How to Taper / Wean Off Meds

When the time comes to begin a slow descent of daily medication dosing, for whatever reason it may be, it is best to be equipped with knowledge of the drug.  This will help explain how to taper / wean off meds. Starting a taper of the drug simply means calculating an average daily dose of the drug (based on past use of drug), and from there lowering the daily dose administered every so often.  The idea is to gradually lower the daily dose in specific increments. The goal may be to achieve a desired daily dose to then maintain. For many the purpose is to reach a low enough daily dose that allows for a more comfortable detox upon discontinuing use of the drug completely.

FACTORS TO CONSIDER 
It is very important to understand a few things about the pharmacology of the drug that is to be tapered.  The half-life of a drug refers to the amount of time that the body takes to eliminate half of the administered dose of the drug from the body.  Short term acting opiates used for treating pain generally have a half-life of 2-4 hours (when administered orally).  A specific drug's half-life will differ from person to person, depending on several factors (health, age).  The half-life of a certain drug will also be dependent on the route of administration (oral, intravenous, intranasal, etc).  Research the drug to be tapered, and understand the approximate half-life depending on specific factors.

Learn more about how drugs make their way the body Pharmacokinetics 101 (LADME)

The drug half-life is important to understand because it determines how long it will likely take to achieve the goal of a specific taper.  It also gives an idea of how often to reduce dose, and by how much each time.

Common Drugs Half-Life for Reference:

Hydrocodone (Vicodin) - 3.8 to 6 hours
Oxycodone (Oxycontin) - 3 to 4.5 hours
Diazepam (Valium) - 20-60 hours (up to 100)
Alprazolam (Xanax) - 10-20 hours
Buprenorphine (Suboxone) - 30-40 hours

*These half-life times are approximate - One of the most important things to remember is to pay attention to what your body is trying to "tell" you.  Withdrawals are in fact your body reacting to less of a substance. This post equips individuals with a general idea of how to taper / wean off meds.*


CREATE A GRAPH SHOWING ELIMINATION OF DRUG 
It is pretty simple to create a graph showing the rate of elimination of the specific drug from the body.  If you understand the concept of a drug's half-life, and research the specific drug enough to help approximate factors that would influence drug elimination - Create a few graphs using different values for time and dosage.  Identify which graph best represents the steadiest decline in blood levels over time.  It may be wise to include a bit of room for error once the best taper has been identified.  For example, if it has been decided that the best taper to use will be a 10% dose decrease every 3 days - reduce the percentage a small amount or add an extra day.  Reason being, it is better to be a little over the calculated dose than be under, and begin to experience unpleasant symptoms of the drug elimination.

This is a link to a Wiki page that contains some useful formulas for drug half-life calculations
Half-Life Information and Formulas (Wiki Page)

CONCLUSION - LINK TO GRAPHING TOOL

Wouldn't it be great if there was a tool that helped to graph and visualize different dosage and time options of the taper, to determine the most comfortable fit?

There is.

The link below directs to a site with a Buprenorphine Blood Plasma Level Graphing Tool.  Microsoft "Silverlight" must be installed to use this tool. It will prompt the download of this program if needed.

This Tool is best when used for a Buprenorphine taper, but the tool allows for the "half-life" to be changed to any amount.

IMPORTANT
If the drug to be tapered is administered multiple times a day, this tool likely will not display an accurate representation of blood plasma levels.  I believe the tool is for once daily administration of a drug.  Elimination of a specific drug from the body will not be equal if dosage is spread throughout the day, even if the total dose per day is equal.

Taper Graphing Tool

If you need help regarding a taper, I can help out.

Take Care