Librium is a long-acting benzodiazepine, available only by prescription for individuals with a legitimate need for this drug. Known as GABA agonist drugs because they increase GABA in the brain, benzodiazepines have a sedative effect. They are, as a class, central nervous system depressants (as is alcohol).
Librium is a brand name drug, and chlordiazepoxide is its generic. The pharmaceutical manufacturer of chlordiazepoxide first received US Food and Drug Administration approval in 1960.
Librium is indicated for the treatment of different conditions, including anxiety disorders, insomnia, seizures, for symptoms associated with irritable bowel syndrome, to induce amnesia before surgery, and during withdrawal for alcohol abuse. Librium is not known to cure any disorders, but rather helps individuals manage symptoms associated with an underlying disorder or condition. Though Librium has well-documented therapeutic value, it also carries a risk of abuse.
Who Is at Risk for Librium Addiction?
The US is steeped in a prescription drug abuse epidemic, and up until recently, the public generally had a benign perception of prescription medications. However, in recent years, with rising rates of prescription drug abuse and fatal overdoses, there is a growing public awareness of the extreme downside involved in using psychoactive pharmaceuticals, namely addiction (also called a substance use disorder).
Anyone can become addicted to Librium, but the ways in which individuals become addicted to Librium may vary. Some individuals are prescribed users. As a general matter, the medical community believes there is little risk of Librium addiction if a person follows the prescribing doctor’s orders for use. But patients may begin to take more Librium than instructed, with or without an abuse intention. For instance, a patient may take too much Librium and enjoy the psychoactive effects. The person may then continue to take too much Librium to experience these effects. The therapeutic value of Librium is now secondary to the high.
In other instances, a prescribed Librium user, such as someone who takes this drug for an anxiety disorder, may want to feel greater relaxation faster and take more Librium. It’s not that this person is necessarily seeking a Librium high, but more accurately, this person wants relief from an uncomfortable physical experience, such as anxiety. In these two scenarios, the person will need more Librium pills since the usual 30-day supply is exhausted in a shorter time window and the prescribing doctor won’t renew the prescription early. The person may begin to “doctor shop,” asks friends or family for Librium (or other benzodiazepine) pills they may have, or buy this drug on the street.
Among recreational users, Librium is abused for the high and other psychoactive effects it can induce. Recreational users are especially at risk for addiction.
In all abuse scenarios, the person who regularly takes Librium will eventually develop physical dependence on this drug. As the person continues to abuse Librium, the road to addiction becomes shorter. Speaking broadly, physical dependence is a biological state, and addiction may not develop. Prescribed users of a drug who strictly follow prescribing doctors’ orders may become physically dependent but will not usually become addicted. However, addiction always involves physical dependence; it’s a biological mechanism entailed in addiction. A main difference between physical dependence and addiction to Librium is the person’s psychological state and behaviors. Individuals who are addicted to Librium, for instance, will demonstrate a preoccupation with getting, taking, and ensuring that they have an adequate supply of this drug. This preoccupation will lead to certain uncharacteristic behaviors, which can include doctor shopping, lying, stealing, borrowing money and not paying it back, and/or being secretive about Librium abuse.
Recognizing Librium Abuse
Symptoms can vary at different intervals. A person will experience symptoms and show signs in the period immediately following use, as a result of chronic use and during withdrawal. Information about Librium abuse symptoms may come from different sources, such as drug abuse research projects or clinical trials for the drug. The latter does not typically investigate abuse of the drug, since that is not the drug’s target; the emphasis is on the medical benefits as part of a supervised treatment plan. However, clinical trials for Librium and benzodiazepines offer helpful information about the symptoms that can emerge when a person abuses this class of drugs. Since benzodiazepine abuse involves taking a high volume of this drug, the side effects of high doses provide insights.
According to WebMD, the following are symptoms that may manifest when a person takes a high dose of a benzodiazepine:
- Lack of coordination
- Slurred speech
- Difficulty breathing
The following are some possible signs of chronic benzodiazepine abuse:
- Behavioral changes, such as diminished performance of tasks at home, work, or school
- Personality changes, such as a different temperament (e.g., being more irritable or uncharacteristically irritable)
- Physical side effects, such as insomnia, anxiety, headaches, weakness, or anorexia
- Doctor shopping, which might involve numerous prescription pill bottles from different medical practices and different pharmacies
There is a general advisement in the medical and addiction treatment community that a person with a history of Librium (or other benzodiazepine) abuse should not abruptly stop using this drug. Medical detox is advised. During medical detox, the recovering person will be tapered off Librium, usually with the use of a benzodiazepine that is considered safe for tapering. The specifics of the tapering process will be determined by the doctor and addiction team, in conjunction with the client, based on a host of relevant factors.
A tapering process helps a person to avoid severe withdrawal symptoms. Benzodiazepine withdrawal can be fatal, especially if a person suddenly stops taking the drug. The following are some of the mild, moderate, and severe symptoms that may emerge during benzodiazepine withdrawal:
- Abdominal cramps
- Muscle cramps
These withdrawal symptoms provide insight into what can happen, but it is important to keep in mind that the type of symptoms that will emerge in any given person depend on a host of physiological factors and facts relevant to the Librium or other benzodiazepine abuse. A rehab center that provides medical detox will introduce clients into a benzodiazepine taper as the first major step in treatment. A taper can occur over the course of a week, months, or a year or more. The induction happens during medical detox, and the recovering person can be stabilized on the benzodiazepine taper throughout the course of primary treatment for the addiction in a program that is 30-90 days (or more in some instances). After completion of the rehab program, the recovering person, as needed, may continue the taper on an outpatient basis. The process can be as gradual as necessary to promote the best chances at long-term recovery.
Additional Treatment Steps for Librium Addiction
Treatment for substance abuse, including benzodiazepine abuse, can have many components. The Substance Abuse and Mental Health Services Administration identifies the following main types of addiction treatment services:
- Individual counseling
- Group counseling
- Case management
- The 12-Step program
After medical detox, or once a person is stabilized on a tapering process, therapy should begin as part of a standard treatment plan for the addiction. This phase of treatment focuses on healing the thoughts, behaviors, and emotions that underlie the addiction. For this reason, therapy is a cornerstone of treatment at drug rehab centers. Thinking about treatment broadly, medical detox can be seen as addressing the biological consequences of addiction whereas the next phase of standard care addresses the underlying attitudes involved in the addiction.
When in rehab for Librium abuse, a person will receive both individual and group counseling. The sessions are therapist-led, and the therapist will generally follow one or more research-based approaches. Cognitive Behavioral Therapy (CBT) is often a staple of programs because it has proven to be effective in the treatment of substance use disorders, as have other approaches, such as Motivational Interviewing, Dialectical Behavior Therapy, and 12-Step facilitation therapy.
Therapy is not the same as peer support groups. In peer support groups, including those that follow the Alcoholics Anonymous model (faith-based) or the SMART Recovery model (non-faith-based), there is no therapist and the groups are member-led. These groups work off the simple but effective principle that people who are similarly situated vis-à-vis drug abuse are potentially able to help each other in recovery. This is why these groups are often referred to as mutual aid groups. A group may have a focus on Librium or benzodiazepine abuse, but a general group meeting, such as Narcotics Anonymous, can be just as helpful. Addiction is not about abusing a specific drug of abuse as much as it is about the thoughts and emotions underlying the abuse.
Case management is a practical component of the recovery process. Individuals who do not have sufficient resources, such as housing, childcare, education, employment, or transportation, are at risk of relapse because of the stresses involved in not having life’s basic needs covered. In order to support the recovery process after graduation from a rehab program, a person in recovery may work with a case manager. A case manager often knows how to navigate the public benefits system and understands what local resources are available to help the recovering person. For instance, a case manager may be able to help a recovering person with housing and job training, give advice on how to arrange for childcare needs, and assist with setting up transportation, such as to local peer support meetings, doctor appointments, and counseling sessions. Case management is not only a relapse prevention tool but also a way to help a person develop a strong foothold in the world.
Twelve-Step programs all trace back to the Alcoholics Anonymous model first started in the 1930s. The 12 Steps serve as a practical guide for a person to follow in order to transform from drug dependence to sobriety, all while building confidence, self-esteem, and self-respect. It’s essentially a method of personal transformation. The program can be adapted to any individual’s experience of drug abuse.
While Librium abuse can occur along different pathways (e.g., as a result of medically prescribed use or recreational use), once a person becomes addicted to this drug, both short-term and long-term side effects will emerge. As stated, Librium withdrawal can be potentially dangerous once physical dependence is in place. Medical detox, including a benzodiazepine tapering process, and additional recovery services can help a person to safely achieve and maintain abstinence.