What Is Diazepam Addiction

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KEY TAKEAWAYS

Diazepam addiction:

Is the physical and psychological dependence on diazepam (Valium) to the extent of experiencing withdrawals and/or psychological cravings
Is characterised by slowed reaction times, due to a 53% reduction in the somatosensory-evoked potential amplitude index [4]
Causes anxiety in 100% of Valium treated mice, despite Valium being prescribed for anxiety [13]

Physical Indicators Of Addiction To Diazepam

Speech Patterns

Slowed speech is a physical indicator of Valium addiction due to lowered activation of Broca's area in the brain, responsible for language production

As usage becomes regular, speech deficits become more pronounced, and users present with slowed speech and an inability to think of words in the correct context
Compared to alcohol addiction that causes slurred speech, speech impairments in Valium addiction relate to word fluency, so those addicted may struggle with sentence flow and stutter on words
Combining alcohol with Valium leads to poor memory function for 4.5 hours after administration, causing users to forget conversations with others [1]

Motor Impairments

The inability to learn new motor skills is a physical indicator of Valium addiction due to a disruption to neuroplasticity of motor performances [2]

Ataxia, or a lack of voluntary coordination of movements, presents in Valium addiction due to the drug doubling the potency of gamma-aminobutyric acid that inhibits neural activity in the cerebellum, responsible for movement [5]
Slowed reaction time to sensory stimuli is a physical indicator of Valium addiction, as studies demonstrate it increases varied potentials by +4 ms and +6 ms [3]
Sensitivity and numbness occur in addiction due to a 53% reduction in the somatosensory-evoked potential amplitude index compared to lorazepam, causing slowed reactions [4]

Eyesight Changes

Valium users engage in head turning or tilting due to visual field loss caused by inhibiting amacrine cells responsible for peripheral vision [6]
Appearing more clumsy or having accidents indicates 'tunnel vision', a physical indicator of Valium addiction
Hyperopia is a physical indicator of addiction due to the convergence near point receding in users, with a change of +3.7cm at 1.5 hours post-consumption [7]
Involuntary eye movements occur 17.6% more in the right eye 1.5 hours following consumption and are caused by overactivation of gamma-aminobutyric acid [7]

Reduced Facial Muscle Tension

Physical signs of reduced muscle tension in Valium users include a low-hanging jaw due to less clenching, and ptosis, or drooping eyelids during periods of non-use

Poor facial muscle tone is caused by inhibition of a2 gamma-aminobutyric acid_Areceptors and a3 gamma-aminobutyric acid_Areceptors when doses increase >30mg/kg [8]
Users appear to have less pronounced facial expressions, such as not smiling at something cheerful, due to lack of control over facial muscles

Sensory Hypersensitivity

Hypersensitivity to touch increases response rates by 54% in mice after Valium administration, causing overreactions to everyday touch [9]
Sensitivity to painful stimuli increases by 72% following consumption in mice, leading to flinching or restlessness when exposed to pain [9]
Valium causes photophobia and phonophobia through lowered gamma-aminobutyric acid activation, resulting in users squinting eyes or self-isolating in a dark and quiet room

Psychological Indicators Of Addiction To Diazepam

Depersonalisation

Case studies demonstrate that depersonalisation persists while using Valium, resulting in users staring vacantly, being unresponsive and less emotionally expressive than normal [10]

In periods of non-use in addiction, 67% report feeling detached from reality, caused by overactive glutamate signalling, leading to anxiety and restlessness [11]

Anxiety

Anxiety is a psychological indicator of addiction in periods of non-use as the drug is no longer available to increase gamma-aminobutyric acid 2-fold, resulting in amygdala excitation and panic [5]
Although anxiety symptoms may be relieved temporarily with Valium, long-term use maintains anxious cognitive biases, such as the belief that attending an event is life-threatening [12]
Valium administration shows increased anxiety in mice studies, indicated in 100% Valium-treated mice through avoiding open spaces and keeping to 'safe zones' [13]

Anterograde Amnesia

Anterograde amnesia is a psychological indicator of addiction, caused by an 11.49mm increase in visual analogue scales resulting in drowsiness and less awareness when forming new memories [14]
5-10mg of intravenous Valium causes poor recognition memory in 90% of users, lasting 20-30 minutes, leading to hesitation when recalling people, places or objects in the environment [15]
Anxiolytic-induced anterograde amnesia can be mistaken for Alzheimer's disease, as users also have suppression to the medial temporal lobe, causing problems in remembering new names, faces or facts [16]

Reduced Emotional Processing

A 0.73Hz reduction in response to flickering light indicates cognitive slowing, causing users to have poor visual-emotional processing and read emotional expressions incorrectly [17]

Valium use suppresses the amygdala and limbic system, resulting in mood imbalances that present as mood switching (e.g., from happy to sad)

Valium users take 22% longer to react to angry facial expressions and 10% longer to react to happy facial expressions, leading to impaired empathy and a poor ability to recognise faces [18]

Cycle Of Diazepam Addiction

Stage Of Diazepam Addiction	Behaviours At This Stage
Initial use of Diazepam	Takes medication as prescribed or in small doses if not prescribed Becomes aware of the euphoric effects
Increased use	Overusing prescription Using for reasons other than prescribed Drug-seeking behaviour
Cravings	Poor concentration Irritability Physical restlessness Risk-taking behaviour to obtain more
Dependence	Cannot function without the drug Risky behaviour to obtain drug (e.g., doctor shopping)
Attempts to stop	Binning leftover medication Mood swings Social isolation Avoiding triggers
Withdrawal symptoms	Vertigo Sensitivity to light and sound Seizures Increased heart rate
Relapse	Risk of overdose due to low tolerance Social isolation due to guilt Erratic behaviour Law-breaking to obtain drug

Vulnerable Groups

Groups	More/less likely	Why?
Anxiety disorder sufferers	More likely	Diazepam provides relaxation Calming for those with social anxiety
Chronic pain sufferers	More likely	Muscle-relaxant properties provide pain relief
Insomnia sufferers	More likely	Sedative effects induce sleep Doses increase to match tolerance
Trauma survivors	More likely	Calming effects overcome trigger responses
PTSD sufferers	More likely	Used to cope with flashbacks Can be overused when PTSD is not dealt with

Sedatives Changing Addiction To Diazepam

Zolpidem changes addiction by causing impaired judgement, sedation and respiratory depression, particularly in older users
Concurrent use of zoleplon with Valium causes central nervous system depression, so patients might appear more drowsy with laboured breathing
Zoleplon changes dependence by binding to the same gamma-aminobutyric acid receptors, speeding up tolerance so more Valium doses are needed for the same effect, leading to physical dependence
Zolpidem increases the rate of suicidal ideation by 1.82 times, and Valium increases this rate 2-fold, highlighting the need to seek support in concurrent addiction [19] [20]

Surgical Use Changing Addiction To Valium

Surgical use of Valium as pre-medication for anxiety allows users to believe it is safe to use for future anxiety, becoming a coping mechanism for those with anxiety
Use of Valium as pre-surgery anxiety medication normalises the use of the drug for stress relief, particularly in those with a history of dependence, so medical histories are examined before use
Psychological dependence on Valium occurs when its effects mask underlying trauma-related anxiety beyond pre-surgery nerves, so this is considered a risk factor before prescriptions are made

Co-Occurring Epilepsy Changing Addiction

20mg/kg less Pentylenetetrazole, a seizure-inducing drug, is required to induce seizures in diazepam using mice in temporary withdrawal [21]
Concurrent use of phenytoin decreases the half-life of Valium by 31%, resulting in users taking more, thus maintaining physical dependence [22]

References

[1] Haffner, W., et al. “Mental and Psychomotor Effects of Diazepam and Ethanol.” Acta Pharmacologica et Toxicologica, vol. 32, no. 3-4, Wiley, Mar. 1973, pp. 161–78. Accessed 20 Nov. 2024.“Both ...complex Coordination and Critical Flicker Fusion Frequency.”
[2] Willerslev-Olsen, Maria, et al. “The Effect of Baclofen and Diazepam on Motor Skill Acquisition in Healthy Subjects.” Experimental Brain Research, vol. 213, no. 4, July 2011, pp. 465–74. Accessed 15 Sept. 2020.“These data indicate...by disrupting some of the neuroplastic changes that are involved in improved motor performance.”
[3] Di Lazzaro, Vincenzo, et al. “Dissociated Effects of Diazepam and Lorazepam on Short-Latency Afferent Inhibition.” The Journal of Physiology, vol. 569, no. 1, Nov. 2005, pp. 315–23. Accessed 29 July 2021.“increases the amount of SAI at ISIs of N20 +4 ms and N20 +6 ms ...mean N20 latency was 18.5 ± 1.3 ms.”
[4] Di Lazzaro, Vincenzo, et al. “Dissociated Effects of Diazepam and Lorazepam on Short-Latency Afferent Inhibition.” The Journal of Physiology, vol. 569, no. 1, Nov. 2005, pp. 315–23. Accessed 29 July 2021.“In addition, SAI was less after lorazepam... (0.40 ± 0.22) (P < 0.05) at this time point.”
[5] Riley, M., and C. N. Scholfield. “Diazepam Increases GABA Mediated Inhibition in the Olfactory Cortex Slice.” Pflügers Archiv - European Journal of Physiology, vol. 397, no. 4, Springer Science+Business Media, Jan. 1983, pp. 312–18. Accessed 20 Nov. 2024.“doubled the potency of the GABA analogue, muscimo” .
[6] Elder, M. J. “Diazepam and Its Effects on Visual Fields.” Australian and New Zealand Journal of Ophthalmology, vol. 20, no. 3, Wiley, Aug. 1992, pp. 267–70. Accessed 20 Nov. 2024.“Therefore it can be concluded that benzodiazepines alter retinal function... has the potential to alter visual field sensitivity purely due to its retinal effects.”
[7] Brand, Rose, et al. “EFFECT of DIAZEPAM on OCULOMOTOR BALANCE.” British Journal of Clinical Pharmacology, vol. 1, no. 4, Aug. 1974, pp. 335–36. Accessed 30 July 2020. “Table 1.”
[8] Crestani, Florence, et al. “Molecular Targets for the Myorelaxant Action of Diazepam.” Molecular Pharmacology, vol. 59, no. 3, Mar. 2001, pp. 442–45. “Thus, the myorelaxant activity ...receptors and at high concentrations also by α3 GABAA receptor.”
[9] Knabl, Julia, et al. “Genuine Antihyperalgesia by Systemic Diazepam Revealed by Experiments in GABAA Receptor Point-Mutated Mice.” Pain, vol. 141, no. 3, Feb. 2009, pp. 233–38. Accessed 25 Jan. 2023. “After 10 min of reperfusion, the neurones exhibited a greater response...enhanced sensitivity persisted over the 60-minreperfusion period” .
[10] Janjua, Ahmed, et al. How Would You Handle This Case? The Woman Who Wasn’t There. 2010. Accessed 20 Nov. 2024. “Because of her persistent complaints of depersonalization, ...months later, she reports her depersonalization symptoms have resolved completely.”
[11] Ashton, H. “Benzodiazepine Withdrawal: An Unfinished Story.” BMJ, vol. 288, no. 6424, Apr. 1984, pp. 1135–40. Accessed 12 Dec. 2019. “Table 11.”
[12] Stitzer, Maxine L., et al. “Diazepam Use among Methadone Maintenance Patients: Patterns and Dosages.” Drug and Alcohol Dependence, vol. 8, no. 3, Nov. 1981, pp. 189–99. Accessed 11 Dec. 2018.“65 -70% of maintenance patients had positive urinalysis tests during a single month.”
[13] Golombok, Susan, et al. “The Effects of Diazepam on Anxiety-Related Cognition.” Cognitive Therapy and Research, vol. 15, no. 6, Dec. 1991, pp. 459–67.This suggests that ...alleviates anxious mood rather than cognitive manifestations of anxiety.
[14] Hou, Ruihua H., et al. “Relationship between Sedation and Pupillary Function: Comparison of Diazepam and Diphenhydramine.” British Journal of Clinical Pharmacology, vol. 61, no. 6, June 2006, pp. 752–60. Accessed 11 Dec. 2021.“Both active drugs reduced the pre-post treatment changes compared with placebo... −11.49 (−19.19, −3.79.”
[15] DUNDEE, J. W., and S. K. PANDIT. “Anterograde Amnesic Effects of Pethidine, Hyoscine and Diazepam in Adults.” British Journal of Pharmacology, vol. 44, no. 1, Wiley, Jan. 1972, pp. 140–44.“The intravenous administration of 5 and 10 mg ...caused anterograde amnesia in 50 and 90%.”
[16] Kaplan, Katherine A., and Holly C. Hunsberger. “Benzodiazepine-Induced Anterograde Amnesia: Detrimental Side Effect to Novel Study Tool.” Frontiers in Pharmacology, vol. 14, Frontiers Media, Sept. 2023. “As previously stated, BZD-induced amnesia...with severe damage to the medial temporal lobe, a hallmark of AD.”
[17] Hou, Ruihua H., et al. “Relationship between Sedation and Pupillary Function: Comparison of Diazepam and Diphenhydramine.” British Journal of Clinical Pharmacology, vol. 61, no. 6, June 2006, pp. 752–60, Accessed 11 Dec. 2021. “Both active drugs reduced the pre-post treatment changes compared ...−0.73 (−1.63, 0.17).”
[18] Murphy, S. E., et al. “Direct Effects of Diazepam on Emotional Processing in Healthy Volunteers.” Psychopharmacology, vol. 199, no. 4, June 2008, pp. 503–13.“Table 2.”
[19] Khan, Hiba, et al. “Zolpidem Use and Risk of Suicide: A Systematic Review and Meta-Analysis.” Psychiatry Research, vol. 316, Oct. 2022, p. 114777. “Furthermore, an increased risk of suicidal death... 1.82 (95% CI: 1.43 – 2.30.”
[20] Dodds, Tyler J. “Prescribed Benzodiazepines and Suicide Risk.” The Primary Care Companion for CNS Disorders, vol. 19, no. 2, Mar. 2017.“Among naturalistic research, the most informative may be a 5-year longitudinal study27 of 21,492 patients with schizophrenia...illness severity and treatment adherence.”
[21] Mori, Tomohisa, et al. “Involvement of the Arachidonic Acid Cascade in the Hypersusceptibility to Pentylenetetrazole-Induced Seizure during Diazepam Withdrawal.” Biological and Pharmaceutical Bulletin, vol. 35, no. 12, 2012, pp. 2243–46. Accessed 9 Mar. 2023. “Figure 1.”
[22] Khoo, Ko-Chin, et al. “Influence of Phenytoin and Phenobarbital on the Disposition of a Single Oral Dose of Clonazepam.” Clinical Pharmacology & Therapeutics, vol. 28, no. 3, Wiley, Sept. 1980, pp. 368–75. Accessed 20 Nov. 2024. “DPH pretreatment increased CZP clearance by 46% to 58% and decreased CZP half-life (t½) by 31%.”

About the author

Philippa Scammell

Philippa Scammell MSci holds an integrated Master's degree in Psychology
from the University of York and has completed undergraduate statistical studies at Harvard University. Philippa has substantial experience in inpatient psychiatric care (Foss Park Hospital York), Research in Psychology at University of York, and group therapy facilitation (Kyra Women's Project). Philippa writes on clinical psychology and addiction recovery. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: December 29, 2025