By Irfana Parveen

B.Sc (Psychiatry Ward)

02 July 2022
Medically reviewed by
Freny Menezes
Pharm. D
Table of Contents

Alcohol withdrawal syndrome(AWS) is a set of symptoms that occur in an individual on abrupt discontinuation or significant reduction in alcohol intake after a period of long-term dependence. The symptoms can range from mild to serious, and if untreated, can also lead to death. Psychological, social, and environmental factors strongly impact alcohol-drinking behavior. 

Excessive alcohol alters the normal functioning of the brain associated with experiencing pleasure, making decisions, and behavioral control. Over time, the central nervous system can no longer tolerate the lack of alcohol. When such individuals stop drinking or reduce alcohol intake significantly, it causes an alcohol withdrawal syndrome. The withdrawal symptoms are categorized into mild, moderate, and severe symptoms.

Mild symptoms occur within 6 to 12 hours, and include tremors, headache, nausea, vomiting, anxiety, high blood pressure, increased heart rate, excessive sweating
Moderate symptoms occur within 12 to 24 hours, and include alcohol withdrawal seizures, hallucinations

The most severe form of alcohol withdrawal syndrome is delirium tremens which occurs within 24 to 48 hours of alcohol withdrawal. The symptoms consist of extreme confusion, hallucinations, and increased excitability. If untreated, it can lead to complications such as cardiac collapse and stroke which could be life threatening. The mortality for this condition ranges from 1 to 5 %.

According to a study, 20% of the US population exhibit alcohol abuse during their lifespan, and more than 50% of those with a history of alcohol abuse can exhibit alcohol withdrawal syndrome on discontinuation or reduction in alcohol intake.

The key to successful withdrawal is to consult a doctor for treatment of the addiction and detox strategies to taper off alcohol. A few ways to get through this are adequate hydration, proper nutrition, family support, and medication. Benzodiazepines(BZDs) such as Valium are an important class of medication to treat alcohol withdrawal syndrome.

What Is Valium?

Valium is used to relieve anxiety and control agitation caused by alcohol withdrawal. It is also used with other medications to control muscle spasms and spasticity caused by certain neurological disorders. 

These disorders consist of: 

  • Cerebral palsy

(a condition that causes difficulty with movement and balance.

  • Paraplegia 

(Inability to move parts of the body), athetosis (abnormal muscle contractions).

  • Stiff-man syndrome 

(a rare disorder with muscle rigidity and stiffness). 

Valium is used along with other medications to control seizures. Valium belongs to a class of drugs called benzodiazepines. It focuses on calming abnormal overactivity in the brain.

Valium is a long acting benzodiazepine with a half-life that affects brain chemistry and stays in the body for a considerable amount of time (48 hours). Its metabolites may require longer duration to undergo metabolism.

Common side effects include drowsiness, problems with movement co-ordination, tremors, and confusion. Some severe side effects include yellow skin discoloration, delusions, amnesia, hallucinations, and mood changes. If you experience any of these, consult your physician immediately.
No. Valium is only a prescription medication and is not available as an over-the-counter(OTC) medication.
One must avoid alcohol when taking Valium. The combination may make you excessively drowsy, and in a few patients it may also lead to breathing difficulties.

Is Valium Safe To Take For Alcohol Withdrawal?

Valium 5 mg to 20 mg every 2 to 4 hours or oxazepam 15 to 30 mg 3 to 4 times daily with lower doses in the elderly are the most common choices of most doctors. 
Changing the amount found in the clinical situation may be preferable to a fixed dose as it can reduce the total amount

Practices And Drugs To Avoid While Having The Course Of Valium

Intensive hydration, gradual withdrawal of alcohol, anticonvulsants other than benzodiazepines, neuroleptics, beta-blockers and clonidine, magnesium, vitamin B6 and nicotinic acid. Medications used to maintain abstinence (acamprosate, baclofen, disulfiram, and naltrexone) should only be started when the withdrawal has been completed.

This GEM(The abbreviation GEM has multiple full forms. The author should state the appropriate full form here) has been viewed and approved by Professor Brian McAvoy of the Tasmanian Department of Health and Human Services, Alcohol and Drug Services.

Valium is less appropriate when

  • If you have a mental illness or depression.  
  • If you have a lung condition or breathing difficulties, or suffer from any liver or kidney disorder. 
  • If you take any other medications or pills, always get a prior consultation from your physician.
  • If you take illegal drugs bought “on the street.” 
  • If you are pregnant or breast-feeding 

The Usual Dose Of Valium?

Doctors will usually start the dose of Valium at 10-20mg four times a day. These conditions may vary according to patient assessment. After a time, the dose will be gradually reduced every one to two days over five to ten days. A short course of treatment will not usually continue longer than two weeks. 

During treatment, you will be evaluated every day for the first few days for alcohol withdrawal symptoms. Alterations to the dose of Valium will depend upon assessments. The doctor may even take a blood test to check that your liver is working correctly and you may be breathalyzed. 

How Should One Take Valium? 

Valium is a prescription medicine. So, as you all know, it needs to be prescribed by a certified doctor. One cannot buy Valium by themselves from the store. If you have further questions after starting the treatment, speak to your doctor or pharmacist.

Never change the dose yourself. The initial amount will be four times a day, which should be equally spaced every four to six hours every day. Constantly take your medicine with a whole glass of water.

Valium: Withdrawal symptoms

The medicine Valium has addiction potential. The Drug Abuse Warning Network(DAWN) indicates that Valium and alprazolam are the two Benzodiazepines with significant addiction potential. Hence, it is available only on prescriptions, and it should not be stopped abruptly.

There is a general timeline to stop the Valium treatment. The duration, intensity, and symptoms of Valium withdrawal will vary from person to person.

Bottom Line From Practical Anxiety Solutions: 

Alcohol use disorder is a major health problem around the world. Along with the use of alcohol, there has been an increasing burden of alcohol withdrawal syndrome(AWS). Prompt and early management of AWS is required to prevent serious complications and fatality.

Medications such as Valium remain the first line of treatment for AWS, and such individuals should receive treatment only under the supervision of a physician to avoid any untoward side-effects, and receive appropriate doses of the medication.


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