1. Principles
Direct taper method focuses on reducing the benzo quantity absorbed by the patient by reducing a quantity of benzo every day or periodically (Eg: every 2 weeks). The precise dose can be obtained by either:
• discarding the unused quantity from a tablet (or pill) with a scraping tool and a precision gram scale
• or from a batch of several tablets previously reduced to fine powder and the right quantity to withdraw by means of a precision gram scale.

The weight of the tablet (Eg: 163 mg) is NOT the same as the medication dose (E.g: 0.5 mg) although they are strictly related. The percentage of reduction by the tablet weight will be the same percentage that reduces the medication dose. Example: If the reduction made by the tablet weight is 10% (16.3 mg), the corresponding reduction of the medication dose will be also 10% (0.05 mg).
2. HowTo
• To discard the unused quantity from a tablet, a gram scale with 0.001 g (or 1 mg) resolution (that can read 3 decimals) will be necessary.
  
  
  Many people use razor blades, nail files to scratch away the unused quantity. Nail files may either be made of ceramic, glass, crystal, plain metal. Emery boards are to avoid as the tiny mineral particles on their surface might detach from their support and remain on the tablet sanded surface or mix up with the removed medication powder. The discarded powder can be kept in a jar with cover and re-used.


• Other people grind a batch of several tablets into fine powder with a pestle and mortar or a back of a spoon. The tablets are more or less homogeneous with the main benzo ingredient spread throughout the volume. There are cases where tablets are equipped with a coating that contributes with an irrelevant percentage to the tablet. But because of that it is preferable to crush the tablets into fine powder instead of small broken pieces.
  
  
  
  Some loss of medication must be taken into account following contact with the tools (pestle, mortar, spoon, jar, mirror...) and ejected particles in the air. The product can be kept for several days in a jar with cover, protected from daylight. Daily, the powder will be loaded to the gram scale to measure out the scheduled dose.


• Due to manufacturing process, the tablet weight is never the same even within the same bottle. Their weights actually vary up to 10% from tablet to tablet. To make calculations, it is recommended to weigh a batch of 10 (or more) tablets and divide the total weight by 10 (or more) to obtain the average weight of one tablet.


• All precision gram scales should be operating on a solid, level table away from all air drafts (windows, vents, breath, pets). Avoid vibrations on the table. Do not lean on the table while using the scale. As precision and reproducibility are required, tare (zero) the scale before the first use and periodically (Eg: every 2 weeks) after. It's is recommended to operate the scale possibly in the same place to reproduce the same working environment.
  
  To improve the responsiveness of the scale, put one of the 2 calibration weights shipped together with the scale on the tray to set the scale in the middle of its operating range where it is optimized to function. Then add the powder dose.


• The percentage of reduction by the weight will be the same percentage that reduces the dose. Example: If a 0.5 mg tablet weighs 153 mg and the reduction made by the weight is 10% (15.3 mg), the equivalent reduction for the dose is also by 10% (0.05 mg).


• Precision and accuracy are important but not as important as a taper practice that consistently lowers doses day after day all along its course.
3. Reduction quantity
   The precise rate of withdrawal is an individual matter. It depends on many factors including the dose and type of medication used, duration of use, personality, lifestyle, previous experience, specific vulnerabilities, and the (perhaps genetically determined) speed of your recovery systems. The general recommendations are then to reduce the daily dose by between 5%-10% every 10-14 days. The taperers are called afterwards to be in control and proceed at the speed that is comfortable to them by lowering or accelerating this pace.
   The application has been designed so the 2 fields Percent and Quantity are mutually exclusive. Clear one field will reset the other and enter value in one field will disable the other. They reflect 2 different philosophies of taper:
   • Fixed percent per period of days (%/days)
     A same and unchanged percent (over a period of days) translated in quantity will be reduced from the daily dose throughout the taper duration. As the daily dose decreases, so does the reduction quantity. That implies a very low reduction evolution, a longer taper duration but it will likely raise less symptoms. This method is "gentler" from a symptoms viewpoint.
   • Fixed quantity per period of days (mg/days)
     A same and unchanged quantity calculated as a percent from the initial dose will be reduced from the daily dose throughout the taper duration. The fixed reduction quantity method, also known as symptoms-based taper method, is easy to understand and to apply. It can eventually offer a shorter taper duration compared to the fixed reduction percent.
     The dark side of this approach is that by the end phase (~1/3) of the taper, many patients seem to become more vulnerable to the same reduction. The risks to feel symptoms due to a fast taper is real. The reduction quantity must be therefore adapted when symptoms occur. In the Taper Plan application, when there is 1/3 of the road to go before the jump dose, the option "Attenuated ending" adapts the reduction quantity to 1/3 of the initial cut. This option works only when the reduction is based on fixed quantity as opposed to fixed percent.
4. Others
   • Daily basis or Periodic basis reduction?
     The reduction quantity might be applied on a daily basis with consequent daily decreasing dose or kept unchanged during the whole period of more days. Compared to the daily approach, the second method also known as "Cut and Hold" is more prone to symptoms. This application has been designed to work exclusively with a daily basis reduction.
   • Across doses or First doses first?
     Across doses: The reduction quantity will be applied simultaneously to all the doses of the day and proportionally to each single dose. Doses will be tapered off all together.
     First doses first: Reduction starts with the first dose until it will be extinguished then it starts with the second dose and so on. The taper will finish with the end of last dose.
   • Which Quit dose?
     Also known as Jump dose or Plunge dose, the suggested Quit dose must be defined by user. When after long months and years of taper user arrives to say 0.025 mg of medication per day which user is taking at the end of his schedule, this small quantity of medicaton has virtually ceased any therapeutic effect and is having little impact apart from keeping the dependence going. User doesn't need to go down to zero mg/day to stop. Based on information of the most potent benzodiazepine that is Clonazepam, the proposed Quit dose is 0.025 mg/day that user is free to modify.
5. Conclusions

"...A slow and steady benzodiazepine withdrawal, with you in control, is nearly always successful..." (H. Ashton).

DISCLAIMER: This help is not a substitute for professional advice provided by a qualified medical physician. Any taper plan including the one produced by this application should be reviewed and approved by your physician before starting the taper. Never change your prescribed dose of any prescription medication without consulting first the prescribing physician.