Careful, Compassionate Tapering
Benzodiazepine Dependence Treatment
Benzodiazepine dependence often develops from legitimate medical treatment. We provide careful, medically supervised tapering combined with psychotherapy—because successful discontinuation requires addressing both the physical and psychological dimensions.
Dependence
Is Not Addiction
This distinction matters. Research shows that while 40-80% of prescribed patients experience withdrawal symptoms when stopping benzodiazepines, only 0.2% meet criteria for a substance use disorder. These are people who took medication exactly as prescribed and developed physiological dependence—not addiction.
The Benzodiazepine Information Coalition, a patient advocacy group, has documented widespread confusion in medicine about this distinction. Patients are often misdiagnosed as "addicted" and sent to rapid detox programs designed for substance abusers—programs that can cause serious harm to someone with iatrogenic dependence.
We understand the difference. Our approach is designed for patients who developed dependence through legitimate medical treatment, not recreational use.
of prescribed patients experience withdrawal
develop protracted withdrawal syndromes
of prescribed patients meet criteria for addiction
Source: Benzodiazepine Information Coalition
The Risks of Long-Term Use
Even when taken as prescribed, benzodiazepines carry significant risks that many patients are not adequately warned about.
Tolerance
The medication becomes less effective over time, often leading to dose escalation.
Cognitive Effects
Memory impairment, difficulty concentrating, and mental "fog" that may persist.
Paradoxical Effects
Some patients experience increased anxiety, depression, or irritability—the opposite of intended effects.
Protracted Withdrawal
10-15% of patients experience symptoms lasting months or even years after stopping.
Why Medical Supervision Matters
Benzodiazepine withdrawal can be medically serious—and in rare cases, life-threatening. A recent study found that abruptly discontinuing long-term benzodiazepine treatment can nearly double the risk of death within a year.
Gradual Tapering
We follow the Ashton Method principles and align with the latest ASAM (American Society of Addiction Medicine) guidelines, which recommend slow, patient-directed tapering rather than rapid detoxification. The 2024/2025 draft guidelines explicitly acknowledge that most patients experiencing withdrawal are not addicted—and should not be treated as such.
Key principles include:
- Reduction of 5-25% every 2-4 weeks, never exceeding 25% in two weeks
- Switching to a longer-acting benzodiazepine (usually diazepam) when appropriate
- Flexibility to pause or slow the taper if symptoms become intolerable
- Supportive medications to manage specific withdrawal symptoms
This Takes Time
A successful taper often takes 6-12 months or longer. Trying to rush typically backfires. We support you through the entire process with regular in-person appointments.
Integrated Psychotherapy
Psychotherapy is not optional—it's integral to our taper process. Our therapists help you develop coping strategies for anxiety, process the experience of withdrawal, and address the underlying issues that led to benzodiazepine use.
Supportive Medications
We may use gabapentin, hydroxyzine, buspirone, or other non-addictive medications to help manage anxiety and insomnia during the taper.
Who We Treat
Prescribed Users Wanting Off
Patients who have been taking benzodiazepines as prescribed—sometimes for years—and now want to discontinue, either because of side effects, concern about long-term use, or simply feeling ready to manage without them.
Failed Taper Attempts
Patients who have tried to taper on their own or with a provider who moved too quickly. We can restart the process with a more gradual approach and proper medical support.
Combination Dependence
Patients who are dependent on benzodiazepines along with alcohol or opioids. These complex cases require integrated treatment addressing all substances simultaneously.
Underlying Anxiety Disorders
Patients whose original anxiety never resolved despite benzodiazepines. We can help taper the benzodiazepine while treating the underlying condition with other approaches.
Your Treatment Team
Paul Abramson, MD
Medical Director & Founder
Dr. Abramson comes from a multi-generational lineage of physicians. He combines rigorous medical training with a background in engineering from Stanford, bringing sophisticated, data-driven expertise to health optimization.
Kelly Yi, PhD
Psychotherapist
Dr. Kelly Yi completed his doctoral training from the clinical psychology program at Sofia University in Palo Alto, CA. He is currently Associate Chair of the psychology doctoral Program at The Institute of Transpersonal Psychology at Sofia University.
Orion Harris, LMFT
Psychotherapist
Orion Harris completed his masters degree in Counseling Psychology at California Institute of Integral Studies. Orion weaves together mindfulness based cognitive behavioral techniques, humanistic-existential and depth approaches.
Ready to Take the Next Step?
If you've been on benzodiazepines and want to get off—or have tried and struggled—contact us for a confidential consultation. We can help you create a realistic plan.
Note: We require in-person visits at our San Francisco office. We do not offer telemedicine-only treatment for benzodiazepine tapering.