Karen LaFlair, PMHNP-BC

Part of our Provider Spotlight series: short interviews with prescribers who support slow, patient-led benzodiazepine tapers. Answers are the provider's own, lightly edited for formatting, and approved by the provider before publication.

Karen LaFlair is a psychiatric nurse practitioner (PMHNP-BC) and the founder of Resilient Mind Clinic, a telehealth practice serving seven states, most of them rural: Colorado, Arizona, Idaho, Kentucky, Montana, New York, and Wyoming. Her practice pairs slow, personalized tapers with support for sleep, nutrition, movement, stress reduction, and nervous system regulation.

Where are patients in their taper when they find you?

"Some people have attempted tapering and most people are just beginning. Most people are somewhere on that spectrum."

What does a slow, supported taper look like in practice, say for someone on 1 mg of clonazepam?

"They have two options, based on the information collected at their intake: a hyperbolic taper, or the Ashton Method, where we would slowly switch them to diazepam. Each taper is specific to each patient as far as timeline and when we make the cuts."

How do you decide which shape a taper takes?

"It depends on the patient's history and needs. I lean more toward hyperbolic tapering and the Ashton Method, which are more patient-driven and flexible compared to the Oregon method."

(For what those methods are and how they differ, see our comparison of the Ashton Method vs. hyperbolic tapering.)

What about doses smaller than the smallest tablet?

"Both liquids and compounding. Again, it depends on what is right for the patient."

What's your view on protracted withdrawal?

"Let's prevent it by moving slowly from the very beginning. Protracted withdrawal is a miserable place to end up. Slow and steady for the best long-term outcomes."

What would you say to someone whose prescriber wants them off in four weeks?

"Don't do it! While not everyone experiences protracted withdrawal, more people experience it than we know. These people often confuse withdrawal symptoms with relapse and then decide 'maybe my brain just needs the meds forever.' The possibility of protracted withdrawal is not worth the risk. Symptoms can last for years and severely disrupt daily activity, and sometimes restarting can make symptoms worse."

Anything you wish every patient knew before starting?

"Meet with a provider who is informed about the risks of moving too fast and the risks of protracted withdrawal. Slow and steady is best for long-term success."

Karen also appears in the prescribers we have vetted section of our doctor-finding guide. If you're preparing for a first appointment with any prescriber, bring a written schedule from the taper calculator and the five vetting questions from the doctor guide.

Disclosure: Provider Spotlights are free. TaperOffBenzos never accepts referral fees or per-patient payments from any provider. This spotlight is education, not a referral or an endorsement of outcomes. Answers are the provider's own, lightly edited for formatting, and approved by the provider before publication. Are you a prescriber who supports slow, patient-led tapers? Introduce yourself.