Librium, which is the brand name for chlordiazepoxide, is a prescription medication that belongs to a class of controlled substances called benzodiazepines. It is a central nervous system (CNS) depressant, meaning it slow down brain activity. Chlordiazepoxide is commonly used to treat anxiety disorders, and to mitigate the symptoms of alcohol and other sedative withdrawal syndromes. In combination with a second drug called Clidinium, chlordiazepoxide is also used to manage the symptoms of irritable bowel syndrome 1, 2, 3.
Overdose deaths due to benzodiazepines are increasing drastically, with a five-fold increase between 2001 and 2014 4.
Deaths due to benzodiazepine overdose often involve concurrent use of alcohol as well 5.
Like all benzodiazepines, Librium can be habit-forming and presents a risk of abuse and addiction 1,2. Misuse of Librium occurs when it is used in larger doses, more often, or for longer courses than directed by a physician 1. Librium abuse frequently occurs when it is taken nonmedically for the intended purpose of getting “high.” Users may snort the contents of the capsules or combine it with other drugs, such as alcohol or opioids to create a stronger effect.
Misusing or abusing Librium can decrease its efficacy, increase the risk of overdose, and lead to unpleasant withdrawal symptoms 1. Its sedative effects can be amplified when mixed with other substances, such as alcohol or other CNS depressants. Combining Librium with other drugs can increase the risk of overdose and adverse effects.
Signs and Symptoms of Abuse
There are several signs and symptoms that someone is abusing Librium, ranging from physical symptoms to behavioral signs of addiction.
Physical Side Effects
Physical side effects can vary among individuals, however, the acute signs often resemble alcohol intoxication 6. Some physical effects that signify someone is abusing Librium include 1,5,6:
- Dry mouth.
- Appetite changes.
- Upset stomach.
- Slurred speech.
- Coordination problems.
- Unsteady gait.
- Slowed movements.
- Uncontrolled eye movements.
Signs of Benzo Addiction
The criteria for the diagnosis of a benzodiazepine addiction include the following 6:
- Using greater amounts of Librium and/or using it for longer periods than intended.
- Consistently failing to cut down or quit using it.
- Spending an inordinate amount of time obtaining and using Librium, as well as later recovering from its effects.
- Having strong cravings or urges to use the drug.
- Failing to fulfill personal obligations due to Librium use.
- Using it in dangerous situations, such as driving.
- Continuing to use Librium in spite of interpersonal, physical, or psychological issues caused by or made worse by the drug.
- Increasing the dose over time to experience desired effects.
- Facing withdrawal symptoms when cutting down or stopping use.
- Prioritizing Librium use over previously enjoyed activities.
Effects of Abuse
- Physical dependence: The body adapts to the presence of the drug and the user may experience withdrawal symptoms, such as anxiety, insomnia, or seizures, when the user stops taking it 5.
- Addiction: The user may develop compulsive and maladaptive patterns of Librium use despite negative consequences in his or her life.
- Polydrug abuse: Drug users commonly abuse multiple substances. Those seeking treatment for benzodiazepines are often addicted to one or more other drugs as well, including alcohol. Polydrug use can increase the risk of adverse effects and overdose.
Someone who’s abusing Librium is also subject to a host of potentially dangerous psychological side effects, such as 5,6:
- Impaired memory.
- Cognitive deterioration in the elderly.
- Poor judgment.
- Diminished emotional reactions.
- Suicidal ideation.
In some cases, a Librium user may experience a reaction called paradoxical disinhibition 5. Paradoxical disinhibition is characterized by contradictory symptoms, including:
- Increased excitement.
In rare instances, this type of disinhibition may lead to antisocial or violent behaviors 5.
The cumulative, negative influence of Librium abuse can severely impact all facets of a user’s life, causing difficulties at work, school, or home. Users may have excessive work or school absences, leading to poor performance. Familial or social problems, such as child neglect, divorce, or loss of close friends, may occur as well. A Librium-intoxicated individual is also at increased risk of involvement in accidents. Impaired judgment and cognition, paired with slowed reaction time can drastically increase the risk of injury or fatality due to a vehicle collision 6.
Finally, abusing this drug can be fatal, especially for those who continually increase their doses to combat the effects of tolerance or who abuse Librium with other substances.
Librium interacts with many different substances, including prescription and non-prescription medications. Using alcohol or opioids, such as prescription painkillers or heroin, in combination with Librium can increase the likelihood of overdose 5. Symptoms or visible signs of overdose can include 7:
- Blurred or double vision.
- Difficult or shallow breathing.
- Bluish fingernails and lips.
- Irregular heartbeat.
- Low blood pressure.
- Profound confusion.
- Extreme dizziness.
- Dangerously low body temperature.
In the case of an overdose, seek the help of emergency services. If the individual appears to be unconscious or is having difficulty breathing, call 911 immediately. This action can save the person’s life.
Statistics specifically regarding Librium abuse aren’t readily available, but benzodiazepine misuse and abuse, both alone and in combination with other substances, is a growing problem nationwide. Some statistics related to general benzodiazepine use include:
- In 2011, an estimated 425,000 emergency department visits were associated with benzodiazepine abuse 8.
- About 0.7% of the American population (1.9 million people) aged 12 or older reported using benzodiazepines in the past month 9.
- A survey of Americans aged 12 to 49 who abuse benzodiazepines shows that the average age of initial use is approximately 23 years old 9.
- Polydrug abuse is present in approximately 95% of those seeking treatment for benzodiazepine addiction 10.
Teenagers often have access to prescription medications in their home medicine cabinets. Many families have a prescription for Librium or other benzodiazepines, and teenagers can obtain these medications quite easily in their own home or the homes of friends. Misuse of Librium in teenagers can involve taking more of the drug than suggested, or even opening the capsules and snorting the contents to provide a more immediate and intense high.
A reported 103,000 adolescents between the ages of 12 and 17 reported using benzodiazepines for nonmedical purposes in the last month, which is about 0.4% of the population 9.
Prevention of benzodiazepine abuse in teenagers starts with education. It is important to teach teenagers about the dangers of prescription medications like Librium, and help them understand the harmful effects the drug can have on the body and brain. Educating parents and family members about the importance of securely storing medications can help to limit the access teenagers have to habit-forming substances.
Individuals should be taught proper techniques to dispose of unused pills, such as mixing them with undesirable items like cleaning products, kitty litter, or coffee grinds 11 or bringing them to sites authorized by the Drug Enforcement Administration (DEA), such as pharmacies, law enforcement locations, or take-back programs 11.
A few signs that your teenager may be misusing Librium or struggling with some other inappropriate drug use or consumption include:
- Changes in attitude, mood, or behavior.
- Hanging out with new friends.
- Poor academic performance.
- Excessive absences.
- Getting in trouble at school.
- Sudden weight loss or weight gain.
As a parent, it’s important that you’re aware of the signs and symptoms of substance abuse so you can help your adolescent get the help he or she needs to prevent or recover from an addiction. Contact your family doctor or a mental health care specialist, such as a therapist or addictions counselor to discuss treatment options for your teen.
Resources, Articles, and More Information
- National recovery month. This site provides information about recovery month events and education.
- Peer/mutual support groups. This site has a number of links to various peer or mutual support groups.
- Too smart to start: information on prevention. This is a site geared towards teenagers and parents, providing information on preventing substance use problems.
- S. National Library of Medicine. (2012). Chlordiazepoxide.
- University of Pittsburgh Schools of the Health Sciences. (2010).Chlordiazepoxide.
- Center for Substance Abuse Treatment. (2006). Treatment Guide for Clinicians.
- National Institute on Drug Abuse. (2015). Overdose Death Rates.
- Longo, L.P., & Johnson, B. (2000). Addiction: part I. Benzodiazepines - side effects, abuse risk and alternatives. American Family Physician, 61(7), 2121-2128.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). Arlington, VA: American Psychiatric Publishing.
- S. National Library of Medicine. (2015). Chlordiazepoxide overdose.
- Substance Abuse and Mental Health Services Administration. (2011). [/link]url="http://www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf" type="ext"]Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits.[/link]
- Substance Abuse and Mental Health Services Administration. (2016). Common mental disorders and misused substances.
- Substance Abuse and Mental Health Services Administration. (2011). Benzodiazepine Abuse Treatment Admissions Have Tripled from 1998 to 2008.
- S. Food and Drug Administration. (2015). How to Dispose of Unused Medicines.