Tapering Methods for Withdrawing From Benzodiazepines

Slow, as-tolerated tapering is the only safe way to come off of benzodiazepines. The following are the various ways that are recommended for tapering but remember, they are just a guideline. Adjust the rate and speed to suit your needs, pay attention to your body, and seek medical care as needed.

This handy TAPER TOOL can help you calculate your taper.

1 – The Ashton Protocol

Professor C. Heather Ashton DM FRCP, the author of the Ashton Manual says, “The rate of tapering should never be rigid, but should be flexible and controlled by the patient, not the doctor, according to the patient’s individual needs, which are different in every case. The decision to withdraw is also the patient’s decision, and should not be forced by the doctor.”

Her protocol recommends making small, frequent cuts, tapering at a rate of no more than five to ten percent every two to four weeks, along with a switching to an equivalent dose of Valium to the benzodiazepine you are currently taking. This method can be better tolerated and result in less interdose withdrawal effects. Because the method focuses on slow tapering to improve safety, it can take months or years to complete the process depending on your current dose.

2 – Dry Cutting

This - popular method of tapering - is easy to do – use a pill cutter or scalpel to cut or shave a small amount off of your benzo and use a digital scale to reduce by 5%-10% every - two to four weeks as recommended in the Ashton Protocol.

3 – Beaded Capsule

This method is for drugs in capsule form that can be pulled apart to expose the beads of medication inside. It involves pouring out the contents and removing a set number of beads based on the planned taper. Again, use of a digital scale can help you reduce by the recommended 5%-10% tapering.

4 – Compounding

If dry cutting seems too difficult, a pharmacist can make a solid drug into smaller doses or a liquid solution of your benzodiazepine, along with a suspension agent such as “OraPlus”. This can make it easier for you to measure and control the rate of your taper.

5 – Manufacturer’s Liquid

Some drugs are already available in liquid form from the manufacturer. All you have to do is slowly reduce the dose using calculated cuts. It may be necessary to dilute the liquid with water to make the reductions possible.

6 – Liquid Titration

There is also a method known as “liquid titration.” For this, you crush a pill and allow it dissolve in a set amount of water or milk (for example, 300 mL). You then remove 1 mL of the solution and ingest the rest. Each day, you remove an extra mL until nothing is left.