Sleep disorders and anxiety issues are among the most common health issues Americans face each year. To combat this, researchers have come up with several different medications that are used to help people relax and get some rest. Many of these medications are in the class of drugs called central nervous system depressants along with alcohol. Valium is one such drug. It’s a benzodiazepine that’s used to treat a variety of issues that are related to nervous system over-activity like anxiety, panic disorders, insomnia, and seizures. However, like other depressants, it can cause acute effects that are similar to alcohol intoxication. For that reason, Valium is sometimes abused to achieve a euphoric high. High doses or long-term use can also lead to dependence and addiction.

Learn more about Valium and how it can lead to substance use disorders after prolonged or recreational use.

How Valium Works in the Brain

Valium is a trade name for a drug called diazepam that’s is in a class of drugs called benzodiazepines which are commonly used to treat sleep disorders, anxiety, muscle spasms, seizures, and alcohol withdrawal. The drug is also in a larger category of drugs called central nervous system (CNS) depressants, which work to limit excitability in the brain. Valium works in the brain by affecting a naturally occurring neurotransmitter called gamma-aminobutyric acid (GABA). GABA is responsible for regulating excitability when you need to rest or relax. When it binds to its receptors, it eases anxiety and promotes sleep. However, people who have sleep problems and anxiety disorders may have some psychological or biological factor that impedes that process.

Valium binds to GABA receptors on small binding sites that are separate from GABA’s own binding sites. Valium is a positive allosteric modulator, which means that it indirectly influences GABA in a way that potentiates the neurotransmitter. In other words, Valium increases the effectiveness of your own naturally occurring GABA. However, that also means that GABAs effects will be more intense. Valium can mitigate anxieties, stop convulsions, and promote sleep, but it can also cause drowsiness, poor coordination, and alcohol-like intoxication.

How Does Valium Work in the Body?

Valium is a relatively fast-acting depressant, especially when compared to other benzodiazepines. It can begin working within 20 minutes after you take it. Another similar benzodiazepine called clorazepate is another fast-acting benzodiazepine that works within 30 to 60 minutes. Other popular benzodiazepine brands like Xanax or Ativan take much longer for their effects to kick in. 

When you take Valium by mouth, it’s absorbed into your bloodstream through your digestive system. As far as prescription drugs go, it has a relatively high oral bioavailability, which is the amount of the drug that’s able to enter your bloodstream when you take it by mouth. Many drugs are broken down in digestion, and only a portion of the active dose enters your bloodstream. However, Valium’s oral bioavailability is 94%. The only way to take it more efficiently is to inject it. After you take it, the drug’s effects on your brain and body last for about five hours.

Valium is used to treat mental health disorders like anxiety, but it can also have some physical effects on your body. Benzodiazepines are sometimes used to treat insomnia and sleep disorders. This is because depressants can slow down the nervous system to promote sleep. GABA is a neurotransmitter associated with sleep and relaxation. It can also be used to treat muscle spasms, so the drug can cause your muscles to relax, and muscle weakness is a possible side effect.

Other physical side effects include fatigue, dizziness, constipation, balance issues, nausea, and decreased libido. 

Does Valium Cause Physical Dependence?

Physical drug dependency is when your brain comes to rely on a foreign psychoactive drug to maintain natural brain functions. Your brain is a cocktail of natural chemicals that keeps everything functioning normally and allows your brain to communicate with the rest of the body. Chemicals carry messages from one nerve cell to the next to facilitate communication through the central nervous system. Psychoactive drugs alter that communication by binding to nerve cells and activating specific receptors. After a while, your brain will start to become more tolerant to the drug. If you continue to use, it will start to integrate it into your natural brain chemistry by producing less of its chemicals that are designed to achieve the same effect as the drug.

Unlike opioids, depressants like valium don’t have special receptors that they can bind to activate direct effects on your nervous system. However, they do indirectly affect GABA by binding to adjacent sites on the neurons. Valium doesn’t increase the amount of GABA in your system either, but it does increase GABA’s effectiveness in your system. After a while, your brain may stop producing its inhibitory effects and start producing excitatory chemicals to counteract Valium’s depressant effects. If you stop using Valium, your brain chemistry will become imbalanced, and you’ll feel the effects of an overly-excited nervous system.

The U.S. Food and Drug Administration warns that Valium can cause dependence, especially in people who have a history with substance use problems. They also note that people who are using Valium for long-term therapy are more likely to develop substance use issues. They write, “Once physical dependence to benzodiazepines has developed, termination of treatment will be accompanied by withdrawal symptoms. The risk is more pronounced in patients on long-term therapy.”

Valium dependence can be treated with medical detoxification and treatment from medical professionals. Without treatment, depressants can cause dangerous withdrawal symptoms like seizures and a condition called delirium tremens. With treatment, the chance of experiencing life-threatening symptoms is significantly lowered.

Does Valium Cause Addiction?

Addiction is defined as a chronic condition that affects the reward center of the brain and causes compulsive drug use. It’s often identified by continued drug use despite harmful consequences like health problems or legal troubles. Addiction is officially diagnosed as a severe substance use disorder by the DSM-5, and it usually develops after a period of consistent drug use. It can happen quickly, but people often follow a pattern of drug abuse, then chemical dependence, then compulsive addiction.

Addiction involves the reward center of the brain, which is primarily located in the limbic system. This part of the brain is tied to reward, motivation, and basic survival instincts. If you have cravings for certain foods or other types of compulsions, you are experiencing your reward center in action. When you eat something like a chocolate chip cookie, your brain releases feel-good chemicals like dopamine. Your reward center takes note that the cookie was good to eat, provided calories, and an enjoyable experience. It logs that information away and will encourage you to seek out chocolate chip cookies again later. This part of the brain is a key part of motivation. When you’re hungry, instead of lying around all day, your brain will encourage you to seek out sustenance by giving you cravings and compulsions.

However, psychoactive drugs like Valium also influence feel-good chemicals in your brain. To your reward center, it’s difficult to tell the difference between a benzodiazepine and other life-sustaining activities like a satisfying meal. Your reward center will learn to encourage Valium use again. Because drugs like Valium can have a powerful effect on your brain chemistry, your brain may cause powerful compulsions to use again. Addiction is this hijacking and rewiring of your reward center to use drugs.

Addiction is a chronic disease that’s difficult to overcome, especially without help. However, treatment can help manage addiction cravings and compulsions to help you avoid a relapse into drug use. Treatment involves personalized care based on your specific needs, multiple levels of care, and a holistic approach that addresses multiple needs. Treatment may involve a variety of therapies, including individual, group, and family therapy. Behavioral therapies are also common and can help facilitate lasting changes. Cognitive behavioral therapy is among the most common therapies in addiction treatment and involves identifying triggers and learning to cope with cravings and stress effectively.

How Addictive Is Valium?

There are several ways to measure how addictive a drug is and the danger it poses to people that use it. The way the drug works in the brain and its likelihood of causing dependence is a good way to determine a drug’s addictive potential. You can also look at the way it’s used both legally and illegally. Commonly misused drugs may have a higher likelihood of causing a substance use disorder. 

As a benzodiazepine, Valium does work in a way that may cause chemical dependence and addiction. Drugs that are likely to cause addiction usually influence the “feel-good chemicals” of the brain, which include dopamine, serotonin, endorphins, and oxytocin. Opioids mimic endorphins and stimulants increase dopamine levels. Benzodiazepines primarily work by influencing GABA, but they can also influence dopamine indirectly. A study in 2010 showed that benzodiazepines can interact with certain GABA receptors in a way that increases the firing of dopamine neurons. 

Dopamine is a chemical that’s tied to positive moods, pleasure, and reward. Drugs that increase dopamine activity may produce a euphoric high. Depressants tend to cause a relaxing high and feelings of comfort.

Valium can also cause chemical dependence, which is when your body adapts to the drug, and you come to rely on it. Dependence and addiction aren’t the same things, but they are often related. Dependence can cause uncomfortable withdrawal symptoms and drug cravings that make it difficult to stop using the drug, which can worsen an addiction. 

Valium is more likely to cause addiction when it’s misused or used for recreational purposes. It does have a significant potential for abuse, and it’s listed as a Schedule IV drug. This means that it has moderate abuse potential, but it also has accepted medical uses. 

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