Treatment Options for Librium

Benzodiazepines are a class of prescription drugs used in the treatment of anxiety as well as severe drug and alcohol withdrawal.1,2 They can be literal lifesavers, but also has the potential for abuse. Librium—the first-ever benzodiazepine to be developed2—is no exception.

Benzodiazepines like Librium are common in cases of polydrug abuse, as they can enhance the effects of other drugs, especially alcohol and opioids.3 This is because alcohol, opioids and benzodiazepines all depress the body’s central nervous system, and the effects and side effects are synergistically cumulative.2,4 Taking more than one of these substances is dangerous, and puts a person at a greater risk of a life-threatening overdose.4

Non-medical use of prescription drugs is a major concern in the U.S. The National Institute on Drug Abuse reports that 18 million people over 12 years of age admitted using prescription drugs for non-medical reasons at least once in their lifetime.5

In 2018, according to the 2018 National Survey on Drug Use and Health, 2.0% of people aged 18 or older reported that they misused benzodiazepines in 2018.6

Recognizing Librium Abuse

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 potential substance abuse include the following:7

  • Repeated obtaining Librium illegally.
  • Repeatedly using Librium for its psychoactive effects and/or in combination with other drugs, such as prescription opioids or alcohol.
  • Having a prescription for Librium but using it in manners inconsistent with the instructions on the prescription.
  • Doctor shopping to obtain more Librium.
  • Finding empty prescription drug containers in clothes, room, car, etc.
  • Appearing drowsy or lethargic during the day (e.g., slurred words, falling asleep in public places, moving very slowly, appearing to be intoxicated without the smell of alcohol, etc.)
  • Continuing to use the drug despite negative effects on life, career, family, etc.
  • Craving for Librium.
  • Experiencing withdrawal symptoms when going without the drug.

Detox and Treatment

Individuals wishing to stop using or misusing Librium—and other substances—have a variety of treatment options that will help them succeed. Given the potentially life-threatening consequences of withdrawal (especially when polydrug use is present), it’s important to consult a doctor or healthcare professional. Medically supervised withdrawal can help to manage withdrawal in a way that is safe and comfortable.2,8

Treatment options following detox include the following:8

  • Inpatient treatment: In an inpatient treatment program, the person remains at the treatment facility 24 hours a day for the duration of treatment. Inpatient treatment is particularly useful for individuals undergoing withdrawal management from benzodiazepines and is also advantageous for individuals who have a number of potential high-risk factors for relapse during the initial recovery phase. Individuals who live in homes or areas with high rates of drug abuse, have a peer group that abuses drugs, who are in abusive relationships, or have other toxic environmental factors may wish to initially begin their treatment in an inpatient unit to isolate themselves from conditions that increase the probability of relapse. Those who have attempted rehab before and relapsed as well as those with co-occurring medical or mental health disorders should also consider inpatient care.
  • Outpatient treatment: Most individuals will engage in outpatient treatment for the bulk of their recovery. Even individuals who initially choose inpatient treatment will not remain in an inpatient unit for the entire duration of their recovery. Inpatient treatment programs are time-limited, and withdrawal management programs are typically terminated once the withdrawal process is under control or completed. Many individuals can choose to use outpatient treatment programs for the entire duration of their treatment. Inpatient and outpatient treatment programs have specific advantages; however, both are effective.
  • Therapy: Substance use disorder therapy should focus on the issues that drove the substance use, the development of positive thinking and coping abilities, stress management, the prevention of relapse, and psychoeducation. Therapy can be performed on an individual or group basis. 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.
  • Mutual support groups: These are not formal therapy groups in that they are not run by professional, licensed, trained therapists. Instead, these groups are run by other individuals with the same or similar presenting problems, such as a substance use disorder. Twelve-step groups are examples of social support groups (e.g., Alcoholics Anonymous, Narcotics Anonymous, etc.). Other social support groups include community-centered support groups, sober living homes, and even private groups that likeminded individuals form on their own. These groups are ongoing, offer positive social support, and often have their own structured programs of recovery.
  • Treatment for co-occurring disorders: This should be considered when a substance use disorder and an additional psychological disorder (e.g., generalized anxiety disorder, mood disorders or any other anxiety disorder) co-occur.
  • Additional activities: Other activities that are not necessarily “therapy” can complement one’s recovery. Meditation, exercise programs, yoga, and volunteer work can be very productive and foster recovery.

There are a number of treatment options that a person can help a person on their pass to recovery from a substance use disorder. The most important thing is that the person in treatment remains committed to their recovery and always strives to move forward.

References

  1. National Institute on Drug Abuse. (2018). DrugFacts: Prescription CNS Depressants.
  2. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  3. Schmitz A. (2016). Benzodiazepine use, misuse, and abuse: A reviewThe Mental Health Clinician, 6(3), 120–126.
  4. National Institute on Drug Abuse. (2018). Benzodiazepines and Opioids.
  5. National Institute on Drug Abuse. (2018). Misuse of prescription drugs: what is the scope of prescription drug misuse?
  6. Center for Behavioral Health Statistics and Quality. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.
  7. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
  8. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
About The Contributor
Ryan Kelley, NREMT
Medical Editor, American Addiction Centers
Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More