Drug and alcohol rehab can be a life-changing experience for someone struggling with addiction. However, weaning off medications or substances is sometimes challenging enough to discourage many people from seeking the help they need. While withdrawal symptoms are often uncomfortable, they can sometimes be life-threatening.

To help promote safety and long-term recovery, many treatment programs have begun to offer drug tapering. By tapering off drugs or alcohol gradually instead of discontinuing use all at once, patients have the opportunity to focus on their treatment and begin the lifelong work of recovery.

What Is Tapering or Weaning off Drugs?

When someone is physically addicted to a drug, their body and brain chemistry can change dramatically. That’s why many people experience withdrawal symptoms when they try to stop taking an addictive substance, especially in cases of long-term or heavy use, because their body and brain can no longer function normally without the presence of the drug. While symptoms can be uncomfortable, others may be life-threatening. This is especially true in instances involving alcohol, opioid and benzodiazepine addiction.

How to Taper off Drugs?

Many rehabilitation centers have begun incorporating drug tapering into their treatment programs to help alleviate severe withdrawal symptoms and promote long-term recovery. Tapering is defined as slowly decreasing the amount of an addictive substance taken over time. When done under the care of experienced medical professionals, tapering can help the body gradually adjust to sobriety and allow patients to find relief from many severe withdrawal symptoms. However, because it’s easy to take too much of a taper medication accidentally, it’s important that people only taper off alcohol or drugs under professional care.

Why Consider Tapering vs. Quitting Cold Turkey?

Tapering is a safe and effective strategy to become sober, particularly if you are under the care of a medical professional. On the other hand, quitting cold turkey can be harmful or even deadly. While it is not common, quitting opioids cold turkey can result in electrolyte disturbances or sudden heart failure that can lead to death. For alcohol and benzos, if you quit cold turkey, you risk having a seizure or dying. As you can see, consequences depend on the substance you are quitting, but tapering is generally safer and more effective.

Types of Tapering

There are three primary methods of tapering: direct, substitute and titration. Which tapering methods are used during treatment is determined on a case-by-case basis depending on the patient’s medical history and current condition.

Direct Tapering

The most straightforward tapering method, direct tapering, involves gradually reducing the amount of a drug an individual takes. In many cases, the substance consumed is slowly decreased weekly until the individual can stop using completely without experiencing unmanageable withdrawal symptoms. Direct tapering is most effective when a person has been consuming high doses of a long-acting substance or one that doesn’t build up in the bloodstream.

Substitution Tapering

In cases where people are addicted to illicit, short-acting or low-dose substances, substitution tapering may be an option. Substitution tapering involves replacing the drug of abuse with a similar but more easily tapered substance. By replacing the original substance with controlled amounts of medication with lower abuse potential, medical professionals can precisely and gradually decrease an individual’s daily dose.

Titration Tapering

Titration tapering involves dissolving a small amount of a low-dose drug in water. Typically, this dilutes a substance further and decreases the amount ingested by small increments daily.

Titration tapering is rarely used in clinical settings and carries significant risk. It should never be attempted without professional supervision. Some drugs are not water-soluble, so their concentration cannot be diluted in water. This may lead an individual to take more of a substance than intended, increasing the risk of overdose. Measuring the dose ingested in each diluted solution is nearly impossible without professional medical equipment, which can further increase the risk of overdose or ineffective tapering.

Common Drug Withdrawal Symptoms

Withdrawal symptoms will differ depending on the type of substance you use, how much, how long you have been using and other factors. In general, symptoms of withdrawal can include: 

  • Nausea
  • Vomiting
  • Diarrhea
  • Anxiety
  • Insomnia 

Medication-Assisted Treatment

Medication-assisted treatment (MAT) is a whole-patient plan of treatment where medications that minimize or alleviate withdrawal symptoms are combined with counseling or behavioral therapies that can help sustain recovery. Medications used will depend on the substance you are working to quit. For example, three FDA-approved medications for opioid use disorder (OUD) include:

  • Buprenorphine reduces cravings and alleviates withdrawal. Buprenorphine can be used during medical detox and long-term as maintenance therapy.
  • Methadone, like buprenorphine, reduces cravings and alleviates withdrawal symptoms. Methadone can also be used to shorten medical detox and long-term as maintenance therapy. 
  • Naltrexone can cause sudden and severe withdrawal if you take it before medical detox is completed, but it can help reduce cravings afterward, which helps prevent relapse. 

There are many options, so always speak with your pharmacist or healthcare provider if you are considering stopping any medication or other substance. 

Drug Withdrawal Timeline

Each medication has a different withdrawal timeline based on the class of substance (e.g., opioid, benzo, etc.), whether it is short- or long-acting, how much you use and for how long you have been using. In general, for short-acting medications, you are likely to feel withdrawal symptoms hours after your last dose. For longer-acting medications, it can take up to 12 hours. 

Early stages of withdrawal are typically very physical, with symptoms like: 

  • Nausea
  • Vomiting
  • Diarrhea
  • Sweating
  • Heart racing 
  • Insomnia 

Later stages of withdrawal are typically more psychological and include symptoms like: 

  • Irritability
  • Depression
  • Anxiety 
  • Panic attacks 

For more specific information, ask your pharmacist or healthcare provider. 

Medications Used When Tapering Off

Some ways to taper off might include using your drug at increasingly lower doses over time (direct taper) or stopping your drug and using another to taper off over time (substitution taper) safely. It is critical that you always speak with your pharmacist or healthcare provider before stopping your medication or other substance — stopping on your own can sometimes result in serious consequences or even death. 

Can Tapering Your Drug Intake Reduce Withdrawal Symptoms?

Tapering your drug intake is much more effective in reducing withdrawal symptoms than quitting cold turkey — which will be uncomfortable, and worst case, may result in death. With the help of a trained medical provider, you can create a plan to taper until it is safe to stop. The type of drug you use, how much and other factors will determine how quickly or slowly you should taper. 

How The Recovery Village Uses Tapering

There is no one-size-fits-all approach to recovery. For treatment to be effective, it must be tailored to each individual’s needs. While some people benefit significantly from drug tapering, others do better with more conventional medical detox care. At The Recovery Village, we meet patients where they are by providing comprehensive treatment that works for them.

  • In cases deemed medically appropriate, this may involve drug tapering. 
  • Withdrawal management is only a small part of care at The Recovery Village.
  • To help patients address both the physical and psychological aspects of addiction, The Recovery Village offers a continuum of treatment with multiple levels of care, including:
  • During each stage of treatment, patients participate in individual, group and recreational therapies that address co-occurring disorders and identify the underlying drivers of addiction. 
  • As patients gradually step down to less intensive levels of treatment, they gain the skills and confidence needed to recognize triggers, resist cravings and lead a rewarding life in recovery.

If you or someone you love struggles with addiction, The Recovery Village is here to help. Reach out to a Recovery Advocate today to learn more about our treatment options or to get started.

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Editor – Theresa Valenzky
Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more
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Medically Reviewed By – Leila Khurshid
Leila Khurshid is a clinical pharmacist based in Denver, CO. After graduating from Regis University with her Doctor of Pharmacy, she completed a PGY1 Pharmacy Residency at St. Mark’s Hospital in Salt Lake City, UT where she continued to practice for a number of years. Read more