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Librium Abuse: Signs, Symptoms & Side Effects

Like all benzodiazepines, Librium has a high potential for abuse and addiction. While Librium is no longer available under this brand name in the U.S., chlordiazepoxide is its generic name.

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Signs and symptoms of Librium abuse include the following:

  • Taking more chlordiazepoxide than prescribed
  • Taking chlordiazepoxide with other substances, such as opioids or alcohol
  • Taking chlordiazepoxide in a form other than as prescribed, such as chewing the pills
  • Changes in behavior or priorities due to Librium use

What Is Librium?

Librium is the common name for chlordiazepoxide, a drug used to treat anxiety and acute symptoms of withdrawal from alcohol. This drug resides within the benzodiazepine class, and these drugs function by acting on the neurotransmitter gamma-aminobutyric acid (GABA), which plays a key role in regulating mood and affect. 

When consumed orally, Librium provides a sedative effect and can produce immediate anxiety and panic symptom withdrawal relief. 

What Is Librium Used For?

Librium is most commonly used to treat anxiety. When Librium is consumed in tablet form, it can provide anxiety relief within 15 to 30 minutes for up to several hours. 

While the precise mechanism of action for Librium is not fully understood, it is known that the drug blocks arousal from stimulation of reticular formation of the brain, which has been discovered through research involving electroencephalography. 

Librium increases GABA activity, which inhibits the activation of the sympathetic nervous system. The sympathetic nervous system responds to a perceived threat in the environment by dilating the blood vessels and increasing heart rate to send blood and oxygen to the limbs. This allows the body to become physically mobile. 

This natural fight-or-flight response is an evolutionary necessity, but it can also produce undesirable symptoms that are not particularly conducive to high performance or functioning in contemporary society. For example, heightened anxiety may be beneficial if in the woods with a bear posing a threat to attack, but it’s not helpful while taking a math exam.

Therefore, Librium can help calm the activation of the sympathetic nervous system and provide relief from symptoms of anxiety and panic. 

Librium’s sedative and anxiety-relieving properties also make the drug beneficial for symptoms of alcohol withdrawal. Alcohol withdrawal symptoms can be anxiety-producing and highly stressful. Librium can help individuals manage these symptoms. 

Additionally, Librium can be used to treat symptoms of the following conditions:

  • Depression: This is a clinical condition associated with at least two weeks of low affect, a loss of interest in previously enjoyable activities, social withdrawal and isolation, hopelessness, sleep disruption, and/or suicidal ideation. Librium can help to improve the effect of antidepressants.
  • Preoperative apprehension and anxiety: This involves excessive fear, worry, and/or preoccupation specifically associated with a pending operation. Chlordiazepoxide may be prescribed to manage this preoperative fear and anxiety.

Librium & Addiction 

Librium can be habit-forming, and this can encourage misuse. For this reason, doctors usually do not prescribe this drug for periods of longer than 10 days. 

Chlordiazepoxide, along with other benzodiazepines, has been commonly mentioned in discussions of the prescription drug crisis in the United States, which has seen a rise in the rate of addictions and overdoses associated with addictive prescription drugs. 

Poly-substance abuse, where benzodiazepines like chlordiazepoxide are abused in combination with other substances like opioids, has become more common in recent years. For example, in 2021, about 14 percent of opioid overdose deaths also involved benzodiazepines. Whenever multiple substances are taken together, the effects of all substances are compounded, increasing risks exponentially.

What Are the Signs & Symptoms of Librium Abuse?

The following signs and symptoms may be present if you or someone you know may be abusing Librium:

  • Excessive preoccupation with locating Librium
  • Confusion
  • Irritability
  • Restlessness 
  • Taking Librium in higher doses or frequencies than what has been prescribed
  • Neglecting regular responsibilities and relationships to focus on locating and using chlordiazepoxide

What Are the Signs & Symptoms of Librium Addiction?

The following are signs and symptoms of a potential Librium addiction:

  • Doctor shopping to obtain more chlordiazepoxide
  • Using illegal methods in order to locate and purchase Librium
  • Lying to friends, family, and loved ones about Librium use
  • Expressing a desire to quit taking chlordiazepoxide but being unable to do so
  • Experiencing financial difficulties due to the cost of locating Librium
  • Physical health issues due to excessive chlordiazepoxide use

Effects of Taking Librium Long Term

Librium is rarely prescribed on a long-term basis because of its tendency to be habit forming. Typically, Librium is prescribed for less than 10 days and used only to manage acute symptoms of anxiety or alcohol withdrawal. 

If you take Librium for longer periods of time, there may be some side effects, which can be categorized as physical, mental, and emotional in nature. 

Physical Side Effects

The following effects may occur is Librium is consumed on a long-term basis:

  • Physical drug dependence: This dependence occurs as a result of modifications that are made to the brain when chlordiazepoxide is consumed for extended periods of time. The body becomes used to the presence of the drug and changes its neurotransmitter production accordingly. If chlordiazepoxide use stops, dangerous and uncomfortable withdrawal symptoms may occur.
  • Organ damage: Consumption of excessive amounts of chlordiazepoxide, particularly when combined with other medications or alcohol, can increase strain on the liver and kidneys. This can lead to long-term impairment in the ability of these organs to function properly. 
  • Coordination problems and an unsteady gait: Balance may become a problem as well as functional movements.
  • Muscle spasms: This involves involuntary contraction of a single muscle or group of muscles. 
  • Upset stomach: A disruption in the homeostasis of the stomach or the presence of a toxin can lead to discomfort. 

Mental Side Effects

The following mental effects are associated with long-term chlordiazepoxide use:

If you have been abusing Librium, you should not stop taking the medication suddenly. You need professional help to stop using it safely.

  • Anxiety
  • Depression
  • Tolerance and dependence
  • Confusion
  • Sleep impairment
  • Changes in appetite
  • Loss of memory
  • Self-harming behaviors and suicidal ideation

Emotional Side Effects

The following emotional symptoms may occur:

  • Loss of interest in enjoyable things or overall apathy
  • Worry and fear 
  • Social isolation or withdrawal
  • Emotional blunting (dampening of typical emotions and feelings)

In some cases, individuals who develop a high level of tolerance to Librium may encounter what is known as paradoxical disinhibition, or the experience of reactions that are typically antithetical to anxiolytics and sedatives. Symptoms of this state can include the following:

  • High levels of impulsivity
  • Irritability
  • High levels of excitability
  • Hostility
  • Aggression 

In some rare cases, paradoxical disinhibition can result in antisocial behaviors and violence. 

Get Help for Librium Abuse

If you have been abusing Librium, you should not stop taking the medication suddenly. You need professional help to stop using it safely.

As part of an addiction treatment program, your treatment team will likely recommend a tapered withdrawal process and comprehensive therapy. You’ll identify what led you to chlordiazepoxide abuse, and you’ll gain the skills needed to build a healthy life in recovery. You can look forward to a better future without substance abuse.

Updated June 9, 2023
  1. Librium C-IV. (July 2005). U.S. Food & Drug Administration.
  2. Pharmacological Modulation of GABAA Receptors. (August 2021). Current Opinion in Pharmacology.
  3. Clinical Management of Alcohol Withdrawal: A Systematic Review. (July–December 2013). Industrial Psychiatry Journal.
  4. Antidepressants Plus Benzodiazepines for Adults With Major Depression. (June 2019). Cochrane Database of Systematic Reviews.
  5. Benzodiazepines and Opioids. (November 2022). National Institute on Drug Abuse.
  6. Drug Overdose Death Rates. (February 2023). National Institute on Drug Abuse.
  7. Active Chlordiazepoxide Metabolites in a Patient Needing Life Support After Treatment of Alcohol Abstinence. (November 2020). Basic & Clinical Pharmacology & Toxicology.
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