Tuesday September 25th 2018

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Diazepam Addiction Treatment

Articles


ARTICLE SUMMARY: Addiction is a brain disease, and it must be treated as such. In this article, we’ll introduce the best practices in addiction treatment and the evidence-based strategies currently in use. Then, we invite your questions at the end.


TABLE OF CONTENTS


Addictive Potential

Introduced to the pharmaceutical market in 1963, the benzodiazepine medication diazepam (brand name: Valium), became the top selling medication in the US from 1968 until 1982 with a peak of 2.3 billion tablets sold in 1978. Currently, there are over 500 different brands of generic diazepam in many forms. But how addictive is it?

The U.S. Drug Enforcement Administration has classified diazepam as a Scheduled IV drug, which means that it is less addictive unless taken with other substances such as alcohol, or opioids.

But, NIDA researchers are looking into the addictive potential with more knowledge of the brain mechanisms underlying the use of diazepam. In fact, this 2012 study reported that benzo medications cause addiction like opioids, cannabinoids, and GHB (gamma-hydroxybutyrate). Also, this 2011 study published in the medical journal, Addiction Behaviors, showed that up to 44% of chronic benzodiazepine users become dependent on their medication.

Thus, we’ve come to think that diazepam is highly addictive because it works on both the mind (diazepam brings psychological relief to some users) and the body (diazepam effects are highly sedative). When combined, true addicts feel euphoric and a deep sense of well-being can trigger the desire to use…again and again. When the habit of popping diazepam becomes daily, there are two main physical signs that can indicate deeper issues.

1. Tolerance. With continued use, you may not even notice that you begin to develop a TOLERANCE to diazepam. Tolerance is when the drug can no longer produce the wanted effects at the old doses, so you need to keep increasing how much and how often you take it.

2. Dependence. Over a period of time, brain adapts to the presence of diazepam and adjusts. At this point, diazepam can structurally and functionally change the nerve cells of the brain. So, once you stop taking the drug… your brain takes time to return to homeostasis and manifests withdrawal symptoms. Individuals who have become PHYSICALLY DEPENDENT on diazepam go through serious withdrawal when the drug is no longer available at expected dosing periods.

Who Becomes Addicted

Not everyone who starts taking diazepam becomes addicted to it. So, why did addiction occur for you … or a loved one?

Diazepam addiction is actually a complex disease – a medical condition – that affects the brain. The drug replaces chemicals normally produced in the brain and slows down any abnormally fast electrical activity. When used, the medication creates general feelings of relaxation and sedation, which is one of the reasons it is so addictive. It also affects your judgment and control.

While the properties of the drug play a role in the development of addiction there is no single cause that makes a person get ‘hooked’. Instead, addiction is likely to be the combination of a variety of different factors, such as:

Brain Chemistry: Your individual biological makeup can make the drug highly “effective”.

Environmental Factors: The influences of your cultural and social environment may encourage or fuel addiction.

Genetics: Addictive behavior runs in families and makes up 50% risk of addiction.

Psychological: You are self-medicating emotional pain, past traumatic experiences, or Co-Occurring Mental Disorders.

Medically, diazepam addiction is psychological and physical. The body and the mind become adapted to the drug and create a strong desire or need to use again and again. If you find yourself in the dark loop of addiction, there are several treatment options that work to help address diazepam use.

Facts & Statistics

So how many people does diazepam addiction affect? How many people are users and/or abusers? First, it’s helpful to know how many people may be taking the medication. According to an analysis published by ACS Chemical Neuroscience, over 14 million prescriptions for diazepam were reported in the US in 2011, which makes this medications one of the top selling drugs.

The Drug and Alcohol Services Information System (DASIS) reported exactly 15, 561 addiction treatment admissions for tranquilizers substance abuse disorder in 2015. But the number of people treated does not meet the need…by far! The 2016 National Survey on Drug Use and Health reported that an estimated 618,000 people aged 12 or older could be diagnosed with a tranquilizer use disorder, including a diazepam problem in the past year. The age groups are divided into three subcategories:

  • 86,000 adolescents aged 12 to 17
  • 188,000 young adults aged 18 to 25
  • 343,000 adults aged 26 or older.

Moreover, the same report found out that an estimated 2.0 million people aged 12 or older in 2016 were current misusers of tranquilizers. The Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health backs this up and reported that in 2015, 18.9 million individuals misuse some prescription psychotherapeutic drugs, from which 1.5 million people misused sedatives such as Valium® (diazepam).

This trend seems to holding steady. Going back only one year, the 2015 National Survey on Drug Use and Health reported that of the 39.3 million use past year users of tranquilizers were:

  • 1.1 million youths aged 12 to 17
  • 4.2 million were young adults aged 18 to 25
  • and 34.0 million were adults aged 26 or older.

The most commonly used prescription tranquilizers among people aged 12 or older in 2015 were benzodiazepine tranquilizers. Of the 39.3 million people aged 12 or older who used tranquilizers in the past year, 29.7 million used benzodiazepine tranquilizers, including 7.4 million people who used tranquilizers that contain diazepam. An estimated 2.8% of the population aged 12 or older used diazepam products.

Quitting diazepam can be difficult… and scary.

But, it doesn’t have to be. Getting off diazepam is much easier with the right medical treatment and care. With professional help, you can achieve long term sobriety.

Signs of a Problem

How can you know when someone is addicted to diazepam? How do you know if you have a problem with diazepam, or not? After all, diazepam is a prescription drug…and sometimes doctors prescribe it over the recommended period of 6 weeks.

Be alert to the following changes, which can signal addiction:

  • Continued use despite problems caused by diazepam.
  • Difficulty functioning on a daily basis without the drug.
  • Having problems at work or school because of diazepam use.
  • Hoarding pills in order to take larger doses or to prepare for a “rainy day”.
  • Isolation from family and friends.
  • Neglecting former friends or favorite hobbies.
  • Obsession about getting and/or using diazepam.
  • Strong cravings for the drug.
  • Taking prescription drugs from family members or friends.
  • Visiting multiple doctors, forging prescriptions, or accidentally losing prescriptions in order to get more medication.

If you recognize these changes in yourself or a loved one, it’s time to ask some bigger questions.

  • What next?
  • How do I/we select appropriate treatment?
  • How do I/we prepare for that treatment?

Have hope! Addiction is a treatable medical condition.

Consequences

If you don’t address a drug problem with diazepam, you risk changing the function of your brain and body. You also increase risk of overdose, or even death.
The DAWN Report of 2014 showed that during the 7 years from 2005 to 2011, almost a million (an estimated 943,032) emergency department (ED) visits involved benzodiazepines alone or in combination with opioid pain relievers or alcohol and no other substances.

The benzodiazepine alone ED visits occurred among the following age groups:

  • 174,998 people aged 12 to 34
  • 88,644 people aged 35 to 44
  • 150,780 people aged 45 to 64
  • 72,575 people aged 65 and older

Moreover, the CDC Report on Emergency Department Visits Involving Nonmedical Use of Selected Prescription Drugs claims that the estimated number of ED visits involving non-medical use of benzodiazepines increased from 143,500 in 2004 to 271,700 in 2008. Among benzodiazepine-related visit, 21% did not involve any other drug. The 2016 CDC Report on Drugs Most Frequently Involved in Drug Overdose Deaths showed that about 6,000 OD deaths involved benzodiazepines alone in 2014. In fact, diazepam was involved in 1,729 OD deaths.

So, don’t waste your time, ask help for your diazepam problem.

Next Steps

STEP #1: WANTING TO QUIT.

You are making the first step towards recovery when you have the desire to quit…for good…for yourself.
Changing any behavior requires determination. Changing an addiction…well, that can feel extremely difficult. Chemical changes in the brain work against you. Old patterns are established. And you know how rewarding it feels to continue using the drug. Plus, you may fear or dread debilitating withdrawal symptoms (don’t worry – we’ll explain how medical detox works below).

But ask yourself this question: What are YOUR OWN reasons for quitting Diazepam?

Maybe you want to be reunited with your kids or your spouse.
Perhaps you want to turn your health around.
It could be that your finances are bottomed out.
Possibly some legal pressure has you burned.

If you are self-motivated, you’ve already made one of the most important prerequisites for behavior change. If you’ve made this decision…things will start to line up for you. If you want to quit diazepam for good…you can!

STEP #2: SEEKING HELP.

Calling an addiction helpline allows you to be anonymous. You might be nervous or uncomfortable to talk to your prescribing doctor because fear judgement or getting cut off of your medication cold turkey.
Call us for a toll-free, completely confidential, and judgment-free conversation. We know that it can be hard to pick up the phone. So, our staff have been trained to understand addiction as a medical condition. You can ask a few questions, talk to someone who is experienced in the area, and get the help that you need without revealing your name or any personal information.

Hotline staffers who answer the phone know how to listen. They understand what you are going through. During the phone call, they will offer strategies and information about treatment services that can best help you. You can talk openly with them about:

  1. Diazepam addiction signs and potential side effects.
  2. How long you’ve been taking diazepam.
  3. How much and how often you use the drug.
  4. Whether or not you’re drinking or using other prescription or illicit drugs.
  5. Other mental health issues you’re battling like depression or anxiety.

STEP #3: ENTERING REHAB AND RECOVERY.

Once you’ve made the decision to get better, you’ll walk you through the stages of treatment. Here is what you can expect during the treatment process:

1. Evaluation of the addiction. Before any treatment program gets underway, it’s important that you are medically assessed. Once you arrive at a rehab clinic, be prepared to take the first few hours to complete an interview, intake evaluation, and drug testing. This initial evaluation will be the basis of your treatment plan.

2. Detox. Medical detox is a safe medically supervised procedure designed to asses symptoms associated with diazepam dependence…and then to address them. Detox is best when it is clinically supervised, as staff can reassure you and make you feel comfortable as the drug is eliminated from your body. In addition to emotional support, medical supervision may include drug prescription to address and minimize withdrawal symptoms and diazepam cravings as they occur.

3. Main treatments. Rehab really consists of a combination of counseling and medication assisted treatment. In fact, scientific evidence has shown that this is how addiction is best treated: a combination of talk therapy and medications. Therapy sessions can be individual, group, or family based. They are designed to help restore balance into your life, so you can look into the deeper psycho-emotional reasons for drug use.
In sum, rehabs are there to help you get better.

Treatment Options

When you deciding on a treatment program that is best fitted to your personal needs and preferences, there are several main choices you can make:

CHOICE #1: INPATIENT VS. OUTPATIENT TREATMENT.

Inpatient rehabs are typically full-time, and comprehensive. You are expected to reside at the facility to avoid potential outside stressors that may hinder recovery. Inpatient care generally offers a more intensive treatment regime for those with long-term or more severe addictions.
Outpatient rehab treatment models include a variety of sessions, meetings, and workshops that you attend for several hours each day and then return home at night. These programs require high motivation and a strong support network focused on treatment and recovery.

CHOICE #2: SELECT A PROGRAM THAT LASTS 30, 60, OR 90 DAYS…OR MORE IF NEEDED.

Although there is no exact timeline specified for the “best” term of addiction treatment, most experts agree that diazepam treatment programs should last at least 30 days, but only if you have a good support system at home. Otherwise 60 and 90 day programs are better suited for most people, especially for those with a more severe case of dependence and addiction. All programs, regardless of their length, should be followed by at least a year of continued care (aftercare).

CHOICE #3: SELECT THERAPIES AND/OR AMENITIES THAT YOU WANT TO INCLUDE IN YOUR TREATMENT.

The main therapies incorporated in your personalized addiction treatment plan can include:

  • Cognitive Behavioral Therapy (CBT)
  • Dual Diagnosis Treatment
  • Educational Sessions
  • Family and/or Couples Therapy
  • Medication Maintenance Therapy
  • Motivational Interviewing
  • Specialized Therapies

Some treatment centers offer specialized therapies that involve art, yoga, animal therapy, quine therapy, or music. There are truly many ways that you can address the reasons behind your diazepam use. REMEMBER: What makes treatment work best for YOU may not be the same thing that works for SOMEONE ELSE. Concentrate on finding a program that can be customized to your unique needs for care. Finding the best treatment option for you is just a phone call away.

Why Treatment Never “Ends”

Recovery treatment does not end at discharge.

In fact, you’ll be learning how to cope without diazepam over time. The year after you leave treatment is critical. During this time, individual counseling or weekly psychotherapy sessions are usually recommended. Family therapy can also be very helpful.
So, near the end of a stay in rehab, staff work to develop an aftercare plan. Having a solid aftercare program can continue the progress made during the initial treatment period. This may include some combination of:

  • Support groups
  • Ongoing therapy
  • Sober living arrangements (if needed)

If, for example, you were taking diazepam as prescribed for an anxiety condition, you may especially benefit from ongoing stress management techniques and other behavioral therapeutic interventions offered through aftercare. Other clients may want to participate in alumni programs in order to remain connected. KNOW THIS: Looking for ongoing support in addiction recovery is one way to ensure long term sobriety!

Does Treatment Work?

Absolutely.

According to this NIDA publication, several studies have shown that drug treatment reduces drug use by 40 to 60 percent and significantly decreases criminal activity during and after treatment. The number one thing you need for treatment to work is your own willingness and motivation. You may have made many attempts to quit in the past. You may have made numerous efforts to break loose from the grips of diazepam addiction…just know that you CAN quit and stay quit.

However, the success rate of a treatment program does not depend on achieving complete sobriety, but on improving your quality of life as a whole. When you start living diazepam-free, you will also experience many of the benefits of recovery, such as:

  • Improved health.
  • Improvements in work or school.
  • Reduced legal problems.
  • Relationship improvements.

…and many more benefits.

You deserve an addiction-free life. Isn’t it time that you gave yourself the chance?

Cost

So, how much is all of this going to cost?

Generally, addiction treatment will depend on the level of care that is needed. Additionally, the choices that you make in treatment setting will increase or decrease bottom line cost. Since inpatient programs offer 24​/7 medical care, they are more expensive than the outpatient. The average costs of rehab services are:

Detox: Cost varies from $6,000-12,000 per treatment episode.

Psychotherapy: Costs start from almost free to $150 or more per hour.

Outpatient treatment:  This program ranges from $50-$135 per day.

Inpatient treatment: Inpatient treatment costs from $235-700 per day.

For more information on the cost of treatment and services visit:

Medications

Gradually lowering the daily doses of diazepam is the safest way to stop taking this medication. The tapering protocol should be medically supervised. In this way, the withdrawal will be taken under control. The rule is that doctors replace short-acting benzodiazepines with a long-acting one during a taper. For more guidelines on tapering, see the paragraph that follows.
During withdrawal from diazepam, a tapering schedule is accompanied with these medications (if necessary):

  1. A short half-life benzodiazepine(s).
  2. Phenytoin or barbiturates to control seizures.
  3. Propranolol to control tremors and heart rhythm, and to prevent migraines.
  4. Medications to manage psychosis (chlorpromazine hydrochloride, pentobarbital, phenobarbital, or haloperidol).

In reality, the other types of benzodiazepine addictions are treated with diazepam itself. The World Health Organization has published protocols stating that the first step in benzo withdrawal stabilization is to put the patient on an appropriate dose of diazepam.

Tapering Protocol

The Ashton Manual offers a very useful tapering protocol for diazepam. Dr. Heather Ashton suggests that patients follow these instructions when eliminating diazepam from the system:

  1. Reduce the daily dose by 2 mg.
  2. First, you lower the morning dose by 2 mg.
  3. Then, you lower the night dose by 2 mg.
  4. Each interval should last 1-2 week.
  5. When you get down to a dose of 5mg daily, you could begin to decrease in 0.5mg doses, but most people manage with 1mg reductions.

Custom is Best

If you or someone close to you suffers from diazepam addiction, what does “best treatment” look like?
While any treatment is better than nothing, tailor-made treatment programs are ideal for lasting recovery and growth. This is why a good addiction treatment program will first assess your past drug use and your current condition, and then recommend a program based on your unique situation. KEEP IN MIND: The professional support that you receive during a stay in treatment can make the difference in whether you achieve long-term recovery, or not.

How to Help a Loved One

Diazepam abuse threatens the health and stability of relationships and families. If your loved one has tried to stop diazepam several times before without success, you are not alone! Help is available for you, too. Here you’ll find some basic info on how to be there for an addicted loved one. With professional help, you can help guide them to rehab and recovery.

Here are some ways you can get the much needed help your family deserves:

1. Call a drug abuse helpline. Making the call you will assess and evaluate a loved one’s problem, and to learn how you can guide them to seeking treatment. Also, when seeking professional help, keep the following questions in mind:

  • What other drugs or alcohol do you think they’re using?
  • How long do you suspect they have been using diazepam?
  • How long they’ve been showing signs of addiction?
  • How much can they afford to pay for treatment?
  • Is insurance an option?
  • Could you (and/or other close family members) help them out financially?
  • Does the addicted individual suffer from any mental, behavioral, or co-occurring disorders?

2. The Stages of Change. A person who wants to quit will start actively seeking help and BE READY for change… internally. On the other hand, a person who is forced into treatment may attend rehab…kicking and screaming all the way. Instead of coercing change, discuss willingness to talk with a professional counselor, a therapist, or a peer…together. Start small and plant seeds of change gradually. This is a much more appropriate and useful place to extend your energy.
In the meantime, you can emphasize personal choice and control. Some examples of what you can say include:

“It really is up to you to decide to make this change.”
“No one else can do it for you.”
“No one else can make you go to rehab.”

3.The CRAFT Model of family training. Community Reinforcement and Family Training is a 3-4 month commitment. During training, you’ll learn how to stay safe around an addict. You’ll learn what to say and when to say it. Additionally, you’ll learn how to set limits: Engage and reward positive behavior….but avoid and disengage with drug use. CRAFT shows remarkable efficacy in getting people into treatment…compassionately and in a way that includes the entire family.

REMEMBER: It is not appropriate or recommended that you attempt to scold, judge or attack someone facing a diazepam problem. Seek professional help from a Licensed Clinical Psychologist, Addiction Psychotherapist, or treatment center.

What’s Stopping you?

There are a few common barriers that we all face when considering rehab. These include:

  1. Leaving family responsibilities.
  2. Taking time off work.
  3. Paying for rehab.

We know what it’s like because we’ve been there too. And we can offer you a sympathetic, understanding ear, as well as solutions to these problems. Here are some ideas to help you move through your fears.

1. Leaving family responsibilities.

If you’re a parent considering rehab, you may hesitate to leave your kids behind. But how can you continue functioning when you are being controlled by diazepam? How can you be present and be the best parent you can be…when addiction is in charge?

If you’re ready to become a better parent, consider trusting your kids to someone close to the family whom your children already know and are comfortable with. Many parents in rehab ask for help from their parents, siblings, spouse/partner, or close friends, as well as daytime child care centers. Some treatment centers also offer child care services or can connect you to local child care resources. Call us to learn how family can be integrated into the treatment process.

We’ll work together to find a solution that works for everyone.

2. Taking time off work.

Going to rehab and getting better is in the best interest of your employer. When you can function without needing diazepam…you can be a more responsible and productive employee. In fact, there are several federal laws protecting your right to obtain treatment:

  1. The Americans with Disabilities Act (ADA) protects employees from discrimination on the basis of disability. Mental health issues such as addiction are legally considered a “disability”.
  2. The Family and Medical Leave Act (FMLA) protects your rights of up to 12 weeks of unpaid leave per year to seek medical treatment. This act further allows you to keep your health benefits when getting treatment!

Under these laws, it is illegal to terminate employment as a consequence of an employee seeking treatment. It is also illegal to discriminate against people in addiction recovery who are seeking employment.

Additionally, some employers have an Employee Assistance Program for substance abuse. They may even pay for some of your stay at rehab. As your HR Department Manager for more details about this possible benefit.

3. Paying for rehab.

While the cost of rehab may be a deterrent for some people, it is important to remember the numerous costs you accumulate due to feeding the addiction, which may include but are not limited to:

  1. Obtaining more diazepam.
  2. Loss of productivity at work and possibly job loss.
  3. Possible legal fines.
  4. Medical bills for physical or mental health issues associated with addiction.
  5. Deterioration of relationships (divorce and loss of custody over children).

The cost of rehab should not be a significant barrier to seeking help.

Your Questions

We hope to have answered all your questions about treating a problem with diazepam. We know that it’s a difficult and long road. So, don’t feel that you have to walk it alone! Please leave us your additional questions in the comments section at the end of this article. Or, give us a call. We’ll do our best to respond to you personally and promptly.

Reference Sources: NCBI: Management of benzodiazepine misuse and dependence
VA: Helping Patients Taper from Benzodiazepines
NCBI: The treatment of benzodiazepine dependence
NIH: Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

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