What is Tapering?

Wednesday, October 2, 2019 | By Cooper Samp

A common fear many people have when entering treatment is their first couple days which usually involve detox. The detox process has been known to cause extreme discomfort. People are told horror stories of how bad their body is going to react when coming off of drugs. The treatment process alone can be intimidating – especially for those who have never gone through the process before – but adding this to the uneasiness of detox can make many people apprehensive. 

Thankfully today there are a variety of modern techniques and medications to help mitigate these discomforts. While detox is no stroll through the park, it has become much more manageable than in years prior. These methods of detoxing the body have helped individuals stay motivated to complete the detox process and are therefore more likely to complete the entire treatment process. One of the techniques used is called “tapering.” Tapering is not a new concept in detoxification, but there are improved varieties of tapering that open up the process to a wider range of substances. 

What is Tapering?

The detox process will depend on what substance(s) a person is coming off of and their history/frequency of use. In rare cases such as a single relapse, a person may be able to quit cold turkey – without any medication of tapering of any kind. However, for the majority entering a treatment program, detoxification is often required. Without proper medical detox, patients will experience intense and severe withdrawal symptoms as their body has become adapted and dependent on this drug to function properly. After a few hours or days, a person will begin to feel withdrawal symptoms including: 

  • Severe cravings to start using the drug again
  • Changes in sleep patterns, including insomnia
  • Emotional instability, including depression, anxiety, irritability, and even violent behavior
  • Digestive issues, such as nausea, vomiting, and changes in appetite
  • Sweating, tearing, shakiness, and changes in heart rate or breathing
  • In the case of alcohol or benzodiazepine abuse, seizures, hallucinations, tremors, and death

Tapering is the process of slowly decreasing the amount of the drug being taken over time. This process helps the body adjust to the loss of drug over time, decreasing the severity of cravings and withdrawal symptoms. By limiting these two factors, tapering allows a person to safely and comfortably rid the body of unwanted substances while also minimizing potential relapse. 

How Tapering Method Helps

When a person uses a substance for an extended period of time, they develop a physical dependence on the drug. This dependence forms because the drug interferes or substitutes with natural body and brain chemistry. Over time the body starts to adapt to these new chemicals and even requires these chemicals to feel normal. For this reason, when a drug is removed suddenly, the body is unable to resume the natural processes, making it unable to function properly. This is the source of the withdrawal symptoms. Tapering off a drug allows the body time to adjust to the drug cessation allowing the body to naturally replace the drug with its own chemicals. 

However, when a person tapers the drug slowly, the body or brain is able to redevelop its natural processes over time without experiencing the full loss of function that occurs when the drug is suddenly stopped. Depending on the length of the taper and the amount of the decrease at each step, withdrawal symptoms can be minimized.

It is important to note that some drug withdrawal processes can be dangerous. In the case of alcohol or benzodiazepines, stopping suddenly can result in withdrawal symptoms like seizures, hallucinations, and other types of physical fluctuations that can result in death if not treated. Part of the treatment that can help to avoid these problems is professionally monitored tapering that can ease the body off the substance gradually.

Types of Tapering

Direct Tapering

Direct Tapering is the type of taper most people think of. This method involves slowly reducing the amount of the drug taken over time. The length of taper can depend on the individual, drug, and length of use but typically tapering is done on a weekly basis. Each week the substance is reduced by a certain amount until the individual is able to stop completely. 

A nutrition plan can be supportive during the tapering process as it can help make up for lost nutrients as a result of the drug use and as the body responds to the withdrawals. The Drug Withdrawal Research Foundation says that nutritional additives can help greatly reduce withdrawal symptoms and can sometimes even shorten the tapering process. 

Always consult a professional before beginning a tapering process as withdrawal side effects can have harmful consequences on the body. For this reason, professionals can help you best determine the best tapering method and appropriate length to minimize symptoms properly, helping to avoid cravings and relapse. 

Substitution Tapering

Certain drugs can have short half-lives or very low dosage making it difficult to perform a direct taper but quitting cold turkey can be extremely uncomfortable or even fatal. For these circumstances, it is better to replace the drug with a similar but more easily tapered drug. This allows direct taper to be performed effectively. This method is called substitution tapering. 

Titration Tapering

With certain drugs like opiates and benzodiazepines, there comes a point where it becomes difficult to taper with low dosages. Titration tapering is a type of tapering that involves dissolving the drug in a specific amount to water, providing measured doses with extremely small, incremental decreases in does. This can be used to provide daily decreases of tiny amounts, which some feel can result in a very smooth withdrawal process.

Before starting a titration taper there are a number of things you should consider. First, because this method can be difficult to measure correctly, it is important to receive medical advice and oversight. Second, this method can only be used for certain drugs as not all drugs are water-soluble. Also, if the drug is normally time-released, dissolving it could release the entire dose at once – creating adverse effects. For these reasons, titration tapering should only be used when directed by medical professionals. 

Tapering Off Multiple Substances

When someone is detoxing from multiple substances, tapering can still be an option. However, with tapering off of multiple substances, additional caution should be used. The withdrawals from multiple substances can be much more intense as the body is learning to deal with the loss of multiple chemicals it is dependent on. 

For this reason, the appropriate way to taper from multiple substances is to handle one taper at a time. This can be frustrating as the length of the taper can be much longer, but the withdrawal symptoms will be easier to manage. It is more likely that the individual will avoid severe cravings and other symptoms, and it improves the chances that detox will be completed and the person will avoid relapse.

The Necessity of Medical Oversight

The tapering method is an appropriate way to minimize the risks associated with coming off of a drug. Often times a person’s body will have built up a tolerance to where the amount they are using is too dangerous to come off of all at once. Even in other cases, coming off of any drug without tapering of some kind can have extreme withdrawal side effects. This is why it is always important to seek guidance from a research-based, experienced treatment program or professional. By seeking professional, they can not only recommend the best taper method but provide any additional medication (especially for substitution tapering) to minimize the unwanted effects of withdrawal. Some people attempt to taper off of a drug themselves but without proper guidance, this can be extremely dangerous. 

For more information on detox and tapering, call Coalition Recovery today and speak with one of our representatives. We can help set up an appointment with our board-certified addiction psychiatrist who can walk you through how to properly manage your taper process. 

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