Most of this was written by someone else and uploaded to the now-defunct Yahoo benzo group that Geraldine Burns founded. I don’t know who authored it, so I’m not able to give credit. I have edited it for grammar and clarity. Major edits and my additions are indicated with italics. I don’t necessarily agree with everything that is said here, but overall it includes some excellent advice.
Here is a link to the original article. What follows is my edited version …
Here are some suggestions based on my experience with getting doctors to help us taper off benzodiazepines. There are exceptions to everything I say here, but hopefully there will be something you can use. I hope this helps anyone looking for a doctor.
1) I don’t recommend looking for a “benzowise” doctor among the psychiatrists or addiction specialists. These doctors are generally trained to drug you, not get you off drugs. Even the addiction specialist will often simply substitute one drug for another, thinking he is helping you. Or he’ll tell you that you’ll be symptom-free about four weeks after coming off these drugs. In other words, he’ll say that any symptoms past four weeks are all in your head.
Please do not read this to say that no psychiatric doctor has ever helped someone off the drugs. That’s not true. I’m just giving you advice on hopefully increasing your chances of finding a willing doctor and getting him to help you. I wouldn’t recommend psychiatric doctors as your first choice.
2) You might try an osteopath. In the U.S., these doctors have the initials D.O. after their names. They are sometimes more inclined to help as they are trained with a more holistic approach that isn’t so married to the Western idea of “a pill for every ill.” The other choice is the old-fashioned family doctor and older might be better. (A lot of resistance we see is from the newly-trained doctors.)
[The doctor who yanked me off Klonopin cold turkey, almost killing me, was an osteopath. Just as not all psychiatric doctors won’t help you, don’t assume that all osteopaths will. My benzowise doctor ended up being my general practitioner.]
3) Believe it or not, I found a nurse practitioner who helped me during part of my taper, so don’t discount these people. Some of these are more open to new information. You would be surprised at how well they can sometimes handle the doctor they work for.
4) The next thing I strongly advise is to get Dr. Peter Breggin’s book, “Your Drug May Be Your Problem: How and Why to Stop Taking Your Psychiatric Medications.” Most libraries now carry this book. Try to photocopy a page or so that shows that Dr. Breggin backs the ten percent method of slow tapering. You can also look at this document which mentions the long-term course of benzo withdrawal.
[This article was written by someone seeking a doctor to assist with a Valium substitution taper, but most of the advice is still applicable even if you plan on using another method. I water titrated directly off of Klonopin.]
Rather than bring the entire Ashton Manual, you might want to take a couple of pages that hit the gist of benzo withdrawal and especially the “Why Valium?” section (Chapter 2).
It is critical that you understand why Dr. Heather Ashton recommends the Valium taper as most doctors are resistant to prescribing Valium. Valium has a half-life of 200 hours allowing for a “smoother” taper and is formulated in 2 mg, 5 mg and 10 mg doses making it possible to do the smaller cuts necessary.
Don’t take a million tons of paper. Take just a few pages with the points you want to cover highlighted. Perhaps bring the entire manual with you, but only offer it to the doctor if he requires it or seems interested. (Later, after you’ve established a rapport with the doctor, definitely try to get an Ashton Manual into his hands.)
5) When you get into the room with the doctor, keep a few things in mind. These guys don’t want to hear a long, drawn-out story. They’re very pressed for time. You need to approach the doctor loaded with all the knowledge you can, but keep your presentation simple and precise. Something like this (and make it fit you) is good …
Hello Dr. Smith,
I’ve been doing some research and would like to stop taking my Xanax. There’s a doctor in the UK who has become world-renowned in the field of benzo withdrawal. Her name is Dr. Heather Ashton and I have her curriculum vitae if you’d like to see it. It’s quite impressive.
Here are a few pages of her manual for helping patients to successfully stop taking benzodiazepines. I’m really excited to have found this. It seems Dr. Peter Breggin and some other doctors in the U.S. have been lecturing about the difficulties of benzo withdrawal for quite a number of years. [This helps put the thought into the doctor’s head that you aren’t talking about the pet theory of some lone-ranger chiropractor, but rather something that lots of other doctors know about.]
Dr. Ashton’s manual even has sample taper schedules for doctors to use. I went ahead and made one that will work for my medication. I’d like to know if you could help me do this. [This is important, folks. Doctors have been known to say no because they are too busy to mess with this stuff, so have your suggested taper schedule ready.]
More helpful hints:
1) Go in there and act as if the doctor is, of course, going to help you. Don’t hem and haw a lot. This might be perceived as drug-seeking behavior. Don’t get hostile, angry or upset. This too is the behavior of a drug seeker. Never react negatively. If the doctor says something you don’t like, at least pretend to listen. Then state your objection firmly, but nicely.
As much as I’d like to hang some of these doctors up by their toes, they’re the doctors. They’ve sacrificed many years and lots of money to get where they are. Some of these people do deserve our respect. Most of them are acting out of ignorance, not malice.
2) If the doctor seems hesitant, especially if you are trying to sell him on the Valium taper, offer to come in weekly if he thinks it would be needful. This will often calm the doctor’s fears about prescribing large doses of Valium (or even messing with a taper at all). I think this offer of being monitored was one of the things that got one doctor on my side.
By the way, if you agree to come in weekly, then it’s important that you do so. (Noncompliance is a good way to get cut off in mid-taper and you don’t want that to happen!) The faster you show him you’re willing to submit to his care, the faster he’ll be inclined to trust you and let you go longer between visits.
3) Be sure you have absorbed as much information as possible about the advantages of the Valium taper (or tapering slowly off benzos in general) if you’re going to attempt coming off your current drug. This goes back to don’t be hemming and hawing. You want to look like you are indeed smart, knowledgeable and might actually have something important to say.
If I hadn’t understood why Ashton says Valium, the following conversation wouldn’t have gone well and I would’ve ended up on Klonopin.
Doctor: Well, of course I’ll help you taper, but here in the U.S. we give Klonopin for that.
Patient: Yes, I think that can be a good choice and I see why that might be done. One drawback that Drs. Breggin and Ashton mention is that Klonopin isn’t formulated in appropriate doses for making smaller cuts. That’s one of the reasons why they believe Valium is the better choice since it’s formulated in 2 mg, 5 mg and 10 mg doses. Also, those can be halved for even smaller cuts.
My doctor allowed me to crossover to Valium.
Also, please, if your doctor helps you, try to get an Ashton Manual and Dr. Breggin’s book into his hands. It just might help that future person, coming into his office on these drugs, who says, “I’m crazy and I don’t know what to do.” Perhaps he’ll respond, “I think I do.”
Note: Any physician may also be referred to Dr. Stevan Gressit with the Maine Benzodiazepine Research Group should he desire more information about benzodiazepine withdrawal syndrome and the appropriate way to approach getting a patient off these drugs.
Please forgive the use of the masculine pronouns throughout in reference to doctors. The original author and I both did that for simplicity’s sake. My doctor is a woman. She was somewhat “benzowise” when I met her, but much more importantly, she was compassionate and willing to listen to me. (I consider those two traits to be far more important than a benzowise label.) My benzowise doctor is a general practitioner.
Below are links to two “benzowise” doctor lists. The names have been provided by patients who’ve seen them and found them to be open-minded, sometimes helpful or both. Nothing more is implied concerning their ability or expertise. The lists may be out-of-date and/or inaccurate, so caveat emptor (let the buyer beware).
Also, this article is a must-read for those of you dealing with psychiatrists. A lot of what it says applies to other doctor visits as well, whether benzo-related or not.