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Developed by Prof. Heather Ashton, Newcastle University. The Ashton Manual is the clinical gold standard for benzodiazepine cessation. The method: switch from a short-acting benzo (Xanax, Ativan) to an equivalent dose of long-acting diazepam (Valium), then reduce by 5–10% of current dose every 1–2 weeks. Total taper: 3–12 months depending on starting dose and duration of use.

Never Cold-Turkey Benzodiazepines

Abrupt cessation after regular use can cause seizures, psychosis, and death. Benzodiazepine and alcohol withdrawal are the two drug withdrawals that can be fatal. Always taper under medical supervision when possible. If medical supervision is not available, use the slowest taper schedule you can maintain.

Equivalency Table — Approx. Equivalent to 10mg Diazepam

BenzodiazepineEquivalent
Alprazolam (Xanax)0.5mg
Lorazepam (Ativan)1mg
Clonazepam (Klonopin)0.5mg
Bromazepam5–6mg
Temazepam20mg
Oxazepam30mg
Nitrazepam5mg
Flunitrazepam (Rohypnol)1mg
Etizolam1mg
Clonazolam0.2mg (approx)

Sample Ashton-Style Taper — 4mg/day Alprazolam → 0

StageDoseDuration
Switch to diazepam80mg/day (stabilize 1–2 weeks)Weeks 1–2
Stage 170mg1–2 weeks
Stage 260mg1–2 weeks
Stage 350mg1–2 weeks
Stage 440mg1–2 weeks
Stage 530mg2 weeks
Stage 620mg2 weeks
Stage 715mg2 weeks
Stage 810mg2 weeks
Stage 98mg2 weeks
Stage 106mg2 weeks
Stage 114mg2–4 weeks
Stage 122mg2–4 weeks
Stage 131mg2–4 weeks
Stage 140mg

Supplements That May Help (With Caveats)

Magnesium glycinateAnecdotal support

Muscle tension, sleep

L-theanineMild, safe

Anxiety

CBDLimited but promising evidence

Anxiety, sleep

NAC (N-acetylcysteine)Some evidence for reducing cravings

Reducing cravings

⚠️ AlcoholContraindicated

AVOID — cross-tolerant, defeats the taper

⚠️ GABA supplementsIneffective

AVOID — don't cross blood-brain barrier meaningfully

When to Seek Emergency Help

  • Seizures
  • Severe confusion or hallucinations
  • Heart palpitations / chest pain
  • Inability to keep fluids down
  • Suicidal ideation

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Last updated: July 2026 · Information provided for harm reduction purposes only · Not medical advice

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