Mixing certain medications with alcohol can cause adverse side effects, and can even cause some serious health issues, so it is important to understand what you can and can’t mix. If you have just been prescribed diazepam or are already taking it, you may need to know the risks involved with drinking alcohol alongside.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about taking diazepam or drinking alcohol, we’re here to help.

What is diazepam?

Diazepam is a fast-acting, long-lasting benzodiazepine which began being used in 1963. Today it is typically used to help treat conditions such as anxiety disorders, acute recurrent seizures, severe muscle spasms, and muscle contractions associated with neurologic disorders. It can also sometimes be used for alcohol detoxification, but this must be monitored by a professional. It’s also important to note that as diazepam can be addictive it is classed as a controlled substance - so you can’t get it without a prescription from a licensed medical professional.

Here in the UK, you may be prescribed diazepam for the aforementioned conditions through the NHS. Although in the UK it may come under a different brand name, around the world the most common brand name for diazepam is usually Valium.

Diazepam can be taken orally, as an intravenous injection, a liquid nasal spray, or a rectal gel, and it works by increasing the activity of something called gamma-aminobutyric acid (GABA). This chemical in the body sends signals to the nervous system, and without enough of it, the body can be in an excited state that causes anxiety, muscle spasms, or even seizures. With more of the chemical in the body, these symptoms tend to ease.

What is diazepam used for?

Diazepam is typically prescribed to help treat:

• Anxiety disorders
• Alcohol detoxification (withdrawal symptoms like agitation or tremors)
• Acute recurrent seizures
• Severe muscle spasms (including those associated with neurological disorders)

Diazepam is sometimes prescribed as part of a combination therapy, which means you may be required to take it alongside other drugs.

So diazepam can be used for alcohol detoxification too?

Yes, but only with the guidance of a medical professional who can monitor the detoxification process. When it comes to acute alcohol withdrawal, diazepam can help to offer relief from the agitation, tremors, alcoholic hallucinosis, and delirium tremens often associated with alcohol withdrawal.

Who prescribes diazepam?

Diazepam can be prescribed by your GP or psychiatrist, or it may be given to you if you are an in-patient in hospital.

The British Journal of General Practice recommends short-term (2-4 weeks) use of diazepam at the lowest possible dosage if being used for severe anxiety, insomnia, or panic disorder. However, it is documented that in reality, large numbers of patients have been prescribed diazepam on a long-term basis at a high dose for less than severe anxiety. This can cause issues because diazepam is known to require a higher dose over time to maintain its effects. As a result, use beyond the short term can lead to dose escalation.

What are the risks of using alcohol and diazepam together?

"Diazepam is a sedative medication so the risk of mixing it with alcohol is oversedation. The more serious side effect would be slowing down someone’s respiratory efforts and shutting down the bodies innate mechanism to breathe, this then becomes a medical emergency." - Dr Shakeel Islam, Consultant Psychiatrist

When it comes to using benzodiazepines, the toxic-to-therapeutic ratio is very high, which means diazepam is a relatively safe medication to use. That said, there is a strong potential for overdose when using diazepam in combination with opioids, alcohol or other centrally acting agents.

Diazepam has the ability to slow down brain activity and interfere with judgement and motor skills, and since alcohol can have similar effects, you should not drink alcohol or take other drugs that can also slow brain activity. In addition, you should not drive a vehicle, operate machinery, or do anything that could cause harm or injury due to a lack of alertness.

Your body processes alcohol and diazepam in a similar way, which means if you drink alcohol, diazepam may take longer than usual to leave your body, leading to a number of potential side effects. Mixing diazepam with alcohol can lead to:

• Disorientation and confusion
• Sedation
• Unsteadiness and dizziness
• Nausea
• Loss of consciousness
• Addiction

In extreme cases, mixing alcohol and diazepam can even cause brain damage, coma or death, so it is extremely important to heed the warning of not mixing these two substances.

How much can you drink while taking diazepam?

A lot of people will have a drink or two even when on drugs that discourage the use of alcohol, sometimes with few short term side effects. However, in the case of diazepam, the NHS advises that you should absolutely not drink alcohol at all while taking it; it increases the effect of the drug and can make you go into an extremely deep sleep. There’s even a risk that you won’t be able to breathe properly, and you might have difficulty waking up. So: no alcohol! This means not having even one beer when out with friends, or a glass of wine with dinner.

Some people do combine alcohol and diazepam because they know doing so can intensify the effects of both, and could even control symptoms of alcohol withdrawal. However, this is how accidents happen, as many people do not understand the potential dangers of mixing diazepam and alcohol.

As both of these substances are central nervous system depressants, mixing them can be both an unpleasant experience, as well as being potentially life-threatening. Therefore, if you are wondering how much alcohol you can drink while taking diazepam, the answer is none.

If you do decide to drink anyway, be aware that research around grapefruit juice has shown that it can increase the amount of diazepam in your bloodstream, which also needs to be avoided in order to minimise side-effects and potential complications. So not only are you risking issues from combining alcohol and diazepam anyway, but anything including grapefruit, like a cocktail, would be even higher risk.

Can alcohol aggravate underlying conditions being treated with diazepam?

There is a chance that taking diazepam could cause more problems for those with potential mental health issues such as a history of severe depression or suicide attempts. Diazepam could exacerbate these issues, so you should always let your doctor know of any medical history like this so they can monitor you more closely.

It’s also worth remembering that diazepam reduces heart rate and blood pressure, as well as causing a reduction in both respiration and body temperature, so make sure you mention any existing conditions like hypertension (or hypotension) or breathing difficulties like sleep apnea when you’re discussing medication with your GP, especially if these might not already be on your medical record for whatever reason.

What to do if alcohol is a concern for you while taking diazepam

If you have been prescribed diazepam but you have concerns about not being able to cut alcohol out of your diet — whether due to potential addiction or other reasons — you should let your GP know this as soon as possible so they can adjust your prescription or refer you to the correct services for alcohol addiction.

You may also find it helpful to speak to a therapist who can help you to work through any worries or underlying issues that might be fuelling your drinking or alcohol consumption. By speaking to a professional, you could receive the advice and support you need that’s specific to your personal circumstances. Our free 15 minute consultation can guide you to the most relevant specialists with experience helping those with alcohol issues, so it’s a great place to start.

Important: If you have been mixing alcohol and diazepam (even if you believe you have managed to do this successfully so far) you should seek help from a medical professional as soon as possible to manage your dosage, find alternative medication, or get help with reducing your alcohol intake. Mixing alcohol and diazepam can be extremely dangerous to health and can cause a risk of death, so it is important to address this as early as possible.

If you have a question about taking diazepam or alcohol consumption, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps. Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments and reviews to broader mental health care: join us today.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any diet, exercise, or other health-related programme.