Librium (chlordiazepoxide) is a medication used to treat several conditions like anxiety, insomnia, and withdrawal symptoms from substance use disorders (SUDs), including alcohol withdrawal symptoms. However, the drug also has the potential to lead to dependence and addiction.
Fortunately, we at PCP have both the knowledge and dedication to help you effectively deal with the challenges of Librium (chlordiazepoxide) dependence and offer you an understanding of how to overcome a Librium addiction.
Key Takeaways
● Librium is a medication that produces a calming effect.
● It is used to treat anxiety disorders, insomnia, and symptoms of alcohol abuse and withdrawal.
● Librium is classified as a controlled substance due to its potential for abuse and dependence.
● Signs of Librium addiction include tolerance, cravings, unsuccessful attempts to stop use, and continued use despite negative consequences.
● Treating Librium addiction involves detoxification therapy, counselling, and rehabilitation programs tailored to address substance use disorders.
● Librium addiction treatment involves customized programs that include detoxification, therapy, and rehabilitation.
What Is Librium Chlordiazepoxide?
Librium is the brand name of the medication chlordiazepoxide, which is classified as a long-acting benzodiazepine. Among the broader category of benzodiazepine compounds, chlordiazepoxide, or Librium, stands out for its historical significance in the development and usage of these compounds, offering insights into their synthesis, applications, and the targeted pharmacist interventions for deprescribing in older adults. Benzodiazepines (such as Librium) are a well-known class of drugs commonly referred to as sedative-hypnotics. Librium is sometimes used alongside selective serotonin reuptake inhibitors (SSRIs) in the treatment of anxiety and other psychiatric disorders.
Sedatives are a class of medication that creates a calming effect by reducing irritability or excitement. They are generally used to promote relaxation or alleviate anxiety. On the other hand, hypnotics refer to medications that are primarily used to promote sleep. These drugs are generally used to treat insomnia and other sleep disturbances.
Many drugs which are sedatives also have hypnotic properties (like Librium), but not always. For example, zolpidem (Ambien) or eszopiclone (Lunesta) are medications that have primarily hypnotic, but little or no sedative properties at lower doses.
History of the Librium
The discovery of chlordiazepoxide was one of the most influential psychopharmacological discoveries of the 20th century. It is also a story of fortuity, initial widespread acceptance, and eventually prudent caution.
Chlordiazepoxide was discovered in 1956 and patented in 1958. The drug was introduced to the market as Librium in 1960 and received widespread acceptance from physicians and patients due to its effectiveness in treating several conditions like, severe anxiety disorders and other forms of minor mental disorders.
This quickly prompted research into other novel drugs of the same class, leading to the discovery and approval of diazepam (Valium) in 1963, nitrazepam (Mogadon) in 1972, flurazepam (Dalmane), which was introduced in 1975, and temazepam (Restoril), which was introduced in 1979.
These medications initially received widespread acceptance due to their effectiveness and perceived safety when compared to other sedative-hypnotics. However, in 1963 a report by Carl F. Essig of the Addiction Research Center of the National Institute of Mental Health revealed the potential for abuse of many of these medications and the risk they pose in terms of dependence and addiction.
However, widespread criticism against Librium and other medications of the benzodiazepine class did not occur until the 1980s. This was due to public outrage over the harmful effects of the drug in terms of dependence and withdrawal. All this eventually led to several lawsuits including the largest-ever class-action lawsuit against drug manufacturers in the UK, involving 14,000 patients and 1,800 law firms.
Following this clinicians took a much more cautious approach to the use of medications with a significant potential for abuse such as benzodiazepines and opioids. However, benzodiazepines are still one of the most widely used medications in psychopharmacology, and their importance cannot be overemphasized in the medical management of several psychiatric conditions like withdrawal and anxiety.
How Does Librium Work?
Librium is a benzodiazepine and works by increasing the activity of a chemical in the brain called gamma-aminobutyric acid (GABA). GABA is a central nervous system (CNS) depressant. This means the drug slows down the activity of the CNS, leading to the relaxing and sleep-promoting effects of Librium. It’s crucial to be aware of drug interactions when taking Librium, especially with CNS depressants or opioids, as these can lead to severe CNS depression, respiratory depression, increased sedation, and even death.
How Is the Medication Taken?
Librium is available in both oral and intramuscular dosage forms only.
The oral capsule comes in 3 common strengths —5 mg, 10 mg, and 25 mg, while the injectable form comes with a concentration of 100 mg/5 mL.
If you miss a dose of Librium, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
What Is the Medication Used For?
Treatment of Anxiety Disorders
Like many benzodiazepines, Librium is prescribed to treat certain types of anxiety disorders like generalized anxiety disorder (GAD), specifically targeting and alleviating anxiety symptoms. The calming effect of Librium is effective in treating the symptoms of anxiety disorders, including the broad spectrum of anxiety symptoms experienced in conditions such as anxiety disorders, alcohol withdrawal, and related psychological effects.
Alcohol Withdrawal
Librium is also used to treat symptoms of acute alcohol withdrawal, including agitation, tremors, severe anxiety, and hallucinations, effectively alleviating these distressing conditions. It does this by stabilizing the CNS during the detox process.
Is Librium a Controlled Substance?
Benzodiazepines like Librium are considered controlled substances and can only be obtained by prescription in most countries.
The potential for abuse is lower with benzodiazepines when compared with other sedative-hypnotics like barbiturates. However, there is still a significant risk of dependence and addiction, with an increased risk of dependence and withdrawal reactions when Librium is not used as prescribed. This highlights why it’s classified as a controlled substance, emphasizing the importance of careful monitoring and adherence such patients to prescribed dosages to mitigate these risks.
Librium (and most other benzodiazepines) are classified as schedule IV drugs by the Convention on Psychotropic Substances. This means that these drugs have a limited risk of physical or psychological dependence. In the UK, Librium is scheduled as a Class C drug under the UK Misuse of Drugs Act, the least harmful class.
Potential Side-Effects
Here are some potential side effects of Librium you may notice:
● Confusion
● Drowsiness
● Severe drowsiness
● Fainting
● Altered sex drive
● Liver problems
● Lack of muscle coordination
● Minor menstrual irregularities
● Nausea
● Vomiting
● Constipation
● Skin rash
● Body swelling
● Yellow eyes and skin
Precautions and Contraindications
Librium should be used with caution in the following conditions:
● Myasthenia gravis
● Acute intoxication with alcohol, narcotics, or other psychoactive substances
● Ataxia (loss of voluntary coordination of muscle movements due to a neurological condition)
● Severe breathing disorders
● Acute narrow-angle glaucoma
● Severe liver disease (like hepatitis and liver cirrhosis)
● Severe sleep apnea
● Allergy to any drug in the benzodiazepine class
● The elderly (due to its long half-life and the risk of undesirable effects of accumulation)
● Pregnancy
● Children
● Individuals who are dependent on alcohol or drugs
● People with psychiatric disorders.
To avoid benzodiazepine withdrawal syndrome, it’s crucial to gradually reduce the dose under medical supervision when discontinuing treatment.
Potential for Abuse
Librium has a risk of abuse, dependence, and addiction, similar to all benzodiazepines and most drugs within the sedative-hypnotic class. The risk of abuse comes from the relaxing, sedative, and euphoric properties of the drug, especially when taken at higher doses than normally prescribed.
This, in turn, leads to long-term abuse, which may lead to tolerance and dependence. Abruptly discontinuing Librium, especially after long-term use, can precipitate severe withdrawal symptoms, including convulsions, tremors, abdominal and muscle cramps, vomiting, and sweating, highlighting the importance of medical supervision during discontinuation.
Tolerance is a situation where higher doses of the medication are required to achieve the same effects and typically occurs after prolonged use.
Dependence refers to discomforting physical and psychological symptoms that occur when the drug is not consumed for some time. Dependence usually occurs when the drug is taken longer than prescribed or at doses typically higher than what is considered safe.
This cycle of tolerance and dependence may eventually lead to drug addiction or a substance use disorder (SUD). This describes a chronic, recurring state characterized by compulsive drug-seeking behaviour, substance abuse, and a lack of control over drug intake despite the harmful consequences of the drug to the user.
Due to the risks of abuse, misuse, addiction, physical dependence, and withdrawal, the US Food and Drug Administration (FDA) requires that a boxed warning be placed for all benzodiazepine medicines to describe these potential consequences.
Let’s take a closer look at some of the potential dangers that come with addiction to substances like Librium such as substance use disorders, withdrawal, and overdose.
Signs of Librium Addiction
Diagnosing substance use disorder or drug abuse or addiction should be done by a qualified healthcare provider. The criteria are based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). This guideline also helps determine the severity of the SUD.
The criteria include:
● Using larger amounts of Librium than intended or taking the drug for a longer duration than originally prescribed.
● Having persistent cravings for the medication.
● Making repeated unsuccessful attempts to cut down or control Librium use.
● Spending a significant amount of time on obtaining, using, or recovering from the effects of the drug.
● Drug use negatively affects your performance at work, school, home, or social obligations.
● Avoiding important social, occupational, or recreational activities because of drug use.
● Using Librium in dangerous situations or Librium use leading to dangerous situations.
● Continuing to use the same benzodiazepine treatment despite persistent or recurrent physical or psychological problems caused or worsened by the medication.
● Continuing to use Librium despite persistent or recurrent social or interpersonal problems caused or worsened by the drug.
● Requiring increased amounts of Librium to achieve the same level of intoxication or desired effect (tolerance).
● Experiencing discomforting symptoms when Librium use stops, which may lead to substance abuse to relieve or avoid these symptoms (withdrawal)
Healthcare professionals diagnose an SUD if an individual meets 2 or more of these 11 diagnostic criteria.
These criteria can also be used to determine the severity of an alcohol use disorder – mild means meeting 2-3 criteria; moderate signifies 4-5 criteria and severe SUDs are when you have 6 or more symptoms.
Withdrawal Symptoms
Librium withdrawal occurs when the drug is stopped abruptly. This is why when taken under medical supervision the dose is tapered off slowly to avoid drug withdrawal. Individuals who have been abusing the medication may develop withdrawal symptoms during the detoxification stage.
Librium withdrawal symptoms include:
● Anxiety
● Nausea
● Vomiting
● Sweating
● Insomnia
● Headaches
● A fast heartbeat
● Palpitations
● Tremors
● Seizures
● Hallucinations
● Disorientation
Everybody experiences withdrawal differently. Due to the risk of developing potentially serious withdrawal symptoms, a benzodiazepine detox should be performed under the supervision of a professional detox centre. For those who have used Librium for an extended period, it is crucial to taper off the medication gradually under medical supervision to avoid severe withdrawal symptoms.
Overdose Signs
Some signs of a Librium overdose include,
● Extreme drowsiness or difficulty staying awake
● Confusion or disorientation
● Slurred speech
● Slow or shallow breathing
● Blurred vision
● Muscle weakness or lack of coordination
● Tremors or involuntary muscle movements
● Dizziness or fainting
● Bluish discoloration of the lips or fingertips
● Seizures
● Nausea or vomiting
● Irregular heartbeat
● Low blood pressure
● Memory loss
● Coma or loss of consciousness
A Librium overdose can be very serious and potentially fatal. If you suspect someone is experiencing a Librium overdose, call emergency services immediately. Prompt detection and immediate medical attention are vital to prevent serious complications or death.
Risk Factors for Overdose
Several factors can increase the risk of overdosing on Librium. These include:
● Taking a higher-than-prescribed dose of the medication.
● Mixing Librium with alcohol or other drugs, especially opioids (e.g. heroin, oxycodone).
● Individuals who have developed tolerance to benzodiazepines may take higher doses to achieve the desired effect.
● People with a history of substance abuse, including chronic benzodiazepine abuse, are at higher risk of overdose due to potential higher tolerance levels and polydrug use.
● Older adults
● Certain medical conditions such as respiratory disorders, liver disease, or impaired kidney function.
● Taking multiple medications concurrently, especially those that interact with benzodiazepines such as antidepressants or anticonvulsants.
● Using Librium for non-medical reasons or in ways not prescribed by a healthcare provider increases the risk of overdose.
● Not being aware of the potential dangers or risks associated with Librium use.
Treating a Librium Addiction
Detox
This is the first step in overcoming a Librium addiction and involves the process of ridding your body of chlordiazepoxide. This process is usually associated with several uncomfortable and potentially dangerous withdrawal symptoms. The side effects of a detox occur because of the long-term effects of benzodiazepines on the brain.
A medically assisted detox program can provide recovering addicts with the professional services they need to safely navigate the process of detoxification and reduce the severity of these withdrawal symptoms. Some of these services include medications, close monitoring, and counselling services.
Therapy
Psychotherapy is an important step in treating SUDs. Therapy helps those recovering from substance abuse to identify the reasons behind their drug use and develop coping strategies they can use to control their addiction. Different therapy techniques can be offered like cognitive behavioural therapy (CBT), group therapy sessions, family therapy, and psychodynamic therapy.
Counselling and patient education
Long-term recovery services like counselling, patient education, and follow-up are another part of the healing journey. Being well-informed about the symptoms of withdrawal, possible duration of recovery, potential relapse triggers and treatment options makes it psychologically easier to deal with the process of recovery, provides comfort when dealing with cravings, and reduces the risk of relapse.
Rehab
Rehabilitation (rehab) is an important part of the recovery process. In rehab, individuals are provided a structured environment designed to support their recovery journey. This is necessary for the intensive treatment and ongoing care necessary to address the underlying causes of addiction and develop essential life skills for sobriety.
Rehab typically involves a combination of individual and group therapy sessions, providing a safe space to explore triggers and learn effective coping mechanisms. Additionally, holistic approaches such as mindfulness practices, relaxation techniques, exercise routines, and nutritional guidance are also offered.
Education on addiction, relapse prevention strategies, and life after rehab equip individuals with the knowledge and tools needed for sustained recovery. Rehab programs vary in duration, type (whether inpatient or outpatient), and intensity. This allows each program to be carefully tailored to each person’s unique needs and progress towards sobriety.
Tips For Preventing Librium Abuse
Here are some tips on how Librium dependence and addiction can be prevented:
● Take benzodiazepines exactly as prescribed by your healthcare provider. Follow the recommended dosage and duration of treatment.
● Regularly check in with your healthcare provider while taking benzodiazepines.
● Avoid consuming alcohol or other substances that can interact with benzodiazepines and increase the risk of adverse effects or addiction.
● Consider alternative therapies for managing anxiety or insomnia, such as cognitive-behavioral therapy (CBT), relaxation techniques, mindfulness meditation, and lifestyle changes.
● Learn about the potential risks and benefits of benzodiazepines. Understand the signs of addiction and dependence, such as cravings, withdrawal symptoms, and compulsive use.
● Perform regular check-ins and keep an open line of communication with your healthcare provider. Discuss any concerns or difficulties you may have with benzodiazepine use, including potential signs of dependence or addiction.
● If you suspect you or someone you know has a dependence on benzodiazepines or is experiencing withdrawal symptoms, seek help from a rehabilitation centre immediately.
Conclusion
In conclusion, while Librium offers therapeutic benefits for various conditions, its potential for dependence and addiction underscores the importance of responsible use and professional guidance.
At PCP, we’re committed to aiding individuals through alcohol detoxification with expertise and empathy. Understanding the detox process and its timeline is key to navigating recovery effectively.
Our comprehensive approach addresses the complexities of addiction, integrating therapy, education, and rehabilitation to support lasting sobriety. By prioritizing individual needs and fostering resilience, we empower individuals to reclaim their lives from substance use disorders.
Together, we can overcome challenges and pave a path towards a healthier, substance-free future.
FAQs
What is the duration of action of Librium?
Librium is a long-acting benzodiazepine with a half-life of 5-30 hours.
Does Librium induce sleep?
Yes, Librium promotes sleep and drowsiness due to its sedative-hypnotic properties. Therefore, do not take the medication while operating heavy machinery or driving.
Does Librium make you hungry?
Yes, Librium has some mild appetite-inducing effects.
What precautions should be taken when taking Librium?
Take the drug exactly as prescribed by your healthcare provider. Follow the recommended dosage and duration of treatment. Avoid consuming alcohol or other substances that can interact with benzodiazepines and increase the risk of adverse effects or addiction.
