without being influenced by someone, they could see as being "in charge", making generalised statements which aren't accurate.

 

I would hate to see a "them and us" mentality come into play between the daily reduction people and the cut and hold people. Frankly I have seen a little bit of an undercurrent of that floating around from some people who have felt they have been "criticised" for their choices, and I'm just worried that comments like "It is not 'wrong' to titrate Valium, it is just unnecessary" is just doing what the "daily reducers" have been (wrongly) criticised of doing. It is very unfair for anyone to be told what is "unnecessary" when they are tapering.

 

Hi Diaz,

 

To be honest, it is also quite possible that the cut and hold people who are on the higher doses, and who have also claimed that the daily reduction people have criticised them or treated them unfairly, will also find that their cut and hold method won’t work for them when they also get down to the lower doses.

 

Really?  - How can you make that statement?  Just because you couldn't cut from 5mgs doesn't mean others cannot, just look at DavidJC, he has been using Cut and Hold from 5mgs, dropping 0.50mgs every 10 days without problem, look at Marina, also dropping 0.50 -1mgs every 7 days and they are doing just fine.  That's a pretty strong statement which is really unsupported and coming only from your experience.  These two people alone show it CAN be done.

 

I'll assume you may be referring to myself as someone who felt treated 'unfairly', your term, not mine, but to illustrate the point, it was disconcerting at best to go on the Valium Support Blog to see the term 'cut and suffer' countless times, yet the very first time I dared to coin the phrase 'drip by drippers', it meet with sheer disdain, surely you can see the point that I was trying to make, courtesy and respect for all tapering methods.

 

Staffy

 

Staffy

[[In...]]

Citing the case of 2 people (DavidJC, Marina) both of whom I do not know, does not make any particular argument for cut and hold as a method as it is but 2 people, and hardly representative of the many people out there using " other" methods.

 

Having said this, I again say that Ashtons method could do with a bit of an update. Why is this such a "bad" idea?

 

From my understanding, her methods are basically dry cutting ones pills all the way down to a small amount, and "jumping." Great. If that works for someone, IMO, more power to them and they would do well to "go ahead" and do it.

 

The other endorsed Ashton method, I believe, is the cross to Valium and then dropping by a Mg. Or 2 and holding until one feels "ok" to drop again. Once again, I say, great, if one can tolerate that method.

 

But what's the big problem with updating this with considering smaller cuts, daily cuts, titration of smaller amounts? Sure, it's fine to say folks are free to do what they feel works for them, and frankly, I think they will. But to say that most people shouldn't or won't necessarily require this, and will most likely be able to manage with only these 2 endorsed methods is, IMO, not seeing what is happening on this forum, and what is working for more and more of them as they "discover" these newer ideas.

 

I'm not at all understanding why a good update of really old ideas is such an apparently "difficult" possible recommendation for this forum, because from what I read, many folks are doing it, finding it's working better for them, and that right there is a much more representative sample, IMO, of reality than citing what 2 people are currently doing. Just wondering.

 

Intend

[Guest [St...]]

Intend,

 

I was addressing Diaz and using an example of real life members who are managing to cut from under 5mgs in reply to her post. I have no idea what your agenda is and nor do I care.  I support Colin's post.  Where and who said it was a bad idea not to improvise with tapers using ones own discretion?

 

To be honest, it is also quite possible that the cut and hold people who are on the higher doses, and who have also claimed that the daily reduction people have criticised them or treated them unfairly, will also find that their cut and hold method won’t work for them when they also get down to the lower doses.

 

This is the quote that I take exception to - who made Diaz the authority on whether a person will be able to cut and hold from 5mgs?  With all due respect I think Colin might have just a tad more experience than Diaz.

 

FFS Intend, I've done the daily cutting and the MT Pat Pending, now back to cut and hold,  and I am coming down from a large dose, so I think I am entitled to comment on a blanket statement.

 

Diaz directly stated that those of us who come down from high doses won't be able to do it when we get lower,(as in the cut and hold method, hence my reference to David and Marina),  I posted a rebuttal to that.  There is absolutely no way anyone can know that, unless of course you are the Queen of Narcissism.

 

Get your facts straight and instead of aiming your thinly veiled problem with Colin's post at me, take it up with him.

 

Hope that clears up your 'just wondering'. 

 

StaffyGirl