IN PRAISE OF VALIUM

  • Valium much less sedating than its predecessors Miltown or Librium (Before Valium came along, millions of Americans begged their doctors for Miltown prescriptions. By 1957, a prescription for Miltown was filled an average of every second in the U.S. Suburbs became the site for Miltown parties, cocktails were named for the pill – a Miltown replaced the olive in a Miltini – and high-end jewelers designed rings with compartments to hold the “tranks.” In 1960, Swiss drug maker Hoffmann-La Roche unveiled Librium, less sedating than Miltown but just as calming. In one famous experiment, the bitter-tasting drug tamed lions and tigers at the San Diego Zoo.)
  • By the end of the 1960s, Valium was the top-selling psychotropic drug in the United States
  • Valium quickly surpassed Miltown and Librium
  • Among Valium’s biggest selling points: no bitter taste, and it was nearly impossible to overdose on (In one widely reported instance that came much later, a Reagan administration official tried to kill himself with a heavy dose of Valium but failed.)
  • In the 1970s, Valium became the most widely prescribed drug of any kind
  • Valium was everywhere: Mike Brady popped a couple on the television show “The Brady Bunch,” and the Rolling Stones composed an ode to the drug, dubbing it “Mother’s Little Helper”
  • Ten of millions of people with anxiety disorders have been able to lead normal lives due to Valium
  • Dr. Leo Sternbach a medical hero who deserves posthumous Nobel Prize in Medicine
Diazepam

Diazepam /daɪˈæzɨpæm/, first marketed as Valium /ˈvæliəm/ by Hoffmann-La Roche, is a benzodiazepine drug.

It is commonly used to treat anxiety, panic attacks, insomnia, seizures (including status epilepticus), muscle spasms (such as in tetanus cases), restless legs syndrome, alcohol withdrawal, benzodiazepine withdrawal, opiate withdrawal syndrome and Ménière’s disease. It may also be used before certain medical procedures (such as endoscopies) to reduce tension and anxiety, and in some surgical procedures to induce amnesia.

It possesses anxiolytic, anticonvulsant, hypnotic, sedative, skeletal muscle relaxant, and amnestic properties. The pharmacological action of diazepam enhances the effect of the neurotransmitter GABA by binding to the benzodiazepine site on the GABAA receptor (via the constituent chlorine atom) leading to central nervous system depression.

Adverse effects of diazepam include anterograde amnesia (especially at higher doses) and sedation, as well as paradoxical effects such as excitement, rage or worsening of seizures in epileptics. Benzodiazepines also can cause or worsen depression. Long-term effects of benzodiazepines such as diazepam include tolerance, benzodiazepine dependence and benzodiazepine withdrawal syndrome upon dose reduction. After cessation of benzodiazepines, cognitive deficits may persist for at least six months and it was suggested that longer than six months may be needed for recovery from some deficits. Diazepam also has physical dependence potential and can cause serious problems of physical dependence with long term use. Compared to other benzodiazepines, though, physical withdrawal from diazepam following long term use is usually far more mild due to its long elimination half-life. Diazepam is the drug of choice for treating benzodiazepine dependence, with its low potency, long duration of action and the availability of low-dose tablets making it ideal for gradual dose reduction and the circumvention of withdrawal symptoms.

Advantages of diazepam are a rapid onset of action and high efficacy rates, which is important for managing acute seizures, anxiety attacks and panic attacks; benzodiazepines also have a relatively low toxicity in overdose. Diazepam is a core medicine in the World Health Organization’s Essential Drugs List, which list minimum medical needs for a basic health care system. Diazepam, first synthesized by Leo Sternbach,  is used to treat a wide range of conditions, and has been one of the most frequently prescribed medications in the world since its launch in 1963.

Medical uses

Diazepam is mainly used to treat anxiety, insomnia, and symptoms of acute alcohol withdrawal. It is also used as a premedication for inducing sedation, anxiolysis or amnesia before certain medical procedures (e.g., endoscopy).

Intravenous diazepam or lorazepam are first line treatments for status epilepticus; However, lorazepam has advantages over diazepam, including a higher rate of terminating seizures and a more prolonged anticonvulsant effect. Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to its anticonvulsant effects usually develops within six to 12 months of treatment, effectively rendering it useless for that purpose. Diazepam is used for the emergency treatment of eclampsia, when IV magnesium sulfate and blood pressure control measures have failed. Benzodiazepines do not have any pain-relieving properties themselves, and are generally recommended to avoid in individuals with pain.  However, benzodiazepines such as diazepam can be used for their muscle-relaxant properties to alleviate pain caused by muscle spasms and various dystonias, including blepharospasm. Tolerance often develops to the muscle relaxant effects of benzodiazepines such as diazepam. Baclofen or tizanidine is sometimes used as an alternative to diazepam.

The anticonvulsant effects of diazepam can help in the treatment of seizures due to a drug overdose or chemical toxicity as a result of exposure to sarin, VX, soman (or other organophosphate poisons; See #CANA), lindane, chloroquine, physostigmine, or pyrethroids Diazepam is sometimes used intermittently for the prophylaxis of febrile seizures caused by high fever in children and neonates under five years of age.  Long-term use of diazepam for the management of epilepsy is not recommended; however, a subgroup individuals with treatment resistant epilepsy benefit from long-term benzodiazepines and for such individuals clorazepate has been recommended due to its slower onset of tolerance to the anticonvulsant effects.

Diazepam has a broad spectrum of indications (most of which are off-label), including:

  • Treatment of neurovegetative symptoms associated with vertigo
  • Treatment of the symptoms of alcohol, opiate and benzodiazepine withdrawal
  • Short-term treatment of insomnia
  • Treatment of tetanus, together with other measures of intensive treatment
  • Adjunctive treatment of spastic muscular paresis (paraplegia/tetraplegia) caused by cerebral or spinal cord conditions such as stroke, multiple sclerosis, or spinal cord injury (long-term treatment is coupled with other rehabilitative measures)
  • Palliative treatment of stiff person syndrome
  • Pre- or postoperative sedation, anxiolysis and/or amnesia (e.g., before endoscopic or surgical procedures)
  • Treatment of complications with a hallucinogen crisis and stimulant overdoses and psychosis, such as LSD, cocaine, or methamphetamine.
  • Prophylactic treatment of oxygen toxicity during hyperbaric oxygen therapy

Dosages should be determined on an individual basis, depending upon the condition being treated, severity of symptoms, patient body weight, and any comorbid conditions the patient may have.[13]

Availability

Diazepam is marketed in over 500 brands throughout the world. It is supplied in oral, injectable, inhalation and rectal forms.

The United States military employs a specialized diazepam preparation known as CANA (Convulsive Antidote, Nerve Agent), which contains diazepam. One CANA kit is typically issued to service members, along with three Mark I NAAK kits, when operating in circumstances where chemical weapons in the form of nerve agents are considered a potential hazard. Both of these kits deliver drugs using autoinjectors. They are intended for use in “buddy aid” or “self aid” administration of the drugs in the field prior to decontamination and delivery of the patient to definitive medical care.

History

Diazepam was the second benzodiazepine invented by Dr. Leo Sternbach of Hoffmann-La Roche at the company’s Nutley, New Jersey, facility following chlordiazepoxide (Librium), which was approved for use in 1960. Released in 1963 as an improved version of Librium, diazepam became incredibly popular, helping Roche to become a pharmaceutical industry giant. It is 2.5 times more potent than its predecessor, which it quickly surpassed in terms of sales. After this initial success, other pharmaceutical companies began to introduce other benzodiazepine derivatives.

The benzodiazepines gained popularity among medical professionals as an improvement upon barbiturates, which have a comparatively narrow therapeutic index, and are far more sedating at therapeutic doses. The benzodiazepines are also far less dangerous; death rarely results from diazepam overdose, except in cases where it is consumed with large amounts of other depressants (such as alcohol or other sedatives). Benzodiazepine drugs such as diazepam initially had widespread public support, but with time the view changed to one of growing criticism and calls for restrictions on their prescription.

Diazepam was the top-selling pharmaceutical in the United States from 1969 to 1982, with peak sales in 1978 2.3 billion tablets. Diazepam, along with oxazepam, nitrazepam and temazepam, represents 82% of the benzodiazepine market in Australia. While psychiatrists continue to prescribe diazepam for the short-term relief of anxiety, neurology has taken the lead in prescribing diazepam for the palliative treatment of certain types of epilepsy and spastic activity, for example, forms of paresis. It is also the first line of defense for a rare disorder called stiff-person syndrome. In recent years, the public perception of benzodiazepines has become increasingly negative.

Recreational use

Diazepam is a drug of potential abuse and can cause serious problems of addiction and as a result is scheduled. Urgent action by national governments has been recommended to improve prescribing patterns of benzodiazepines such as diazepam. A single dose of diazepam modulates the dopamine system in similar ways to how morphine and alcohol modulate the dopaminergic pathways. Between 50 and 64% of rats will self administer diazepam. Benzodiazepines including diazepam in animal studies have been shown to increase reward-seeking behaviours by increasing impulsivity, which may suggest an increased risk of addictive behavioural patterns with usage of diazepam or other benzodiazepines. In addition, diazepam has been shown to be able to substitute for the behavioural effects of barbiturates in a primate study.  Diazepam has been found as an adulterant in heroin.

Diazepam drug misuse can occur either through recreational misuse where the drug is taken to achieve a high or when the drug is continued long term against medical advice.

Sometimes, it is used by stimulant users to “come down” and sleep and to help control the urge to binge.

A large-scale, nationwide study conducted by SAMHSA found benzodiazepines in the USA are the most frequently abused pharmaceutical, with 35% of drug-related visits to the emergency department involving benzodiazepines.

They are more commonly abused than opiate pharmaceuticals, which accounted for 32% of visits to the emergency department. Males abuse benzodiazepines as commonly as females. Of drugs used in attempted suicide, benzodiazepines are the most commonly used pharmaceutical drug, with 26% of attempted suicides involving benzodiazepines. The most commonly abused benzodiazepine is, however, alprazolam. Clonazepam is the second-most-abused benzodiazepine. Lorazepam is the third-most-abused benzodiazepine, and diazepam the fourth-most-abused benzodiazepine in the USA.

Benzodiazepines, including diazepam, nitrazepam, and flunitrazepam, account for the largest volume of forged drug prescriptions in Sweden, a total of 52% of drug forgeries being for benzodiazepines.

Diazepam was detected in 26% of cases of people suspected of driving under the influence of drugs in Sweden, and its active metabolite nordazepam was detected in 28% of cases. Other benzodiazepines and zolpidem and zopiclone also were found in high numbers. Many drivers had blood levels far exceeding the therapeutic dose range, suggesting a high degree of abuse potential for benzodiazepines and zolpidem and zopiclone. In Northern Ireland in cases where drugs were detected in samples from impaired drivers who were not impaired by alcohol, benzodiazepines were found in 87% of cases. Diazepam was the most commonly detected benzodiazepine.

Legal status

Diazepam is regulated in most countries as a prescription drug:

  • International: diazepam is a Schedule IV controlled drug under the Convention on Psychotropic Substances
  • UK: classified as a controlled drug, listed under Schedule IV, Part I (CD Benz POM) of the Misuse of Drugs Regulations 2001, allowing possession with a valid prescription. The Misuse of Drugs Act 1971 makes it illegal to possess the drug without a prescription, and for such purposes it is classified as a Class C drug. “List of Controlled Drugs”
  • Germany: classified as a prescription drug, or in high dosage as a restricted drug (Betäubungsmittelgesetz, Anhang III)
Judicial executions

The State of California offers diazepam to condemned inmates as a pre-execution sedative as part of their lethal injection program.

Veterinary uses

Diazepam is used as a short-term sedative and anxiolytic for cats and dogs, sometimes used as an appetite stimulant. It can also be used to stop seizures in dogs and cats.

Letter
Valium Saved My Life
Published: October 5, 2012

To the Editor:

Re “Valium’s Contribution to Our New Normal,” by Robin Marantz Henig (Sunday Review, Sept. 30):

After serving in the Army in Vietnam and suffering from what is now called post-traumatic stress disorder, I found that Librium, and then Valium, definitely saved my life.

Whatever negatives there may be about the use and overuse of Valium, it has saved many lives and improved the quality of millions of lives.

Its positives dramatically outweigh its negatives, and right now, there is really no adequate substitute for the psychoactive drugs.

MICHAEL J. GORMAN
Whitestone, Queens, Sept. 30, 2012

Metheral66’s Story: Booze, pills, marijuana, cocaine, hallucinations, ECT, the madhouse and a rope

My Story - A Trip away from me
« on: June 18, 2012, 08:55:57 am »

Metheral66

Hi. I’m a 27 yr old male from Vancouver B.C. I was 18 years old when I had a bad anxiety attack from smoking weed. I saw a psychiatrist who put me on 0.5mg of clonazapam. I was told to take it indefinatly. I got my life back…… for a while. I finished high school, went to work for a year, then went to university. All the while I began to drink more and more and more. I was drinking everyday and smoking weed, doing coke, and poping t 3’s. My life lead me down to a dark path. I was hanging around the wrong people and ended up having a tramatic event happen to me at the age of 20. My anxiety kicked it ten fold. I fell into a horrible depression. I quit the drugs but kept on drinking and taking benzo’s. Eventually my depression and anxiety sx got so bad I attempted suicide by taking a handful of asprins and 2 bottles of wine. I ended up in hospital, they pumped my stomach, and put me in the psychward. I couldn’t move or get out of bed for 2 months. I was given lithium, serequel and effexor. Eventually through alot of hard work I came back to life. I had to learn how to walk again and how to talk again. I went to rehab for 4 months and felt about 80% back to normal. I went back to school for a year. Then one day I got the idea that a drink or two wouldn’t kill me. I had one drink at my buddies cabin. By the next day I couldn’t stop. I drank around the clock for the next 3 months. I ended up back in rehab. This time though they cut off my benzo’s c/t. I ended up going insane. I lasted about a month or so then I slit my wriste, they immidiatly put me on an even higher dose of clonazapam then before. I was now on 1.5mg. Things were shaky after my failed c/t. I never felt right. I suffered from depression, dp/dr, anxiety, dizzyness, intrusive thoughts, suicidal thinking, and restlessness. I got involved in A.A. Everything was going smoothly. I was going to a meeting a day, volenteering, working here and there and going to therapy. However those sx’s lingered. No matter how hard I tried I just never felt right, I never felt I was getting any rewards for the work I was putting in.

FINALLY I talked to a therapist who informed me about benzodiazapeins. I was shocked. But at the same time my situation finnally made sence. I was suffering from benzo tolerance withdrawal! AND THE SOLUTION WAS TO GET OFF THESE MEDICATIONS!.

So thats exactly what I started to do. I found informatin on the net about how to withdrawl. I tried to follow the ashton manual but my tapper became very scattered. I would cut down from 1.5 to 1.2 then back up to 1.3 then down to 1.1 then up to 1.2 and on and on and on. My sx’s became unbearable. I could no longer leave my house. I locked myself in my room. I was in isolation 24/7. My mind started playing tricks on me. I had horrible depression, dp/dr, panic attacks, aggression, insane thoughts, I would think I was someone else, I didn’t know who I was, I lost my identy, I was suicidal, constently tried to figure out life, terrified of death, lost faith in my faith, my self, my life, life became pointless, I was utterly hopless.

I remember when the day when I went to a friend/adviser. She is an amzing person, someone who has overcome many many obsticals in her life and full of advise. I told her I could no longer go on. She kept telling me “don’t stop, don’t quit your taper, you’ve come so far” But to my regret I didn’t listen. I was taking to the psychward where they uped my dose. They put me on 2.5mg’s, a full mg over my original dose.

We all waited. My family, my friends, myself waited for me to feel better. But I never did. My sx’s never improved. I thought I was hopless before, now I knew I was hopless. I couldn’t come off benzo’s and couldn’t be on them. There was no way out. I was admited once again to the psych ward

I escaped the nut house 2 times, and staggered back to the arms of the secuirity gards a few house later drunk from alcohol I had stolen from the liquore store up the street. It must of been quite a sight to a guy in a hospital gounde with two bottles of wine running down the street.

When the psychiatrist got word of this he told me I had ran out of options. I was simply not getting any better. The only thing left to do was Electro Shock Therapy. The nurses brought me into a small room and showed me a video of the ‘miricals’ of E.C.T. I was more than horrified. When I told my parents, they came to get me immidiatly. Before I left I had to talk to the head of the psychiatry at the hospital. I clearly remember him telling me that I was a hopless case. Over and over he repeated these words to me “you don’t want to get well you want to die” those were is exact words and he repeated it about five times. I left his office in tears. For someone who is suicidal those arn’t exactly the words you want to hear.

I became a full time job. My parents, more than once, found suicide notes I had writen. Luckily they found me before I could do anything. They decided I couldn’t be alone so they constently watched over me. They got tired of doing this and sent me to a trusted family friends house. There I had to sign a contract saying that if I tried suicide or if I felt like it I would tell her.

Over the next 3 months I was admited to the psychiatric ward 8 times. Either for suicidal behavior or cutting my wriste. Eventually they stoped taking me. I will never ever be able to express the hell I felt at this time. I wanted to die. It was all I thought about. The pain was so over the top it was unbeleivable. I found out that it is absolutly impossible to discribe Hell.

I was sent to another facility for the severly mentally ill. I stayed the maximum lenghth of time and forced to leave. I tried 5 different anti depressents, 2 different mood stabalizers, and had my benzo’s switched, decreased, increased, you name it. I was given the diagnosis of major depression, bi polar, boarderline personality disorder, ptsd, and even scizophrenia. I started to hear voices and see things that were not there. The voices came on as a rare side effect of a medication. They stoped once I got off it.

During this time alot things happend. I got stories for days, it was just insane. There was a month were I ran drugs for a ‘friend’ in exchange for money and booze. I had an incident with a clint that had me pinned to the floor with a knife to my neak. All I remember was screaming at him to do it, but he never did. Another time I purposly drove my truck into a telephone pole going 70 km/h. I was completly unharmed. I often wondered how I managed to stay alive.

Eventually they put me on lithium which I must say is the best medication I have been on. It definatly stoped the suicidal thoughts.

I moved back to my parents place and was on the waiting list for a mental health and addictions center. Unfortuanatly I started to drink again. I have a history of alcoholism. I was on 60mg of valium a day along with effexor, serequel, and lithium.

I drank and drank and drank. I had six months to kill while I waited to get into this treatment center. During those six months I was sober only 3 times. And that was for days when I was so physically and mentally sick I feared I would have a heart attack. My weight went up to 260pds from 200pds only a year later. I had trouble breathing, constently sweated, and delerium tremers.

One night I had attempted to go out with some friends. It had been months since I had ventured out of my house. I got so drunk I made a fool of myself. My social skills were obviously out of wack. Everyone, including myself, had difficulty understanding me. I stole as much liquore as I could find and made my way home. I drank all that I could. I found a rope and made a noose. I hung it from the roof of my garage, wraped it around my neak, and jumped. I was so drunk that instead of hanging my head sliped out of the noose and I landed flat on my ass. I dusted myself off, drank some more and passed out.

My drinking continued on until finnaly a bed opened at the recovery center. I found out later that this was place were people were sent who were to sick to get into regular rehab centers. I remember calling alot of other rehabs and being told I was to unstable to be accepted. They said I was a danger to myself and others.

When I arrived at the treatment center I quickly found out that this is not so much of a treatment center than it is a mental hospital. The only remain insane assylm had shut down and alot of the patients were sent here. About half of the patients are scizophrenics. There is fights almost everyday, people trying to escape, and drug use almost every where you look. I often walked in the bathroom to find people shooting heroin. Many people smoked crack or meth in right in there rooms. People often talk to themselves. Cursing the voices in there head. The halls are narrow and the rooms small. We have small activities through out the day to keep us busy. Thats helped me out a lot with my benzo withdrawal.

I have gone from 60mg of valium to 16mg in 6 months. Its been far from easy. I have countless stories about the facility I’m in and the journey through this hell that I’ve been on.

I just hope that I can somehow someway find a way back to me.
« Last Edit: June 18, 2012, 09:12:43 am by Metheral66 »