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Drug tapering can be a safer way to reduce and stop substance use rather than abruptly stopping. This guide explains what drug tapering is, how long it can take, and what kind of support individuals can utilize.
- Drug tapering involves a controlled reduction in substance use, helping to minimize withdrawal symptoms and reduce physical dependence.
- The duration of tapering depends on factors like addiction severity and dosage, ranging from weeks to months.
- Professional supervision ensures safe tapering, with medication-assisted treatment available for severe cases or challenging substances.
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What is drug tapering?
Drug tapering means to slowly reduce a substance's dosage before stopping completely. It can refer to medications that have been prescribed by a doctor and to substances that are taken illicitly. [1]
Tapering is often recommended when a person has developed a physical dependence or addiction to a substance, which can then cause unpleasant or dangerous withdrawal symptoms when use is stopped. Tapering can help reduce the occurrence and severity of withdrawal symptoms. [2]
Drug tapering timelines can vary depending on the individual and how much or for how long they have been taking the substance.
Is tapering the same as weaning?
Yes, tapering and weaning both mean to gradually reduce the amount of something until it is stopped, becoming accustomed to and managing without the substance.
How long does drug tapering take?
Drug tapering can take different lengths of time depending on the individual, the severity of their addiction, the current amount of substance use, and other factors. People with a more severe addiction are likely to experience worse withdrawal symptoms, thus meaning that they should taper more slowly to pretend unpleasant or dangerous effects. [2][3]
For example, someone who has been using large doses of a substance for a prolonged period might need to taper very slowly. This might involve making small reductions each week or two, which may take up to five or six months.
In contrast, someone who has been using small quantities and has not developed a severe physical dependence may be able to taper off the substance within a week or two. For example, this might involve halving the dose every three days. [3]
Additionally, tapering can be paused, slowed, or quickened, depending on the individual’s response to dosage changes, which can impact the duration of the taper. [4]
How to taper off drugs
There are risks to coming off a substance, whether it is prescribed or used illicitly. Because of this, it is often safer to consult with a medical professional before and during the tapering process. They can provide advice about a safe taper schedule and monitor for any withdrawal symptoms or other adverse effects during the process. [2]
It is important to follow the instructions of the medical professional, making dose adjustments as planned. If someone chooses to taper without professional advice, they should ensure that they make gradual dose reductions. It may also be helpful to learn about the potential withdrawal symptoms and how to manage them. [4][5]
When tapering, it is advised to continue taking the drug at the same time each day in gradually decreasing doses, rather than increasing the time between each dose. It can be helpful to have a written plan, specifying when and by how much doses will be reduced. [4]
Medication-assisted treatment
Some substances can cause severe or dangerous withdrawal symptoms and can be particularly difficult to reduce or stop. For example, tapering off opioids or alcohol might involve the use of a medication to reduce withdrawal symptoms and cravings. This might include: [5][6]
- Clonidine: Clonidine does not reduce cravings but can help manage withdrawal symptoms, such as nausea, anxiety, and insomnia.
- Benzodiazepines: Benzodiazepines are sometimes used during tapering for alcohol use disorder, in order to help reduce insomnia, agitation, and delirium tremens.
- Buprenorphine: Buprenorphine can be used to assist with opioid tapering and can reduce cravings and withdrawal symptoms. It can also be continued long-term to prevent relapse and maintain abstinence.
Benefits of drug tapering
Benefits of drug tapering include:
- Preventing or reducing withdrawal symptoms
- Gradual reduction of cravings and drug effects, helping to improve and sustain recovery
- Being able to remain at home during tapering, rather than requiring inpatient or rehabilitation treatment
- Being able to pause, reduce, or increase dosage changes as needed
- Gradual reduction of physical dependence and addiction symptoms
Tapering vs. Going cold turkey
Going ‘cold turkey’ means to abruptly stop taking a drug completely, with no gradual reduction. For some people, this can be appropriate and is typically a quicker process. If a person has been using small amounts of a drug for a short period of time, they may be able to stop cold turkey without experiencing severe withdrawal symptoms. [4]
However, once a physical dependence has developed, stopping the drug cold turkey can cause very unpleasant and potentially dangerous effects. This can occur with prescribed medications, including opioid pain relievers, antidepressants, and benzodiazepines, as well as with illicit substances. [2][5]
Because of this, tapering is typically the safer option of the two. If a person chooses to stop a drug cold turkey, they may need professional monitoring and treatment in a detox facility.
Risks of drug tapering
Although tapering is often safer than stopping abruptly, it can still cause risks and adverse effects.
Withdrawal symptoms
Withdrawal symptoms may occur even with tapering, which can include physical and psychological effects. It can be helpful to find out more about potential withdrawal symptoms before starting a drug taper and discussing with a professional how to manage them. [4]
Overdose
When a person becomes dependent on a drug, they often also develop a tolerance. When tapering takes place, this tolerance decreases, which can mean that a small dose of the drug causes more potent effects. Because of this, people may be at a higher risk of overdose if they take a large dose during the tapering process. [5]
Rebound symptoms
If the drug is a prescribed medication, such as those used for mental health conditions or pain management, rebound symptoms can occur when the dose is reduced. This can cause the original symptoms to recur, potentially returning to their initial severity or worse, for a temporary period. [1]
Additional treatments
Some people may choose or require medically-assisted detox. This involves stopping the use of the substance, either instantly or with tapering, under 24-hour monitoring and treatment in a detox center. Medications might be used to manage withdrawal symptoms, alongside professional medical and psychological support. [7]
Detox is often the first stage in treatment, followed by inpatient or outpatient rehabilitation programs involving medical, psychological, and psychosocial interventions to treat the behaviors and symptoms of substance addiction. This might include maintenance medications, individual and group therapy, and financial, housing, and employment support. [5][7]
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