Blog - Beach House Rehab Center
February 21, 2019

Librium Detox Guide

Librium (chlordiazepoxide) is a brand name anti-anxiety and alcohol withdrawal medication that belongs to a class of drugs known as benzodiazepines or “benzos.”  Although Librium is classified as a Schedule IV controlled substance by the Drug Enforcement Administration (DEA)—a lower designation than prescription opiates such as hydrocodone or illicit drugs such as heroin—its potential for addiction and abuse remain high. Librium is considered a long-acting benzo and is frequently abused by snorting and through intravenous injections (IV) by users seeking a more immediate, potent high. Librium’s psychotropic effects also make it popular for use in treating insomnia, seizures, muscle tension, and irritable bowel syndrome (IBS).  According to the Centers for Drug Control and Prevention (CDC), there were approximately 11,000 benzo-related overdose fatalities in 2016, and approximately 50 million benzo prescriptions are written annually.


A long-acting benzo, Librium blocks receptors in the brain that trigger stress and anxiety through the mechanism of increasing GABA—a major neurotransmitter found in the brain and central nervous system (CNS). Once unleashed, GABA slows down multiple bodily functions by activating the parasympathetic nervous system. It can take as little as a month to become Librium-dependent, at which point increasing frequency and dosage are required to maintain the same short-term effects. Due to the sedating, euphoric high induced by the drug, once a user becomes addicted and stops, the brain responds by becoming hyperactive. Librium is potent enough that even casual, recreational users may experience significant withdrawal symptoms.

Upon admission into a detox program, a team of trained medical professionals and licensed clinicians help evaluate the severity of withdrawal symptoms using a variety of evidence-based tools. These assessments then dictate client-specific treatment goals including when medication-assisted treatment (MAT) begins and recommended timelines for therapy.  Depending upon whether a client is in late or early stage addiction and the intensity of dosage, the following cluster of symptoms may occur:

  • Irritability
  • Tremors
  • Disorientation
  • Insomnia
  • Panic attacks
  • Depression
  • Psychosis
  • Nausea


Librium withdrawal is usually broken down into four stages, with the intensity and longevity of each phase varying depending upon multiple factors including the length of addiction, usual dosage, gender, age, weight, height, and overall physical and psychological health. During stage one, initial symptoms usually begin within hours—the approximate time it takes for Librium to begin exiting the system (it features a half-life of approximately 5-30 hours)—and peak with maximum intensity. This phase, which lasts for up to 72 hours, includes primarily psychological symptoms including depression, irritability, and intense cravings. The remaining stages mirror the following pattern:

  • Stage two—after 72 hours, Librium is no longer present in the body in any significant quantity. During this phase—which lasts for approximately one week—physical and psychological symptoms begin to diminish in intensity, although exhaustion and lingering cravings may remain.
  • Stage three—within 10 to 14 days, Librium is no longer present in the system. Although clients may still experience insomnia, mood swings, and other sleep-related difficulties, their appetite usually returns to baseline (Librium acts as an appetite-suppressant).
  • Stage four—this final Librium withdrawal stage is characterized by a diminishing regularity and severity of symptoms. Although stage four generally subsides after one month, lingering symptoms may persist for months or even years—a phenomenon known as post-acute withdrawal syndrome (PAWS). Unfortunately, the milder effects of PAWS may lead certain clients to feel that they have prematurely overcome their addiction. However, this is not the case. Additional precautions must be taken during PAWS to help ensure optimal recovery outcomes and prevent relapse.


Inpatient treatment for Librium is a popular, evidence-based protocol in which clients live at a designated residential facility—usually for a period of one month—but in some cases as many as three.  During their stay, clients receive intensive medical and clinical supervision by a team of highly qualified professionals. This expert-level monitoring and management is why inpatient treatment is widely considered the industry gold-standard for effective Librium treatment. At reputable inpatient facilities, clients benefit from round-the-clock observation, heightened security, enhanced camaraderie, and impressive ancillary services and benefits—all of which add significant value to the experience.  


Librium addiction is best treated with a combination of ongoing psychotherapy and pharmacological interventions—an industry trusted protocol known as MAT. The staple of Librium addiction treatment involves a variety of Food and Drug Administration (FDA)-approved medications combined with the following evidence-based therapies:

  • Motivational interviewing (MI)
  • Trauma-focused therapy
  • Cognitive behavioral therapy (CBT)
  • Dialectical behavioral therapy (DBT)
  • Narrative therapy
  • Family therapy
  • Creative and expressive therapy

Pharmacological interventions may include Librium or other benzodiazepines (during initial detox), antidepressants, anticonvulsants, and a wide range of other primary or supplemental medications. In certain clients, medications are explored on a trial basis depending upon symptoms and switched based upon the findings of thorough follow-up evaluations. Although clearly established Librium treatment guidelines are generally followed, administering physicians demonstrate flexibility when attending to individual client needs and understand that there is no one-size-fits all protocol.   


Librium addiction frequently occurs in tandem with a broad range of anxiety and depression-related disorders including major depressive disorder (MDD), bi-polar disorder, generalized anxiety disorder (GAD), and numerous others. For many clients, the presence of untreated co-occurring disorders fuels and ultimately sustains their addiction. Based upon the findings of a comprehensive physical and mental health evaluation, a variety of medications may be used to supplement treatment including: pregabalin, buspirone, gabapentin, and SSRIs.   


Outpatient treatment is an affordable alternative to inpatient treatment that involves transitional care. In outpatient settings, found in various public and private institutions, clients receive less intensive care and do not live at the facility 24/7. Particularly attractive to clients with demanding personal and professional schedules, outpatient treatment offers many of the same services and benefits as inpatient treatment on a less comprehensive basis.


Librium is a powerful benzo that requires professional addiction treatment. At-home, self-guided detox is extremely dangerous and never recommended regardless of the reason. Although those suffering from amphetamine addiction sometimes resort to self-administered treatment in order to save time and money, they end up saving neither while incurring unnecessary risks. The safest, most evidence-based method of detox always involves qualified medical supervision and intensive clinical care, both of which lead to improved long-term recovery outcomes and help minimize the likelihood of relapse


The safest, most effective Librium detox method involves administering controlled doses of medication (Librium or other) on a gradually diminishing basis, a process known as tapering. Considering Librium’s potentially deadly potency—especially when interacting with other prescription medications or illicit drugs—quitting cold turkey is never recommended and may lead to a rapid onset of withdrawal symptoms. For this reason, professional medical assistance is a critical aspect of successful treatment, with tapering the clinically preferred standard for allowing physical and psychological processes to safely readjust. 


The decision to enroll in treatment is a major step in the right direction, but it is also a complex and highly involved process. For many clients, financial considerations, facility location, reputation, and insurance coverage represent the most critical factors in choosing an appropriate treatment program. Most reputable treatment facilities have experienced admissions staff on-hand to help facilitate the enrollment process. They can help answer questions or resolve concerns related to insurance coverage and benefits, making the overall admissions process a relatively stress-free, even enjoyable scenario. When researching optimal treatment facilities, many clients find the following features, benefits, and services extremely important:

  • Aftercare planning
  • Alumni networking
  • State-of-the-art technology
  • Evidence-based therapy (EBT)
  • Alternative / holistic healing modalities
  • On-site recreational amenities
  • Close proximity to major attractions
  • Accessibility from major airports


Simply completing medically managed detox is not sufficient to ensure long-term recovery success. A key component of long-term abstinence and recovery involves following a multi-pronged approach.  Many inpatient facilities can help with strategizing and planning an optimal post-treatment regimen. This should include ongoing medication management, one-on-one and group therapy, life and job skills coaching, regular physical activity, a healthy, nutritious diet, random drug testing and continual sober peer support.  


Although genetic tendencies and environmental factors make certain people more prone to addiction, any one, at any time, regardless of race, socioeconomic status, age, gender, or religion can end up in need of Librium detox. If you or someone you love are addicted to Librium and in need of medical help, call a substance abuse professional today.

Most importantly, remember that Librium abuse may result in overdose—and potentially death. Overdose is considered a life-threatening emergency requiring immediate medical attention in a hospital emergency room (ER) or intensive care unit (ICU).

For more about Librium addiction and recovery, check out these related articles:


  • Journal of Clinical and Diagnostic Research. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond.  Sept, 2015.
  • Industrial Psychiatry Journal. Clinical Management of Alcohol Withdrawal: a systematic review. July, 2013.
  • Journal of Anxiety Disorders. The discovery of chlordiazepoxide and the clinical introduction of benzodiazepines: a half a century of anxiolytic drugs. Jan, 2011.
  • Alcohol and Alcoholism.  Is Daily Single Dosage of Diazepam as Effective as Chlordiazepoxide in Divided Doses in Alcohol Withdrawal—A Pilot Study.  March, 2000.