Millions of people manage anxiety and anxiety-related disorders daily. Many prescription medications on the market help them do so that they can go about their day without complications.
One such medication is Librium (chlordiazepoxide), a benzodiazepine medication that slows down the central nervous system (CNS) and blocks nerve impulses, making it easier for a person to relax and control their anxiety, stress, and fears. Librium can also be prescribed for people who are in alcohol withdrawal as well as patients who use it as a muscle relaxant.
Benzodiazepines, such as Librium, are among the most widely prescribed medications, which make them prone to misuse, abuse, and addiction, something the U.S. Food and Drug Administration (FDA) recognizes.
According to the federal agency, U.S. outpatient pharmacies dispensed an estimated 92 million prescriptions for benzodiazepines in 2019. In 2020, it announced that it would be updating its boxed warning to alert medical professionals and patients to the risks the medications pose.
Librium use has therapeutic effects when taken as prescribed. However, Librium users can also experience side effects, which include:
Recreational use of Librium is dangerous and can come with life-threatening symptoms. People who use the drug for recreational purposes could experience severe side effects if they use the drug in higher amounts than prescribed.
Some of these severe side effects that occur with misuse are:
One reason Librium abuse is especially dangerous is because the medication is a long-acting benzodiazepine, which means its half-life is longer than that of most benzodiazepines, meaning it takes longer for the body to clear it. A drug’s half-life is how long it takes for half of it to be broken down in the body. Librium can take anywhere from 10 hours to 30 hours to exit the body. This is why it can take hours for users to feel its effects, and it also means it can take longer for withdrawal symptoms to start once a person stops taking it.
As the FDA notes, patients can develop physical dependence while using benzodiazepines when they are regularly taken over several days or weeks. The federal agency also advises that patients who have been taking the medications for weeks or months can experience withdrawal when use of the medication stops suddenly.
It is never recommended to stop use of a substance after long-term use. A sudden break can send the body into shock, and patients can suffer debilitating, life-threatening symptoms and medical emergencies as a result.
If you have been regularly using Librium and have recently stopped, you may be wondering if you are in withdrawal and what to do if you are.
First, Librium withdrawal can be uncomfortable and challenging. People in withdrawal experience:
These symptoms can be challenging to manage on one’s own and often require professional help.
If you are experiencing Librium withdrawal, you may be wondering how long it typically lasts. Withdrawal timelines are difficult to pin down because various factors affect how long withdrawal lasts. These factors include age, sex, weight, and more. Other factors that can affect how long it takes to withdraw from this medication include:
All of these factors and many more shape the Librium withdrawal and detox timelines.
Generally, users who are in withdrawal from this medication will start to notice symptoms two to three days after stopping use. It is also possible for some users to not notice symptoms for up to four days. Withdrawal can vary widely; some people may go through it for a week, while others can continue to experience it for up to six weeks.
The withdrawal timeline could look like the following:
24 to 72 hours: Librium’s half-life is longer than most benzodiazepines, which means it takes longer for the users to feel peak symptoms. Several hours can pass before they start to notice any changes. Sharp or severe symptoms of Librium withdrawal occur in this period and increase in intensity. Users may have increased anxiety and sweating and notice an irregular heart rate.
4 to 7 days: Physical and psychological symptoms occur during this phase and can be severe.
Week 2: Peak symptoms occur, including life-threatening seizures.
Weeks 2 and 3: Patients may have less severe physical symptoms, and in some cases, they may have completely disappeared. However, psychological symptoms can linger in this phase. Some users will find them easier to manage.
Month 1 and later: At this point, recovering Librium users may experience benzodiazepine withdrawal syndrome, which is a set of symptoms that occur in people with benzodiazepine dependence. Persistent depression and anxiety, insomnia, Librium cravings, and other symptoms occur in this stage.
Benzodiazepine withdrawal can be painful and unpredictable, and users can experience life-threatening medical emergencies in some cases. Some symptoms by themselves may not be life-threatening, but they could lead to life-threatening situations. Excessive diarrhea and vomiting, for example, could lead to someone being malnourished and dehydrated. Both of these conditions are dangerous and could lead to a loss of life.
If you are in Librium withdrawal, it is important that you get through this period safely.
Going to a licensed facility that knows how to handle withdrawal can save your life. Medical professionals at such a facility know how to handle withdrawal from Librium and can provide around-the-clock care and set a tapering schedule to ensure you withdraw from the drug carefully, giving your body time to adjust to the absence of Librium in your system.
Getting medical detox help ensures that you will also receive observation of not only your physical symptoms but your psychological symptoms as well. You may be given medications to aid your recovery during this process.
Getting medical detox is often the first step of a recovery program. Clearing the body of the substance is not enough to ensure a person will not use Librium again. Dependence and addiction are often about the psychological effects, not just the physical. Also, substance abuse and addiction can change how the brain functions, so people in recovery must learn how to manage these changes, which, in turn, will affect how they manage their lives going forward, including how they guard against having a relapse.
Once a person has gained medical stability from detox, addiction care and health care professionals will likely recommend moving on to a treatment setting that will help the recovering Librium user address their substance use and addiction and related issues.
Recovering patients may be encouraged to start a residential (inpatient) or outpatient treatment program where they can focus on their addiction and understand the reasons behind it and how to manage their lives going forward.
Your treatment program should be tailored to your needs and take your history of Librium use into consideration. Your placement will depend mostly on how far along you are in your Librium dependence and the supports you will need as you recover from it. If your Librium dependence is severe, you likely will be placed in a residential treatment that offers 24-hour care in a structured and monitored environment.
If you are in the early or mild stages of Librium dependence, a less restrictive setting may be recommended for you, such as outpatient treatment. Intensive outpatient treatment offers nine or more hours of therapy and counseling a week, while outpatient treatment offers fewer than nine hours.
The National Institute on Drug Abuse (NIDA) recommends that people in recovery spend at least 90 days or three months in treatment. The agency says longer stays in treatment can lead to lasting favorable outcomes for people who want to live without using substances.
After your treatment program ends, you are encouraged to continue to pursue your recovery by joining an aftercare program that offers resources that support sobriety. Such programs can connect people to 12-step programs that meet regularly, sober living transition housing, job training, and career development, and more.
Commissioner, O. (n.d.). FDA Requiring Labeling Changes for Benzodiazepines. from https://www.fda.gov/news-events/press-announcements/fda-requiring-labeling-changes-benzodiazepines
(October 2018). Librium. RxList. from https://www.rxlist.com/librium-drug.htm#side_effects
Rahman, A. (2018, November 18). Delirium Tremens (DT). from https://www.ncbi.nlm.nih.gov/books/NBK482134/
Post-Acute Withdrawal Syndrome (PAWS). (n.d.). from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS
NIDA. (January, 2018). “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment