Diazepam is a benzodiazepine commonly prescribed under the brand name Valium. This substance depresses the central nervous system (CNS) to manage 1,2:
- Muscle spasms.
- Alcohol withdrawal symptoms.
Is Diazepam Harmful?
Despite diazepam’s ability to effectively treat the issues listed above, it can be harmful. The substance is classified as a Schedule IV controlled substance, indicating the potential for abuse and dependence.
The risk of harm associated with diazepam increases when 1,2,3:
- Use continues for a period longer than 4 months.
- The medication is used in ways other than prescribed (higher doses, more frequent administration, or alternate methods of use such as injection).
- A user takes diazepam that is not prescribed to them.
- The medication is used with the intention of getting high.
Unfortunately, abuse of the drug is all too common. Consider that 2:
- In 2010, nearly 27,000 emergency room visits were related to its use.
- More than 20 million people have abused benzodiazepines like diazepam in their lifetime.
Diazepam abuse can be fatal. In fact, more than 7,900 people died from benzodiazepine-related overdoses in 2014 3. The risk of death increases when it is combined with other substances like alcohol or other CNS depressants (e.g., opioid painkillers like OxyContin). If you’re abusing dizepam, don’t wait to get help. Call to find a treatment program today.
When taken as prescribed, diazepam decreases anxiety and agitation. It can also calm the nervous system to minimize seizure activity and alleviate symptoms of alcohol withdrawal.
When abused, the sedating effects of diazepam are heightened and the drug can cause a high marked by 2,3:
- A pleasurable or euphoric sensation.
- A state of intoxication similar to that of being drunk, with slurred speech and lack of coordination.
It is sometimes used to intensify the highs of other drugs (e.g., opioid painkillers) or to counteract the side effects of other drugs (e.g., cocaine, amphetamines) 2. Abusing multiple substances in this way increases the risk of adverse effects.
How Does Diazepam Work in the Brain?
The rewarding effects of diazepam are elicited primarily via the influence of the drug on two neurotransmitter systems:
- GABA. On certain neurons, the drug increases the activity of GABA, which slows brain activity and accounts for the calming, sedative effects 3.
- Dopamine. On other neurons, diazepam will actually reduce the inhibitory tone that GABA normally has on certain dopaminergic neurons. As a result, benzodiazepine use will contribute to increased dopamine release, which contributes to the pleasure and reward associated with diazepam use 4. Artificially prompted dopamine surges in the brain—such as those mediated by drug use—are associated with euphoric highs and the development of addiction.
Whether the medication is prescribed or abused, diazepam can generate a long list of side effects that range from uncomfortable to dangerous and may include 1:
- Dry mouth.
- Gastrointestinal symptoms (nausea, diarrhea).
- Feeling restless, excited, or fidgety.
- Urinary problems.
- Blurred vision.
- Reduced sex drive or sexual functioning.
The following side effects may be dangerous if left untreated 1,2:
- Problems walking.
- Feeling shaky or having tremors.
- Problems breathing.
- Irregular heart rate.
With excess doses of diazepam, the risk for and intensity of side effects increases. The likelihood of serious dangers is also heightened any time diazepam is combined with other drugs, such as 3:
- Alcohol or alcoholic beverages.
- Prescription painkillers.
- Certain cold or cough medications, like dextromethorphan (DXM).
Long-Term Effects of Abuse
At high doses, diazepam can contribute to numerous physical and mental symptoms over the long term, including memory problems. Diazepam use and abuse is specifically associated with anterograde amnesia, which entails the inability to remember events that occur after the drug is consumed. 2,8
Someone who continually abuses diazepam might also experience 2:
Dependence and Addiction
Beyond the physical and mental health risks that come from abusing diazepam over time, continuously misusing this drug may easily lead to addiction, which may be reflected in the following 5,6:
- Changing priorities and problems managing responsibilities.
- New and different social circles or increased conflict with loved ones.
- Spending more time focused on getting and using diazepam.
- Financial or legal problems associated with using.
- An inability to quit use despite efforts to do so.
Addiction is a frequently encountered problem for people abusing diazepam, as is physical dependence.
Physical dependence can develop even when a person is taking diazepam as prescribed. Dependence is the body’s adaptation to the constant presence of the drug in the system. Over time, this artificially high level becomes the new normal. Unfortunately, this means that the supply of diazepam must be steady for the body to operate optimally 5. Again, physiologic dependence may eventually be present in anyone using the drug for a certain duration of time; however, it may be quicker to develop in those who misuse the drug.
In most cases, those who have become dependent on diazepam will experience a withdrawal syndrome upon attempting to cease or reduce use. Withdrawal from sedatives like diazepam may be dangerous and often necessitates medical monitoring to ensure the safety of the detoxing individual. Symptoms may include 2:
- Inability to sleep.
- High levels of anxiety called “rebound anxiety.”
- Dysphoria (a general feeling of dissatisfaction).
- Shakiness and tremors.
Symptom severity will depend on the dose and duration of use. Concurrent use of other substances may further complicate withdrawal and treatment 7.
Withdrawal and Addiction Treatment
n many cases, addiction treatment or other medical professionals may recommend a supervised, medical detoxification for people attempting to curtail or altogether quit their use of diazepam. This level of treatment will allow for the safe removal of the remaining medication from the body. Medical providers on staff will be able to address any complications and risks as they arise.
There are several medically managed approaches to diazepam withdrawal treatment. These include 7:
- Weaning the individual from their current dose over the course of weeks or months.
- Switching to another longer-acting benzodiazepine (e.g., chlordiazepoxide or Librium).
- Substituting phenobarbital in those with especially lengthy periods of high-dose benzodiazepine abuse.
Anticonvulsants and sedating antidepressants like trazodone may be used to manage symptoms of diazepam withdrawal, as well.
Following detoxification, addiction treatment should begin. Treatment will include behavioral therapies to manage thoughts, feelings, and behaviors associated with substance use while finding ways to build motivation and reward the individual for periods of abstinence. Options include 7:
- Engaging the family system in therapy is a positive and effective way to promote recovery.
- Cognitive behavioral therapy (CBT) to work with the individual to understand triggers of use and methods to prevent relapse.
- Interpersonal interviewing techniques to build an internal sense of motivation and commitment towards recovery.
- Behavior modification therapy and management to provide rewards for recovery-focused behaviors like community activities and attending treatment.
To begin the process of exploring treatment options for you or your loved one, call today.