Does stopping the drug matter to the patient, and are their physical and psychological health and personal circumstances stable? Enquire about:
- Symptoms of depression.Withdrawal can worsen symptoms of clinical depression. The priority is to manage depression first, before attempting withdrawal
- Symptoms of anxietyWithdrawal in the presence of significant anxiety is unlikely to succeed. However, when symptoms are reasonably well controlled and stable it may be possible to attempt careful drug withdrawal
- Symptoms of long-term insomnia.If insomnia is severe, consider treating this with non-drug treatments prior to starting withdrawal
- Medical problems are well controlled and stable.If other problems are causing significant distress, consider managing these first, prior to starting withdrawal
- Withdrawal in primary care. Is there adequate social support with no previous history of complicated drug withdrawal and ability to attend regular reviews?
- Specialist advice or referral. Consider where there is a history of alcohol or other drug use or dependence. Also where there is severe medical or psychiatric disorder or personality disorder. A history of drug withdrawal seizures where low tapering is recommended