Diazepam 119epileptic seizures. Among epileptics the drug can also cause status epilepticus,
a potentially fatal condition in which seizures occur back to back.
Injecting diazepam into an artery is perilous. This mishap has been known
to occur even when medical professionals administer the drug, and most rec-
reational users lack training in anatomy. This mistake can cause gangrene,
leading to amputation of appendages. Intravenous injection of diazepam can
stop breathing and heart action; when administering the drug intravenously
hospitals are prepared for such emergencies, but most street users are not.
Intravenous injection can also lower muscle strength and blood pressure. In
a small percentage of human volunteers (5% or less), rectal administration has
produced euphoria, breathing difficulty, skin rash, runny nose, or diarrhea.
Diazepam is one of the few drugs that can cause flat brain wave readings
in a living person. Such readings are a classic sign of death, and medical
personnel seeing such readings might decide to stop efforts that are keeping
a patient alive.
Abuse factors.Among illicit drug users in the 1990s diazepam was the most
common benzodiazepine. When researchers supplied recreational drug users
with several benzodiazepine class substances, diazepam was rated as having
the most abuse potential. In testing of the drug’s appeal, volunteers reported
that the higher the dose, the higher the attractiveness. Researchers evaluating
results of an experiment involving recreational drug users judged diazepam
to be even more effective in producing pleasure than in producing medical
effects.
In one experiment with recreational drug users over one third of them de-
scribed diazepam’s effects as reminiscent of barbiturates, which produce ef-
fects similar to alcohol. Perhaps such effects explain why tests of drug
preference show diazepam to be popular among moderate alcohol drinkers.
Research indicates that euphoria from diazepam is more likely in a person
with a family history of alcoholism. Moderate drinkers find diazepam more
appealing than light drinkers do, but that may be due less to alcohol per se
than due to a personality that finds drugs generally attractive.
A rat experiment measured development of diazepam tolerance in those
animals. Humans can develop dependence with diazepam, causing a with-
drawal syndrome if dosage ceases all at once instead of gradually. Depending
on how much of the drug has been used for how long, withdrawal symptoms
can be mild or strong. Mild cases may simply involve trembling, reduced
appetite, and trouble falling asleep. In bad cases a person can experience per-
spiration, muscle cramps and tremors, vomiting, and convulsions. Sudden
stoppage of long-term diazepam dosage can provoke seizures, so doses need
to be tapered off instead.
Drug interactions.Alcohol and diazepam can boost each other’s actions.
Diazepam effects can also be intensified by barbiturates, opiates, and mono-
amine oxidase inhibitors (MAOIs—found in some antidepressants). Those in-
teractions can be fatal. Effect of a diazepam dose can be lengthened by
propoxypheneand by the ulcer drugs omeprazole and cimetidine. One study
found that a dose tends to last for a shorter time among alcoholics. In a dog
experimentphenobarbitaldecreased diazepam levels in the animals. In mice
diazepam has boosted toxic effects from the cancer medicine ifosfamide. The