Valium Misuse and Addiction: Signs, Overdose & Treatment
Valium, which is the brand name for diazepam, is a benzodiazepine and central nervous system (CNS) depressant medication that doctors may prescribe to treat various conditions, such as anxiety disorders and acute alcohol withdrawal.1
Diazepam can be helpful when used as directed, but it can also result in adverse effects, including dependence, withdrawal symptoms, overdose, and addiction.1 If you or someone you care about uses Valium, it’s helpful to familiarize yourself with Valium addiction and misuse, the potential effects of Valium, and related treatment options.
What is Valium?
Valium is a long-acting benzodiazepine that can reduce anxiety and act as a sedative, muscle relaxant, and anticonvulsant.1
So how does diazepam work?
Like other benzodiazepines, diazepam facilitates the action of gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter in the CNS. Ultimately, this can help calm an overexcited central nervous system.1
Although Valium can be beneficial for its intended purposes, it can also be misused. Misuse is when you take the medication in a dose other than what’s prescribed or in other unintended ways, such as taking someone else’s prescription or using the substance to get high.2
People who misuse benzodiazepines almost always take doses that are higher than prescribed, and they commonly combine benzos with other substances, such as alcohol and opioids.3 While many people simply swallow diazepam tablets, misuse can also involve crushing the pills and snorting the powder.4
Diazepam is a Schedule IV substance under the Controlled Substances Act, which means that it has a known potential for dependence and misuse.1,5 According to the 2020 National Survey on Drug Use and Health, 4.8 million people aged 12 or older misused prescription benzodiazepines, and 971,000 of those people misused diazepam in the past year.6,7
What Is Valium Used For?
Valium is FDA-approved for short-term treatment of anxiety, for treating muscle spasms and convulsive disorders, and to relieve symptoms of acute alcohol withdrawal.1 However, diazepam and other benzodiazepines are misused for a number of reasons, some of which include:4,8,9
- To experience euphoria and to get high, either by taking diazepam alone or by using it to increase the euphoric effects of opioids or other substances.
- To help with sleep and relieve stress and tension.
- To alleviate the side effects of cocaine and other drugs.
Adverse Effects of Valium
Valium is a fast-acting benzo that typically produces effects within 15 to 60 minutes when taken orally.10 The most commonly reported adverse effects associated with chronic diazepam use include:11
- Ataxia (i.e., poor muscle control).
- Tachycardia (i.e., heart rate of more than 100 beats per minute).
Is Valium Addictive?
Indeed, Valium can lead to an addiction, which is a medical condition characterized by uncontrollable use of a substance despite negative consequences, such as a health problem, the inability to attend to responsibilities at work, school, or home, etc.1,2
Benzos like diazepam also can produce tolerance, meaning you need higher doses to experience previous effects, and can lead to physiological dependence. Typically occurring with chronic or long-term use (i.e., longer than four months), dependence is a physiological adaptation where your body becomes accustomed to the presence of the drug and you develop withdrawal symptoms if you stop using it or significantly reduce your dose. The risks of dependence can be more likely with regular, high-dose use.1
Signs of Valium Addiction
Addiction to Valium is diagnosed as a sedative use disorder.3 Only a qualified healthcare professional can provide a diagnosis, but it can be helpful to be aware of the diagnostic criteria so you know when it might be time to seek help.
Clinicians use criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to guide their diagnosis. To receive a diagnosis of a sedative use disorder, a person must meet at least 2 of the following criteria over a 12-month period:12
- Using sedatives like Valium in increasing amounts or for longer periods of time than originally intended.
- A persistent effort to cut down or stop sedative use despite expressing a desire to do so.
- Spending a great deal of time obtaining, using, or recovering from the effects of sedatives.
- Feeling cravings or strong urges for sedatives like Valium.
- Being unable to fulfill major obligations at work, home, or school because of sedative use.
- Continuing to use the drug despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the sedative.
- Giving up important social, work, or recreational activities because of sedative use.
- Recurrent use of the sedative in situations where it is physically hazardous to do so (such as when driving or operating machinery).
- Continuing to use sedatives like Valium despite knowing that you have a physical or psychological problem that is likely to have been caused or exacerbated by your substance use.
- Tolerance (which means needing more of the substance to experience previous effects). (This criterion doesn’t count toward diagnosis if the sedative is being used as prescribed.)
- Withdrawal (which refers to the symptoms you can develop when you stop using Valium). (This criterion doesn’t count toward diagnosis if the sedative is being used as prescribed.)
Valium Overdose: Can You Overdose on Valium?
When used as directed, diazepam is generally considered safe, and overdose on diazepam alone, especially a fatal overdose, is rare but still possible.1,10 Compared to Valium use alone, overdoses and associated fatalities are more commonly a result of polysubstance misuse, which in the case of benzodiazepine tends to involve opioids or other CNS depressants, such as alcohol, other benzos, or “z-drugs” such as Ambien (zolpidem) and Lunesta (Eszopiclone).1,6
Milder cases of Valium overdose may result in symptoms such as:1
Serious cases of Valium overdose without the presence of other substances are not common, and serious outcomes such as coma or death are even more rare. Symptoms of oversedation will result and may include:1
- Ataxia (a degenerative disease of the nervous system).
- Diminished reflexes.
- Low muscle tone.
- Low blood pressure.
It’s also important to note that counterfeit pills are often crafted to look like prescription medications such as Valium, Adderall, Xanax, and others. Data from the U.S. Drug Enforcement Administration indicates that these fake pills often contain fentanyl or methamphetamine, both of which can be dangerous. In fact, DEA testing results revealed that 2 out of every 5 counterfeit pills with fentanyl contain a potentially lethal dose of the drug.13
If you suspect that a person is overdosing on Valium, call 911. Then, follow these steps:14,15
- Administer naloxone, a life-saving medication that can help in cases of opioid overdose, if available. (It won’t harm a person if they don’t have opioids in their system.)
- Keep the person awake and breathing.
- Lay them on their side to prevent choking.
- Stay with the person until medical help arrives.
What Can Happen When You Mix Valium With Other Drugs?
Mixing Valium with other substances can have harmful consequences. For example, combining diazepam with opioids, alcohol, or other CNS depressants can increase the risk of overdose.14
Additionally, mixing Valium with stimulants can have unpredictable effects. Doing so can mask or modify the effects of one or both substances. This may mislead you into thinking that the drugs aren’t affecting you, potentially leading to overdose.14
The dangers of drug mixing apply to prescription drugs as well. So always inform your healthcare provider of the prescriptions you’re taking and never take medications prescribed for someone else.14
Benzodiazepine dependence that co-occurs with dependence on another substance can complicate treatment and exacerbate withdrawal symptoms.3
Valium withdrawal can cause uncomfortable, unpleasant, and even life-threatening symptoms.12 Common symptoms of Valium withdrawal include:1
- Abnormal involuntary movements.
- Blurred vision.
- Gastrointestinal problems (e.g., nausea or vomiting).
- Muscle pain and stiffness.
Severe withdrawal symptoms can include:1
- Catatonia (typically seen as a lack of movement and communication).
- Delirium tremens.
- Suicidal thoughts.
Valium Addiction Treatment
People who misuse Valium or suspect that they have an addiction may benefit from Valium addiction treatment.
If needed, detox is an initial part of treatment comprising interventions that manage acute intoxication and withdrawal. Medical detox, which can take place in inpatient and outpatient settings, can not only help prevent potentially life-threatening complications associated with benzodiazepine withdrawal but also act as a sort of palliative care that helps to reduce the intensity of symptoms.16
The Substance Abuse and Mental Health Services Administration explains that hospitalization or medically equipped inpatient detox may be useful for people who have chronically used high doses of benzodiazepines and other sedatives due to the risk of experiencing dangerous, sometimes fatal withdrawal symptoms.16
To mitigate the risk of seizures and other severe withdrawal symptoms, doctors may taper doses of diazepam during detox or substitute another long-acting benzodiazepine and taper that.16
Meanwhile, outpatient detox can be an option for people with less severe use of benzodiazepines, who are not dependent on other substances, and who have supportive friends or family to help them through the process.16
Although detox can be an important first step to treatment, it is often not enough to help people achieve long-term sobriety because it does not address the underlying issues associated with chronic substance misuse or addiction. After completing detox, people may benefit from transitioning to inpatient rehab or outpatient treatment to help them address these issues.2
Treatment should not only address the patient’s drug use but also any other medical and mental health issues.17 As such, treatment often employs the use of various therapies, such as the following:18
- Cognitive-behavioral therapy (CBT) can help you identify high-risk situations for drug use, life stressors, and coping skills and can aid in employing modeling and rehearsal techniques to positively alter behavior. Additionally, CBT focuses on personal responsibility for recovery and promotes relapse prevention, which helps people identify and avoid triggers to resume substance use.
- Motivational interviewing can help increase your motivation to make positive changes, such as reducing or stopping substance use and sticking with treatment.
American Addiction Centers (AAC) has accredited treatment facilities across the United States with the ability to treat diazepam addiction, polysubstance addiction, and other co-occurring mental health disorders. Contact us to speak with our Admissions Navigators. They can answer your questions and help you find the treatment center that might be right for you.