What is Diazepam Withdrawal?
When someone abruptly discontinues or reduces diazepam use, unpleasant withdrawal symptoms may emerge. Diazepam withdrawal symptoms include anxiety, nausea, vomiting, increased heart rate and blood pressure, excessive sweating, hallucinations, tremors, and grand mal seizures.
Diazepam (Valium) is a medication that is used to treat anxiety, seizure disorders, muscle spasticity, and symptoms of alcohol withdrawal.1,2 Valium and other benzodiazepines are central nervous system (CNS) depressants.1,2 Diazepam misuse or abuse can trigger pronounced calming and euphoric effects. People can misuse and abuse diazepam in several ways, such as:
- Taking it without a prescription.
- Taking it in larger doses or more frequently than prescribed.
- Combining it with other substances, such as alcohol or opioids.
- Dissolving it in fluid and injecting it.
In 2015, nearly 450,000 Americans aged 12 or older reported misuse of sedatives, including diazepam.5
The Drug Enforcement Administration (DEA) classifies diazepam as a Schedule IV controlled substance, which means that it has potential for abuse, dependence, and addiction.3 Dependence develops when the body becomes accustomed to the presence of diazepam and if use is dramatically reduced or stopped altogether, withdrawal symptoms may appear.1,6 Dependence on its own is a physical adaptation. However, diazepam addiction, which is typically accompanied by dependence, is marked by compulsive Valium abuse despite significant impairment in one or more areas of functioning.6
Once you have developed a diazepam addiction, it can be difficult and dangerous to quit on your own due to life-threatening withdrawal symptoms and strong cravings.6 Attending a diazepam detox center can help manage the withdrawal symptoms, prevent complications, and prepare you to transition into a comprehensive addiction treatment facility.
Choosing the Best Detox Clinic For You
There are many factors that should be taken into consideration when you choose the best detox clinic. The education and training of the staff at the facility should be of paramount importance. Read More
Short-term Effects of Diazepam Use
People often abuse diazepam for pleasurable effects, such as relaxation or a feeling of well-being, but they may not be aware of the potential for certain dangerous or unwanted effects.3
Some of the immediate physical and psychological effects of diazepam abuse can include:3,6,10,
- Slurred speech.
- Lack of coordination.
- Unsteady gait.
- Involuntary eye movements.
- Impaired attention and memory.
- Muscle weakness.
- Blurred or double vision.
- Nausea and vomiting.
- Emotional blunting or numbness.
- Stupor or coma.
Although rare, some people may experience paradoxical disinhibition, which is characterized by hostility, aggression, irritability, impulsivity, and increased excitement. These behaviors may normally be suppressed due to social norms and emerge since benzodiazepine use can reduce inhibitions (much like alcohol).10
Long-term Effects of Abuse
Chronic Valium abuse can lead to several problematic or potentially harmful effects. Someone who abuses diazepam, even for 4-6 months, can develop tolerance to the drug, which means that they require higher doses to achieve the desired effects.10 Tolerance can be dangerous, as it can increase the risk of overdose, particularly when combined with other depressants, such as alcohol or opioids.
Signs of a Valium overdose include:11
- Respiratory difficulties.
- Bluish fingernails and lips.
Other possible consequences of long-term diazepam use include:6
- Dependence, resulting in withdrawal symptoms if you attempt to quit.
- Addiction, characterized by compulsive Valium use regardless of ramifications.
- Loss of interest in previously enjoyed hobbies.
- Social isolation.
- Exacerbation of physical or psychological problems.
- Interpersonal consequences, such as divorce or loss of custody of children.
- Legal issues resulting from illegally obtaining the drug or driving under the influence.
- Termination from your job.
- Expulsion from school.
The longer you abuse diazepam, the more likely it is that you will experience negative ramifications. These consequences can be prevented by seeking out detox and addiction treatment services.
What Are the Signs and Symptoms of Addiction?
Though it may be unclear whether you or a loved one has a problem, there are many signs and symptoms that can signal the presence of an addiction to Valium, or as it is diagnosed by medical professionals, a Sedative, Hypnotic, or Anxiolytic Use Disorder. Signs and symptoms may include:6
- Continuing to use diazepam even when it affects your ability to function at work, school, or home.
- Experiencing intense cravings for diazepam.
- Giving up or cutting back on activities that involve work, socialization, or recreation due to diazepam use.
- Spending a great amount of time getting or using diazepam, as well as recovering from its effects.
- Failing to cut down or quit use despite efforts to do so.
- Taking larger amounts or for longer periods of time than originally intended.
- Using diazepam even after it has created or exacerbated social or relationship issues.
- Using diazepam in situations that can be dangerous, such as while driving.
- Using diazepam with the knowledge that it has caused or worsened a physical or mental health problem.
- Developing a tolerance to diazepam, which means that you require higher doses to experience the desired effects.
- Experiencing diazepam withdrawal symptoms when use is stopped or dramatically reduced.
Experiencing at least two of the signs and symptoms listed above could mean that you or a loved one has developed an addiction; attending a formal diazepam detoxification facility may be the most beneficial choice to overcome addiction to diazepam.
Diazepam Detox Symptoms and Timeline
Diazepam is a relatively long-acting benzodiazepine, and withdrawal symptoms generally appear between several days to 1 week after the last dose.6 Diazepam withdrawal symptoms tend to peak after the second week, and gradually dissipate over 3 to 4 weeks.6 Diazepam withdrawal symptoms can include:3,6
- Increased blood pressure and heart rate.
- Increased sweating.
- Nausea or vomiting.
- Visual, auditory, or tactile hallucinations.
- Psychomotor agitation (repetitive, purposeless movements).
- Grand mal seizures.
Approximately 20%-30% of individuals who withdraw from a sedative without detox treatment experience a grand mal seizure, which is why it is so vital that you seek out professional detox services.6
What Does Detox Entail?
It can sometimes be scary and overwhelming to enter a diazepam detoxification program, particularly if you aren’t familiar with the detox process. Detox is a safe, medically supervised way to clear your system of diazepam and any other substances.7,8 Medical and psychiatric staff are available to monitor progress, identify and treat any possible physical or mental health conditions, and intervene in the event that medical complications arise.7,8
The objective of a diazepam detox facility is to help patients withdraw from Valium safely and prepare them to enter substance abuse treatment to better promote lasting recovery. Detox occurs in 3 phases:8
- Evaluation is the intake process in which a mental health professional gathers information to guide the development of a treatment plan. A detailed medical, psychiatric, family, and substance abuse history will be taken and drug testing is typically conducted. The staff member will also identify any issues that can be addressed after detox, such as legal, social, vocational, or residential problems.
- Stabilization involves gradually tapering the patient off of Valium to ensure their safety. Medical staff members monitor patients around the clock to identify potential complications as early as possible and treat them appropriately. During the stabilization process, facility staff work with each patient to identify what is expected of them during detox, as well as continue to develop a follow-up plan for continued sobriety.
- Fostering the patient’s entry into treatment is the final phase of diazepam detoxification. While detox is an important first step, it does not replace comprehensive addiction treatment. Additional treatment can help patients maintain sobriety by providing education about drug abuse, exploring underlying factors or triggers that contribute to addiction, and developing relapse prevention skills.
Studies suggest that spending a minimum of 3 months in addiction treatment can increase the likelihood of maintaining long-term sobriety.7 Detox facilities provide a safe and structured environment for individuals to withdraw from diazepam, while rehabs provide a comprehensive, intense duration of treatment that help patients develop relapse prevention skills in order to build a strong foundation in sobriety.
Diazepam Detox Centers
Diazepam detox can occur in various settings, in order to best meet the needs of each individual patient. These settings include:
- Inpatient, which can provide 24-hour medical and psychiatric care and monitoring. Inpatient detox is strongly recommended for diazepam detox in order to adequately manage potentially severe withdrawal symptoms and ensure safety.
- Hospitals, which offer intensive detox services. Many people may be admitted to acute care after overdosing or experiencing a medical emergency related to benzodiazepine abuse. Much like inpatient detox, hospital-based detox services can provide patients with around-the-clock care.
- Outpatient detox, which allows the patient to live at home while receiving detox services. This type of facility works well for individuals with less severe addictions, stable living environments, good physical and mental health, and sober, supportive relationships. Patients are able to continue to participate in activities related to their daily routine, such as at school, home, or work. Before attending an outpatient detox program, someone who is addicted to diazepam should receive a medical evaluation to confirm that they have little to no risk of experiencing a complicated withdrawal.
- A physician’s office, which can also prescribe a detoxification regimen and monitor patient progress on an outpatient basis. For individuals who have mild addictions, strong social supports, and a shorter duration of diazepam use, this can be the least restrictive type of formal detoxification. As with other outpatient detox options, thorough medical assessment will determine the safety and viability of detoxing in this manner.
Diazepam Detox Medications
Several medication options can be used to manage diazepam detoxification. When paired with counseling and therapy sessions, medications can aid the detox process by reducing withdrawal symptoms and minimizing the risk of relapse. There are different options for medication-assisted detox:8
- The treatment team may create a tapering schedule in which the person’s dosage of diazepam is gradually reduced over a predetermined period of time.
- Sometimes using a benzodiazepine other than diazepam, as it is the problematic agent of abuse, can be therapeutic. Switching to a different benzodiazepine medication and slowly tapering off of that is a viable option. Chlordiazepoxide (Librium) and clonazepam (Klonopin) are often good choices since they are long-acting benzodiazepines.
- Utilizing phenobarbital as a substitution medication in tapering doses can also ease the symptoms of diazepam withdrawal.
- Anticonvulsant medications (carbamazepine or valproate) in combination with sedating medications (trazodone) can help to manage withdrawal symptoms in less severe cases.
Dangers of Continued Diazepam Abuse
If you don’t seek help for a diazepam addiction, it can lead to severe long-term consequences in terms of your physical and mental health. Chronic abusers of diazepam may have an increased risk of the following effects:4,6,9,10
- Severe drowsiness
- Slurred speech
- Blurred vision
- Poor concentration
- Profound confusion
- Muscle weakness
- Emotional blunting or numbness
- Paradoxical disinhibition, characterized by increased hostility, aggression, impulsivity, excitement, and irritability, which may lead to acts of violence or other antisocial behaviors
- Impaired memory
- Lowered blood pressure
- Dangerously slowed breathing
- Changes in sex drive
- Contracting HIV, hepatitis, and other infectious diseases from intravenous use
- Track lines, collapsed veins, and abscesses from intravenous use
- Overdose, if combined with other depressants, such as alcohol or opioids
Post-Detox Rehab and Care
There are pros and cons to each type of program, which is why it is so important to collaborate with a treatment team to determine the best program for you.
While in detox, the treatment team works collaboratively with each individual patient to develop a treatment plan that facilitates the transition into a formal addiction treatment facility. Detoxing without receiving substance abuse treatment can increase a person’s risk of relapse since they aren’t equipped with the skills necessary to remain sober in the long run. Many types of addiction treatment programs can help you stay clean:
- Inpatient programs require that patients reside at the facility while receiving intensive individual and group therapy sessions, along with psychiatric and medical monitoring.
- Outpatient programs offer different levels of care based on the needs of each individual patient and the severity of the diazepam addiction. They allow patients to live at home and continue to participate in their usual daily responsibilities. Partial hospitalization programs (PHPs) provide highly structured and intensive group and individual sessions for the majority of the day. Intensive outpatient programs (IOPs) provide group sessions that last several hours for various days per week and provide individual counseling sessions as well. Standard outpatient programs last about an hour for a set number of days per week, as dictated by the needs and level of recovery of each patient.
- Luxury facilities are private, upscale, residential programs and they are usually located in desirable settings, such as those with ocean views. They are more expensive than standard inpatient programs due to the luxurious amenities and services, such as swimming pools, gourmet meals, and massage therapy.
- Executive programs are tailored for business executives and provide access to telephones and computers for work purposes. Patients receive high-quality treatment and access to many luxury amenities to recover while still attending to work duties.
- Holistic programs base their treatment philosophy on the interconnection between mind, body, and spirit. This type of facility utilizes alternative treatment methods, such as acupuncture, biofeedback, meditation, nutrition counseling, and creative arts therapy.
- Population-specific facilities help certain people feel comfortable in a group of their peers. Some of these populations include teenagers or young adults, female or male, LGBTQ, or veterans.
- 12-step programs, such as Narcotics Anonymous (NA), utilize the 12 steps originally created by Alcoholics Anonymous (AA). These groups are free to join and many people benefit from the support and encouragement they receive from one another.
- Non-12-step programs utilize evidence-based practices based on scientific research to help members achieve long-term sobriety. There are many of these programs available, including Secular Organizations for Sobriety (SOS), SMART Recovery, and Women for Sobriety.
Each person has a different treatment and recovery experience, so make sure that the mission statement and values of the program align with yours, and the facility can meet your needs.
- Mayo Clinic. (2017). Diazepam (oral route).
- Drug Enforcement Administration. (2015). Drugs of abuse.
- National Highway Traffic Safety Administration. (n.d.). Diazepam.
- National Institute on Drug Abuse. (2017). Commonly abused drugs charts.
- Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 national survey on drug use and health.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th). Arlington, VA: American Psychiatric Publishing.
- National Institute on Drug Abuse. (2012). Principles of drug addiction treatment: A research based guide (3rd edition).
- Substance Abuse and Mental Health Services Administration. (2006). Detoxification and substance abuse treatment.
- U.S. National Library of Medicine. (2016). Diazepam.
- Longo, L.P. & Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61 (7), 2121-2128.
- MedlinePlus. (2015). Diazepam overdose.