Diazepam

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Common Trade Names: Valium, Diastat, DiaStat Acudial, Diaz Intensol, Dizac, Vazepam, Valrelease, Valtoco Other Names: Blues, Eggs, Jellies, Vallies, Yellows

Diazepam, most commonly known under the brand name Valium, is an anxiolytic drug from the benzodiazepine family. Launched in 1963, it is currently one of the most frequently prescribed medications in the world, and it was once the highest selling medication in the United States for 14 years, between 1968 to 1982. As of 2018, it was the 115th most commonly prescribed prescription drug in the country, with more than 6 million prescriptions. Though it is most recognized under the brand name Valium, there are currently more than 500 different brands of diazepam available on the market today. Diazepam is also currently part of the World Health Organization’s List of Essential Medicines.

For all intents and purposes, diazepam is considered a versatile and highly beneficial drug that is effective at treating a wide range of physical and psychological conditions. However, it also carries a black box warning from the US Food and Drug Administration. This is the most serious warning that the agency can issue, used to signify to both physicians and patients that its effects may be dangerous. Use of this drug, even as prescribed, can lead to physical dependence. Users may also experience potentially life-threatening withdrawal symptoms should they suddenly stop taking it. Diazepam also carries a high risk of misuse and addiction, which, in turn, increases a user’s risk for overdose and death. It’s best to catch the signs and symptoms of diazepam use disorder early, before anything serious happens.

Here’s an extensive overview on the history and nature of this drug, how it is most commonly consumed, its short- and long-term effects on the mind and body, and what treatment for diazepam addiction involves.

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A Brief History of Diazepam

Diazepam is the generic name of compound 1, originally manufactured by Swiss pharmaceutical company Hoffmann-La Roche as Valium. It was invented by Polish-American chemist Leo Sternbach, dubbed the “father of benzodiazepines” after being the first to synthesize this specific class of psychoactives. His other notable discoveries include chlordiazepoxide (Librium), flurazepam (Dalmane), nitrazepam (Mogadon), flunitrazepam (Rohypnol), clonazepam (Klonopin), and trimethaphan (Arfonad).

It was aggressively marketed in the 1970s as a substance that could “reduce psychic tension,” and subsequently went on to become the Western world’s most widely prescribed remedy to anxiety. Diazepam is the very first drug to ever reach $1 billion in sales, as well as one of the first substances to become so culturally relevant that it is now considered iconic. It proved so popular, in fact, that sales of the drug are credited for catapulting the company that first manufactured it from relative obscurity to pharmaceutical industry juggernaut.

Part of diazepam’s early appeal lay in the fact that medical professionals considered it an improvement over not just its predecessor, Librium, but also barbiturates, which have a comparatively narrow therapeutic index and are far more sedative when administered at therapeutic doses. Widespread public support and portrayals of its beneficial effects in popular media only bolstered its status. However, even as early as 1964—only a year after it was released—experts were already warning consumers about diazepam’s addictive potential. That same year, it was classified a Schedule IV controlled substance by the US Justice Department due to that same potential for abuse and dependence. The ruling limited refills and imposed sanctions on persons and establishments that sold diazepam illegally.

Valium’s fall from grace began when a number of high-profile deaths were found to have at least been partially caused by the drug. Among these included Elvis Presley, whose autopsy revealed that he had massive amounts of diazepam in his system at the time of his passing, along with other drugs. Former United States first lady Betty Ford also admitted to being addicted to Valium and alcohol in 1978, and she had to be admitted to a Californian hospital for treatment and rehabilitation.

Though sales for diazepam have dropped in recent years, it continues to be one of the most-prescribed medications in the United States: over 14 million prescriptions of the drug were reported in 2011.

How Is Diazepam Used?

Valium is available for sale in variants of 10, 5, and 2 milligram tablets in the United States. Generic diazepam from over 500 different brands is also available and sold in a variety of tablets, extended-release capsules, gels, solutions, suppositories, suspensions, and various other formulations.

The tablets and capsules may simply be ingested through the mouth and swallowed, though some users prefer to grind diazepam pills down to a powder so that they can be snorted or injected directly into the veins. Diazepam in liquid form is similarly taken orally. Injectable diazepam is administered intramuscularly. The drug can also be given intravenously, though it must first be diluted, as it is painful when delivered in this manner and can be damaging to the veins. Finally, diazepam is also sold in suppository form, and it is administered by insertion into the rectum.

How Does Diazepam Work in the Human Body?

Diazepam is a benzodiazepine, which means that it belongs to a family of drugs commonly known as minor tranquilizers. They enhance the effect of a neurotransmitter called gamma-aminobutyric acid (GABA) at the GABAA receptor. In simple terms, this increases the levels of a certain brain chemical that then calms neural activity. Benzodiazepines can have a sedative, hypnotic (sleep-inducing), and anxiolytic (anti-anxiety) effect. They are also highly effective anticonvulsants and muscle relaxants. These properties are what make them so versatile, which is why diazepam is considered the ideal treatment for a wide range of conditions, including anxiety, alcohol or benzodiazepine withdrawal syndrome, muscles spasms, restless legs syndrome, and seizures. Some psychiatric professionals also prescribe diazepam to help patients who have trouble sleeping.

A single dose of diazepam can have a similar intoxicating effect on the dopamine system as morphine or alcohol, a property that recreational users of the drug particularly enjoy. Users of stimulant drugs or “uppers” also reach for diazepam to “come down” from a high, help them sleep, and resist the urge to binge. However, in order for the drug to have the desired effect, these users often escalate the dosage from 2 to 25 times the advised therapeutic dose of 5 to 10 milligrams.

What Are the Immediate and Long-Term Effects of Diazepam Abuse?

The most common side-effects of benzodiazepines like diazepam are also their desired effects: they are sedating and muscle-relaxing. However, users may also experience dizziness, drowsiness, or lack of coordination, which can lead to falls and injuries. The drug also decreases alertness and negatively affects concentration. Users have also reported decreased libido and erection problems as common side-effects. Those who take diazepam intravenously may suffer from hypotension and hypoventilation. Psychologically, diazepam abuse can lead to depression and lack of inhibition.

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The drug’s long-term effects, on the other hand, can include cognitive impairment, affective problems, and behavioral issues. Users report agoraphobia, social phobia, mounting anxiety and depression, loss of sex drive, inability or difficulty to think constructively, and loss of interest in pursuits they were previously passionate about. Inability to experience or express one’s feelings is also a known long-term effect.

Signs of Diazepam Use Disorder

Someone has a diazepam use disorder if they use the drug without a prescription, often for recreational purposes. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Criteria from the American Psychiatric Association provides further guidance on how to spot substance use disorders, including diazepam use disorder:

  • Users take diazepam in larger doses than the recommended therapeutic dosage or for longer than they are meant to. In the case of diazepam, the advised therapeutic dose is 5 to 10 milligrams over a period of 2 to 4 weeks only.
  • Users want to minimize or stop their consumption of diazepam but are unable to.
  • Users spend an extraordinary amount of time, effort, and resources to obtain, use, or recover from diazepam.
  • Users crave and have urges to use diazepam.
  • Users are unable to focus on daily tasks at work, home, or school due to diazepam use.
  • Users persist on taking diazepam despite it causing issues with their interpersonal relationships.
  • Users willfully persist on taking diazepam, even if it puts them in danger.
  • Users continue to take diazepam, even if they have an underlying physical or psychological condition that may have been caused by or aggravated by it.
  • Users develop a tolerance to diazepam, thus needing more of it to achieve the desired effect.
  • Users suffer from symptoms of withdrawal that are only alleviated by taking more diazepam.

Rehab and Treatment for Diazepam Use Disorder

Because diazepam is a long-acting benzodiazepine, it can take a significant amount of time for a user’s body to achieve equilibrium when they decide to quit. It is not advised for users to quit using diazepam cold turkey or unsupervised. Those who do are at risk for developing withdrawal symptoms that could potentially be fatal.

Instead, those looking to quit using it are strongly advised to enter a rehabilitation and treatment facility where they can safely go through the detoxification process in a controlled and monitored environment. From there, the patient should be able to choose from a wide range of post-detox treatment options. Cognitive behavioral therapy is usually a staple of many of these programs, where patients are encouraged to change the way they view their drug of choice and develop more positive coping methods for the triggers that motivated them to use in the past.

Get the Help You Need

Overcoming any kind of addiction problem can be challenging, but it is achievable when you have the right kind of support on your side. Take control today: log on to Better Addiction Care to find the help you need if you or someone you know is abusing diazepam or Valium and want to quit. With Better Addiction Care’s network of trusted local drug rehabilitation centers, you can take your first steps towards a drug-free future.

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