Librium is the brand name of the drug known as chlordiazepoxide. It belongs to the most extensive drug group, benzodiazepines. Librium is widely prescribed for the relief of anxiety, insomnia, and muscle spasm. Doctors also prescribe it for the treatment of convulsive disorders and alcohol dependence.
In recent years, Librium has become notorious due to its effects both as a street drug and as a prescribed medication.
Any form of Librium abuse, especially long-term, increases the chance of developing an addiction. Librium is considered safe only when taken correctly and under the supervision of a doctor.
A substance use disorder can develop if the medication is misused and abused. Some people admit to abusing Librium to experience feelings of relaxation. However, abuse can cause significant impairment and distress after long-term use.
When Librium is frequently taken in higher doses for an extended period, it can result in tolerance to the drug.1 Tolerance happens when the brain needs higher doses of the substance to experience the same previous effects. The drug targets the brain’s reward system and floods the brain with dopamine. Over time, the brain will get used to the excess amounts of dopamine.
When dependence is developed, the following behavioral signs may appear:
Continued use of the drug after it's no longer needed for a specific health issue
Needing more and more of the drug to experience the same effect (called "tolerance")
Not being able to stop using the drug, even if desired
Spending a lot of time thinking about how to get more of the drug and how good it will feel
Losing interest in the things once enjoyed
Trouble performing day-to-day things, such as working or cooking
Borrowing or stealing money to pay for the drug
Lying about drug use to friends and family
Trouble getting along with friends, family, or coworkers
Changes in sleep and eating patterns
Changes in appearance; bad breath, shakes, bloody noses, bloodshot eyes, or have gained/lost weight
Paying visits to more than one doctor to obtain prescriptions
Taking the prescribed medicine with alcohol or other drugs
Librium belongs to a class of sedative medications known as benzodiazepines. Benzodiazepines are widely used as a treatment for anxiety and insomnia. They are also useful for managing the symptoms of alcohol withdrawal. The class includes drugs such as Valium (diazepam), Xanax (alprazolam), and Klonopin (clonazepam).
Leo Sternbach first discovered benzodiazepines in the 1930s. When he discovered the substance, he was working at the Hoffman-LaRoche Company. The first benzodiazepine that was introduced to the market was Librium in 1957. During the 1980s, benzos became the most prescribed medications in the US. The class of drugs is notoriously associated with emergency room visits, mental disorders, and substance abuse.
According to the 2015-2016 National Surveys on Drug Use and Health, researchers found that:
of US adults used benzodiazepines (30.5 million people)
Misused them at least once
Among users, 17.1% misused them, and 2% suffered from use disorders
When researchers tried to understand why people misuse benzos, they found that:
Misuse the drug to relax and relieve tension
Said it helped them with sleep
Said that they’re using the drug because of physical dependence
Reported they were experimenting with the drug
The Controlled Substances Act classifies Librium as a Schedule IV drug. Schedule IV drugs are drugs that have a low potential for abuse and low risk of dependence. Other Schedule IV drugs include Valium, Xanax, Darvocet, Talwin, Soma, Ambien, Tramadol, Darvon, and Ativan.
Librium affects the brain and central nervous system, producing a feeling of calmness and relaxation. It works by enhancing the effects of GABA, a neurotransmitter in the body.
Over time, if the drug is taken in larger doses regularly, it will change brain chemistry. In other words, higher doses are needed to feel the same effect. For that reason, Librium should always be taken as recommended by a doctor.
Librium is highly dangerous to mix with alcohol. Overdose can happen from the combination of these two central nervous system depressants. The side effects of Librium and alcohol consumption can include:
Reduced motor coordination
Accidental falls and accidents
Long-term use of Librium and alcohol might lead to:
Liver and kidney injury
Psychosis and suicidal thoughts (for those with pre-existing psychiatric conditions)
Benzodiazepines are also commonly taken with opioids such as heroin as they enhance the effects of opioids. In 2016, the Centers for Disease Control and Prevention released a new set of guidelines concerning benzodiazepine use and opioids. According to the guidelines, clinicians should avoid prescribing benzodiazepines together with opioids. Combining the two types of drugs is considered to be unsafe as they both produce a sedation effect and suppress breathing.
Popular street names of Librium include:
When prescribed, Librium comes in the form of a tablet or capsule that is taken orally. Some people abuse the medication by emptying the capsules or crushing the tablet to snort the contents. Others mix the powder with liquid and inject it intravenously. These methods of using Librium are done in an attempt to force the drug to act on the brain faster and enhance the rush.
Snorting Librium is one of the most common ways of abusing it as the thin lining inside the nose allows the drug to enter the bloodstream. This rapid delivery method can increase the chances of dependence and addiction to the drug.
Snorting Librium can lead to over sedation. In these cases, it’s possible to experience side effects like:
Inability to concentrate or retain new information
Loss of coordination
Other methods of abusing Librium involve combining the tablet or the contents of the capsule with other substances such as opioids to increase its effect.
Librium is also often abused alongside alcohol or other CNS depressants. Combining the drug with opioids or alcohol increases the risk of overdose and life-threatening side effects. Abusing Librium can be fatal, especially if the dose is continually increased to experience the same high.
When used in the short-term, Librium acts as a central nervous system depressant and slows down brain activity. The immediate effects include:
Relief from anxiety
A sense of calm and relaxation
A feeling of well-being
Whether people use Librium as prescribed by their doctor or abuse it, there are potential short-term side effects. The most common include:
Librium can also cause psychological side effects that include:
Chronic use of Librium can result in a range of life-threatening long-term effects, such as:
Mixing Librium with other substances such as cocaine or alcohol significantly increases the risk of an overdose. Librium also has the potential to change the brain’s chemistry over time. People who are abusing the drug should seek treatment sooner rather than later.
Apart from cognitive and physical side effects, long-term Librium abuse can also impact social life. Some of the issues might involve:
Loss of employment
Impaired work or school performance
Difficulties maintaining relationships with friends and coworkers
Librium overdoses, although less frequent, can happen. Benzodiazepines can be life-threatening, especially when taken without a prescription or used differently than what the doctor recommended. In 2010 in the US, the number of emergency room visits due to benzodiazepine abuse was more than 400,000.3
When doctors prescribe Librium to patients, they recommend starting with 5 mg to 10 mg of Librium up to four times a day. In cases of severe anxiety, the dose may be increased to 20 mg – 25 mg three or four times per day.
Many people develop a tolerance to the medication if taken regularly for an extended time. Some research shows that benzodiazepines may lose their full effect after 4 to 6 months of daily use.4 When tolerance to the drug is developed, higher doses are needed to experience the same high. By taking larger doses than recommended, there is a higher risk of overdose.
Moreover, some people tend to take Librium in combination with other substances as they can increase each substance’s effects. Other substances can include alcohol, opioids, or prescription painkillers.
The National Institute on Drug Abuse found that nearly 30% of opioid overdoses also involve benzodiazepines. In 2015, around 23% of people who died from an opioid overdose also had traces of benzodiazepines in their bloodstream. Another study conducted in North Carolina discovered that the overdose death rate in patients who received benzodiazepines and opioids at the same time is ten times higher than in patients who only received opioids.5 Overdoses are also more likely to happen when the drug is being injected.
The symptoms of overdose include:
Lack of response to pain
Low blood pressure
In rare cases, dangerous complications may occur after a Librium overdose. These complications can arise from the lack of oxygenated blood, respiratory distress, or physical trauma from a loss of consciousness, and include:
If an overdose takes place, call 911 to receive immediate help. If possible, a sample of the drug should also be taken to the medical center for analysis.
Addiction can occur if the medication is not taken carefully. If misused or taken for a long time, anyone can find themselves with a Librium use disorder. When a person tries to stop use, a rage of painful withdrawal symptoms may take place.
For that reason, the best way to end Librium use is to enroll in a comprehensive substance abuse treatment center and undergo detox. The best chances of getting sober are with the help of professionals. These people understand substance abuse and the underlying mental issues that lead to the substance use disorder.
A sudden stop in use of Librium can lead to severe anxiety and agitation, withdrawal psychosis, or seizures. Gradual reduction, done under the supervision of medical personnel, is the safest way to end Librium use.
Librium is a habit-forming benzodiazepine that can result in dependence and addiction with chronic use. It acts by enhancing the effects of the GABA neurotransmitter in the brain. As a result, feelings of calm and relaxation may occur.
Over time, the brain will become reliant on the drug to feel calm and relaxed. If Librium is quit abruptly, the brain will still produce calming neurotransmitters, but having adjusted to the additional chemical in the brain, less will be produced. As a result, feelings of anxiousness and a range of other withdrawal symptoms will occur.
Withdrawal symptoms will linger until the the brain has readjusted to a pre-Librium state of functioning. Symptoms usually last a few weeks to a couple of months and can be moderate or severe, depending on several factors such as:
The length of time Librium was used
How much Librium was used
How it was taken
In general, the more severe the addiction, the more serious the withdrawal process.
The most common symptoms of Librium withdrawal include:
High blood pressure
Increased heart rate
Loss of appetite
In addition, several psychological withdrawal symptoms may continue for a more extended period of time. This phenomenon is known as post-acute withdrawal syndrome. Withdrawal symptoms may be felt even 18-24 months after the last use.
Librium withdrawal can be risky and potentially even fatal. For this reason, it’s recommended to attend a medically-supervised detox.
The majority of treatment centers use the taper method to treat patients. In a tapering program, the drug is gradually removed, allowing the body to readjust to its Librium-free state. It’s a process that can take several weeks and in which several withdrawal symptoms may occur, although milder.
The tapering process involves substituting Librium with a different type or lower amount of benzodiazepine. The doctor might opt for Valium, Clonidine, or Propanolol to manage the symptoms in the acute phase of withdrawal.
Medically supervised detox is a useful first step on the road to recovery from addiction. However, long-term abstinence from Librium also requires proper rehab care. After detox, it’s always recommended to continue with a structured addiction treatment program in an inpatient or outpatient setting.
Inpatient treatment is more suitable for people who are suffering from severe addiction and need a safe place to get sober. This type of care can last anywhere from 21 days to several months, depending on the severity of the addiction. During inpatient care, patients live on-site and participate in:
There is a myriad of different rehab centers to choose from, some of which also offer more holistic approaches, such as meditation, yoga, art, music, and nature therapy. The focus in every inpatient treatment center is learning new healthier habits, attitudes, and behaviors. Treatment can include stress management, relapse prevention, and addressing underlying mental health issues.
Outpatient care is more appropriate for patients who are suffering from a milder addiction and have a safe and loving home in which they can stay. These patients require minimal care and supervision. Other daily responsibilities, including school, work, or family can also make outpatient treatment a better option for some.
The best way to know whether inpatient or outpatient care is needed is by talking to a medical professional. A professional can determine the most suitable type of care for each person.
During outpatient care, the person lives off-site but attends on-site meetings for several hours each day. Similar to inpatient care, participation in 12-step meetings and individual therapy sessions are expected. Holistic classes such as meditation and yoga may also be attended. At the end of the day, outpatient attendees return to their own home or sober living home.
Although inpatient and outpatient treatment for Librium varies, it eventually comes to an end. Good treatment centers make long-term recovery a priority and offer a thorough aftercare plan.
Prolonged substance abuse can change the brain’s chemistry. For this reason, aftercare is essential for long-lasting sobriety. These changes don’t instantly go back to normal after drug use stops. In reality, the brain changes can last for months or even years after the last use.
The goal of an aftercare plan is to help:
According to SAMHSA, a successful aftercare program has these four components:
It can be hard to imagine how a drug that is effective in the treatment of anxiety and alcohol addiction can have a range of adverse effects on a person’s health. But many studies confirm that when used for an extended time, some degree of Librium addiction is likely to develop. Abusing the drug, especially when mixed with other substances, can be life-threatening and dangerous.
People who are taking the medication must do so with precaution and by following their doctor’s recommendations. If an use disorder develops, the safest way to sobriety is through a medically supervised detox program and an effective inpatient/outpatient care. Ongoing recovery efforts, including aftercare, are also critical for a successful and long-term recovery.
This information should not replace a visit to a doctor or treatment center. If you are concerned that you or your loved one might be suffering from Librium addiction, ask for professional help today.