Helping clients slowly taper off of benzos and/or opioids for over 6 years has been extremely rewarding. Watching people get their energy, focus, strength and vitality back is like watching a miracle happen. I have so many more success stories to share, I can’t wait to write them. Often people get labeled and stigmatized as addicted because they are physically dependent on these medications for pain, sleep or anxiety.
Recently, I have found myself on the other side of supporting individuals in this epidemic. Working for a company called Marvin where I help physicians manage burnout and stress, more times than I can count I have helped by sharing the guidelines of the Ashton Manual for safe tapering of benzos and the Health and Human Services Guidelines for Opioid Tapering to new residence and physicians that have inherited practices of retiring physicians that were swept up into the practice of overprescribing benzos and opioids.
The physicians are overwhelmed by the side effects and dependencies that they find their patients in and have not been guided with a solution to help taper them safely and properly so they can maintain functioning at work and home. When I share this resource they wonder why they were not provided this information, but more often are just thankful to know that there is literature out there to provide a clinical pathway to help their patients regain their freedom from the chains of physical dependence on opioids and/or benzos that have devastating long term health outcomes.
I am grateful to be able to help in more ways than one by simply sharing educational materials to physicians that helps to reduce their stress and burnout as well as improve the lives of their patients. It is their scope of practice to implement the guidelines, it is within my scope as a therapist to provide bridges to information and resources that improve their life by reducing their stress and burnout because they now have information. Knowledge is power.
The Health and Human Services Guidelines outlines that anyone that has been on an Opioid longer than a year, physicians need to consider a slow taper of no more than 10% or less a month, otherwise the patient runs the risk of experiencing psychological distress and worse, suicidal ideation. The same goes for benzos. The Ashton Manual is an international guide for tapering benzos slowly.
The typical rate outlined in the Ashton Manual is 5-10% every 2-4 weeks. However, with benzos it may even need slower rates. A woman interviewed by Dr. Josef Witt Doerring, a psychiatrist that helps people slowly taper benzodiazepines, recently shared that she was awarded the first settlement in the United States for dysregulation to her nervous system from short term use of a benzodiazepine for sleep. When she stopped taking them, her brain went into a condition called beta-spindling that causes insomnia and hyperactivity which was documented in a manner that had a direct correlation with the benzodiazepine.
Her recovery from this dysregulation will likely be longer and more non-linear than those who are able to taper slowly because of the stabilization slow tapering provides, but she will eventually heal as psychologist Dr. Jennifer Leigh always says everybody heals if they survive the withdrawal. The nervous system is just the slowest healing system in the body as it is imprinted through our interactions, response and behavior in our environment as well as persons’ foundational perceptions of their life experiences it is filtered through. That is why it is important to work with a professional while tapering to understand these mechanisms in the rewiring of one’s nervous system through techniques such as CBT, DBT and Mindfulness.
