Valium is a benzodiazepine often used to treat anxiety, alcohol withdrawal symptoms, and muscle spasms, as well as a sedative given before specific medical procedures (again for anxiety). Benzodiazepines are a class of drugs that act as tranquilizers and are among the most frequently prescribed substances in the United States. These types of drugs are formulated to have a direct impact on the central nervous system (CNS), reducing anxiety levels and promoting muscle relaxation.

Generally speaking, Valium (Diazepam) is used in one of three ways. The first is to treat individuals with anxiety disorders, as diazepam directly addresses the chemical imbalance that may be responsible for the condition. Valium is also used to treat muscle spasms and alcohol withdrawal symptoms due to alcohol addiction’s impact on the body's central nervous system. In some cases, though notably less common, Valium may be used in combination with other medications to treat seizures.

While Valium is a legal substance, it can be quite dangerous when taken with alcohol. Both substances impact the central nervous system and, combined, can lead to severe side effects including respiratory depression, loss of consciousness, and in some cases, death. In this article, we'll look more closely at Valium, its side effects, and what happens when you mix it with alcohol.

What is Valium?

As mentioned, Valium is a type of benzodiazepine that impacts the chemicals in the brain in a way that reduces anxiety, muscle spasms, and causes sedation. Valium increases the activity of gamma-aminobutyric acid (GABA), an amino acid and neurotransmitter that acts as a depressant in your central nervous system.

If your body is low on GABA, it may cause you to become overly excited and, as a result, you may feel anxious or experience muscle spasms or seizures. Valium, and other benzodiazepines, are used to treat issues associated with that "excited state" by increasing GABA production.

Like other benzodiazepines, Valium can be habit-forming, which means that, unfortunately, the drug is often abused by those with prescriptions as well as those without. The drug offers a euphoric effect to users in high doses and, when combined with alcohol, can result in a range of undesirable health outcomes.

As with any prescription drug, it's essential that Valium only is taken under the direction of a doctor with a full picture of your medical history. This way, they can gauge whether the drug is safe based on existing conditions, allergies, and any other medications you may be taking.

Common Side Effects of Valium

Benzodiazepines, including Valium, come with a wide range of side effects, including addiction. Valium also may cause patients to become sedated and may lead to more severe issues such as respiratory depression, coma, or even death.

In many cases, Valium should only be prescribed to patients if alternative medications or therapies are deemed inadequate, and doctors aim to limit use to the lowest dose possible for the shortest duration possible. Doctors should also watch out for signs of sedation or respiratory depression.

Many side effects associated with using Valium do not require medical attention and are likely to go away after your body has some time to adjust to the medication.

These side effects include:

  • Tiredness
  • Drowsiness
  • Loss of coordination
  • Weakness

Keep in mind that your healthcare provider may also be able to offer some ways to reduce or prevent unwanted side effects.

That said, the following symptoms may indicate an overdose and require immediate attention:

  • difficult or troubled breathing
  • Fast, slowed, or shallow breathing
  • Loss of consciousness
  • Muscle pain or weakness
  • Pale or blue lips, skin, or fingernails
  • Unusual tiredness, weakness, or sluggishness

It's also worth noting that, for those using Valium as a treatment for alcohol addiction, the drug may cause reactions with other medications used for this purpose. For that reason, it's essential to make sure that Valium is taken as directed, under the supervision of a doctor, ideally in an in-patient, alcohol detox environment. Still, Valium is often used in an outpatient setting to help patients manage their alcohol withdrawal symptoms.

Interactions of Valium and Alcohol

The relaxing effects associated with Valium are similar to those you might get from consuming alcohol. However, it is partially because of those similarities that mixing these two substances is particularly dangerous. Individually, both substances come with health risks when abused, though effects vary based on the person; size, weight, and overall health all come into play here.

Alcohol abuse comes with a long list of both short- and long-term side effects, which vary based on the amount of alcohol consumed over a given period. For instance, low to moderate consumption can result in fewer and less severe effects than those who habitually drink in larger quantities.

Short-term effects linked to alcohol abuse include the following:

  • Impaired vision
  • Slurred speech
  • Mood swings
  • Slowed breathing
  • Lack of coordination
  • Memory lapses

These symptoms are similar to the side effects that you might experience if you have a Valium prescription and take the recommended dosage as directed by your doctor.

Long-term alcohol abuse can lead to more severe conditions, such as malnutrition, liver disease, pancreatitis, and cancer. Again, alcohol is a central nervous system (CNS) depressant that impacts every organ in the body as, when a person consumes alcohol, it is absorbed into their bloodstream from the stomach and small intestine, and from there, is circulated throughout the rest of the system. The brain, liver, heart, pancreas, stomach, and kidneys are all susceptible to damage caused by alcohol abuse. However, specific effects vary based on several factors like age, gender, health condition, use of medications, and duration of abuse.

Valium is known to enhance the effects of alcohol, which can result in a euphoric feeling that may lead to repeated use, and later abuse, of this combination. When combined with another CNS depressant, like Valium, consuming even a modest amount of alcohol can cause serious harmful effects.

Alcohol Poisoning and Valium Overdose

According to data from the Centers for Disease Control and Prevention, alcohol is involved in over a quarter of all ER visits for benzodiazepine abuse. More troublingly, the CDC found that alcohol played a role in about 20% of deaths attributed to benzodiazepines. Because both drugs suppress breathing, combining alcohol and Valium can trigger a fatal overdose. What's more, the amount of Valium that can lead to an overdose dramatically decreases when alcohol enters the picture, again, increasing the risk of overdose.

Additionally, any time someone drinks alcohol, their system metabolizes the alcohol first, before moving on to other substances in their system. This means that benzodiazepines stay in person's system longer than they would normally, and those abusing both drugs long-term risk developing extremely dangerous Valium levels inside their bodies, which has a chance of hitting all at once when the alcohol has been metabolized fully.

Withdrawal for Alcohol and Valium Abuse

Withdrawal symptoms for both alcohol and Valium abuse depend on how long the substance was used, how much was consumed, how often substances were abused, and whether an individual quit “cold-turkey” or tapered off slowly, among a long list of other factors. Long-term, heavy use can lead to a more extended withdrawal period and adding alcohol withdrawal to the mix can further complicate the process and makes it more dangerous as well.

According to data from the Diagnostic and Statistical Manual of Mental Disorders, those who use as little as 15 mg of Valium daily for several months may experience withdrawal symptoms after ceasing to use the drug. People who take more than 100 mg of Valium a day are more likely to experience severe withdrawal symptoms and complications.

Valium withdrawal often lasts longer than other types of benzodiazepine, as it is designed to provide extended relief from anxiety. Because of its long-lasting effects, it can also take a while for patients to start experiencing withdrawal symptoms as it takes longer to fully leave the body. Withdrawal symptoms often take place in two phases: the acute stage and general withdrawal. Here's a quick breakdown of what that means:

Acute stage: The acute stage lasts between 1-4 days after the patient stops using Valium. The drug has a variable half-life as long as 48 hours, creating a delay for some individuals who may metabolize the drug more slowly. Still, most people will begin to experience acute withdrawal symptoms by day three or four.

When symptoms start to appear depends on several things, including:

  • How much and how often the person took Valium
  • How long they were abusing the drug
  • Whether they abused alcohol or other drugs in addition to Valium
  • Individual differences in metabolism
  • Emotional health
  • Psychological stability
  • Physical health

Acute withdrawal will often include a wide range of physical, mental, and neurological symptoms.

Here’s a look at some of the symptoms that might happen within those first few days:

  • Nausea
  • Vomiting
  • Stomach cramps
  • Tremors
  • Elevated heart rate
  • Increased blood pressure
  • Anxiety
  • Cravings
  • Mood swings
  • Confusion
  • Seizures
  • Depression
  • Panic Attacks

In more severe instances, Valium withdrawal symptoms may include:

  • Psychosis
  • Seizures
  • Hallucinations
  • Delirium
  • Numbness in arms or legs
  • Convulsions
  • Depersonalization
  • Coma
  • Death

General withdrawal: Following the 3-4 days of acute symptoms, the patient will move into a more prolonged withdrawal phase that typically lasts between 10-14 days. During this period, the patient may begin to experience increased cravings for Valium, along with both physical and mental symptoms, including headache, mild fever, nausea, chills, and lightheadedness, as well as depression and anxiety or panic attacks.

While these symptoms are less intense than those associated with the acute withdrawal phase, this phase may prove challenging. Patients will likely experience flu-like symptoms combined with depression, anxiety, or a general sense of melancholy for up to two weeks.

Additionally, some patients experience anxiety after general withdrawal, which may last another 10 to 14 days. This is known as rebound anxiety and often shows up in individuals who are prone to anxiety and depression. They may begin to experience rebound anxiety after a relatively short period of not using Valium.

Treatment

Valium and alcohol are a dangerous combination, and use of both drugs simultaneously could be the sign of a substance abuse disorder. If you or someone you know is habitually using Valium with alcohol or other substances, the best treatment option is one that addresses all substance abuse issues holistically. Meaning, you'll want to seek out a program that focuses detox from two substances simultaneously.

These two substances are closely linked, affecting similar parts of the brain. If users stops use of one substance, but continues to abuse the other, be it alcohol or Valium, they will be at a high risk for relapse. For instance, continuing to use alcohol after recovering from Valium addiction may lower inhibitions to the point that it leads to relapse. Entering a long-term substance abuse rehabilitation program will help keep this from happening.

Ultimately, long-term abuse of either Valium or alcohol can have a negative impact on a patients physical and mental health. Together, Valium and alcohol can lead to serious health problems and even death. Individuals abusing both drugs may require long-term, in-patient treatment programs to help them safely recover from their addiction and minimize withdrawal symptoms.

Sources:

  • https://www.ncbi.nlm.nih.gov/pubmed/19062773

  • https://www.drugs.com/sfx/valium-side-effects.html

  • https://www.healthline.com/health/diazepam-oral-tablet#about