Mental health articles

OF mental health care and mentally ill

Withdrawal from non-opioid drugs

To withdraw a patient from any benzodiazepine, fi rst convert the misused drug into an equivalent dose of diazepam, chosen because of its long half-life. Reduce the diazepam dose by 2 mg a fortnight over a period of two to six months. Even those individuals on large amounts of benzodiazepines can be reduced fairly rapidly.

For a small minority of patients, a maintenance prescription of benzodiazepines may be more benefi cial than insisting on abstinence. This is best undertaken in collaboration with a specialist service. At present there is no recommended substitution treatment for cocaine or amphetamines, although many different pharmacological treatments have been tried. Antidepressants in therapeutic doses may help specifi c symptoms. Cannabis, ecstasy and volatile (solvent) substances may all be withdrawn abruptly, but abstinence is more likely to be maintained if attention is paid to any psychological symptoms that emerge. Nicotine cessation products may be a helpful adjunct in cannabis withdrawal to offset any nicotine withdrawal effects.

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