Librium is the brand name of one of the first benzodiazepines to enter the United States prescription market. The generic drug, chlordiazepoxide, was created in 1955 as medical scientists worked to find sedative drugs that were less addictive than barbiturates.
Librium was approved by the Food and Drug Administration (FDA) in 1960, followed by the more infamous Valium in 1963. Currently, Librium is a Schedule IV drug under the Controlled Substances Act (CSA), and it has fallen out of favor as an anxiety treatment in the U.S. Even so, it is sometimes still available, though other benzodiazepines are more widely prescribed and abused.
Since Librium is a long-acting benzodiazepine drug, it is not typically prescribed for as-needed use to manage anxiety or panic attacks unlike other benzodiazepines such as Klonopin or Xanax. Instead, Librium is rarely prescribed to treat more severe conditions like ongoing severe anxiety disorders and withdrawal symptoms like seizures associated with alcohol use disorder (AUD). In some instances, the medication is prescribed to reduce a patient’s panic before they undergo surgery.
Librium and other benzodiazepines act on the gamma-Aminobutyric acid (GABA) receptors in the brain, which manage the absorption of the GABA neurotransmitter. This neurotransmitter is tied to regulating how fast neurons fire. When there is not enough GABA, neurons fire quickly, and depending on how fast they fire, conditions from anxiety to seizures can occur. When a chemical acts on the GABA receptors, there is more of the neurotransmitter available to manage neuron interactions. This allows the person to feel calm, pleasant, relaxed, and even sleepy.
Alcohol, barbiturates, and benzodiazepines all have some interaction with the GABA receptors. However, benzodiazepines’ interaction is the strongest. Because both alcohol and benzodiazepines work on the GABA receptors, Librium is used to manage alcohol withdrawal. Unfortunately, this similar action means that people who struggle with sedative and/or alcohol abuse are at risk of becoming addicted to benzodiazepines as well.
Unlike other benzodiazepines, Librium works best when it is taken consistently and slowly over time, building up effectiveness as there is more available in the body. Still, like other benzodiazepines, tolerance to and dependence on the drug can occur quickly, so if you are taking this medication as prescribed, you may feel like you need a larger dose to get the initial effects.
Dependence also means your body needs the presence of the drug to manage brain chemistry. While dependence is often associated with drug abuse and addiction, this condition can occur in people who take benzodiazepines like Librium as prescribed. If you want to stop taking Librium, or you and your doctor agree that you would benefit from a different medication, your doctor will work with you to gradually reduce how much Librium you take, which is called a taper.
Using any drug, whether it is a prescription medication or an illicit substance, will cause some side effects. Prescription drugs can cause side effects even when they are taken as your doctor intended, but these effects are more likely to occur in people who abuse the drug for nonmedical reasons. Potent drugs like Librium, which are designed for long-term use, are more likely to lead to side effects after a few weeks or months of consumption. Speak with your doctor if you have concerns about side effects or want to adjust your dose.
Unfortunately, people without the oversight of a medical professional may not get the help they need to manage Librium, which means you may escalate how much you take, become physically dependent on it, and take it compulsively. You may experience withdrawal symptoms, panic, and cravings if you are not able to take the drug.
Long-term abuse of any benzodiazepine, including a potent and long-lasting one like Librium, can lead to impaired thinking, memory, and judgment that may not clear up after quitting; disorientation; confusion; slurred speech; and muscle weakness. Additionally, anxiety, insomnia, and seizures may occur after discontinuation. These issues may persist to some extent even after stopping drug abuse, so it is important to get help as soon as signs of addiction begin.
If you notice someone showing the following signs of a drug overdose, call 911 immediately. They need emergency medical attention regardless of what is causing the overdose.
Overdose deaths involving benzodiazepines have been on the rise for more than 10 years in the U.S. alongside the increase of the opioid addiction and overdose epidemic. Between 2002 and 2015, overdose deaths involving any benzodiazepine quadrupled, and prescriptions for these drugs rose 67 percent between 1996 and 2013. In 1999, for example, there were 1,135 overdose deaths involving any benzodiazepine; by 2015, that number was up to 8,791 deaths.
Most benzodiazepines, especially the short-acting ones, are limited to one to two weeks of ongoing use or used only for as-needed use. This is because these drugs lead to tolerance and dependence in three to four weeks of continuous use.
Since Librium is a longer-acting benzodiazepine and is intended to be taken consistently, it is crucial that you work with your doctor to take the drug only as prescribed and to slowly taper off Librium when you are done with your prescription. After two or three weeks, the body has developed a dependence on this medication, so a taper is necessary to ease the body off the substance and avoid withdrawal symptoms.
Suddenly quitting Librium can be dangerous. Not only will the discomfort increase your risk of relapsing and overdosing on these drugs, but seizures are also a withdrawal symptom associated with any substance that interacts with the GABA receptors. It is important to have medical oversight to safely detox.
Unlike other benzodiazepines, Librium remains in the body for a long time. It is detectable in blood tests for 6 hours to 48 hours, meaning that its half-life is about 24 hours. Withdrawal symptoms won’t start for about two days after the final dose is taken.
When working with addiction specialists, the oncoming withdrawal symptoms can be explained and managed. If you just quit cold turkey, this can lead to unnecessary hardship if you think you will not experience withdrawal symptoms and suddenly they appear after a couple of days.
There are many reasons to get help from medical professionals to overcome any kind of drug or alcohol abuse; however, managing withdrawal symptoms and avoiding relapse and overdose are the most important reasons to seek help. Librium, along with many other drugs, is potentially deadly if you take too much during a relapse and overdose.
The core pillars of addiction treatment are safe, medically supervised detox; behavioral therapy in rehabilitation; and a solid aftercare plan. For drugs like alcohol and opioids, there may be medications like buprenorphine or diazepam (Valium) that can ease withdrawal symptoms.
Although Librium is sometimes used in addiction treatment, there is no good prescription replacement for the substance in this context since it is already a long-acting benzodiazepine. An addiction specialist may work with your physician to create a taper to ease your body off the drug. However, if you did not have a prescribing physician and took Librium illicitly, this option may not be available.
Working with medical professionals in a safe detox setting means any withdrawal symptoms, including seizures, can be managed with other medications, like antiseizure drugs, anti-nausea medications, and even antidepressants if there is an underlying anxiety or depression condition that needs treatment.
Ready to get Help?
Talk to a treatment expert
Entering a rehabilitation program after detox is finished is crucial. Addiction is a disease involving compulsive behaviors, and working with trained behavioral therapists means you can see when these harmful behaviors appear and learn new ways of coping with stress and managing compulsions.
The foundation of rehabilitation is group therapy, and many outpatient programs center around group meetings. Intensive outpatient and inpatient treatment are more likely to offer individual therapy and complementary therapies, which can support your healing process. If you find you are not safe living at home or need stronger social support, inpatient, or residential treatment at a facility may be the best approach for you. If you live in an environment that is supportive of your recovery and have a strong social network of healthy people, outpatient treatment is a great option.
The creation of an aftercare plan should come at the end of rehabilitation. This plan helps you transition back into your daily life. You should find support groups, either in person or online; continue individual therapy; create an exercise and healthy eating plan; and make a list of people you can contact in times of stress when you need emotional support or help with avoiding relapse from cravings. There are many other things you can add to an aftercare plan—it should be tailored to your individual needs—but starting with a few daily, weekly, and long-term steps to take care of yourself, with the help of an addiction specialist, will give you an initial path to follow out of intensive treatment and into ongoing recovery.
Although depressant addiction, including Librium abuse, is tough to overcome, many programs understand the severity of prescription drug dependence and know how to help. Evidence-based treatment uses the latest science to understand how addiction affects individuals, which means that treatment is continually improving. Contact a physician, therapist, or addiction specialist now to get started with an assessment or treatment referral.
(September 28, 2013). The history of benzodiazepines. The Consultant Pharmacist: The Journal of the American Society of Consultant Pharmacists. Retrieved September 2018 from https://www.ncbi.nlm.nih.gov/pubmed/24007886
Librium C-IV (chlordiazepoxide HCl) Capsules. United States Food and Drug Administration (FDA). Retrieved September 2018 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/012249s049lbl.pdf
Benzodiazepine Abuse. WebMD. Retrieved September 2018 from https://www.webmd.com/mental-health/addiction/benzodiazepine-abuse#1
(June 1, 2015). What is Librium (Chlordiazepoxide)? Everyday Health. Retrieved September 2018 from https://www.everydayhealth.com/drugs/librium
(April 1, 2000). Addiction: Part I. Benzodiazepines – Side Effects, Abuse Risk and Alternatives. American Family Physician (AAFP). Retrieved September 2018 from https://www.aafp.org/afp/2000/0401/p2121.html
(March 1, 2017). Chlordiazepoxide Hydrochloride (Oral Route). Mayo Clinic. Retrieved September 2018 from https://www.mayoclinic.org/drugs-supplements/chlordiazepoxide-hydrochloride-oral-route/side-effects/drg-20072246
(July 2, 2017). Chlordiazepoxide overdose. Medline Plus. Retrieved September 2018 from https://medlineplus.gov/ency/article/002607.htm
(October 29, 2013). Benzodiazepines. Center for Substance Abuse Research (CESAR), University of Maryland. Retrieved September 2018 from http://www.cesar.umd.edu/cesar/drugs/benzos.asp
(August 3, 2018). Antianxiety drugs – often more deadly than opioids – are fueling the next drug crisis in US. CNBC. Retrieved September 2018 from https://www.cnbc.com/2018/08/02/antianxiety-drugs-fuel-the-next-deadly-drug-crisis-in-us.html
(October 1, 2015). Management of benzodiazepine misuse and dependence. Australian Prescriber: An Independent Review. Retrieved September 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/
(April 23, 2018). How Long Does Librium Stay in Your System? Verywell Mind. Retrieved September 2018 from https://www.verywellmind.com/how-long-does-librium-stay-in-your-system-80272
(December 25, 2016). Librium. RxList.com. Retrieved September 2018 from https://www.rxlist.com/librium-drug.htm#description