What is Librium? Addictive Potential, Uses, and Side Effects

Last Updated: August 3, 2021

Authored by Olivier George, Ph.D.

Reviewed by Michael Espelin APRN

Librium is a benzodiazepine used for the treatment of an array of health conditions that have their foundation in the central nervous system. It includes the treatment of anxiety disorders and the use of chlordiazepoxide for alcohol withdrawal.

Besides the legitimate uses of this medication, it is sometimes abused recreationally. Therefore, users should know more information about this medication before using it. This article will answer the question: what is Librium; and discuss how it acts in the body, Librium side effects, and whether it is addictive.

What Is Librium?

Librium is the brand name for chlordiazepoxide. This substance belongs to a class of drugs known as benzodiazepines. These drugs are CNS depressants.

It was approved for use in 1960, two years after being patented. The Food and Drug Administration approves it for short-term relief of anxiety. Another use is chlordiazepoxide for alcohol withdrawal symptoms.

Woman feeling anxiety at home sitting on the couch.

According to the drug schedules of the Drug Enforcement Agency, chlordiazepoxide is a Schedule IV medication, which means that it possesses recognized medical use with low potential for abuse.

Chlordiazepoxide comes in other brand names besides Librium, which include Poxi, Mitran, and Libritabs.

Chlordiazepoxide Mechanism Of Action

Chlordiazepoxide exerts its effect by binding to the benzodiazepine site at the gamma-aminobutyric acid (GABA) receptor-chloride ionophore complex in the central nervous system. It leads to an increase in the opening of chloride channels, membrane hyperpolarization, and increases the inhibitory effect of GABA on the CNS. Such activities help to alleviate anxiety, tension, reduce psychological excitement, and provide weak analgesic actions.

What Is Librium Used For?

There is a wide range of disorders that can be treated by chlordiazepoxide. Being a long-acting benzodiazepine and an FDA-approved medication, its labeled uses for adults include treatment of:

  • mild-moderate to severe anxiety disorder
  • preoperative apprehension and anxiety
  • withdrawal symptoms of acute alcohol use disorder

It is also FDA-approved for pediatric patients older than six years old in the treatment of anxiety. Off-label uses include catatonia, social phobia, posttraumatic stress disorder, insomnia, premenstrual syndrome, and other conditions.

Every symptom and dosage should be discussed and approved by a medical doctor. Self-treatment can be dangerous and lead to severe Librium side effects and drug addiction in long-term users.

Librium For Anxiety

A medical doctor usually prescribes chlordiazepoxide to decrease the level of anxiety for a short time in adults, older people, and children over six years old. The drug affects neurotransmitters that send signals to certain brain cells that produce a calming effect. Information from studies has been able to back up the health effects of this drug in the treatment of anxiety, with one study showing nearly half of the patients placed on chlordiazepoxide with significant improvement. The drug is recommended only for short-term use to treat anxiety and no longer than four weeks at a time.

Librium For Alcohol Withdrawal Protocol

Chlordiazepoxide for alcohol withdrawal should be prescribed in the exact dosage because the medicine is habit-forming, and taking too much can lead to drug addiction. In case the patient has hypersensitivity to the drug, Librax can be an optional medication.

Many former alcoholics put on Librium for alcohol withdrawal have reported beneficial effects. Some patients find chlordiazepoxide helpful in treating headaches, vomiting, seizures, and other symptoms.

Librium Also Improves the Emotional State Of Many Patients, As It Helps With:

  • Anxiety
  • Disordered thinking
  • Emotional well-being
  • Panic attacks
  • Appetite

The drug also relieves severe tremors and palpitations, often observed in people experiencing ethanol withdrawals.

Patients experiencing alcohol withdrawal should be monitored closely, and their chlordiazepoxide dosage should be prescribed by a professional. The length of therapy is unique to the individual, and it depends on the history of abuse and current health. Doctors shouldn’t give Librium to pregnant women or patients at risk of liver failure.

For acute withdrawal, higher doses are necessary compared to the doses prescribed for anxiety. Usually, 50-100 mg is a reasonable amount that can be repeated after two to four hours. It’s not recommended to exceed 300 mg/day. However, case reports and studies have shown that some professionals have used up to 600-800 mg/day to treat severe cases.

Librium is used to achieve sedation, but if sedation can’t be induced and the patient is unresponsive, a barbiturate can be employed.

Librium and Alcohol Dangers

As a drug that acts on the central nervous system, there are dangers in using this substance together with alcohol. Both of these are CNS depressants, so when used together, they will cause synergistic effects between the two substances, resulting in increased intensity of chlordiazepoxide side effects. They include extreme drowsiness, which is particularly dangerous when a person might be at risk of severe injury if they are inattentive. Life-threatening outcomes like respiratory depression and coma can also occur, which will cause death if they are not treated promptly.

Drunk man holding a glass of alcohol in hands.

Librium for alcohol withdrawal is a common line of treatment for those attempting detox and recovery. Therefore, patients who use Librium medication for this indication must know what to do if they relapse. They are at the same risk if they suddenly resume alcohol while still on Librium for alcohol withdrawal. People who relapse should contact their medical doctor and recovery or rehab center for help.

Chlordiazepoxide Side Effects

Like any drug, there are chlordiazepoxide side effects that can occur in some people with the normal use of Librium medication. It is crucial to keep in mind that abuse of the drug increases the risk of these chlordiazepoxide side effects, particularly the severe ones.

The Side Effects Include the Following:

  • Drowsiness
  • Depression
  • Increased sedation
  • Constipation
  • Impaired muscle control
  • Confusion
  • Dizziness
  • Skin problems
  • Decreased libido

The severe Librium side effects include blood disorders, liver dysfunction, coma, and even death if taking this pharmaceutical with other CNS depressants or opioid medications at the same time.

Long-term and severe chlordiazepoxide side effects that can occur include the development of dependence and psychological symptoms such as memory loss, suicidal thoughts, and violent behavior.

Is Librium Addictive?

Being a strong medication with long-lasting effects, chlordiazepoxide is considered to be a target for abuse. One of the ways chlordiazepoxide is abused is crushing and snorting it instead of taking the drug orally. In this way, the chemicals quickly get into the bloodstream through the thin lining inside the nose and faster influence brain chemistry. Abuse leads to addiction over time. Even after the immediate cancellation of taking the drug, people can feel unpleasant Librium withdrawal.

The Most Common Signs of Addiction Include:

  • Having cravings for the substance
  • Tolerance
  • Taking the drug in larger doses more frequently
  • Mixing chlordiazepoxide with alcohol and other drugs to achieve the desired effect
  • Feeling withdrawal symptoms when trying to quit

Getting addicted to Librium medication is entirely possible, similar to other benzodiazepines. It presents a unique risk in patients who are using it to get over an alcohol addiction may eventually find themselves addicted to this substance.

In such situations, users usually need professional support and addiction treatment to help them quit the drug. Trying to manage it by oneself could be very hard.

Young female doctor talking to a patient about Librium addictive potential.

There is no official information on chlordiazepoxide abuse in particular, but the statistics show that cases of benzodiazepine abuse are increasing every year. Among 30% of all overdose cases from opioids in the US also included the presence of benzodiazepines. From 1996 to 2013, benzodiazepine prescriptions increased by 67%, from 8.1 million to 13.5 million users. In 2019, 16% of those who died from an opioid overdose had a positive result for benzodiazepines.

Chlordiazepoxide Overdose

There is a high chance of Librium overdose when using it in large uncontrolled amounts. There is no estimated chlordiazepoxide overdose amount, but taking the substance more frequently in higher doses than those prescripted by a physician can be extremely dangerous for life. In case of any unusual symptoms, one should immediately address the doctor.

The Most Common Signs of Overdose Are:

  • Difficulty breathing
  • Difficulty during urination
  • Double vision or blurred vision
  • Rapid side-to-side movement of the eyes
  • Irregular heartbeat
  • Low blood pressure
  • Drowsiness, stupor, even coma
  • Confusion
  • Feeling lightheaded, fainting
  • Loss of balance or coordination
  • Seizures, tremors
  • Weakness, uncoordinated movements
  • Bluish-colored lips and fingernails
  • Yellow skin
  • Nausea

Overdose Treatment

In case of taking a large Librium dose or mixing it with alcohol or other drugs and realizing one has any of the above symptoms, it is essential to seek medical help. The sooner assistance is provided, the higher chances of a full recovery are. At the drug rehab center, the patient may be provided with oxygen and endotracheal intubation for definitive airway management if they have difficulties in breathing. IV fluids are usually administered during rehab to stabilize the water balance. Anticonvulsant medications can be used to deal with seizures.

Treatment for Librium Abuse

Abuse and addiction to chlordiazepoxide are possible even when the drug is used exactly as prescribed, though it is more likely to occur with misuse. For individuals who end up abusing the drug, it is best to seek treatment as soon as possible.

While a person can attempt to detox from this drug on their own, it is not recommended. Stopping cold turkey is likely to have worse effects on the health in the form of withdrawal symptoms. That is why your medical doctor is likely to taper the medication off, though patients are unlikely to adhere once dependence has formed.

Patients can do detox at a recovery and rehab center either as an outpatient or an inpatient. However, inpatient treatment tends to be more effective, as licensed medical professionals at the center will be there to help the patient around the clock. The patient will be given medication to help with recovery and withdrawal symptoms.

How To Prevent Librium Abuse

Chlordiazepoxide is a long-acting benzodiazepine that provides anxiolytic, sedative, and hypnotic effects. The medicine should be used only when prescripted by a doctor strictly for its intended purpose. In case of Librium side effects and uncommon health symptoms, individuals should contact their doctors for help.

Addiction to chlordiazepoxide is possible, so people on the medication need to follow their doctor’s instructions when using the substance and seek help if dependence develops. One should ask for professional help at a specialized rehab and addiction center to start on the path to recovery.

Frequently Asked Questions

Is Librium A Benzo?

Yes, the chlordiazepoxide drug class is a benzodiazepine. Like other drugs in its family, Librium provides a sedative-hypnotic effect because of the changes in the chemical balance on GABA receptors in the brain. Also, Librium’s half-life is among the longest in the benzodiazepine drug class.

Is Librium A Narcotic?

The term “narcotic” usually refers to a drug belonging to the opioid class. Opioids work like painkillers. They interact with opioid receptors in the brain, providing an analgesic effect and calming down different aches. Drugs like chlordiazepoxide work with the central nervous system and help to cope with mental illnesses. Thus, the Librium drug class is not a narcotic.

Is Librium A Depressant?

Chlordiazepoxide has depressant properties, as it influences the central nervous system and slows brain activity. Such actions cause short-term changes in one’s condition, usually in the form of relaxation and anxiety decrease. In addition, it slows heart rate, pulse, and respiratory rate.

Is Librium A Controlled Substance?

Librium classification was determined by the Drug Enforcement Administration as a Schedule IV controlled substance. Drugs in this class have less potential than drugs in Schedules I, II, and III. However, there is still a potential for dependence and addiction.

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Published on: October 2nd, 2015

Updated on: August 3rd, 2021

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.