Librium is a prescription drug that can be used for several medical purposes. It’s primarily used as a treatment for anxiety disorders. However, it also has an application as a treatment for alcohol withdrawal. Alcoholism is one of the most common causes of substance use disorders, next to opioids. However, unlike opioids, alcohol can cause potentially life-threatening symptoms during withdrawal. Librium may be an option to make alcohol withdrawal safer and more successful. Learn more about Librium and its use in alcohol withdrawal.

What is Librium?

Librium is a prescription brand name for a drug called chlordiazepoxide, which is used as a sedative medication. It may be used to manage anxiety disorders, and it may also be used for the short-term relief of anxiety symptoms. Its anxiolytic (anti-anxiety) effects can help calm anxiety symptoms and allow you to rest and relax. In addition to anxiety disorders, Librium has also been used to treat alcohol use disorders. It’s specifically used to manage alcohol withdrawal and alleviate uncomfortable or dangerous symptoms. 

Librium is in a class of drugs called benzodiazepines, which have a specific chemical structure that allows it to bind to GABA receptors in your brain and nervous system. GABA (gamma-aminobutyric acid) is a naturally occurring chemical in your brain that works to bind to receptors and slow down activity in your central nervous system. It’s an important chemical that’s tied to rest and relaxation. People with anxiety disorders may have trouble resting and relaxing, and managing distressing emotions when they need to. Drugs like Librium can help increase the effectiveness of GABA, which can provide needed relaxation to people with anxiety disorders. 

Benzodiazepines work with GABA in a very similar way to alcohol, which is why they may also be used to treat alcohol-related problems like withdrawal.

Benzodiazepines are typically prescribed for short-term therapeutic use. Whether they’re used to treat anxiety or alcohol use disorders, they will ideally be used for a few weeks. Long-term benzodiazepine use may be less effective over time. As your body builds up a tolerance, your regular dose may feel less effective. Long-term use can also increase your risk of chemical dependence on a benzodiazepine. 

Some benzodiazepines are also used as recreational drugs. When Librium is abused, it increases your risk for potentially dangerous side effects and consequences, including overdose, dependence, and addiction. Quitting Librium after becoming dependent on it can cause withdrawal symptoms that are similar to alcohol.

How Does Alcohol Withdrawal Work?

librium for alcohol withdrawal

Alcohol withdrawal is an unpleasant consequence of alcohol dependence. Since alcohol is so common in our culture, that withdrawal has been a well-known phenomenon that comes with alcoholism for centuries. It’s often called by a variety of colloquial terms, including the shakes. Severe alcohol withdrawal has been called the horrors, bats, and shaking delirium. There are several prescription and illicit drugs that can cause withdrawal symptoms, but few cause symptoms that are as dangerous as central nervous system depressants.  

Alcohol is a depressant, and frequent heavy drinking causes your body to get used to the effects of alcohol. As your body adapts to alcohol’s depressing effects, it will start to rely on it to maintain chemical balance. When you try to cut back or stop drinking, your body will suddenly be without the nervous system suppressing chemicals it has become used to, and you may feel the consequences of chemical imbalance. 

Withdrawal symptoms are often the opposite of the drug’s effects. Since alcohol slows down central nervous system activity, withdrawal can increase stimulation. Withdrawal symptoms can range from mild discomfort to potentially life-threatening symptoms. 

Alcohol withdrawal is officially diagnosed as alcohol withdrawal syndrome. While it can be dangerous, there are ways to get through alcohol withdrawal safely.

Early Alcohol Withdrawal Symptoms

Alcohol withdrawal can start within 12 to 24 hours after your last drink, depending on several factors. If you’ve been dependent on alcohol for a long time and you’re used to heavy drinking, you may experience alcohol withdrawal more quickly. The early symptoms of alcohol withdrawal can include:

  • Headaches
  • Tremors
  • Nausea
  • Anxiety
  • Insomnia
  • Itchiness 

Alcohol withdrawal symptoms may start out mild and increase over the next few days. You’ll also experience cravings to drink alcohol that may be difficult to control or resist. You may reach peak symptoms within 48 hours. Peak symptoms are when you feel the worst in the course of withdrawal. You may experience nausea, vomiting, tremors, and even hallucinations. When your withdrawal reaches its peak, you’ll start to feel better. Some symptoms like cravings and anxiety may continue.

Severe Withdrawal Symptoms

Severe withdrawal symptoms can occur before, during, or after your peak withdrawal symptoms. A common severe symptom in bad cases of alcohol withdrawal is a seizure. Seizures that are caused by alcohol withdrawal can be very similar to ones that are caused by epilepsy, which are called tonic-clonic seizures. They can lead to injury, unconsciousness, and other complications, especially if you go through them alone. Seizures can also occur after your acute withdrawal phase has ended. For that reason, people that have gone through alcohol withdrawal may be monitored for several days or a week after their acute withdrawal phase.

In some cases, alcohol withdrawal can cause a condition called delirium tremens. Delirium tremens is a set of severe symptoms that can come on abruptly. Symptoms can include extreme confusion, panic, shaking, seizures, irregular heartbeat, hallucinations, and fever. In some cases, delirium tremens can cause fatal complications, including heart attack or stroke. However, delirium tremens are much less dangerous when you have access to immediate medical attention. 

How Does Librium Treat Alcohol Withdrawal?

Librium and alcohol work in similar ways in the brain. Both influence GABA receptors and increase the effectiveness of GABA in causing central nervous system depressing effects. When you go into alcohol withdrawal, it’s caused by the sudden shift in your brain’s chemical balance. Alcohol withdrawal is worse when you quit cold turkey. However, Librium can help alleviate some alcohol cravings and stave off uncomfortable or dangerous withdrawal symptoms. Librium can be used to treat acute alcohol withdrawal symptoms to avoid potentially dangerous complications. However, it can also be used to taper off of alcohol gradually to avoid severe symptoms. 

Why can’t you taper off alcohol with alcohol?

Tapering requires careful attention to dosage. Too much, and your taper will be ineffective. Too little, and you may experience more severe withdrawal symptoms. There are several reasons why it’s better to taper with prescription medication and a doctor’s help rather than tapering with alcohol. Alcohol is less standardized, and different drinks contain different amounts of alcohol. If you have an alcohol use disorder, it may be harder to stop drinking than it is to take a proper dose of a medication. Librium may also be less likely to cause intoxication symptoms, like alcohol can.

Benzodiazepines are also less likely to lead to a dangerous overdose than other depressants, including alcohol. So Librium may be safer overall than alcohol for someone with a substance use problem.

Librium is used in patients that are already showing acute withdrawal symptoms. Heavy drinkers may take doses that are used in treating anxiety. However, it’s important to work closely with your doctor to find the right dose for your needs. While they are safer than other depressants, benzodiazepines can be potentially dangerous in high doses. An appropriate dose for your needs may be anywhere from 5 to 100 milligrams. In some cases, higher doses may be needed. 

Potential Side Effects of Librium

Librium comes with several common side effects, including drowsiness, ataxia, and confusion. According to the FDA, it’s rare that these side effects are so unpleasant that patients need to stop using the medication. Side effects may be more pronounced in high doses of the drug, including drowsiness, sedation, memory issues, and confusion. 

Like other benzodiazepines, Librium can cause chemical dependence. People that take it for too long or use it in high doses may become dependent on it. Quitting abruptly after developing a chemical dependence on the drug can cause withdrawal symptoms that are similar to alcohol withdrawal. 

When Librium is being used to treat alcohol withdrawal, it’s important for prescribers to only give you the drug after withdrawal has already started. Alcohol withdrawal indicates that you no longer have high concentrations of alcohol in your body. If alcohol and Librium are taken at the same time, it could lead to a potentially life-threatening overdose. 

If Librium is misused or abused recreationally, it can lead to substance use disorders, just like alcohol can. It can also lead to dangerous overdose if it’s mixed with other benzodiazepines, barbiturates, or opioids.

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