Ativan & Florinal - I want to quit

[djg81]

To keep a long story short my wife (we are both 28 with a 3 year old daughter) has been receiving chemotherapy since april. Like I said, to keep it short I basically crashed and burned mentally, being young and having to all of a sudden shoulder all the workload of the house hold while supporting my wife, being a single dad, and crunching the budget of the household.

I currently take 4mg of Ativan a day and up to 3 of those yellow/blue Florinal caps w/codeine a day (for migraine headaches).

While the meds have never effected my ability as a father, husband, or employee - honestly Im just burned out from being in what seems like a constant haze.

Ive tried quitting cold turkey, with unpleasent effects - what do you suggest?

[flob]

as a side note...if you're going to attempt this while you have so many other stressors in your life, it could be a disaster if you don't have some form of support team...whether it just be your doctor, or your doctor and this forum...or someone else you know and trust. the reason i say this is because you're going through a tough time and both butalbital and ativan strongly effect how you are coping with the situation, so any change in dose or reduction of dose could have an impact you might not expect. this is where a support system comes in handy. the addiction forum would suggest the same thing...it's why so many fail at withdrawal. they don't have good support systems to help them through the whole process.

[flob]

the half-life of butalbital is anywhere from 24 to 72 hours. i understand it's prescribed as needed, but you've said you take 3 a day. i guess if this is not every day, then it's not such a concern. the typical dose of butalbital is up to 300mg daily and this is safe if it's not done every day. if it IS done every day, then a taper should be used to discontinue.

i know you want to avoid speaking with a doctor, but if you aren't abusing these meds, you have NO reason to fear speaking with your doctor. only express your concerns of abrupt discontinuation. it would be unwise for anyone here to give you suggestions as to how to taper on these meds due to the risk involved. my advice was given under the assumption that you are taking 4mg of ativan and 3 fiorinal (florinal) every day. what it comes down to is if you aren't taking that amount every day, then you still need to talk with a doc.

if you are taking the fiorinal every day, or close to every day, a taper would be a good idea. so if you start at 3 a day, then you would, for example, reduce that by 1 capsule a day every 3rd or 4th day  until off. having said that, you certainly discuss any taper with your doctor first.

[djg81]

I guess I should have been more clear that the Ativan is daily (60 prescribed @ 2mg every 30 days) and the Florinal is more of a "as needed" - sorry for triple posting I dont seem to see a way to edit my posts. I think I gave the wrong impression that I was taking more Florinal than I am.

[djg81]

One more thing - Ive only been on the Florinal for 2 months, which was only 60 of them (actually I still have about 15 left from the second refill). With such a low amount in my system would it be ok to trash those and just taper on the Ativan?

Now the Ativan Ive been on for atleast half a year. Starting with 1mg x2 a day and then 2 months ago switched 2mg x2 due to tolerance levels.

Im more eager to get off the Florinal, more so than the Ativan.

[djg81]

Thanks for the replies - don't think Im ignoring any advise. I do have a question - some days I dont take any meds at all, generally days Im off work, which results in lower managable stress levels. I feel a bit tired, but nothing out of the oridinary, sometimes this is one day, sometimes its two days I skip. Im going to guess Im not feeling anything severe because the meds are still floating in my system at lower levels?

[flob]

yes, but you'll need to consider the fact that at your doses, you're at a high risk of seizures and possibly even death if you quit cold turkey. benzo and barbiturate withdrawal is nothing like opiate withdrawal...these are things that you can't predict, and just because you're successful once in quitting cold turkey doesn't mean you'll be successful again without experiencing severe side effects. the butalbital dose alone is enough to potentially cause severe withdrawal symptoms, and you augment that with the high daily dose of ativan and that really puts you at high risk.

this isn't information that i'm just making up. it would be a good idea for you to look this information up on your own. just type 'barbiturate withdrawal' or 'benzo withdrawal' into a search engine and you'll find gobs of info about it.

[djg81]

Well, when I quit cold turkey the two major systems I had was insomnia and lack of energy. Let me make it clear that Ive never had suicidal thoughts or become so depressed I cannot fullfil my duties as an employee, father, or husband. Throw in cold sweats and its just a very uncomfortable way to stagger through the day.

As far as tapering, I feel like Im at the point where I am just sick to taking meds all together. Ive had to quit 10mg percoet cold turkey (2 week supply after surgery some years ago) and while the next 7 days are like being a zombie - I did it.

Just to the point where I feel like a good dose of w/d will make me consider ever taking this crap again. Im not above punishing myself a bit to get it out of my system. :)

[flob]

and just to mention another danger...if you were to ever run out or your doctor ever denied a refill without knowing how dependent you are on these meds...that would force you to stop cold turkey and at your doses it really would be dangerous...sort of like playing russian roulette. all the more reason to discuss this with your doc.

[flob]

fiorinal is much more dangerous than the ativan, to be sure. it contains butalbital, a fast acting short to intermediate acting barbiturate, and obviously it also contains codeine. the barbiturate it in it similar to secobarbital and pentobarbital. the true danger of this drug is that it's not considered to be dangerous...but believe me it is.

addiction to benzo's is treated much the way addiction to barbs is treated....both require a doctor to help you through w/d...there is no question about this. you have to come clean with your doctor. you've already said you can't quit if they're available.

a daily dose of 3 fiorinal a day is 150mg of butalbital...relatively low compared to most barb abusers, but the concern isn't the dose, but rather that it's being taken every single day....so you'd probably want a taper as you would with the ativan.

i'm surprised these drugs are being prescribed together. if you're taking those doses every day, then you certainly would never want to stop cold turkey. VERY bad idea for either medication. you should really tell your doctor.

[nursegirl6572]

Yes, that is a quite high dose of Ativan, which will probably require an extra long taper.  It is admirable of you to admit that tapering would be rough for you.  Is there anyone who can hold the meds for you and give them to you per the MD instructions?

I also would suggest you visit our addiction community here (Substance Abuse, not Social)...they are a group of awesome and helpful people....both forums can really give you some tips on how to proceed.

You have a lot on your plate right now....hopefully your stress level will improve soon.

[djg81]

My problem is if I know the medications are available, I will take them. Im humble enough to admit I probably would not be able to control my own tapering. Sad fact, but there is no point in being dishonest if I am looking for real solutions.

Should I suggest to my doctor about taking something more passive that is not considered a narcotic? I know Ativan is a quick acting, quick fading drug.

From my understanding 4mg of Ativan a day is quite high.

[M4Y0U]

Hello there,

Benzodiazepine like Ativan cessation must be done by tapering off of it slowly by reducing the dose slowly. You can have to still take the med for 1 to 2 months or more to experience no withdrawal symptoms at all.

It is almost normal at some point to experience stress and anxiety with all the things happening in your life right now. The severe illness or lost of a close one is number 1 factor of stress. I suggest you a therapy with a qualified therapist since it is important to talk about all this to someone that can give you precious advice but most importantly it is important to talk to avoid recessed emotions that might play a huge role in the development of depression and anxiety.

Best regards,
M4

I'm am sorry for your wife and i wish her a complete recover.

[Chrissy1972]

Hi

So sorry for all you are going through. I dont know anything about the Florinal but I do know Ativan is a Benzo and benzos should not be abruptly stopped. You need to taper off them. I suggest you speak with the prescribing Dr for a safe tapering dosage.
All the best to you  & your family!