A vast majority of the American adult population has consumed alcohol at some point. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) publishes that as of the 2015 National Survey on Drug Use and Health (NSDUH), 86.4 percent of people (aged 18 and older) reported having a drink at least once in their lives. The National Council on Alcoholism and Drug Dependence (NCADD) labels alcohol as the most regularly used addictive substance in the country.
Alcohol can be consumed responsibly and safely by most people who drink it. It is almost never a good idea to mix alcohol with medications or other mind-altering substances however.
Valium (diazepam) is a prescription-based anti-anxiety medication that has sedative, anticonvulsant, and relaxant effects. Diazepam is a benzodiazepine drug that acts on levels of GABA (gamma-aminobutyric acid) in the brain. GABA regulates the “fight-or-flight” stress reaction and acts like a natural tranquilizer. Valium increases levels of GABA in the brain and thus lowers anxiety.
Both alcohol and Valium are central nervous system depressants, and both interact with chemicals in the brain that send signals to lower blood pressure, slow heart rate, and reduce body temperature. When combined, these depressant substances can compound the effects of each other, increasing potential short-term and long-term side effects.
Risk for Overdose and Other Hazards
When someone mixes two substances with similar effects on the brain and body, such as a benzodiazepine drug like Valium and alcohol, less of each substance may be needed to cause disastrous consequences. It will take much less alcohol than a person normally drinks to have a serious reaction if they are also taking Valium, for example.
Valium is taken for the short-term relief of anxiety symptoms, so a person often takes it to relieve stress. Drinking is another method of stress relief that people commonly use. A person may keep drinking after taking a Valium, perhaps in an effort to self-medicate, before the effects of the benzodiazepine kicks in, which can easily lead to alcohol poisoning or overdose when the full effects of both substances hit the system.
Psychiatric Times reports on a national study finding that nearly 30 percent of all emergency department (ED) visits for issues related to benzodiazepine use or misuse also involved alcohol, as did almost a quarter of all benzodiazepine-related deaths. Combining these substances carries a greater risk of a serious medical outcome, often resulting in hospitalization. The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes that 44 percent of the ED visits involving both alcohol and benzodiazepines ended up with serious, or even life-threatening, medical outcomes, which were compounded even more in individuals over the age of 65.
Mixing alcohol and Valium can overwhelm the system, dangerously slowing life-sustaining functions like breathing, pulse, heart rate, and body temperature.
Alcohol and benzodiazepines are one of the most deadly drug combinations, according to Psych Central, which warns that mixing them can lead to mental confusion, dizziness, impaired memory, irritability, increased aggression, loss of consciousness, or coma.
Labeling for Valium by the Food and Drug Administration (FDA) warns against drinking alcohol while taking it for risk of a heightened sedative effect. Individuals may therefore be more likely to suffer from a “blackout” when drinking and taking Valium, and have no recollection of entire chunks of time. Combining these substances may also cause a person to become more severely intoxicated, or even “pass out,” more quickly than they would when just taking one or the other substance by itself.
Alcohol and benzodiazepines, or benzos, also impair judgment and may therefore contribute to poor decision-making, heightened risk-taking behaviors, and increased odds for being involved in an accident or getting injured. A person under the influence of alcohol and Valium may be more likely to engage in risky or questionable sexual encounters, which can increase the risk for contracting an infectious or sexually transmitted disease.
Potential Long-Term Consequences
When taken as directed, Valium can be a relatively safe and effective medication for the short-term relief of anxiety, for help with insomnia, as a muscle relaxant, to control seizures, and even to aid in the management of alcohol withdrawal symptoms. It is not intended to be taken long-term, however, as benzos are considered to be addictive substances with a high potential for misuse and abuse.
Valium, and alcohol, interact with brain chemistry to create the mellowing, pleasant, and relaxant effects they have. Both of these depressant substances change the chemical makeup of the brain and can lead to drug tolerance when taken regularly. As a person becomes tolerant to certain levels of a mind-altering substance, they will need to take more of them the next time to keep feeling the same way. Dependence can quickly form.
Physical drug dependence occurs when the brain expects the presence of the drugs to keep brain chemistry in balance and can no longer regulate itself without the interaction of the drugs. When the drugs wear off and are not active in the brain, powerful cravings and significant withdrawal symptoms can manifest.
Withdrawal symptoms from both alcohol and benzodiazepines can include:
- Nausea and vomiting
- Short-term memory loss
- Mental confusion and trouble concentrating
- Tremors and muscle tension
- Irregular heart rate and blood pressure levels
- Sensitivity to light, sound, and touch
- Feeling “on edge” and jittery
When central nervous system depressants like alcohol and Valium are in a person’s system, they act as a kind of damper, suppressing certain nerve firings. When these substances are suddenly not there anymore, after prolonged exposure, the brain may experience a rebound effect as it struggles to restore balance too quickly. This rebound can have significant physical and emotional ramifications.
Withdrawal symptoms from both benzodiazepine medications like Valium and alcohol can actually be life-threatening. The New England Journal of Medicine (NEJM) warns that people struggling with alcohol dependence suffer from delirium tremens (DTs) 3-5 percent of the time. DTs is a potentially fatal form of the withdrawal syndrome caused by stopping use of a central nervous system depressant substance after significant physical dependence has formed. DTs includes hallucinations, fever, seizures, and extreme confusion. The risk for DTs increases when two depressant drugs are taken simultaneously.
Risk of Addiction
Addiction may be a potential consequence of long-term drug use and drug dependence as well. Addiction is a brain disease, and when someone suffers from addiction, they are unable to control their drug use. Taking more than one substance at a time can lead to addiction and this loss of control more quickly.
Since both Valium and alcohol interact in similar manners in the brain, they can form a kind of cross-tolerance and cause the possible side effects of each substance to be heightened. The rates of drug tolerance, dependence, possible life-threatening withdrawal symptoms, and addiction are all heightened when substances like Valium and alcohol are combined.
In addition to polysubstance abuse, age at first use, genetic and biological factors, environmental aspects, and the presence of co-occurring disorders can all contribute to the onset of addiction. Co-occurring addiction and mental health disorders are common, and each disorder can serve to exacerbate the other. SAMHSA estimates that nearly 8 million Americans struggled with co-occurring disorders in 2014.
A person taking Valium for anxiety may be at a greater risk for addiction, especially if alcohol is also involved. The reverse is also true, as a person who regularly consumes alcohol and takes Valium may actually cause an increased rate of anxiety and mood disorder symptoms. Abuse of these substances can lead to more anxiety and depressive symptoms when the substances wear off.
Combining alcohol and Valium can also interfere with treatment for both addiction and mood disorders, and increase the risk for relapse. An integrated treatment program that can address both addiction and any co-occurring mental health or medical disorders is optimal for promoting a long and sustained recovery.
A specialty treatment program will often begin with a medical detox program that will slowly taper down the central nervous system depressants in a safe and controlled manner in order to minimize withdrawal symptoms. Medical detox will also often use medications to manage specific withdrawal symptoms, and these facilities provide around-the-clock supervision and monitoring of vital signs and emotional wellbeing to ensure safety and security.
After detox, individuals can then enter into a specialized treatment program that focuses on life skills training, relapse prevention, and ongoing support. These programs should tailor treatment plans to suit the needs of each individual client.