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Librium (chlordiazepoxide) is a benzodiazepine. Benzodiazepines are primarily used for anxiety management, seizure control, sleep inducement, and muscle relaxation, though they have other secondary uses. Librium was the very first benzodiazepine to be developed, and it has been used in the treatment of anxiety disorders, the control of seizures, and in the management of withdrawal symptoms from alcohol and other benzodiazepines.
Benzodiazepines are all considered to be drugs that contain significant risks for abuse and the development of physical and psychological dependence by the United States Drug Enforcement Administration (classified as Schedule IV controlled substances). In terms of their abuse, benzodiazepines like Librium are very often abused in combination with other drugs, such as alcohol, other benzodiazepines, opiate drugs like OxyContin and heroin, and stimulants like cocaine. An anxiolytic use disorder is a substance use disorder to drugs which are primarily used in the medicinal treatment of anxiety and anxiety disorders.
According to academic texts, such as Stahl’s Essential Psychopharmacology and other sources, the immediate effects of Librium include sedation, a reduction in anxiety, a reduction in the subjective perception of stress, drowsiness or sleepiness, a sense of euphoria, a sense of relaxation, and a sense of wellbeing.
Benzodiazepines like Librium affect the neurotransmitter GABA (short for gamma-aminobutyric acid). GABA is the major inhibitory neurotransmitter in the central nervous system (the brain and spinal cord). Inhibitory neurotransmitters dampen or slow down the activity of the neurons in the brain and spinal cord. This is why these drugs have medicinal uses in the control of anxiety and seizures, as sleep inducers, as muscle relaxants, etc., because they have a calming or sedating effect on the functions of the brain and spinal cord.
The calming and sedating effect can be perceived as euphoric, and benzodiazepines also facilitate the release of the neurotransmitter dopamine, which is involved in the experience of pleasure and reward. Thus, benzodiazepines have the effect of being reinforcing when taken because they make individuals feel relaxed and comfortable, and provide euphoria associated with being rewarded for taking them. Individuals who abuse these drugs are often motivated to take them in increasingly larger doses because tolerance to them develops rapidly, and the drugs have the potential for the development of a withdrawal syndrome.
A withdrawal syndrome occurs when the person’s system has adjusted its functioning to be consistent with the presence of the drug in its tissues. When the levels of the drug drop due to normal metabolic functions (a process known as detoxification that occurs primarily through the liver), the person’s system is thrown out of balance, and they experience a number of ill effects. Individuals who abuse Librium and other benzodiazepines find themselves repeatedly taking the drug once they begin to perceive that they are going through withdrawal, due to minor headaches, irritability, nervousness, nausea, etc. This behavior of using a drug to avoid negative consequences is known as negative reinforcement, and it is a very powerful behavior observed in individuals with substance use disorders to drugs that produce physical dependence. This behavior is very hard to reverse unless the individual is extremely motivated and can receive assistance. Withdrawal from benzodiazepines can also produce a number of ill effects that can include potentially fatal delirium and seizures.
In addition to the aforementioned effects of Librium abuse, some individuals may experience side effects that can include:
There are some typical signs and symptoms that might indicate an individual is abusing Librium. While only a licensed mental health professional can make a formal diagnosis of a substance use disorder, some of the signs that may indicate that an individual needs to be assessed for potential substance abuse include the following:
A person who exhibits two or more of the above symptoms may be developing or have a substance use disorder. Individuals with substance use disorders need formal treatment.
There are a number of treatment options for Librium abuse. Medical detox is required for Librium withdrawal. This is important because the withdrawal process from benzodiazepines has potentially fatal consequences for some individuals, and there is no way to determine who may develop delirium, hallucinations, and seizures when withdrawing from the drug. Anyone who abuses benzodiazepines should consult with a physician before attempting to discontinue use.
According to professional sources like the American Society of Addiction Medicine, treatment options include the following:
Individual therapy has the advantage of being focused, tailored to the specific needs of the individual, private, and allows the individual to disclose most information without fear that it will be released to others. Group therapy has the advantage of allowing the person to learn from others, develop important peer relationships, and get different points of view. It is often less expensive than individual therapy.
There are a number of treatment options that a person can become involved in to address abuse of Librium. The most important thing is that the person in treatment remains committed to their recovery and views any setbacks that occur as learning experiences and opportunities to move forward.