Is Librium a Benzodiazepine?


Librium is the brand name for the benzodiazepine medication chlordiazepoxide.1 As a benzodiazepine, Librium acts to increase the activity of GABA in the brain. GABA is an inhibitory neurotransmitter—a signaling molecule in the brain that, when active, can lower certain types of brain activity; by increasing the effects of GABA in the brain, Librium can decrease anxiety while promoting feelings of calm and sleepiness.2

What Is Librium Used For?

Librium (chlordiazepoxide) pills

Librium is prescribed for the short-term management of:3

  • Anxiety symptoms.
  • Acute alcohol withdrawal.
  • Pre-operative fear and anxiety.

The Drug Enforcement Administration has classified the medication as a Schedule IV substance, indicating that while it has medical utility, it also has abuse and dependence potential.3,4

While Librium, like other benzodiazepines, is considered safe for short-term use, long-term use may result in tolerance, physical dependence, and addiction.5

Side Effects of Librium

The potential side effects of Librium include the following:1, 2, 3,6

  • Sedation.
  • Drowsiness.
  • Impaired cognition and/or memory.
  • Confusion.
  • Lightheadedness.
  • Dizziness.
  • Impaired muscle coordination.
  • Slurred speech.
  • Blurred vision.
  • Lowered blood pressure.
  • Nausea.
  • Constipation.
  • Appetite changes.
  • Dry mouth.
  • Edema.
  • Changes in libido.

Side effects of any benzodiazepine, including Librium, are less likely to be severe when the medication is taken as directed. However, people who abuse Librium for nonmedical or recreational reasons, or who become addicted to Librium, are more likely to experience serious side effects.3

Librium’s depressant effects on the central nervous system (e.g., sedation and respiratory depression) may also be amplified and become very serious in the case of very high-dose use or polysubstance abuse (e.g., taking the drug in combination with an opioid, alcohol, or other CNS depressants).2,5

Signs of a Librium Overdose

An overdose of chlordiazepoxide is much more likely to produce severe or life-threatening symptoms when the drug is taken in combination with another CNS depressant substance such as opioids (prescription painkillers or heroin) or alcohol.3 Unfortunately, benzodiazepines are often abused in this way.2,5 People may combine CNS depressant drugs to achieve a more significant high, but the combination increases the risk of a potentially deadly overdose.

A Librium overdose may produce the following symptoms:3

  • Extreme sleepiness (somnolence) or inability to wake.
  • Profound confusion.
  • Diminished reflexes.
  • Slowed breathing.
  • Slowed pulse.
  • Very low blood pressure.
  • Coma.

Librium Addiction, Dependence, and Withdrawal

Misusing benzodiazepines such as Librium alone or together with other drugs can increase the likelihood of developing what’s known as a sedative use disorder, or a benzodiazepine addiction.2

Signs of an addiction to Librium include craving the medication, needing more and more to achieve the desired effects (tolerance), ignoring obligations and abandoning previously enjoyed hobbies or activities in order to use, and continuing to use Librium despite the problems that arise or worsen as a result.8

Long-term use of any benzodiazepine can also result in significant physiological dependence.2,3 A potential sign of addiction, dependence refers to how the body adapts to a drug that is regularly present in the system. As the brain and body adapt, a person may become dependent on a consistently used drug to the point that it becomes difficult to function in the usual way in its absence.9

Someone who has developed a substance dependence may experience withdrawal symptoms when they significantly cut down their use or quit altogether.9 The severity and character of different acute withdrawal syndromes will depend on the type of drug as well as other factors such as length and amount of use. For benzodiazepines, including Librium, acute withdrawal can be very serious, especially among long-term high-dose users and elderly individuals.3,10

Librium is a long-acting benzodiazepine, so withdrawal symptoms may not begin as quickly as those for relatively shorter-acting benzos like Xanax (alprazolam). In some individuals, withdrawal from Librium might not start for up to 1 week after the dose reduction of cessation of the drug, may peak around the 2nd week, and may take up to 3 to 4 weeks to resolve.8

Symptoms of Librium withdrawal may include:3,8

  • Dysphoria (feeling of dissatisfaction or unease).
  • Anxiety.
  • Insomnia.
  • Autonomic hyperactivity (manifested by symptoms like rapid pulse, sweating, high blood pressure, and high body temperature).
  • Hand tremors.
  • Nausea.
  • Vomiting.
  • Purposeless movements.
  • Hallucinations.
  • Delirium.
  • Grand mal seizures.

Not every person will have severe symptoms when detoxing from Librium; however, those who have been abusing the drug for a long period of time, at high doses, and/or in combination with other drugs like alcohol or opioids may very well experience a severe withdrawal. In addition, it may be difficult to predict just who will suffer the more dangerous symptoms of benzodiazepine withdrawal. Patients can have peace of mind during the acute withdrawal process by entering a medical detoxification facility. In this type of facility, a team of doctors and nurses can care for the patient and medically manage the detox process to increase the patient’s comfort and help to prevent the more severe symptoms or complications associated with Librium withdrawal.10

Finding Help for Librium Abuse

Woman in therapy session

Getting help for Librium abuse and addiction may begin with medical detox, but it should not be limited to this step alone. Addressing the compulsive use of any substance often goes far beyond just overcoming physical dependence to the drug. New coping skills are needed to avoid future substance abuse and, in many cases, old traumas or issues require treatment to prevent relapse.11

Much of addiction treatment that is provided after medical detox involves individual and group therapy. It is in therapist-led sessions, which may follow a particular approach, such as cognitive-behavioral therapy (among other research-based therapy approaches), where recovering individuals learn about the root causes of their addiction. Therapy can help a recovering person to gain an understanding of how the drug abuse started, why it continued, and the emotional, psychological, behavioral triggers that were involved. In this way, therapy provides individuals with an education about drug abuse and addiction, as well guidance on how to build a drug-free life with a new understanding of how all aspects of life can positively support that goal.

In the case of Librium, because it is an anti-anxiety medication, the person in treatment may need a new plan for addressing anxiety that does not involve the use of benzodiazepines. Drug addiction treatment facilities that focus on the treatment of co-occurring disorders (addiction and mental health issues) may be best for those struggling with anxiety, depression, or other mental health conditions in addition to their problems with benzodiazepine abuse. To learn about Recovery First’s co-occurring disorder care and how we can help you or a loved one recover, give us a call at any time at 954-526-5776. Addiction is treatable, and we can help.

References

  1. U.S. National Library of Medicine. (2017). Chlordiazepoxide.
  2. National Institute on Drug Abuse. (2018). What are prescription CNS depressants?
  3. Valeant Pharmaceuticals. (n.d.). Librium C-IV (chlordiazepoxide HCl) capsules.
  4. United States Drug Enforcement Administration. (n.d.). Drug Scheduling.
  5. Tan, K. R., Rudolph, U., & Lüscher, C. (2011). Hooked on benzodiazepines: GABAA receptor subtypes and addiction. Trends in neurosciences34(4), 188–197.
  6. John Hopkins. (2016). Benzodiazepines.
  7. Jones, J. D., Mogali, S., & Comer, S. D. (2012). Polydrug abuse: a review of opioid and benzodiazepine combination useDrug and alcohol dependence125(1-2), 8–18.
  8. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  9. National Institute on Drug Abuse. (2018). Is there a difference between physical dependence and addiction?
  10. Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.
  11. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.


 


About The Contributor

Scot Thomas, M.D.
Scot Thomas, M.D.

Senior Medical Editor, American Addiction Centers

Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating... Read More


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