(With regard for The Rules for Treating Benzodiazepine Withdrawal) I practice in a jail on the East Coast. I totally agree that Benzo’s must be used, but I can’t find anything in the literature concerning length of treatment to avoid life-threatening vs. annoying symptoms. The months-long tapers are not well accepted by either Correctional Healthcare companies or Correctional institutions. Most providers here go with a week of tapering diazepam. I usually go with 10-14 days. I would like to try your general formula of choosing the dose of diazepam, then tapering down every 4-6 days. Do you have any literature or expert panel opinion on how long to taper in order to avoid life-threatening consequences? Do you see any benefit to using other meds after the benzo taper simply to decrease annoying symptoms from withdrawal?  Steven Wilbraham MD

Thanks for the question, Dr. Wilbraham!  Yes, the psychiatry literature talks about tapering benzodiazepines very gradually over many months or even years. But what they are doing is different than what we are doing.  They are treating benzodiazepine addiction and we are treating withdrawal with a detoxification protocol.  It is analogous to the difference between treating opiate addiction in a methadone clinic (which also can last for months or years) versus what we do when we treat opiate withdrawal for at most a couple of weeks.