Скачать или смотреть Science Teacher / Addict Explains Tapering Tips for Opioids and Other Substances

*Note: I am not a clinician. I studied biochemistry / physiology in undergrad (and worked in a hospital after finishing my Bachelor's), but I left medical school after my MS1 year because of my addiction. These tapering tips are distillations / applications of what I have learned in my medical studies as well as my own experiences with tapering off of benzos and opioids. This information is meant to be used in consultation with a trusted physician or other provider to come up with a tapering plan that works for you!

I use opioids as the example substance class for this video, but much of what I say is applicable to benzodiazepines - as well as alcohol, nicotine, caffeine, and many psych meds. I discuss the general theory of tapering low and slow using an agent with a long half-life, then launch into specific tips:

General theory: 4:00
Go slow (w/ long half-life agent): 6:35
Go low (w/ volumetric dilution): 10:05
Rest areas: 16:27
Rescue doses: 18:30
Comfort meds: 22:05
Exercise / diet (ketogenic?): 27:20
Therapy (CBT / DBT): 29:10
Journaling / creativity / community: 34:02
Avoid the pitfalls (esp. alcohol): 38:30
Reward yourself: 41:00

*When discussing clonidine at 22:50, I said "alpha blocker" when I meant "alpha agonist [stimulator]"; clonidine works by activating the alpha-2 subset of adrenergic receptors.

**During the section on comfort meds, I meant to mention medications for sleep. Despite the "lack of sleep never killed anybody" cliche, sleep is in fact a vital part of early recovery: Insomnia fuels cognitive, emotional, and physical shifts that can increase impulsivity and therefore push you into negative decision-making patterns (such as deciding to abandon your taper or to relapse on other addictive substances).

Trazodone is an old-school antidepressant that is very sedating and non-abusable, which explains why it is often prescribed as a sleep medicine when people are tapering off of benzos and opioids; however, I have not found it particularly effective, it can significantly increase RLS / crawling-out-of-your-skin feelings if you take it and then don't fall asleep, and it has a heavy hangover effect the next day. Therefore, I recommend Seroquel (quetiapine), an antipsychotic that at low doses is a little calming and quite sedating. I recommend avoiding Ambien and other Z-drugs for the same reason that I discuss avoiding benzos (cross-addiction, basically).

Also, depending on your openness to Complementary and Alternative Medicine (CAM), you might consider kava kava, ashwagandha, and other plant-based medicines - as well as our good-old, OTC staple melatonin - to help with sleep and anxiety.

***If you are tapering off of benzos, I highly recommend Benzo Buddies and the work of Dr. Heather Ashton, a British psychiatrist who has devoted her life to getting people off of benzos using a slow taper / long half-life method (with a success rate of 90%, which is phenomenal). Her book is available for free in e-book format through Kindle / Amazon.

If you have any questions about the theory or pragmatic aspects of tapering off of any substance, fire away in the comments section below! I love this stuff.

If you're a fellow refugee from the War on Drugs or just someone who enjoys learning about neuroscience and mental health, come join us at ‪@concreteconfessional‬! I wish every single one of you the best on your journey toward greater health and "happiness without a half-life" (TM, lol).