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Mixing Valium and Alcohol, Dangers, Effects, & Treatment

Because Valium works on the central nervous system to calm overactive electrical impulses in the brain, it reacts poorly with depressants like alcohol. Read to learn more about the effects of mixing valium and alcohol.

By We Level Up | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: January 30, 2023

What is Valium (Diazepam)?

Valium, also known as diazepam, is a prescription drug used for anxiety disorder treatment and muscle spasms. Prescription of valium for alcohol withdrawal symptoms, and as a sedative before surgery or to treat seizures. Diazepam (the generic name for Valium) is an anxiolytic benzodiazepine, first patented and marketed in the United States in 1963. It is a fast-acting, long-lasting benzodiazepine. In the setting of valium dosage for alcohol withdrawal, diazepam is helpful for symptomatic relief of agitation, tremor, alcoholic hallucinosis, and acute delirium tremens

As a benzodiazepine medication, Valium suppresses excitability in the nervous system. It accomplishes this goal by affecting a brain chemical called gamma-aminobutyric acid (GABA), which binds to GABA receptors and regulates excitement [1].

Unfortunately, long-term use of this medication, even with a prescription from a doctor, can lead to physical dependence on the drug and uncomfortable and potentially fatal Valium withdrawals when someone decides to quit using. In addition, this drug can lead to addiction, especially when higher dosages are used. Moreover, mixing Valium and alcohol (diazepam and alcohol) is dangerous because they can pose severe bodily risks. Someone with a history of alcoholism may be at risk of addiction to this drug.

Valium comes in 2 mg, 5 mg, or 10 mg oral tablets. The drug was first approved for use in the early 60s and is a central nervous system (brain and spinal cord) depressant with a half-life of nearly 48 hours. This means it takes a healthy adult about two days to process half a dose of Valium to half its concentration. As a result, a person can accumulate the drug in their system. Valium suppresses excitability in the nervous system so that users can get to sleep or stay asleep or go about their daily activities with less tension and stress. It can also be taken as a muscle relaxant.

What Is Alcohol?

Alcohol is a psychoactive substance with dependence-producing properties that has been widely used in many cultures for centuries. The harmful use of alcohol causes significant disease, and social and economic burdens in societies, according to the World Health Organization (WHO). Alcohol consumption is a causal factor in more than 200 disease and injury conditions. Drinking alcohol is associated with a risk of developing health problems such as mental and behavioral disorders, including alcohol dependence, major non-communicable diseases such as liver cirrhosis, some cancers, and cardiovascular diseases, as well as injuries resulting from violence and road clashes and collisions.

Alcohol is classified as a depressant, which slows down vital functions, resulting in slurred speech, unsteady movement, disturbed perceptions, and an inability to react quickly. Alcohol poisoning or alcohol overdose causes even more severe depressant effects (inability to feel pain, toxicity where the body vomits the poison, and finally unconsciousness or, worse, coma or death from severe toxic overdose). These reactions depend on how much is consumed and how quickly.

Fermented drinks, such as beer and wine, contain from 2% alcohol to 20% alcohol. Distilled drinks, or liquor, contain from 40% to 50% or more alcohol. The usual alcohol content for each is:

  • Beer 2–6% alcohol
  • Cider 4–8% alcohol
  • Wine 8–20% alcohol
  • Tequila 40% alcohol
  • Rum with 40% or more alcohol
  • Brandy 40% or more alcohol
  • Gin 40–47% alcohol
  • Whiskey 40–50% alcohol
  • Vodka 40–50% alcohol
  • Liqueurs 15–60% alcohol

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Valium Addiction Statistics

Over the past two decades, the number of substance abuse cases related to Valium and other benzodiazepines has tripled to over 100,000 cases of treatment admissions.  Valium is often abused when taken in conjunction with other drugs, medications, alcohol, or other possibly illegal substances. This can cause severe and even lethal repercussions for the patient or the abuser. This is why Valium is considered to be a controlled substance and should only be taken as directed. 


33 percent

About 33 percent of the elderly population has been prescribed some kind of benzo medication like Valium for anxiety or sleep-related issues.

Source: NIDA

50 million

More than 50 million prescriptions for drugs like Valium and other benzos are written each year in the United States.

Source: NIDA

30 percent

Recent Valium abuse statistics show that nearly 30 percent of all related deaths from pharmaceutical medications like Valium and other benzodiazepines and 75 percent of overdose deaths were not intentional.  

Source: NIDA


Valium (Diazepam) Drug Facts

Diazepam

Diazepam is a benzodiazepine medication that is FDA approved for the management of anxiety disorders, short-term relief of anxiety symptoms, spasticity associated with upper motor neuron disorders, adjunct therapy for muscle spasms, preoperative anxiety relief, management of certain refractory epilepsy patients, and adjunct in severe recurrent convulsive seizures, and an adjunct in status epilepticus.


Indications

Diazepam is an anxiolytic benzodiazepine, first patented and marketed in the United States in 1963. It is a fast-acting, long-lasting benzodiazepine commonly used to treat anxiety disorders and alcohol detoxification, acute recurrent seizures, severe muscle spasms, and spasticity associated with neurologic disorders. In valium taper for alcohol withdrawal, diazepam is useful for symptomatic relief of agitation, tremor, alcoholic hallucinosis, and acute delirium tremens.


Mechanism of Action

Benzodiazepines exert their effects by facilitating the activity of gamma-aminobutyric acid(GABA) at various sites. Specifically, benzodiazepines bind at an allosteric site at the interface between the alpha and gamma subunits on GABA-A receptor chloride ion channels. The allosteric binding of diazepam at the GABA-A receptor increases the frequency at which the chloride channel opens, leading to an increased conductance of chloride ions. This shift in charge leads to a hyperpolarization of the neuronal membrane and reduced neuronal excitability.

Pharmacokinetics

Absorption: After oral administration of diazepam >90%  is absorbed, the average time to achieve peak plasma concentrations is 1 to 1.5 hours. Absorption is delayed and decreased when administered with a meal. There is an increase in the mean time to achieve peak concentrations to approximately 2.5 hours in the presence of food. 

Distribution: Diazepam is highly lipophilic. While there is a moderately quick onset of action, the drug quickly redistributes. Diazepam and its metabolites have high plasma protein binding.(diazepam 98%). Diazepam and metabolites penetrate the blood-brain and placental barriers and are found in breast milk. The volume of distribution is 0.8 to 1.0 L/kg. 

Metabolism: Diazepam is mostly broken down by the microsomal enzymes CYP2C19 and CYP3A4 enzymes to several active metabolites, mainly desmethyldiazepam. Other minor active metabolites include oxazepam and temazepam. The average half-lives of oral diazepam and desmethyldiazepam are about 46 and 100 hours, respectively.

Excretion: The initial distribution is followed by a prolonged terminal elimination(half-life ~ 48 hours). Additionally, the terminal elimination half-life of the active metabolite N-desmethyldiazepam is up to 100 hours. Diazepam and its metabolites are excreted predominantly in the urine. Diazepam accumulates upon multiple dosing; consequently, the terminal elimination half-life of diazepam is slightly prolonged.[6]

Can You Drink on Valium? Mixing Valium and Alcohol

People may not realize the danger of mixing Valium and alcohol (valium and alcohol mixing). For example, if you get anxious at social functions, you may instinctively take Valium to help you with the anxiety, and you get through the party. However, social engagements are also a typical setting for alcohol. Because it may take up to forty minutes for Valium to take effect, you may be able to get to a party and have a drink before you even begin to feel its effects. As a result, many individuals may take Valium and alcohol mixture accidentally, not knowing the dangers.

However, some users mix alcohol with valium to take advantage of specific effects. Valium can cause a feeling of deep relaxation or euphoria, and individuals sometimes try to enhance those effects by mixing alcohol. When combined, “Valium alcohol mix” may generate an enhanced buzz. Users describe the experience as more relaxing than an alcohol or benzo buzz on their own. However, it also may strengthen other side effects.

Valium and Wine

Are alcohol and valium dangerous? Together, the sedative effects of alcohol with diazepam (drinking on valium) can be more potent, which increases the risk of substance dependence, unconsciousness, brain damage, and even death. While some people accidentally consume a glass of wine or beer without realizing that Valium and alcohol shouldn’t be combined (diazepam alcohol), others relish the effects that alcohol and Valium have on their bodies. In either case, it’s critical to understand the drawbacks of combining the two. Valium is generally regarded as safe when taken as prescribed, however, when combined with alcohol, it can have certain harmful effects on health.

Effects of Mixing Valium & Alcohol 

Are valium and alcohol safe? While some users mix Valium drug with alcohol or other drugs to intensify its calming effects, others take Valium with other substances without being aware that they endanger their health and safety. Although Valium is safe for most adult users when prescribed under a doctor’s supervision, abusing this medication by mixing it with other medicines, illicit drugs, or alcohol poses serious risks. To prevent excessive sedation, it is critically important to be aware of the possible alcohol valium interaction. Mixing Valium with alcohol or other drugs can lead to:

  • Confusion
  • Disorientation
  • Accidents
  • Sedation
  • Stumbling
  • Dizziness
  • Liver damage
  • Nausea
  • Loss of consciousness
  • Addiction
  • Brain damage
  • Coma
  • Death
Valium and alcohol addiction can be hard to identify at first, but this disorder will soon take over different parts of your life to become evident to the people around you.
Valium and alcohol addiction can be hard to identify at first, but this disorder will soon take over different parts of your life to become evident to the people around you.

Benzodiazepines have a mild cardiovascular effect that can lead to hypotension in some users. However, when alcohol is combined, it can lead to a “synergistic effect” on blood pressure, meaning that both Valium alcohol mixtures work together to intensify the effect. In some cases, Valium can cause tachycardia or an abnormal heart rate.

Despite wine having a much lower alcohol content than spirits like tequila, vodka, or whisky, it’s still a depressant that can have devastating effects when combined with Valium. If you take Valium and want to come home to a glass of wine, you should speak with your doctor about your options. They’ll likely tell you to skip the wine and look for alternatives that don’t contain alcohol. Combining Valium and alcohol can lead to respiratory depression or death. 

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Valium and Drinking: Mixing Valium & Alcohol Effects on the Brain

Valium works on the central nervous system ( brain and spinal cord) to slow down excessive electrical impulses in the brain. This sedating effect can help to prevent abnormal body movements, seizures, and muscle spasms. It can also quiet the user’s emotions and mood or make them drowsy. Valium is usually prescribed to help people with anxiety or insomnia to help them relax and fall asleep. However, people who use the drug for recreation take Valium for its calming, soothing effects.

When taken by itself according to a doctor’s or therapist’s directions, Valium is a relatively safe drug with a low risk of harmful side effects. But the dangers of this drug increase significantly when this medication is taken simultaneously with other substances, like alcohol. In particular, the following substances mixed with Valium pose a high risk of overdose, loss of consciousness, coma, and death:

  • Alcoholic beverages
  • Opioid painkillers, such as prescription drugs that contain hydrocodone (Vicodin, Norco), oxycodone (Percocet, OxyContin), hydromorphone (Dilaudid), and other narcotics
  • Illicit opiate drugs, like heroin
  • Other tranquilizers or sedatives, such as alprazolam (Xanax) or lorazepam (Ativan)
  • Sleep medications such as zolpidem (Ambien)
  • Barbiturates like secobarbital (Seconal) or phenobarbital (Nembutal)
  • Cocaine
  • Methamphetamine (meth)

Many of these substances have depressant actions, slowing various physiological processes and suppressing activity in the brain. Mixing these drugs with Valium can boost the effects of this tranquilizer, making the user even more vulnerable to the dangers of central nervous system depression. The use of Valium with stimulants like cocaine and methamphetamine can also endanger the user’s health and safety. Abusing multiple drugs increases the risk of dangerous drug interactions, overdose, polysubstance addiction, accidents, and fatalities.

The use of Valium and alcohol, opiate drugs, or other prescription medications is not always deliberate. Some people with legitimate prescriptions for Valium may consume alcohol or take other prescription drugs that interact with Valium without being aware of the possible dangers. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) cautions that depressants can increase the sedative effects of alcohol, making the user even more disoriented, sleepy, and vulnerable to accidents or injuries. Valium users should read medication labels carefully and avoid alcohol while taking this drug.

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Alcohol vs Valium: Mixing Valium & Alcohol Effects on the Body

Drinking alcohol while you’re taking Valium can increase your risk of experiencing a depressant overdose. Even if you’ve only taken relatively small doses of each drug, potentiation can cause you to experience overdose symptoms. A depressant overdose can cause nausea, sedation, and vomiting but can also cause potentially life-threatening symptoms. Depressant Overdose symptoms may include:

  • Heavy sedation
  • Confusion
  • Loss of consciousness
  • Heavy intoxication
  • Loss of motor control
  • Changes in vision
  • Memory impairment
  • Nausea and vomiting
  • Slowed breathing
  • Bluish coloration in lips and fingertips
  • Oxygen deprivation
  • Coma

One of the most dangerous symptoms of a depressant overdose is respiratory depression. Respiratory depression is when your breathing is slowed to a dangerous degree. Depressants like Valium and alcohol can slow down your breathing by slowing nervous system activity relating to essential automatic functions in your body. Slowed or stopped breathing can happen during heavy sedation or unconsciousness without you realizing it. During a fatal depressant overdose, respiratory depression is often the cause of death.

Another potentially dangerous complication is the aspiration of vomit. Since alcohol and Valium overdose can cause nausea and a loss of consciousness, you may be at risk of vomiting while you’re asleep and aspirating it. This can be similar to drowning. If someone is with you when this happens, they may be able to intervene by helping you to sit up or roll to your side. Valium and alcohol misuse is likely to cause some acute, short-term effects, but mixing them may also cause dangerous long-term consequences. Misusing these drugs can affect multiple areas of your body, leading to long-lasting health problems. 

Both drugs can affect your heart rate. Alcohol misuse can contribute to high blood pressure, strokes, and heart disease. Depressants manipulate some parts of the brain that are related to automatic functions like heart rate and blood pressure. Alcohol and benzodiazepine misuse can cause long-term issues with these critical functions. 

Alcohol misuse is known to be hard on your liver. Long-term alcoholism can lead to liver disease and dysfunction. However, Valium may also damage your liver if used for a long time, significantly if it’s misused in high doses. The FDA warns that liver function tests should be used to monitor your liver during the long-term use of Valium. If you use both of these drugs at the same time, it could cause liver disease to develop more quickly. 

If you are taking Valium for anxiety disorder treatment, let your doctor know what prescription and over-the-counter medications you are taking.
If you are taking Valium for anxiety disorder treatment, let your doctor know what prescription and over-the-counter medications you are taking.

Valium and Alcohol: How Long After Taking Valium Can I Drink?

Valium and alcohol how long to wait? People should refrain from drinking for one or even two days after taking benzodiazepines, with the caveat that some benzodiazepines, like Valium, have a longer half-life and will stay in your system longer than others (Xanax is considered shorter-acting). So is it safe to drink alcohol after diazepam? It is not.

Can You Use Valium For Hangover?

Even when Valium is a painkiller that can ease a headache, it is not recommended to use it to treat a hangover, because you should wait at least two days to take valium after drinking alcohol.

Negative Side Effects of Valium and Alcohol

Using too much of any substance can cause mental and physical harm to your body. Mixing Valium and alcohol—which are both depressants—can lead to the following side effects:

  • Extreme drowsiness
  • Extreme dizziness and confusion
  • Blood poisoning
  • Loss of balance that can lead to falls
  • Loss of control over bodily functions
  • Nausea and vomiting
  • Slowed breathing
  • Slowed heart rate
  • Brain damage
  • Coma
  • Overdose

Some factors put you at higher risk for overdosing when mixing Valium and alcohol. If you are taking prescription medications other than Valium, Valium and alcohol could also interact with that medication. If you consume too much alcohol or Valium too fast, your organs may not process them, leading to an overdose. Psychological distress and personal stressors—such as relationship problems—may play a role. Combining or intentionally misusing Valium and alcohol can be potentially life-threatening.

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Can You Overdose on Valium?

1,135 drug overdose fatalities with benzodiazepines occurred in the United States in 1999; 11,537 occurred in 2017. Such unsafe pharmaceutical use practices can be a nightmare for patients and their families even when the medication is generally safe and effective.

Valium has a low threshold for overdosing when used alone. For fatal overdoses, this is significantly reduced. To overdose on the drug alone, let alone succumb to the symptoms and die, would require a significant amount of the substance. Although improbable, an overdose is nevertheless possible.

Treatment for Polysubstance Addictions

Alcohol is the most abused addictive substance in America, as more than 17 million people in the United States are considered to suffer from addiction to alcohol. The Substance Abuse and Mental Health Service Administration (SAMHSA) publishes that over 1.5 million American adults are considered to be currently abusing a prescription drug. 

Mixing Valium and alcohol can lead to addiction and dangerous side effects, including a greater risk of overdose. People with a history of problem drinking and alcohol dependence will need to inform their doctor about these problems. In addition, it’s crucial that these individuals get help from a qualified addiction rehabilitation center. 

Polysubstance abuse is the consumption of more than one substance simultaneously. While some drug users have a preferred drug, others have several drugs they like to take. Polysubstance abuse is common, and these drug users are clinically classified as having multiple comorbid substance disorders.

Because valium and alcohol withdrawal is more complicated, inpatient medical detox is generally recommended. The goal of treatment is to restore some or all normal liver functioning by addressing the underlying issue of mixing the prescription drug with alcohol.

If you are struggling with alcohol use, it’s crucial to get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and lifestyle changes are effective for coping with functional. 

Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated process of alcohol withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can give the necessary medication and medical expertise to lessen cravings and the effects of withdrawals.

Psychotherapy 

Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves changing both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.
Comprehensive therapy can help people address the root causes of Valium and alcohol addiction and develop the skills necessary for lifelong sobriety.
Comprehensive therapy can help people address the root causes of Valium and alcohol addiction and develop the skills necessary for lifelong sobriety.

Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in mental health disorders and substance abuse. Dual-diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. This strategy treats both the substance abuse problem and the mental disorder simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend mainly on the treatment for both diseases done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

 If you or a loved one are struggling with long-term drug abuse and a co-occurring mental health condition such as depression, contact one of our helpful treatment specialists today. We Level Up can provide information on dual diagnosis and detox programs that may fit your specific needs.

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Search We Level Up “Mixing Valium and Alcohol Topics & Resources
Sources:

[1] NCBI – https://www.ncbi.nlm.nih.gov/books/NBK537022/
[2] CDC – https://www.who.int/news-room/fact-sheets/detail/alcohol
[3] NIAAA – https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-and-brain-overview
[4] FDA – https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/013263s094lbl.pdf
[5] NCBI -https://pubmed.ncbi.nlm.nih.gov/32856316/
[6] Valium Addiction – https://welevelupnj.com/addiction/valium-addiction/
[7] NIDA – https://archives.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties
[8] NIDA – https://nida.nih.gov/international/abstracts/benzodiazepine-use-in-subjects-alcohol-opioid-dependence-pilot-study
[9] NIDA – https://archives.drugabuse.gov/publications/nida-community-drug-alert-bulletin-prescription-drugs/what-types-prescription-medications-are-commonly-abused
[10] SAMHSA – https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/co-occurring-disorders