Tapering Off Drugs: Does It Work? Should You?

January 8th, 2019

Tapering is a common and effective means of cessation for those on a prolonged regimen of prescription drugs. It can also work for those using illicit drugs who are on the cusp of dependency but may not need professional treatment at their current level of use. Tapering involves the gradual and clinically supervised decrease of the use of prescriptions like opioid painkillers, benzodiazepines, stimulants, and more. Patients work with their prescribing physicians to gradually decrease their intake of the drug in question. Tapering is meant to be a safe and controlled means of preventing withdrawal and ensuring that patients are medically or psychologically stable enough to live without the drug.

How Long Does It Take to Taper Off Drugs?

Each person’s tapering plan will vary based upon the scope and duration of their drug intake. In most cases, the tapering process takes a few weeks; but it can take months if the patient needs ongoing help stepping down. It’s important not to rush the tapering process, as doing so can be counter to its aims. It’s critical that patients work with their physicians and be honest with themselves about their symptoms and the ability to function without the drug. The clinical detox process will usually last around three to five days but can go longer based on patients’ progress and ongoing care needs. A joint study from several prominent universities concludes that patients stabilized physiologically on a range of buprenorphine doses can be tapered successfully over seven days, and there is no advantage to prolonging the tapering schedule for weeks.

Why Should I Taper Off Drugs?

Prolonged use of any prescription or illicit substance may eventually give way to dependency. These substances create serious and potentially permanent changes in brain chemistry and can lead to serious withdrawal symptoms. Abruptly stopping intake can accelerate and magnify these symptoms. Gradually ceasing use in a controlled, organized, and planned paradigm can be less of a shock to the system and give the body the time and conditioning it needs to comfortably and safely revert back to normal function without consistent use. Tapering is safer and more comfortable with the guidance of an experienced and qualified health care professional who is trained to prevent withdrawal symptoms and intervene in the event of a medical emergency.

How Does Tapering Off Drugs Work?

While the concept of tapering is the same from drug to drug, the timeline and process will be different for everyone as there are different health concerns associated with each drug. Tapering off prescriptions requires developing a schedule with your prescribing physician that takes into account your personal physiology, any existing withdrawal symptoms, underlying medical or mental health issues, and other factors. The timeline of tapering is contingent upon the scope and duration of patients’ prescription use. Extended use of benzodiazepines like Xanax and opioids like OxyContin can require a months-long tapering program, but it truly is different for everyone.

Tapering Off Prescription Drugs

In some cases, tapering off prescription drugs is the safest and most effective way to cease use. These include the use of powerful and potentially addictive medications like painkillers, antidepressants, and benzodiazepines. When endeavoring to taper off prescription drugs, it’s important to develop a clear and realistic timeline for cessation with the help of your doctor. The amount of time it takes to taper will depend on the scope and duration of prescription use. Those who are taking prescriptions for two weeks or less should be able to stop with no issue, while more protracted use will warrant a tapering plan.

During your tapering plan, your doctor will:

Assess vital signs, including your pulse, blood pressure and temperature.
Conduct urine or blood screenings to check the type and amount of medication or other substances in your system.
Speak with your other health care providers, pharmacists, or family members to obtain information that may help with your medication tapering.
Integrate other appropriate pain therapies.
Prescribe other types of medications to help you manage withdrawal signs and symptoms such as sleep, appetite, and mood disturbances.

To make your tapering plan safer and more comfortable, your physician may recommend taking certain lifestyle-related measures such as adding thirty minutes of physical activity to regulate blood pressure, and natural pain-management exercises such as acupuncture, massage, yoga, or meditation. Regular follow-up appointments are necessary to assess withdrawal symptoms and progress and to determine when you can curtail your use.

Tapering Off Illicit Drugs

While it’s generally advised that illicit drug users stop their drug use all at once and enter medical detox under the supervision of experienced and qualified treatment professionals, those who are not yet at the point of dependency may be able to use tapering to ultimately curtail their use. Generally speaking, the concept of tapering off illicit drugs does not actually mean gradually decreasing use of the drugs themselves; rather, it involves the use of FDA-approved drugs that yield similar effects to help safely detox.

Tapering off Opiates

Tapering off heroin and prescription opioids often includes the use of maintenance drugs like buprenorphine (Suboxone®), naltrexone (Vivitrol®), and methadone.

Tapering off Cocaine

Tapering off cocaine is often aided through the use of drugs such as gabapentin, modafinil, and topiramate. It’s important to realize that the FDA hasn’t approved any specific medication for the treatment of cocaine addiction.

Tapering off Methamphetamine

Tapering off methamphetamine is often aided with drugs like bupropion, modafinil, paroxetine, mirtazapine, and more. Again, while these drugs can help the withdrawal process, there is no FDA-approved drug to treat methamphetamine addiction.

Tapering off Marijuana

Tapering off marijuana can generally be done independently and with the help of an experienced and qualified healthcare professional, or even a mental health expert.

Each of these drugs creates different types of withdrawal symptoms and will require expert medical assistance.

Who Should Taper Off Drugs?

Some of the primary candidates for tapering off drugs include but are not limited to:

Individuals engaged in prolonged prescription opioid use for a medical injury.
Patients who have been on stimulants like Ritalin® or Adderall® for months or years.
Patients who have taken benzodiazepines like Xanax® for anxiety; and patients on antidepressants who are ready to lessen their intake.

If you or someone you care about have been abusing the aforementioned prescription drugs recreationally or are engaged in the continued use of illicit drugs, it’s critical that you seek treatment immediately to prevent the onset or worsening of chemical dependency.

Is Tapering Right for Me?

If you need to start decreasing your intake of prescriptions or need help quitting your use of illicit substances, tapering can be a safe and effective means of ceasing use without being overwhelmed by physical and psychological withdrawal symptoms. Without tapering or a cessation plan of any kind, patients render themselves more vulnerable to withdrawal and subsequent addiction. Don’t leave yourself open to addiction. Very few medications are meant to be taken forever—eventually you’ll have to curtail your use. Tapering can make the process as easy and as comfortable as possible. Talk to your doctor today to learn more.

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