Benzodiazepines, or benzos, are a class of medications commonly used to treat anxiety, insomnia, and other conditions. However, even short-term or intermittent use can lead to physical dependence, and withdrawal can be challenging. One approach to withdrawing is to crossover to Valium, which the late Dr. Heather Asthon promoted in the Ashton Manual. Dr. Ashton ran a benzodiazepine clinic in the UK during the 1980s. She routinely transitioned her patients to Diazepam, the generic for Valium, as it is longer acting and comes in small doses, making tapering much more straightforward. In the years since the manual was published, the recommendation is to taper from one’s benzodiazepine if at all possible. In this blog post, we will discuss the process of crossing over to Valium during benzo withdrawal/BIND and the pros and cons of doing so.
It is essential to approach this crossover process with caution. Rather than switching out the original benzodiazepine for Valium in one go, the process should be gradual, spanning over weeks or longer if need be. The initial medication is slowly reduced while Valium is progressively introduced. This approach allows the body time to adapt to the change, thus mitigating the risks associated with abrupt withdrawal.
It is crucial to swap the correct amount of Valium for the benzo that one is taking. Ativan is approximately ten times stronger than Valium, and Xanax and Klonopin are about twenty times stronger. You can Google benzo conversion chart and put in your benzo and dosage to find out what the approximate amount of Valium would be.
Symptoms and Challenges During the Crossover
While the Valium crossover can be helpful for some individuals, it’s important to acknowledge that it is not a perfect solution, and not everyone can make the transition successfully. Some people may become too symptomatic during the crossover process, experiencing worsened anxiety, insomnia, or other withdrawal symptoms. (I was unable to crossover to Valium from Clonazepam; the process made my withdrawal symptoms much worse.)
It’s also essential to recognize that there is nothing magical about Valium. It is still a benzodiazepine, and individuals undergoing the crossover process and afterward will continue to experience withdrawal symptoms. Valium may create more sedation and depression during withdrawal/BIND.
Furthermore, Valium may interfere with the production of diamine oxidase (DAO), an enzyme that breaks down histamine. This interference can lead to histamine intolerance in some individuals, which may manifest as allergy-like symptoms, such as itching, hives, or difficulty breathing.
Pros and Cons of the Valium Crossover
- Gradual tapering: The Valium crossover allows for a more gradual tapering process due to its longer half-life compared to other benzodiazepines. This can help with inter-dose withdrawal one may experience on shorter-acting benzodiazepines such as Xanax and Ativan.
- Ashton Manual guidelines: The Ashton Manual provides a well-researched and structured approach to benzodiazepine withdrawal, making the crossover process more predictable.
- Not suitable for everyone: Some people may be unable to successfully make the crossover due to worsened withdrawal symptoms.
- Continued withdrawal symptoms: As Valium is still a benzodiazepine, individuals undergoing the crossover process will continue to experience withdrawal symptoms.
- Increased sedation and depression: Valium’s longer half-life and its metabolites can result in more sedation and depression for some individuals, which may complicate the withdrawal process.
- Histamine intolerance: Valium’s interference with DAO production can lead to histamine intolerance in some people, which can further impact their quality of life during withdrawal.
- Valium breaks down into three metabolites, oxazepam, desmethyldiazepam, and temazepam, which can increase the drug’s duration, a problem for some, especially elderly users.
- Valium is known for causing severe depression in some individuals.
The Valium crossover, as outlined in the Ashton Manual, can be a helpful approach to managing benzo withdrawal for some individuals. Its lower dosage makes the mechanics of tapering easier, and its longer half-life potentially reduces interdose withdrawal symptoms. However, it’s essential to recognize that this method may not be suitable for everyone, and some individuals may not do well with a crossover. Crossing over to Valium will not guarantee a reduction in overall benzo withdrawal/BIND symptoms and, in fact, may increase them in some people. The only way out of benzo withdrawal/BIND is through, and most often, it is best to stay the course with your benzo and taper from it.