Benzodiazepine Tapering & Deprescribing
in Oakland Park, FL

Somewhere in an Oakland Park household, a person is taking a benzodiazepine that they have tried to stop and could not. This page is written less for that person than for the one who shares the kitchen with them: the spouse, parent, adult child or sibling trying to understand what a loved one is going through and what good help looks like. Dr. Leeds is an osteopathic physician whose work is the slow, supervised discontinuation of medications that cause physical dependence, benzodiazepines first among them. His office is in Fort Lauderdale, a few minutes by car from Oakland Park. Yet, nearly all of the care still happens over video from home.

A benzodiazepine taper is slow, it is medically supervised, it runs from the patient’s own living room, and the people around the patient matter more than they usually realize. The rest of this page explains why, and what a family can practically do from a house in Oakland Park, Wilton Manors, Lauderdale Lakes or Lauderdale-by-the-Sea.

Why is this page written for families in Oakland Park?

Oakland Park is a small city of roughly eight square miles, surrounded for the most part by Fort Lauderdale and sharing a border with Wilton Manors. Its downtown runs along Dixie Highway and the railroad tracks, and its neighborhoods sit on both sides of Interstate 95. When a resident is on a long taper, the household usually knows.

What families notice first is usually a pattern rather than a diagnosis. A loved one cannot miss a dose without becoming ill, or a medication that once helped sleep or quieted panic now seems to do less.

First of all, a family needs to understand that physical dependence is not addiction. A prescribed benzodiazepine taken exactly as directed, for months or years, can leave a person unable to stop without severe symptoms, because the nervous system has reshaped itself around the drug. In fact, that adaptation is predictable and physiological, not a moral failing and not something the person chose. The way out is a slow, planned reduction under medical supervision, with the people closest to the patient understanding what they are watching.

What does a benzodiazepine taper look like from the outside?

Dr. Leeds’ lead service is benzodiazepine and z-drug tapering, and from a relative’s chair it looks like a long stretch of ordinary days with hard ones mixed in. For example, the person may be more irritable than usual, and sleep is often broken. Ordinary noise and light can become difficult. There may be surges of anxiety that match nothing happening in the house, stomach trouble, muscle aches, or a flatness that looks like depression.

These are withdrawal symptoms. They are not evidence that the person is failing or exaggerating, and they are not proof that the original anxiety is “coming back” and the dose should go up. The family’s work is simple to state: believe what the person reports, and do not press for a faster pace. It is harder to do.

One fact belongs at the center of every family conversation: stopping a benzodiazepine suddenly is not safe. After months or years of regular use, an abrupt stop or a steep cut can bring on severe withdrawal, including seizures. In 2020, the Food and Drug Administration (FDA) expanded the boxed warning on every benzodiazepine label to cover physical dependence and withdrawal reactions, including the risk of an abrupt stop. So, a family frustrated by the slowness of a taper should hold that warning in mind. Slow is the point.

The method Dr. Leeds uses draws on the Ashton Manual, Professor C. Heather Ashton’s guide to withdrawal, and on the Maudsley Deprescribing Guidelines. In practice this means small reductions, sometimes a switch to diazepam because its long action gives steadier levels between doses, and cuts made as a proportion of the current dose so that each step gets smaller as the dose gets lower, which is called hyperbolic tapering. Z-drugs such as zolpidem and eszopiclone are tapered on the same principles. Realistically, a full taper takes a year to 18 months or longer, and its speed is governed by the patient’s symptoms, not by a date circled on a calendar. The benzodiazepine dependence and tapering page goes into the method in more depth.

How does a telemedicine taper run from an Oakland Park home?

The mechanics matter to families because families often end up handling some of them. Care begins with a consultation, by video or in person. From then on the patient sees Dr. Leeds by video every week, often up to an hour, and has 24/7 text access to Dr. Leeds for urgent questions between visits. It is one physician throughout, with no handoffs, no coaches and no substitute physicians. Dr. Leeds runs a concierge practice and does not bill insurance. The concierge telemedicine page explains how it works. For someone outside Florida, a consultation may still be possible.

A prescription travels electronically to the pharmacy of the patient’s choosing, usually a chain or neighborhood pharmacy early on. As a diazepam taper gets low, the tool becomes the manufactured 1 mg per mL diazepam oral solution, because it allows reductions far smaller than any tablet can be split. Unfortunately, few pharmacies keep it in stock. Chain and neighborhood pharmacies in Florida can order it, though, so the refill is best requested several days ahead. For custom low doses or other medications, compounding pharmacies around Florida make up a liquid or capsules at exactly the strength prescribed and ship the order to the door. Whether a prescription is a pickup at the counter or a package on the step is the patient’s choice, and a relative who does the pharmacy run or signs for the delivery is doing real work for the taper.

Of course, an in-person visit is almost no effort from here. The office at 3290 NE 33rd Street in Fort Lauderdale is a few minutes by car from most of Oakland Park, by Oakland Park Boulevard or Federal Highway, and nearly as close for Wilton Manors and Lauderdale-by-the-Sea. The office takes calls Monday to Friday, 10 AM to 2 PM. A first visit at the office, with the rest of the taper by video, suits many households in this corner of Broward County. Still, video stays the routine, because a person in withdrawal who is sensitive to light, noise and waiting rooms does better at home, and because a relative can be nearby without taking the morning off work.

What is BIND, explained for a family?

Benzodiazepine-induced neurological dysfunction, BIND for short, names the wider set of symptoms that can appear during a taper and persist after the last dose, beyond what any single reduction explains. Families hear about burning or tingling skin, ringing in the ears, blurred vision, muscle twitching, a sense that the world looks unreal, or fatigue that sleep does not fix. The symptoms are real and physiological. They are not imagined, not a bid for attention, and not a new psychiatric illness.

The hardest part for a family is that these symptoms do not move in a straight line. A person can have a good week and then a rough one for no reason anyone can find, and this can continue for months after the taper ends, which is what protracted withdrawal means. Unfortunately, relatives who expect steady improvement sometimes decide the person is not trying, and that skepticism is a second injury the family can prevent. Reading the practice’s guide to BIND before the hard weeks arrive is time well spent.

Fortunately, what helps from the outside is modest: keep the house predictable, lower the stimulation when asked, stop asking whether the person is better yet, and treat a rough day as weather rather than as a verdict.

Why is patience the family’s version of harm reduction?

Harm reduction in a taper means the goal is steady, sustainable progress rather than obedience to a schedule. Some weeks the dose comes down. Some weeks it holds. And, occasionally a small, physician-guided increase is the right move when a cut proves too much or tolerance withdrawal breaks through, and that is responsible medicine, not a failure. The patient sets the pace in consultation with Dr. Leeds.

The evening dose is usually the last one Dr. Leeds reduces, so that sleep is protected for as long as possible. At the end of a diazepam taper he continues on the 1 mg per mL solution below half a milligram and stops at about a tenth of a milligram, so the final step is a small one. Professor Ashton’s half-milligram stopping point remains an option rather than the default.

Relatives sometimes ask whether a second medication could be added to make the taper easier. Dr. Leeds’ usual answer is no. He typically does not add gabapentinoids, and in general he avoids starting any new medication that would need a taper of its own. A second dependence only puts a second taper on the family calendar. A relative who wants to manage the medication can do so when the patient agrees to it and the arrangement has been discussed with Dr. Leeds. The medication belongs to the patient, and the plan belongs to the patient and the physician.

What should a family do in an emergency or during hurricane season?

Withdrawal can occasionally become a medical emergency, usually when a benzodiazepine has been stopped or cut too fast. If a loved one has a seizure, collapses, or cannot be roused, call 911. If a loved one talks about suicide or about not wanting to go on, call or text 988, the 988 Suicide and Crisis Lifeline, and stay with them. Neither situation is a reason for the family to adjust the dose on its own.

South Florida adds a seasonal question. A taper does not stop for a storm, and Oakland Park households know the routine of shutters and storm plans. Dr. Leeds’ position is that during a hurricane evacuation or any similar emergency the dose should be held, not cut. An evacuation is stressful enough without a withdrawal step layered on top of it. Additionally, a reserve of medication in the house is, in his view, sensible preparation for a natural disaster, and it means a storm does not turn into a missed dose. Families can help by keeping the written dose plan with the important papers and packing the medication with the things that leave the house first.

What other medications does Dr. Leeds help patients taper?

The second service is psychiatric medication deprescribing. Many patients arrive on more than one medication, often a benzodiazepine alongside an antidepressant, a gabapentinoid, or an antipsychotic given for sleep. Dr. Leeds tapers selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and the gabapentinoids gabapentin and pregabalin using the Maudsley Deprescribing Guidelines and the same proportional reductions, one medication at a time, and antipsychotics such as quetiapine may be tapered in a similar way. Overlapping tapers make it very hard to tell which drug is causing which symptom.

Keep in mind that antidepressant discontinuation symptoms, such as dizziness, electric-shock sensations and sudden low mood, are easy to mistake for the original illness returning, and a relative who panics at the first bad day can push a patient back onto a medication they were safely leaving. More is on the psychiatric drug tapering hub.

Does Dr. Leeds also treat opioid and alcohol dependence?

Yes, as secondary services. For opioid dependence, Dr. Leeds prescribes buprenorphine, including the combination products sold as Suboxone and ZubSolv, with visits monthly and weekly when needed. The medication can be continued or slowly tapered depending on the patient’s goals.

The Sinclair Method is the practice’s approach to alcohol: naltrexone, taken ahead of drinking, so that over time alcohol loses its reward, a process called pharmacological extinction. Abstinence is not a precondition. The method begins while the person is still drinking. The Sinclair Method page explains how it is done. He also prescribes low dose naltrexone (LDN) for some autoimmune-related pain conditions. Other substance problems can be discussed at a consultation.

What does a family gain from one concierge physician?

Dr. Leeds serves on the medical advisory board of the Benzodiazepine Information Coalition (BIC), which works to raise awareness about benzodiazepine dependence and the challenges patients face during and after withdrawal, and that background shapes how the practice regards the people around a patient. The model is one physician who knows the patient, sees them every week, and can be reached by text when something goes wrong late at night.

For a relative in Oakland Park, that structure answers the question that keeps families up at night: who is watching this? Someone is. The patient has a standing weekly appointment and a direct line in between, and the taper happens at home, with the family part of the process rather than separated from it.

Frequently asked questions

How can a family in Oakland Park best support someone during a benzodiazepine taper?

Patience and belief are the two things that cannot be bought. Withdrawal symptoms are real and physiological, so a relative should take them at face value rather than looking for a hidden motive. Avoid pushing for a faster timeline, avoid comparing the person to someone else’s taper, and avoid making every conversation about the medication.

Can a relative sit in on a video visit?

With the patient’s consent, a family member is welcome to join a video appointment, and because the visit happens at home this takes nothing more than a second chair. Many relatives find that hearing the plan explained once, and seeing that the pace is deliberate, settles their own worry.

Should a family member hold the medication or handle the pharmacy pickup?

Handling the pickup, signing for a compounding pharmacy delivery, or calling ahead to make sure the diazepam solution has been ordered are all useful jobs for a relative. A family member can also manage the medication itself. Dr. Leeds has no problem with that arrangement when the patient agrees to it and it has been discussed with him first, so that it is a decision the patient makes openly with the physician rather than one imposed at home.

Why does physical dependence develop when the prescription was followed exactly?

Because dependence is a response of the nervous system to the steady presence of the drug, not to how the drug was obtained. The brain adjusts its own activity to compensate for the medication, and removing the medication quickly leaves it out of balance. This happens whether the prescription was followed to the letter or not, which is why physical dependence is not addiction and why it is treated by careful dose reduction.

What happens after the taper is finished?

Some people feel well within weeks of the last dose and others carry symptoms for months. Fortunately, care does not have to end on the day of the final dose. Dr. Leeds recommends ongoing medical supervision after a taper is complete, because the weeks after the final dose are often when a patient needs help telling withdrawal apart from the return of an older condition. For families, this is the stretch where support is most likely to lapse, and it is exactly the stretch where it matters.

What if the person is not ready to taper yet?

The decision belongs to the person taking the medication. You cannot taper someone else, and pressure tends to produce either a rushed attempt or a refusal. What a family can do is learn how a safe taper works, make clear that they will not judge the timeline, and keep the door open. When the person is ready, the first step is a consultation.

Patients in Oakland Park, Wilton Manors, Lauderdale Lakes and Lauderdale-by-the-Sea, and the families supporting them, can reach the practice through its contact form. A member of the office staff replies first, and a first consultation can be arranged by video or at the Fort Lauderdale office. Contact the office today.

This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.