What Is Valium Withdrawal?
Valium, also known as diazepam, is a benzodiazepine drug used for the treatment of anxiety and muscle spasms.1 It can also be used to reduce some of the more severe symptoms of alcohol withdrawal.1 Long-term use can lead to physical dependence on the drug ,1-3 as well as uncomfortable and potentially fatal withdrawal symptoms when someone decides to quit using.
The severity of symptoms varies depending on the amount of Valium used and the length of time it was used.1,5 Those who have used higher doses, with a longer duration of use, or have simultaneously used multiple benzodiazepines may experience a more serious withdrawal syndrome.5
Valium withdrawal symptoms may include the following:1,5,6
- Heart palpitations
- Stomach cramps
- Muscle pain and stiffness
- Ringing in the ears
- Blurred vision
- Hypersensitivity to light, sound, taste, and touch
- Poor concentration and memory
- Tremors or shakiness
Psychological withdrawal symptoms may also occur. These symptoms can increase cravings for Valium and the risk of relapse.
These withdrawal effects may include:1,5,6
- Confusion or delirium.
- Depersonalization (one’s thoughts and feelings seem unreal).
Valium withdrawal can be divided into two phases, which include:5
- An acute phase, which can last 5–28 days and may be more severe in intensity.
- A protracted (longer-lasting) or post-acute phase, which can last 12 months or longer.
Some Valium withdrawal symptoms occur within specific timeframes or stages of withdrawal. More intense withdrawal symptoms may occur early on in the detox process and lessen as time passes. Seizures typically occur within the first 12 days after stopping the use of Valium.6
A general timeline of withdrawal symptoms is as follows:7,11,12,13
- 1–7 days: Users begin to experience symptoms, which can include heart palpitations, nausea, loss of appetite, insomnia, tremors, and hallucinations.
- 7–9 days: Symptoms peak in intensity and begin to subside.
- After 2 weeks, users may experience what is known as “rebound” withdrawal symptoms. This refers to the return of withdrawal symptoms experienced within the first few days of withdrawal. These symptoms may be just as intense as they were in the beginning of withdrawal. Hypersensitivity to light, touch, and taste may be common during this time.
- After 3–4 weeks, withdrawal effects tend to lessen and former users may begin to feel “normal” again. Another rebound of withdrawal symptoms can occur, but usually these are not as severe as the initial rebound.
Causes of Withdrawal
Research indicates that it may increase dopamine release in the reward centers of the brain, which is responsible for the pleasurable feelings associated with Valium abuse.4 These euphoric effects serve as positive reinforcement for continued use and abuse.
Over time, Valium use can lead to tolerance, or the need to take increased doses to achieve the same or desired effects. Someone who develops tolerance may take Valium more often or in greater amounts for euphoria or anxiety relief.
In as little as 3 to 6 weeks, the body can adapt to the presence of Valium, and the person may become physically dependent on the drug.5 Physical dependence is not the same as an addiction, though, which is characterized by problematic and compulsive Valium use resulting in negative consequences. However, someone who is dependent will experience distressing and sometimes serious withdrawal symptoms if they suddenly stop taking the drug.
Treatment for Withdrawal
Although some people may attempt to stop using Valium on their own, many seek professional help.
- Detox centers provide short-term medical treatment to help users safely and comfortably withdraw from Valium. Detox is the first step to recovery from Valium addiction, and many people transfer to an inpatient or outpatient recovery program once detox is completed.
- Inpatient rehab centers provide a structured environment in which people can receive around-the-clock, intensive level of substance treatment. Recovery services can include individual therapy, group counseling, family therapy, drug education classes, holistic and alternative treatments, medical care, medication-assisted treatment, and aftercare planning.
- Outpatient rehab centers provide treatment sessions while allowing participants to live at home. Some programs may require 1-2 hours of therapy per week, while others may consist of several hours a day, 4-5 times per week. Many people who can’t afford to leave work or school for an extended period of time find outpatient recovery programs beneficial. Similar to therapy in inpatient centers, there is a focus on staying sober and preventing relapse.
- Partial hospitalization is an intensive type of outpatient program that consists of 4–6 hours of individual therapy and group counseling a day while still living at home or in a halfway house. The program length can vary, and it is best suited for users who have a strong support network.
Several different types of treatment for Valium withdrawal are available.8,9 Valium users can increase their chances of maintaining sobriety and reduce the risk of relapse by continuing on with some form of substance abuse treatment after detox.
Medications for Valium Withdrawal
Tapering may be used to gradually reduce the dose of Valium.
Several medications may be used during withdrawal treatment to help alleviate withdrawal symptoms and reduce Valium cravings.
- Romazicon (flumazenil) is typically given intravenously or under the skin and can help reduce acute withdrawal symptoms.5 However, this medication may increase the risk of seizures in certain individuals and should be used with caution.5,10 Flumazenil can also be used to reverse the effects of a benzodiazepine overdose.10
- Anti-convulsants may be used to prevent or treat seizures if the user is not addicted to any other drugs.5
- Anti-nausea and anti-diarrhea medications can help to treat stomach and digestion symptoms.
- Aspirin or anti-inflammatory medications can help ease muscle and joint pain.
Withdrawal treatment can include a number of techniques and may vary depending on the length of use, amount used, and the presence of polydrug abuse.
For clients who used high doses of Valium over an extended period of time, tapering (gradually reducing) the amount of Valium a user receives may be appropriate.1
There is no standard tapering schedule, since each person is different. The tapering regimen may be adjusted according to how well the person tolerates the reduced dose. 5
- Genentech, Inc. (2013). Valium (Diazepam): Package Insert.
- Voshaar R.C., Couvee J.E., van Balkom A.J., Mulder P.G., & Zitman F.G. (2006). Strategies for discontinuing long-term benzodiazepine use: Meta-analysis. British Journal of Psychiatry, 189, 213–220.
- Fenton M.C., Keyes K.M., Martins S.S., Hasin D.S. (2010). The role of a prescription in anxiety medication use, abuse, and dependence. American Journal of Psychiatry, 167(10), 1247–1253.
- National Institute on Drug Abuse. (2012). Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties.
- Hood S.D., Norman A., Hince D.A., Melichar J.K., & Hulse G.K. (2014) Benzodiazepine dependence and its treatment with low dose flumazenil. British Journal of Clinical Pharmacology, 77(2), 285-294.
- Brett J., Murnion B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152–155.
- Melor C.S. & Jain V.K. (1982). Diazepam withdrawal syndrome: Its prolonged and changing nature. Canadian Medical Association Journal, 127(11), 1093–1096.
- Center for Substance Abuse Treatment. (2008). What Is Substance Abuse Treatment? A Booklet for Families. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- National Institute on Drug Abuse. (2016). DrugFacts: Treatment Approaches for Drug Addiction. Washington, DC: National Institutes of Health.
- Roche Laboratories.(2007). (Flumazenil): Package Insert.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition.
- Ries, R. K., Fiellin, D. A., Miller, S. C., & Saitz, R. (2014). The ASAM principles of addiction medicine. New York: Lippincott Williams & Wilkins.
- Petursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455–1459.