Valium, also known as diazepam, is a drug from the benzodiazepine class and is predominantly used for treating anxiety disorders as it helps people to relax which means it is useful for calming people before medical procedures. (3)
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Valium is a very fast-acting drug but the effects do last for several hours Valium is a drug with a half-life of 20-50 hours, which tends to be greater than the majority of benzodiazepines.
A drug’s half-life refers to the length of time it takes for the body to remove half of the drug. Drugs with a longer half-life tend to stay in the body for longer and therefore continue to affect us for longer.
Valium tends to be the preferred option for medical practitioners who are required to prescribe suitable medication for patients suffering from anxiety.
Valium (diazepam) is also used to assist with the detox process for patients going through treatment for alcohol use disorder. (4,8)
All drugs in the benzodiazepine class fall into two categories, these are:
All psychoactive drugs tend to elicit positive effects that will appeal to recreational users who wish to alter their mood, or emotional state or experience different physical sensations, particularly if they feel that their life has become mundane.
Valium places people in a very relaxed state and even produces a greater state of euphoria than can ever be achieved naturally.
Recreational users taking Valium to elevate a low mood are placing their physical health in danger by taking a benzodiazepine drug without consulting with medical professionals who can oversee their treatment.
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Valium possesses chemicals that affect the activity of a key brain neurotransmitter called GABA. GABA is responsible for inhibiting any neural activity in the brain that leads to us performing any actions.
Valium triggers GABA into action which leads to all brain and central nervous system activities slowing down and making us feel calm, relaxed and slightly drowsy. (3,11)
All benzodiazepine drugs should only be taken for a maximum of one month although many medical practitioners feel that this is too long and that they should be used for no more than two weeks as physical dependence can develop quickly.
The consequences of long terms Valium use include:
Many people who are diagnosed with Valium addiction started taking Valium as patients who used the medication under the guidance and supervision of their GP.
However, due to the nature of the drug and how effective it is at treating anxiety, many people do not strictly adhere to the instructions.
This results in them either taking too much Valium or taking Valium for longer than they should which ends up with them becoming physically dependent on Valium. (3,4)
People who become dependent on Valium may display the following behaviours:
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Since the introduction of DSM5 in 2013 Valium addiction now falls under the umbrella of sedative, hypnotic and anxiolytic use disorder which covers most benzodiazepine drugs.
A regular user of Valium will be diagnosed as having an addiction if they meet two or more of the following diagnostic criteria, which include: (1)
Overall DSM5 has set 11 criteria for diagnosing SHAUD (Valium addiction) and if a patient has met two of the 11 criteria in a one-year period they will be classified as having a mild addictive disorder.
Meeting 4/5 of the criteria will result in a diagnosis of a moderate addictive disorder and anyone meeting over 6 of the criteria will be judged to have a severe addictive disorder. (1)
Developing a physical dependence on Valium is one of the key indicators of Valium addiction and a sure sign that specialist pharmacological treatment is needed.
Because Valium is a drug that alleviates symptoms of anxiety it is easy for patients to become dependent on it very quickly as they have a strong need to alleviate their anxious feelings.
However, medical practitioners advise that no patient should be taking Valium for longer than one month as there is a risk of dependence if the drug is taken any longer.
Physical dependence occurs when a patient’s tolerance to Valium has increased meaning they now require a higher dose to provide the same calming effect that they had after they consumed their first dose.
If the person’s tolerance continues to increase and they stop taking Valium for 1-2 days (or in some cases as little as 4-6 hours) they will experience withdrawal symptoms. (10,11)
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Whenever a patient or recreational users take a psychoactive drug such as Valium the body is automatically primed to process the drug as efficiently as possible.
Benzodiazepines only tend to be effective for 2-3 weeks and after that their effects begin to wane as the body has adapted to its presence, meaning patients will soon need to take higher doses to feel its effects.
As the body and brain have become accustomed to functioning effectively with Valium present, the central nervous system starts to behave erratically when Valium intake is then suddenly ceased.
This can trigger unpredictable cardiac and brain activity which can lead to a range of withdrawal symptoms which can be very unsettling, uncomfortable and even life-threatening. (3,6)
As well as being physically dependent on Valium people who take Valium frequently will become reliant on the drug to help them cope with the stresses of day-to-day life.
This is even more likely if they refuse to look for alternative ways to help tackle their anxiety such as counselling, exercise programmes or relaxation techniques.
If patients become too reliant on Valium they may reach the stage where they cannot function to any degree without Valium.
Patients who fall into this category require specialist psychological treatment to help them overcome their psychological dependence on Valium.
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Treatment services for Valium addiction utilise a combination of pharmacological and psychological approaches to treatment.
Once a person has been referred to drug rehab services for treatment they will enter the assessment process which is an information-gathering exercise designed to build up a complete medical and psychiatric profile of the patient.
The assessment also seeks to gain extra information about each patient including their own personal resources and the support systems that they have around them.
Treatment specialists usually refer to ASAM 6 dimensions of care to help assess the treatment needs of the patients in six separate areas of their life. (3,4)
The setting in which the patient receives their treatment can vary between patients and depends on several factors.
Inpatient treatment may be preferable for patients with a severe Valium addiction who do not have a strong social support network around them and also have problems with heavy alcohol use.
There is also a danger that patients with severe addiction may experience seizures during the early stages of withdrawal and having expert medical care close at hand would be beneficial during the early stage of withdrawal.
Patients also have the option of just having the detox treatment element of their programme in residential rehab accompanied by psychological support for a period of 7-10 days and then receiving ongoing counselling sessions as an outpatient.
Patients who are less of a risk and who have been diagnosed with mild to moderate Valium addiction can follow an outpatient programme if doctors do not deem their personal and domestic situations to be too problematic.
They can follow a detox schedule set by their GP or designated psychiatrist and attend individual and group therapy sessions whilst living at home.
Treatment usually begins with a pharmacological procedure called detoxification which helps the patient remove all the toxic traces of Valium from their body which will slowly reduce the intensity of their withdrawal symptoms. (2)
As with all benzodiazepine drugs, there is a standardised procedure set up to help patients detox from the drug.
Detox treatment can take several months to be completed for some patients depending on the dose size they regularly consumed and the pattern of their use.
The first stage in treating Valium addiction is to establish the patient’s level of intoxication and their pattern of Valium use and this information would have been gathered during the assessment phase.
This will help the medical practitioners assess the level of Valium that the patient has in his/her body and also help calculate the starting dose for the detox treatment. (7,10)
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Tapering is a technique used by medical practitioners to help patients slowly detox from a drug that they have become physically dependent on.
Benzodiazepine drugs such as Valium can take a long time to leave the system and the longer a person has been taking the drug the longer the tapering schedule will take. (2,7)
In essence, doctors provide all patients with their own tapering schedule which gradually decreases the dose size they will take over a period of several months.
This will enable the toxic elements of Valium within their body to be safely eliminated and ensures the patient does not experience any withdrawal symptoms.
The starting dose should be enough to keep withdrawal symptoms at bay and nothing more. If the tapering process is rushed then the patient can experience withdrawal as their body has not had time to adapt to the current dose size.
The doctor will consider all aspects of the patient’s medical history, their pattern of benzodiazepine use and several social factors before devising their tapering schedule. (9)
All patients will have their tapering regime based on the information gained during the assessment phase but an example of a tapering schedule devised by doctors is shown below for patients who have been taking 40mg of diazepam per day or less:
The estimated withdrawal time for diazepam for those taking 40 mg a day doses is 10/15 months, whereas the estimated withdrawal time for diazepam for those taking 20mg per day is only 25-40 weeks
The decreased dose size should still be enough to prevent withdrawal symptoms, if not then the doctor will have to re-calculate the tapering regime so that the dose they take does prevent withdrawal symptoms. (10,11)
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It is essential that patients recovering from Valium addiction undergo an intense programme of psychological therapies.
As well as providing emotional support whilst going through a challenging detox treatment phase, counselling can help the patients understand the reasons for their Valium addiction.
Therapists will help clients to develop strategies to cope with the anxiety generated from dealing with life’s challenges by providing them with a new psychological skillset that will develop their inner resilience.
Some of the therapies used in rehab are:
Research has suggested that anyone going through detox treatment for drug addiction is more likely to remain motivated and stick to their regime if they receive regular emotional support consistently through the detox period which can take several months. (4)
One-to-one addiction counselling is very beneficial for patients overcoming Valium addiction. The sessions can help the patient retain the motivation to stick with their challenging detox schedule and discuss strategies with the counsellor that they can implement to make the detox process easier.
Research has suggested that counselling sessions offer a valuable source of support for people going through detox treatment.
Addiction counselling also helps patients come to terms with any unresolved and difficult feelings they have been unable to express over the years which may have been a major factor in their Valium addiction and the accompanying psychological distress it caused. (3,4)
Many patients seeking to overcome Valium addiction have found CBT very useful in helping them gain control of their thought processes which enables them to reduce their anxiety levels, as negative thoughts do tend to cause anxiety and low self-esteem. (3)
DBT is very helpful for providing patients with key psychological skills that can enable them to deal with difficult day-to-day emotions so they are not overwhelmed by them, which for some people can see them enter a negative spiral of panic, stress and anxiety. (6)
Regular MI sessions with a qualified therapist will help patients retain their motivation levels to recover from their Valium addiction.
Addiction is a very challenging mental health condition to overcome and many patients experience a drop in motivation during the course of their treatment.
MI sessions will help patients overcome their emotional reliance on Valium as the therapist will help the patient resolve any internal psychological barriers that they may have which is preventing them from fully engaging with treatment. (4)
The support of people who are going through a similar challenge to you can be very helpful and enable patients to maintain the motivation and belief that they can recover and turn their lives around.
Support groups for Valium addiction include Narcotics Anonymous which follows the same principles of alcoholics anonymous in that it promotes fellowship and mutual support between everyone who attends its meetings.
All members attending the meeting can draw strength from the support they give each other as they each work through the 12 steps to recovery. (6)
Group therapy helps patients understand aspects of their personality and behaviour that they were unaware of.
This could be a very useful form of therapy for people who suffer from social anxiety as it will help them improve their confidence when interacting with others.
Group therapy sessions also help to boost attendees’ relational skills and develop their empathic side after they begin to realise that they have many things in common with other group members who share the same feelings as them and have had similar experiences. (3)
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All patients seeking to recover from Valium addiction will have a relapse prevention and aftercare plan to help them continue to maintain their recovery after their rehab programme has been completed.
Engaging in relapse prevention sessions will enable patients to identify significant triggers in their life that could cause them to relapse. These triggers could be internal feelings or situations or even people that make the patient feel anxious and emotionally vulnerable which can act as a prelude to drug use.
Once these high-risk situations are acknowledged the patients can work in collaboration with their designated therapist to develop cognitive strategies to use when they encounter high-risk situations, which will protect them from slipping back into Valium use again. (4,6)
Aftercare packages are designed to help patients build a new life for themselves.
To achieve this it is recommended that they follow a routine to enable them to fully focus on positive, meaningful things far away from the short-term pleasures of substance use.
It also ensures that they have a strong support network around them that they can turn to if they ever feel vulnerable.
An aftercare plan may include:
There is an abundance of research in the area of addiction recovery which has emphasised the importance of the above areas as part of an aftercare plan.
Many people in recovery have commented on how important working on these aspects of their lives has been for helping them overcome addiction. (4)
(1) Black, D., Grant, J. (2013) DSM5 Guidebook: The Essential Companion to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. APP. London.
(2) Cambridgeshire and Peterborough Clinical Commissioning Group NHS (2021) Coming off Benzodiazepines and “Z” drugs: A guide for patients. Available onlinegetresource.axd (cambridgeshireandpeterboroughccg.nhs.uk)
(3) Ghodse, H. (2002) Drugs and Addictive Behaviour: A guide to treatment Cambridge University Press
(4) Herie, M. & Skinner, W. (2014) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.
(5) Kahan, M. (2014) Physical Effects of Alcohol and Other Drugs. In Herie, M. & Skinner, W. (ed) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada
(6) Moss, A, Dyer, K (2010) The Psychology of Addictive Behaviour. Palgrave McMillan. New York
(7) National Institute for Health and Care Excellence (2019) Benzodiazepine and Z drug Withdrawal..Available onlineBenzodiazepine and z-drug withdrawal | Health topics A to Z | CKS | NICE
(8) Newton, D.E. (2016) Prescription Drug Abuse. ABC-CLIO California.
(9) Southend Clinical Commissioning Group NHS (2021) Withdrawal of Benzodiazepines.available@file (southendccg.nhs.uk)
(10) Wales NHS (2021) Hypnotics and Anxiolytics Practice Guide. Available online @Guide_Hypnotics & Anxiolytics Practice Guide_version02.pdf (wales.nhs.uk)
(11) Wirral NHS (2021) Benzodiazepine WithdrawalAvailable onlineBenzoWithdrawalGuidance.pdf (wirral.nhs.uk)
