Once you’re ready to enter rehab your first step will be detox. While you’re here you may hear the term “tapering.” You may have some questions about this term that we’d like to answer for you here.
What is Tapering?
When you’re physically addicted to a drug your body and brain chemistry are dramatically changed. This is why withdrawal symptoms occur, especially when you’ve used the drug heavily or for a long period. Your body and brain are no longer able to function without the drug. To help alleviate severe withdrawal symptoms and allow for long-term recovery, most rehab centers will taper you off the drugs you were abusing.
Tapering is the process in which the substance you were abusing is slowly decreased. This helps your body gradually adjust to sobriety, but this needs to be done under professional care. They have a set of guidelines from the American Society of Addiction Medicine that they use to help with effective and safe tapering.
Why is Drug Tapering Done?
Your dependence on the substance you’re abusing is physical in nature. This means the drug is interfering or substituting for the chemicals that are found in your body, especially in your brain.
Your dependence on the substance you’re abusing is physical in nature. This means the drug is interfering with or substituting for the chemicals that are found in your body, especially in your brain. So, when you suddenly remove that substance from your body it can’t resume the natural processes. However, by tapering off of a drug your body will have time to adjust to no longer having the drug and start replacing it on its own again. Withdrawal management and tapering are also ways to manage withdrawal symptoms and help you avoid the risk of death in benzo and alcohol withdrawal.
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Which Drugs Require Tapering?
Detox should always be handled carefully. With some drugs, tapering is the only way to safely detox. For instance, benzodiazepines (e.g., Xanax, Ativan, Valium), opioids (e.g., fentanyl, heroin), and alcohol must all be tapered because sudden withdrawal can be fatal. There are also some people whom medical professionals strongly advise tapering, including people:
- Over the age of 65
- Abusing more than one type of drug
- With cognitive disorders, traumatic brain injuries, or current or past substance use disorders
- Using large amounts of a drug
- With co-occurring illnesses (both mental and physical)
- Who’ve abused substances in the past
- Used a substance frequently for a long period
How can I make Withdrawals Less Painful?
There are various ways in which you can get through your withdrawal symptoms with minimal discomfort. It is up to you and your doctor to decide which of these is right for you. They include:
Medical detox is the best way to manage withdrawal since some symptoms can be fatal. Here you’ll spend 5 – 10 days being supervised 24/7. At Icarus Behavioral Health, our clinicians will provide medication and therapists are available to support you around-the-clock.
- A healthy exercise routine helps your brain release endorphins (“feel good” chemicals). It also reduces stress, helps you sleep better, enhances self-esteem, minimizes relapse, and decreases cravings.
- Maintain a balanced, nutritious diet so both your body and mind can heal. Make sure you have plenty of proteins and essential vitamins and nutrients to restore healthy brain and body functioning. Avoid caffeine, processed food, refined sugar, oil, and saturated fats. Most people’s addiction diminishes their vitamins A, C, D, and E levels. Replenishing these vitamins also help reduce cravings and enhance self-esteem. Additionally, a well-nourished body will improve your mood.
- Stay hydrated so your body can heal properly. Cravings are frequently mistaken for thirst or hunger so when your body is properly hydrated and nourished you’ll have fewer cravings.
- Maintaining good sleep hygiene is an important part of healing you both physically and emotionally. When you’re well-rested you not only think better but you’re better equipped to manage your mood swings and cravings.
- Participate in a support group (e.g., AA, NA) so you get the encouragement and support you need to minimize relapse.
- Combine both traditional and holistic (e.g., acupuncture, chiropractic care, massage therapy) methods of recovery. Holistic care can help reduce stress and physical pain while re-establishing blood flow, circulation, and balance.
- Stretch or do yoga frequently to stimulate blood flow and circulation.
- Practice mindfulness or meditation so you become more in tune with your body and reduce symptoms of anxiety or depression.
- Make sure you have people around you that you can talk to (e.g., family, therapist, loved ones, friends). This is a beneficial therapy that allows you to externalize things so they’re not kept bottled up inside of you. Therapists can also help you learn healthy coping mechanisms and modify behaviors so they aren’t self-destructive.
How Does Tapering Help with Detox?
When you’ve abused a substance for a long period you develop a physical dependence on the drug because the drug interferes or substitutes with the natural chemistry of your body and brain. As your body begins adapting to these new chemicals it also starts requiring more of them to feel normal. Suddenly removing this substance from your body sends your system into chaos because it can’t automatically resume these natural processes and thus it’s unable to function properly which is why you experience withdrawal symptoms.
By tapering off a drug your body has time to adjust to the cessation of the substance. It can then naturally replace the substance with its own chemicals. Since your body and brain are given time to redevelop their natural processes you won’t experience such extreme withdrawal symptoms.
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What are the Risks of Not Tapering off Substances?
While in addiction your brain started depending on the substance you were abusing. Depending on the substance in question, when you suddenly stop abusing it you may experience some potentially life-threatening complications. It’s important to know what these complications are so you can immediately seek medical attention if you experience them. They include:
- Severe tremors or muscle spasms
- Loss of consciousness
- Irregular or very fast heartbeat
- Severe and persistent headache
- Tactile hallucinations (e.g., feeling like spiders are crawling on your skin)
- Breathing difficulty or shortness of breath
- Chest pain or pressure
- Frequent or severe vomiting
What are the Different Methods of Tapering?
There are three ways that medical professionals use to taper people off addictive substances. They’ll consider your case individually to determine which method is right for you. In doing so they’ll look at both your medical history and your current condition. Once they’ve considered these factors, they’ll use one of the following methods.
This is the most straightforward tapering method. It involves gradually reducing the amount of the substance you’re taking. Typically, the substance is decreased each week until you’re completely off of it. This makes withdrawal symptoms more manageable especially if you’ve been using a lot of a substance over a long period.
When you’ve abused a short-acting substance, or you haven’t used high dosages of your drug of choice doctors may choose to use substitution tapering. This involves replacing the substance you’re abusing with a similar, but more easily tapered substance. Doing so allows our medical professionals to decrease your daily dosage gradually and precisely.
This type of tapering is rarely used in a clinical setting because it carries with it a significant amount of risk. You also should never use it without professional supervision. However, when you’re abusing a water-soluble substance (one whose concentration can’t be diluted in water) you may be taking more than you intended.
Not only does this increase your chances of overdosing but it also means that your medical team can’t determine exactly how much you ingested each time. Therefore, they use special equipment that enables them to dissolve a small amount of the substance in water. Each day you’ll ingest less until you’re finally clean.
Medically Supervised Detox and Tapering
One of the ways to successfully taper a person off drugs and alcohol is through an inpatient medical detox program. While some patients have been able to successfully taper off drugs themselves, not having professional guidance while doing so can trigger a relapse. This also is unadvisable because some withdrawal symptoms can be fatal if not treated immediately.
When you choose to undergo medical detox, you may wonder what to expect. The program starts by admitting you into a safe, comfortable detox environment. While there you’ll have 24/7 medical assistance available. You’ll receive nutritious meals and snacks while being allowed to engage in leisure, rest, and various holistic treatment options.
While in detox the main goal is to help your body start functioning healthily again so you feel good without the substance. Once you’re tapered off the drug and your medical team believes you’re stable you can then move on to either an inpatient or outpatient treatment modality.
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A Sample Tapering Schedule
The tapering schedule for each substance is different. For instance, when you’re tapering off opioids the dosage is reduced by 5% – 20% every four weeks until you’re clean However, with benzos the drug is reduced by 50% in the first month. You’ll then maintain that dose for up to two months before reducing the dose by 25% every two weeks until you’re clean, depending on situation and setting.
You should also know that there are also a few different ways to taper. These include:
- Direct taper: This is the safest type of taper to undertake when you aren’t under direct medical supervision. It allows you to gradually lower the amount of the substance you use each day.
- Substitution taper: This is the taper that you’ll undertake while receiving direct medical supervision. Here your physician will substitute a prescription medication for the substance you’ve been abusing.
If your drug of choice was alcohol, there are a few other tapering options available to you. This is something you should discuss with your doctor. They’ll be able to determine what will work best for you.
Dependence vs Addiction and Treatment Options
There’s only a slight difference between addiction and dependence since many signs and symptoms intersect. However, here are some of the differences you should understand:
- Addiction means the harmful effects that a substance has on a person. Whereas dependence means that the person relies on a substance despite its negative consequences.
- Addiction is characterized by the inability to stop using a substance. Dependence is a physical reliance on a substance.
- Addiction to a substance you’re unable to handle your responsibilities. Those with dependence may still be able to handle their responsibilities
- Addiction occurs because of chronic substance use. Dependence is usually the result of environmental factors.
Whether you’re seeing signs of dependence or addiction, you should encourage your loved one to seek treatment. If you’re wondering if you need help, just asking yourself this question is enough to indicate that you do.
Managing Withdrawals is Not a Total Solution
Just because you’ve undergone the withdrawal process doesn’t mean that you’re at the end of the recovery journey. Studies have shown that longer periods of treatment for longer sobriety are as equally as beneficial as relapse prevention and planning.
Therefore, you should continue with treatment after you make it through detox and finish either an inpatient or outpatient treatment protocol. These things only help to prepare you for a life of recovery. You will need therapy and support groups, and Icarus provides each customized to your unique history and the path that led you to seek sobriety.
Find a Lasting Recovery Path at Icarus Behavioral Health
For some people changing treatment facilities throughout their recovery isn’t comfortable for them. Fortunately, at Icarus Behavioral, we offer a full continuum of addiction treatment. This starts with detoxing in our comfortable, medically supervised setting.
Once the alcohol and substances are out of your body our team will work with you to start crafting a personalized treatment plan, for both addiction and any other underlying conditions you may have. We’ll walk with you through early recovery and then help you create an aftercare plan for when you eventually leave our treatment facility.
Even then we’ll continue to check up on you and make sure that you have the community support you need so that you can continue in your sobriety. Find out why so many clients and their loved ones trust us for treatment and contact us today to begin your own journey towards a brighter future.