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How to Not Complete A Benzo Detox

Stuart Kloda, MD
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ID-10046658I have my own ‘formula’ for success when it comes to benzodiazepine detoxification. It is not the only way, but it is the way that has worked for me, and for the patients that I have treated, since starting private practice. Most of the patients that come to me for this treatment have anxiety disorders. They have become physically dependent on prescription benzodiazepines that are being taken as prescribed. They are not using the medication in an addictive manner.

I do long slow tapers with Valium that are based on the Ashton Method. When a potential patient calls, I explain to him or her that I have never seen patients successfully complete their tapers with me in the following situations:

1. Patients refusing to treat their primary anxiety disorder with an antidepressant or with Buspar. The primary anxiety disorder is being unmasked as the taper progresses. If this is not treated, the anxiety becomes overwhelming. After all, this is the reason that the patient started taking benzodiazepines in the first place. Standard first line therapy for anxiety disorders are antidepressants such as Prozac, Zoloft, Cymbalta, and Effexor. Buspar is a different type of medication that was developed specifically to treat anxiety. While Buspar does not work for a lot of patients, it is extremely effective for some.

2. Patients that drink alcohol. Benzodiazepines work on the same receptor as alcohol (GABA and glutamate). Benzodiazepines are basically freeze dried alcohol, and alcohol is basically liquid Valium. Drinking alcohol causes rebound anxiety when the effect wears off. It disrupts a GABA/glutamate system that is already very dysregulated from benzodiazepine dependence. Some patients really want to taper, but are unable to abstain from alcohol. In this case, after a discussion of the risks and benefits of the medication, Antabuse is given as an observed dose in the office. When someone drinks alcohol while on Antabuse, they develop a horrible reaction. The reaction includes symptoms of nausea, vomiting, palpitations, flushing, and headache. Antabuse almost guarantees a benzodiazepine detox that is not disrupted by alcohol.

3. Refusing to engage in CBT (Cognitive Behavioral Therapy). CBT is a therapy of choice for anxiety disorders. It teaches coping skills. CBT is based on ten cognitive distortions. These are ten dysfunctional ways of thinking that can cause anxiety and depression. The symptoms of benzo withdrawal can be overwhelming. CBT is needed to help patients cope with this. Medication alone is not enough.

4. Personality disorders. So far, I have never seen a patient with a personality disorder complete a benzo detox with me. For example, one of the hallmarks of borderline personality disorder is pervasive emotional dysregulation. Patients with this disorder have a biologically based emotional vulnerability. Emotional vulnerability includes extreme reactions over “small” things. These reactions are also long lasting, and it takes time to quiet their emotions down. Patients like this are unable to tolerate the roller coaster of withdrawal symptoms.

5. Refusing to take medications to treat withdrawal symptoms. I use medications as sparingly, and in as low doses, as possible. However, if withdrawal symptoms are so intense and/or persistent, they need to be treated. The patient and I are unable to continue tapering if withdrawal symptoms are active. Patients are ready to taper, and lower their Valium dose, only when they are in a place of stability and control with their anxiety.

So in order to be successful in a benzo detox, these factors need to be carefully considered.

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  • I can’t say enough about Dr. Kloda. I have been on Suboxone for a little under two years. I’ve always wanted to taper off, but my previous doctor did not seem interested in doing so. Instead, I think that she was just trying to keep me on it indefinitely so that she could get more office visits. I switched to Dr. Kloda, and the difference has been phenomenal. I have a very demanding and high pressure job. Dr. Kloda has been able to successfully start tapering me off, while allowing me to continue working without feeling sick. He takes his time, listens, is patient, and does not make you feel bad about yourself or judge you. I wish that I would have started Suboxone with him to begin with.

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  • Smart, intuitive, and actually cares about you. Highly recommended!

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  • I started seeing Dr. Kloda for alcohol abuse six months ago. I can only say I wish I’d started seeing him sooner. He is extraordinarily thorough in assessing a diagnosis and was able to start me on a course of action that has kept me away from alcohol from the moment I went to his office. And, for me, the process has been surprisingly easy. This will likely not be the same result for everyone, but for those it works for, my goodness, it works well. I have actually not wanted alcohol since I started the treatment.

    I’ve seen comments about cost but I can only ask you to do a cost benefit analysis. The immediate savings I’ve seen from not buying alcohol combined with the longterm savings of reclaiming my health more than make up for the cost of seeing Dr. Kloda. In addition, there are the unseen future costs – court costs, hospital bills, loss of income, etc. – that are too often part of the equation with alcohol addiction. I feel like this was an investment that provide immediate and longterm returns.

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  • Dr. Kloda is an experienced and well versed doctor. He is very empathetic with his patients and understands their needs. He has helped me a great deal with a slow Valium taper. He constantly monitors your progress. He is available by phone anytime and a great doctor.

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  • Ok so some of the reviews are still skeptic and yes it is not cheap. But Dr Kloda is helping my wife. Her original dr who put her on the Rx drug did not know how to fix it and another Dr who had years of experience wanted to up her dose and give her more addictive drugs. Then there was the rehab places that wanted to take her out of state without her family. So that wasn’t working for us. We had serious trust issues with every Dr that we talked to.

    With lots of internet research she found Dr Kloda. After a few conversations with him she studied the Ashton method and found she wanted to go down this road.

    We find Dr Kloda to be extremely knowledgable about this method and about the chemical interactions on the various drugs that replaced her addictive drug. She has been doing well with his help and is almost done with the addictive drugs. Each session is an analyst of her well being and if she can reduce that week. Scripts are written and med boxes are filled. Outside of the sessions Dr Kloda is always available by phone for emergencies or if we have questions big or small. Other reviewers stated he only cares about the money and the TV fame. We found Dr Kloda cares a great deal about the person. He totally understands what we both are going through and is always there for my wife and I.

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  • I do not usually write many online reviews but on occasion I find a retailer or service provider that really is exceptional or is horrible enough that I feel I need to write a review.

    The reason I am writing this particular review is because Dr. Kloda is an exceptional Doctor.

    My background as an addict is extensive , and for these reasons I feel that I have a certain level of authority when if comes to Doctors and recovery. I’ve been in recovery in one form or another on and off for almost 20 years and I have been on Suboxone for about five years, I spent most of this time in recovery directed by two other doctors that prescribe Suboxone.

    Thomas V, Fulton NY

  • I was surprised to see a two star review for Dr. Kloda, so I am writing a five star review in response. Dr. Kloda was recommended to me by another patient of his, and he has been treating me for the past two years. I have found him to be extremely competent, genuinely caring, and available for questions and concerns.

    His office charges are in line with many other physicians in Manhattan, and you definitely get your money’s worth. He does not just write prescriptions. In addition to meds, He talks to you and does addiction counseling, as well as give you general advice and support.

    Joseph B, New York NY

  • As a patient, I can attest to Dr. Kloda’s expertise and practice and excellence. He is a remarkable physician. He is attentive, supportive, and is at the cutting edge of addiction medicine. He is broad minded in his approach and treats each of his patients with understanding and concern. He is extremely thorough and appreciates differences, both physiological and psychological. I found him remarkably intuitive and he means it when he says he is available by phone–and boy sometimes you need that. I found out recently that he is sometimes called on to speak to other doctors and psychiatrists about all kinds of addictive treatments and meds, including benzo’s–which so few doctors know about. I was fortunate to find him. I highly recommend him. And no, I have no affiliation with him or his practice other than as a patient.

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