Going cold turkey when trying to quit a drug habit has its appeal. During the depths of addiction, cutting out all usage and going clean all at once can sound like the best kind of breakup.
In some cases, that’s a perfectly good approach. In others, weaning or tapering medications or other drugs may be the better alternative.
Drug weaning and tapering are ways to gradually — and more safely — reduce usage of a specific substance, thereby cutting cravings and dependence. The drug being given up should inform the strategy behind quitting.
For substances such as tobacco, there is evidence a cold turkey quit can prove more effective than tapering. Finding help, though, can make cutting the habit even more likely to stick.
Other drugs are much harder to stop using. Heroin, for example, causes painful cravings and withdrawal symptoms when someone tries to discontinue taking the opioid. Other medications or substances that impact mood or reduce anxiety are best quit under the care of a professional.
How Do You Define Tapering and Weaning Off?
Tapering or weaning is cutting back on medications, drugs, or alcohol. It’s a form of detoxification drawn out for the comfort and safety of the person quitting the substance.
According to the Centers for Disease Control and Prevention (CDC), drug tapering is advised when:
- A person asks for it
- There is no reduction of pain or progress is minimal
- Dosages are becoming too high
- A person is taking both opioids and benzodiazepines (Xanax, etc.)
- There are signs of substance use disorder
- People may have a high chance of overdosing or have already experienced overdoses or other serious events
Typically a doctor will tailor a plan for a person’s needs and monitor progress to ensure that the treatment proceeds as seamlessly as possible. Sometimes medication is prescribed to manage the most painful symptoms of detox and withdrawal, which may help toward long-term sobriety.
Simply going clean may not be enough to conquer addiction, however. Addressing the issues that led to addiction in the first place, and practicing healthier coping mechanisms tend to ensure a better outcome.
Some substances can be quit cold turkey without much risk, aside from creating stress and physical and/or psychological cravings. Others pose real dangers.
Quitting the benzodiazepine Xanax too quickly, for example, can trigger seizures. For those cases, slowly reducing the dosage (ideally under medical supervision) is the safer way to stop. Stopping and then starting opioids can be troublesome, too, if one has grown accustomed to lower doses. The person may not be accustomed to higher doses and may be more likely to overdose. Relapse is a whole other can of worms and may also create considerable problems.
Withdrawal can cause any number of unpleasant symptoms, both physical and emotional.
Physically, any of the following may occur:
- Nausea, vomiting
- Pains, aches
- Rapid or slowed heartbeat
- Chills, shaking, goosebumps
There also are emotional and mental side effects from withdrawal, including:
A medical professional or a treatment center can make the process less painful, letting clients know what to expect and offering alternatives and coping mechanisms to ease or alleviate discomfort.
What Are the Dangers of Not Tapering?
An addict’s brain begins to depend on the drug (or drugs) in question, and stopping them suddenly can lead to potentially life-threatening seizures, irregular heartbeat, and other problems. It doesn’t just have to be from trying to overcome addiction to illicit drugs such as heroin, either. Stopping prescription medications such as Xanax can be just as dangerous.
If you are trying to quit a substance and experiencing any of the following, find immediate emergency medical assistance:
- Frequent vomiting
- Chest pain
- Breathing problems
- Irregular heartbeat
What Kinds of Drugs Require Tapering?
A better question might be, what kinds of drugs don’t require tapering? Most stories about dangerous drug withdrawals tend to focus on opioids, benzodiazepines, alcohol, and antidepressants.
It’s hardly limited to those substances. Stopping any drug should handled cautiously. Consulting with a professional is strongly advised. Stories have peppered the media about people quitting antidepressants and committing suicide not long after, but other drugs pose other risks. For example, when suddenly halted, heart medications can make cardiac arrests or strokes more likely to occur.
The nature of the drug being tapered will dictate its medication tapering schedule. In general, slower is seen as better. Regular checkups are recommended to ensure that tapering dose protocols are going smoothly. If so, a smaller dose may be prescribed.
People who have a history of depression or anxiety (dual diagnosis cases, when a mental illness is paired with an addiction) should be especially cautious.
Benzodiazepines are medications that are commonly prescribed to treat anxiety. Alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), and clonazepam (Klonopin) are four common examples.
If a person becomes dependent on one of these medications or a similar substance, tapering medications is advised, because to suddenly stop such drugs can bring the anxiety roaring back or trigger severe withdrawals.
Depending on how long a drug stays in the system (its half-life), some drugs make better medications to use as needed. Benzodiazepines are good at producing a sense of calmness, but it’s easy to grow addicted to them. Higher doses will be sought to produce the same anxiety relief as before.
Taking benzodiazepines for just a month means weaning off medication may be in order. More than likely, the following people should be weaned:
- People older than the age of 65 (their risks of falling escalate and it is more likely that they have cognitive impairments)
- People taking more than one type of benzodiazepine (or pairing them with opioids or amphetamines, or using doses exceeding prescribed strength)
- People with cognitive disorders, traumatic brain injuries, or current or past substance use disorders
The U.S. Department of Veterans Affairs also offers advice and schedules for gradually reducing drug dosages in a controlled and safe manner.
How to Taper Off Medication?
When helping someone wean off an addictive substance, several approaches may work:
- Taper off the existing medication until the withdrawal risk is nil
- Offer a substitute medication that has a longer-lasting effect
- Prescribe additional medicines to complement the weaning off meds and reduce withdrawal symptoms
Weaning or tapering off medications and other drugs is only part of recovery. Substance abuse and addiction is a complex disorder, and it should be noted that weaning or tapering is only part of the treatment experience.
For treatment to be effective, a number of factors come into play. Besides helping individuals to stop using, they will also have to learn to live a drug- or alcohol-free lifestyle, and adjust to new, sober family, social, and workplace dynamics.
Getting clean is only the first step. But it is a huge one, and a leap worth taking.
Talk with one of our treatment specialists . Call 24/7: 949-276-2886
- Books.google.com – Psychopharmacology for the Non-Medically Trained
- CDC.gov – Pocket Guide: Tapering Opioids for Chronic Pain
- DrugAbuse.gov – Principles of Drug Addiction Treatment: A Research-Based Guide
- DrugAbuse.gov – Understanding Drug Abuse and Addiction: What Science Says
- Healthline.com – Is it safe to quit substances cold turkey? Here’s what to consider
- NCBI.NLM.NIH.gov – Drug Discontinuation Effects Are Part of the Pharmacology of a Drug
- Psychnews.psychiatryonline.org – Tapering Meds: When and How to Do It?
- VA.gov – Effective Treatments for PTSD: Helping Patients Taper from Benzodiazepines