Everything You Need to Know About Protracted Withdrawal

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If you have a protracted withdrawal injury, you are probably carrying questions that nobody in your medical system has been able to answer. Should I reinstate or taper? Is it safe to keep going down? Is this withdrawal, or is something wrong with me? In this video I answer the questions I hear most often from patients with these injuries, based on my clinical experience and the expert guidelines we work from.

Here is some of what I cover.

Reinstating versus tapering. If you reinstated a medication after an injury and haven't seen clear, meaningful improvement within one to two months, holding on is unlikely to help. In some people the drug now irritates the nervous system rather than stabilizing it, a phenomenon called kindling, and a gradual taper becomes the better path.

Why tapering is not what hurt you. If a previous taper went terribly, the problem was almost certainly the speed, not the act of tapering. Receptors do not let go of these drugs in a straight line. Hyperbolic tapering makes each reduction smaller as the dose gets lower, precisely so your nervous system is never shocked. A rapid taper and a hyperbolic taper are not two versions of the same thing. They are different interventions with different outcomes.

Acute withdrawal versus injury. A defining feature of acute withdrawal is that it improves when the drug is reinstated. If reinstatement didn't resolve your symptoms, or made them worse, you are likely dealing with a protracted withdrawal injury, and that distinction changes everything about the right way forward.

Injury versus mental illness. These injuries follow a recognizable pattern: neurological, physical, and sensory symptoms that ebb and flow in waves and windows. That pattern is not what depression or anxiety looks like. When doctors respond to it by adding more medications, the additions usually fail to help and can worsen the injury.

And the question underneath all the others: will I recover? I want you to hear my honest answer. Severe injuries often take 18 to 24 months, and I won't pretend otherwise. But the nervous system has a remarkable capacity to heal when you stop irritating it and give it a stable environment. I have watched people who were bedridden and housebound make full or near-full recoveries by following these principles. Hopelessness is a symptom of this condition. It is not a prophecy.

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DISCLAIMER: All the information on this channel is for educational and/or entertainment purposes and not intended to be specific/personal medical advice from me to you. Watching the videos, or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, these videos can maybe help you prepare for your discussion with him. We do our best to spread awareness with these videos, but for legal reasons we can’t answer health questions in the comments. If you leave questions, we’ll make videos about common questions in the future! If we catch incorrect health information, hate speech, illegal solicitation of drugs in the comments, we will remove them.