Valium (diazepam) is a member of the benzodiazepine class of medications. Benzodiazepines were developed in an effort to create a medication that could effectively treat anxiety and seizures but did not have the addictive potential of barbiturate drugs that were commonly used for these purposes at the time. Nonetheless, benzodiazepines are significant drugs of abuse.
What Is Valium?
Valium is listed as a Schedule IV controlled substance by the United States Drug Enforcement Administration (DEA). This indicates that the drug does have the potential for abuse and for the development of physical dependence in individuals who use it consistently for any significant length of time. In many cases, people who develop physical dependence on benzodiazepines do so rather quickly, and the symptoms may begin to appear within only a few weeks of consistent use.
At one time, Valium was regularly prescribed for the treatment of anxiety and became one of the most commonly prescribed drugs in the world. The use of benzodiazepines for anxiety is designed to be a short-term solution and not intended to be used over the long-term in most cases. Individuals with issues concerning anxiety and even with anxiety disorders should learn to address the cause of their anxiety through behavioral means rather than medication.
Unfortunately, in many cases, this treatment approach was not adhered to by psychiatrists and other physicians who often prescribed the drug to individuals who did not have clinically significant issues with anxiety. Because of widespread prescriptions for Valium to treat issues associated with everyday nervousness, Valium became a significant drug of abuse. Eventually, other drugs like Xanax (alprazolam) that have shorter durations of action were more often used in its place.
All benzodiazepines are central nervous system depressants that increase the actions of the inhibitory neurotransmitter gamma aminobutyric acid (GABA) and affect other neurotransmitter systems.
The main effects of taking Valium include:
- Reduction in the experience of stress
- Reduction in anxiety
- Suppressed functioning of all physical functions, such as respiration, heart rate, neuronal firing, etc.
- Feelings of relaxation at low to moderate doses
- Extreme sedation or lethargy at moderate to high doses (similar effects to alcohol intoxication)
- Decreased response times, issues with motor coordination, decreased speed of thought, loss of inhibitions, and, in some cases, confused thinking
The major actions associated with Valium’s central nervous system depressant features account for its efficiency in reducing anxiety as well as its ability to decrease the frequency of seizures in individuals who suffer from them. However, these same actions can also lead to a number of untoward effects associated with use of the drug.
Side Effects of Valium Use and Abuse
Because of its central nervous system depressant effects as well as its effect on several different neurotransmitter systems, the immediate side effects of using Valium may include:
- Feelings of wellbeing or euphoria
- A reduction in motor coordination that is dose-dependent, such that motor coordination rapidly declines as one takes more of the drug
- Decreased rate of thought
According to the Food and Drug Administration (FDA), some other common side effects associated with use of Valium include:
- Slurred speech
- Muscle weakness
According to the FDA, some of the infrequent side effects associated with Valium use include:
- Extreme confusion
- Extreme weakness
- Significantly reduced energy levels
- Dry mouth
According to the FDA, rare side effects associated with Valium use include:
- Allergic reactions that can include the development of hives or rash, swelling in the face or extremities, difficulty breathing, anxiety, and confusion
- Gastrointestinal issues that can include nausea, constipation, and other issues
- Other central nervous system effects, including depression, dysarthria, tremor, headache, and vertigo
- Problems with vision, such as blurred vision or double vision
- Cardiovascular issues including significant hypotension; in some cases, increased potential for heart attack
- Paradoxical reactions, such as becoming very excited, anxious, agitated, irritable, or more aggressive; in some rare cases, rapid heartbeat, high blood pressure, and/or seizures
- Sleep disturbances, such as insomnia and nightmares
- Hallucinations and delusions in some individuals
- Muscle spasticity
- Memory issues, such as antereograde amnesia (difficulty forming new memories or remembering events that occurred)
- Liver and kidney damage
In some cases, individuals who have used Valium for a significant length of time and then discontinue its use may develop a rebound effect. This effect occurs when discontinuation of the drug results in the occurrence of symptoms that the drug originally controlled. Rebound effects that are common with the discontinuation of Valium include increased anxiety, insomnia, irritability, and, in some cases, aggressiveness.
Because Valium use can result in the development of physical dependence, tolerance is a very common side effect of taking Valium on a regular basis. Tolerance to Valium develops rapidly. Tolerance occurs when the individual no longer gets the same effects from the dosage they have been taking and needs to increase the dose to achieve the desired effects.
Some individuals who use Valium on a regular basis for more than several weeks may also develop withdrawal symptoms when they stop using the drug. Withdrawal symptoms associated with discontinuing Valium can be potentially severe and include issues with nausea, vomiting, tremors, irritability, restlessness, insomnia, and potential seizures, which can be fatal.
Side Effects and Valium Abuse
According to the FDA and the Substance Abuse and Mental Health Services Administration (SAMHSA), when Valium is used under the supervision of a physician and in accordance with its prescribed dosage and frequency of use, it produces very few side effects. Individuals who experience side effects most often have issues with motor coordination, dizziness, lethargy, and mild muscle weakness. If a person experiences more severe side effects, the medication can be discontinued and a different medication used.
Individuals who abuse benzodiazepines often abuse them in combination with other drugs, such as alcohol. When a person takes Valium more frequently than it is designed to be taken, at higher doses than recommended, and/or with other drugs, the potential for the development of any of the above side effects listed as rare increases. This includes issues with aggressiveness, irritability, psychosis, and potential damage to the central nervous system, cardiovascular system, and excretory system.
Individuals who take extremely high doses of Valium are at risk for overdose, which can include comatose states and a lack of oxygen to the brain that can be potentially fatal. In addition, individuals who mix different drugs are at an increased risk to develop idiosyncratic reactions that can be puzzling to even the most experienced emergency room physicians. People who mix central nervous system depressant drugs (e.g., Valium and alcohol) are also at an increased risk for overdose and the development of unusual side effects.
The development of physical dependence on Valium (having both tolerance and withdrawal syndromes) is typically not problematic for individuals who use the drug under the supervision of a physician and according to its prescribed purposes. These individuals often develop a low-level physical dependence that is controlled by their medicinal use of the drug. If the patient and physician decide to discontinue use of Valium, the physician can discontinue it on a tapering schedule to allow the person to slowly be weaned off the drug.
Individuals who abuse Valium often use it in far greater amounts than the dosages prescribed for medicinal purposes, and this often results in significant issues with withdrawal for many of these people. For many abusers, the onset of withdrawal symptoms leads to increased drug use, polydrug use, and issues with controlling behavior that can lead to numerous legal problems, financial issues, and other problems. Issues controlling drug use and experiencing significant dysfunction and impairment associated with Valium use are extremely rare in people who use the drug for medicinal reasons and under the supervision of a physician.