Why are dr's refusing to put me on a tapering program

Patient

Q: I am up to 100 mg/night of Ambien. All of it is supplied to me without a prescription. I would like to quit this addiction thtough a taper down program monitored by a Dr, but I have been to 3 local Drs. (One of them an addiction specialist and each one has refused to treat me with a tapering plan. What gives?

Symptoms:  Insomnia. Tough to fall asleep right away.
Doctor

A:   Welcome to Ask The Doctor.We understand your concern.

Ambien is used for only short-term treatment of Insomnia.
Since you have been using it without a prescription and that too in such a high dose, tapering would be risky.
Now there can be 2 reasons why they are refusing the tapering:
1. Medico-legal issues - as this unauthorized supply has to be informed to the concerned authorities.
2. They are worried about the side effects that you may get because of tapering down the drug. And in such cases, when you have a source for unregulated supply, you will start it again.
Most commonly addictions with Ambien are dealt with the help of a Psychiatrist.
Usually, they don't taper the drug but substitute it with other anti-anxiety drugs, and try to control your withdrawal symptoms accordingly.
Symptoms of sweating, tachycardia, tachypnea, tremors, and severe anxiety can occur on discontinuation of zolpidem.
The preferred option would be to substitute Ambien with an equipotent benzodiazepine with a longer half-life and taper the new benzodiazepine to discontinuation.
The taper generally starts at two-thirds of the Ambien dose.
I would advise you to see a psychiatrist and discuss your issues as well as my opinion with him.
I hope it helps.
Stay Healthy.

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