View Full Version : Alcohol & Diazapam question
Hi,I'm on diazapam (2mg) I've been taking one every other night just before i go to bed for about 3 to 4 weeks,last one I took was wednesday night and im wondering if it's safe to have a couple of beers nothing heavy just 2 or 3 cans.??
I'll try to be as objective as possible.
Eventhough the most likely thing is that you'll be okay, I really wouldn't do it. Both diazepam and alcohol are CNS depressants, so they're going to synergize with one another and you'll feel very sedated. 2 or 3 cans of beer might become like 5 or 6.
Potentially, there CAN be respiratory system issues, like respiratory depression (hard to breathe) which can be dangerous. It is NOT likely to happen with 2mg diazepam and 1 beer but still, if you play with fire, you can get burnt.
Don't do it, it's not worth it. If you want to enjoy alcohol, quit diazepam for at least 4 to 5 days before drinking to be 100% safe.
Hi,I'm on diazapam (2mg) I've been taking one every other night just before i go to bed for about 3 to 4 weeks,last one I took was wednesday night and im wondering if it's safe to have a couple of beers nothing heavy just 2 or 3 cans.??
I take 5mg morning and night and have 3 Bourbons after work
Have done it for years with no probs
Go for it
I take 5mg morning and night and have 3 Bourbons after work
Have done it for years with no probs
Go for it
Sorry... that's just irresponsible advice.
Positive thoughts
As much as I respect your advice it works for me with no probs
Been on that dose for 12 yrs now with no ill effects
It would be different if it was a high dose and a dozen beers
MyNameIsTerry
15-02-16, 04:55
I'll try to be as objective as possible.
Eventhough the most likely thing is that you'll be okay, I really wouldn't do it. Both diazepam and alcohol are CNS depressants, so they're going to synergize with one another and you'll feel very sedated. 2 or 3 cans of beer might become like 5 or 6.
Potentially, there CAN be respiratory system issues, like respiratory depression (hard to breathe) which can be dangerous. It is NOT likely to happen with 2mg diazepam and 1 beer but still, if you play with fire, you can get burnt.
Don't do it, it's not worth it. If you want to enjoy alcohol, quit diazepam for at least 4 to 5 days before drinking to be 100% safe.
I don't think it's worth citing the potential of death from respiratory depression as a reason if you don't think it's even likely to be a possibility.
It may also take a lot longer for the Diazepam to clear as well, the active drug may be out sooner but the active metabolite will be in there far longer than 4-5 days.
Although I should add that I think it's better not to mix the two.
---------- Post added at 04:55 ---------- Previous post was at 04:50 ----------
As much as I respect your advice it works for me with no probs
Been on that dose for 12 yrs now with no ill effects
It would be different if it was a high dose and a dozen beers
True Phill, it's only a couple of cans the OP is asking about. I just wouldn't be using them close to each other.
I wouldn't personally do it but when you spend your life on a med, the situation changes. Many people don't believe in drinking on SSRI's but doctors understand that is not the reality and restricting your life for 20 years on a med isn't always the best anyway as you can end up depressed.
In terms of being irresponsible, I wouldn't agree there. BUT above we have respiratory depression cited when that occurs due to a) overdose, b) in IV and c) sever sleep apnea. Alcohol isn't cited so I'm sure we would be talking a lot of both to cause something like this and that's not what is being discussed.
When somebody asks for advice like this, I can't be too cautious. You know how YOU react to the combination but can't know how somebody else will.
All I said was purely objective. Respiratory depression is unlikely to happen, but it can and it must be taken into consideration.
For the OP, if you want to risk it just go for it, but be aware that the combination of alcohol and benzos is never a good thing.
I seriously can't get through my mind how you, or anybody, would try to entice someone to try a combination like this. It's just a combo to be avoided, no matter the quantity of either components. But hey, I was just offering information, I'm not a fortune teller, so you may be able to combine the two and be perfectly fine.
MyNameIsTerry
15-02-16, 12:09
Is there some evidence that combining the two, and at what level, can cause respiratory depression? Or are you stating that on the basis of combining two CNS depressants?
http://www.drugs.com/food-interactions/diazepam,valium.html?professional=1
The levels on both need to be high in most of the situations, but there has also been anecdotal evidence of people who got issues by using a lower level combination of benzos and alcohol.
It's general consensus to advice against the combination of ethanol and benzodiazepines, because even if the most likely thing (99,9%) is that it's fine to mix 3 beers with 2mg diazepam, that still doesn't make it a good idea.
An analogy would be like telling a couple that having unprotected sex and making the guy pull out is fine because the most likely thing is that, if done correctly, it works and the girl doesn't get pregnant. And while this is technically true, it's still ill advice and it's just better to tell the couple to use protection.
When somebody asks for advice like this, I can't be too cautious. You know how YOU react to the combination but can't know how somebody else will.
All I said was purely objective. Respiratory depression is unlikely to happen, but it can and it must be taken into consideration.
For the OP, if you want to risk it just go for it, but be aware that the combination of alcohol and benzos is never a good thing.
I seriously can't get through my mind how you, or anybody, would try to entice someone to try a combination like this. It's just a combo to be avoided, no matter the quantity of either components. But hey, I was just offering information, I'm not a fortune teller, so you may be able to combine the two and be perfectly fine.
I speak from experience not from the product leaflet and find that it's fine in moderation.
Fine for you doesn't have to mean fine for everyone.
It also doesn't make you right
2mg is half of nothing
Even my GP says it's no prob but you obviously know more than him
Your GP knows you and how you'll react to the combination, you don't know the OP and you are not a professional qualified to tell him to go do benzos with alcohol even if it's a low dose.
Don't try to be right about something you're not right about, come on. I'm all in for not being alarmist and I am also a very rational person who understands that the risk of mixing a couple of beers with 2 mg diazepam is almost negligible for most people, but it's still ill advice, what is so hard to understand?
If somebody asks me if it's safe to swim in the sea under a storm I'm not going to tell them "yeah sure, I did it a few times and nothing happened", I'll tell them "I wouldn't do it because the currents might be unpredictable".
Fine for you doesn't have to mean fine for everyone.
Exactly. Phill, if you want to do that then that's your prerogative. To post on a public anxiety forum that it's Ok to mix benzos and alcohol is irresponsible regardless of the dosage or number of drinks. Leave it at that and go enjoy what you're doing. No need to beleaguer the point.
Positive thoughts
Your GP knows you and how you'll react to the combination, you don't know the OP and you are not a professional qualified to tell him to go do benzos with alcohol even if it's a low dose.
Don't try to be right about something you're not right about, come on. I'm all in for not being alarmist and I am also a very rational person who understands that the risk of mixing a couple of beers with 2 mg diazepam is almost negligible for most people, but it's still ill advice, what is so hard to understand?
If somebody asks me if it's safe to swim in the sea under a storm I'm not going to tell them "yeah sure, I did it a few times and nothing happened", I'll tell them "I wouldn't do it because the currents might be unpredictable".
If you feel good denying someone the simple pleasure of a couple of beers go for it.
I'll bow to your obviously superior knowledge
BTW My GP gave me that advice when he first prescribed them not after
MyNameIsTerry
17-02-16, 07:30
Your GP knows you and how you'll react to the combination, you don't know the OP and you are not a professional qualified to tell him to go do benzos with alcohol even if it's a low dose.
Don't try to be right about something you're not right about, come on. I'm all in for not being alarmist and I am also a very rational person who understands that the risk of mixing a couple of beers with 2 mg diazepam is almost negligible for most people, but it's still ill advice, what is so hard to understand?
If somebody asks me if it's safe to swim in the sea under a storm I'm not going to tell them "yeah sure, I did it a few times and nothing happened", I'll tell them "I wouldn't do it because the currents might be unpredictable".
Don't do it, it's not worth it. If you want to enjoy alcohol, quit diazepam for at least 4 to 5 days before drinking to be 100% safe.
Thats incorrect. Whilst the half life of the active drug maybe up to 48hrs you don't then multiply that by 2 to ensure the drug is out of the body. Drug elimination in the body doesn't work like this, it takes a number of half lives. At 4 days, using a standard pharmacokinetic calculation (all drugs differ), the drug could be at 25% in the body. This is also lengthened by accumulation in fatty tissue. 5 days would not be sufficient either. However, what about the active metabolite? That has a half life of 100 hours. So, this won't be cleared for some time after 5 days.
I see you have picked Phill up on what he does not being applicable to someone else. So, why then have you just told someone that a drug will be out 100% in 4-5 days when drug elimination is individual to all people and affected by various conditions, none of which you have bothered to determine?
You have said there are "anecdotal" reports of respiratory depression in low use cases. First off, are these medically vetted & accepted? And given the OP will still have the active drug, let alone the active metabolite, in their body after 4-5 days, wouldn't that mean a low dose scenario could still be possible? Hence you are advising he take the same risk Phill has.
You state you are not "alarmist" yet you have planted a seed in your first post that respiratory depression is possible and all we have to go on are anecdotal reports, which haven't been confirmed anyway at this stage. You further state that even a 0.1% risk means you shouldn't take the chance. So, if we look at a common SSRI like Citalopram, in the 0.1% category we have " Aggressive reaction, delusion, depersonalization, drug dependence, emotional lability, euphoria, hallucination, mania, panic reaction, paranoid reaction, paroniria, psychosis, psychotic depression". Suicide attempts sit in 1-10%. Serotonin Syndrome has also been reported with SSRI/SNRI's so presumably you will be quoting these potential risks when people ask about these meds and following it up with a caveat of "but it probably won't happen to you". But the seed is already planted at that point. Whilst the manufacturers are legally obliged to print this in their PIL's, I would regard this as scaremongering on a forum such as this. You had no need to quote respiratory depression to state your case over mixing alcohol with Diazepam, but it does make things stand out more when you connect the dots to something potentially dangerous. You could have easily just explained about the CNS overlap and it would have been a valid and important case that the OP could consider.
Would it really be worthwhile to report Serotonin Syndrome in my example? You may argue that this is under medical supervision. But what is that from a GP? You get handed a prescription and told to come back for a review in 7 days. You can call inbetween but not all surgeries are currently able to allow emergency appointments, many won't let you speak to GP's or allow GP's to call you, and some you can struggle to get a follow up appointment with in under 3 weeks or longer. So, there is little in the way of medical supervision hence that argument would be a poor one. You could argue that we don't need alcohol, which is true. But thats not what we are discussing here, we are discussing your use of a potentially serious-to-fatal outcome and whether it is appropriate to do so.
Pulling the medical advice card against Phill is inappropriate when you have given medical advice yourself without being a professional either. You could have easily just advised they speak to their GP about it. Of course, we break the forum rules on this one all the time, some of the boards alone encourage this by their mere existence but if you are going to pull this rule out, you need to be following it yourself and you aren't. And Phill's GP had no idea how he would react, how could he?
Hi,I'm on diazapam (2mg) I've been taking one every other night just before i go to bed for about 3 to 4 weeks,last one I took was wednesday night and im wondering if it's safe to have a couple of beers nothing heavy just 2 or 3 cans.??
Hi Daniel
I'm unsubbing from this thread
I suggest you consult your GP
I'm sure they will say it's OK in moderation
Thats incorrect. Whilst the half life of the active drug maybe up to 48hrs you don't then multiply that by 2 to ensure the drug is out of the body. Drug elimination in the body doesn't work like this, it takes a number of half lives. At 4 days, using a standard pharmacokinetic calculation (all drugs differ), the drug could be at 25% in the body. This is also lengthened by accumulation in fatty tissue. 5 days would not be sufficient either. However, what about the active metabolite? That has a half life of 100 hours. So, this won't be cleared for some time after 5 days.
I see you have picked Phill up on what he does not being applicable to someone else. So, why then have you just told someone that a drug will be out 100% in 4-5 days when drug elimination is individual to all people and affected by various conditions, none of which you have bothered to determine?
You have said there are "anecdotal" reports of respiratory depression in low use cases. First off, are these medically vetted & accepted? And given the OP will still have the active drug, let alone the active metabolite, in their body after 4-5 days, wouldn't that mean a low dose scenario could still be possible? Hence you are advising he take the same risk Phill has.
You state you are not "alarmist" yet you have planted a seed in your first post that respiratory depression is possible and all we have to go on are anecdotal reports, which haven't been confirmed anyway at this stage. You further state that even a 0.1% risk means you shouldn't take the chance. So, if we look at a common SSRI like Citalopram, in the 0.1% category we have " Aggressive reaction, delusion, depersonalization, drug dependence, emotional lability, euphoria, hallucination, mania, panic reaction, paranoid reaction, paroniria, psychosis, psychotic depression". Suicide attempts sit in 1-10%. Serotonin Syndrome has also been reported with SSRI/SNRI's so presumably you will be quoting these potential risks when people ask about these meds and following it up with a caveat of "but it probably won't happen to you". But the seed is already planted at that point. Whilst the manufacturers are legally obliged to print this in their PIL's, I would regard this as scaremongering on a forum such as this. You had no need to quote respiratory depression to state your case over mixing alcohol with Diazepam, but it does make things stand out more when you connect the dots to something potentially dangerous. You could have easily just explained about the CNS overlap and it would have been a valid and important case that the OP could consider.
Would it really be worthwhile to report Serotonin Syndrome in my example? You may argue that this is under medical supervision. But what is that from a GP? You get handed a prescription and told to come back for a review in 7 days. You can call inbetween but not all surgeries are currently able to allow emergency appointments, many won't let you speak to GP's or allow GP's to call you, and some you can struggle to get a follow up appointment with in under 3 weeks or longer. So, there is little in the way of medical supervision hence that argument would be a poor one. You could argue that we don't need alcohol, which is true. But thats not what we are discussing here, we are discussing your use of a potentially serious-to-fatal outcome and whether it is appropriate to do so.
Pulling the medical advice card against Phill is inappropriate when you have given medical advice yourself without being a professional either. You could have easily just advised they speak to their GP about it. Of course, we break the forum rules on this one all the time, some of the boards alone encourage this by their mere existence but if you are going to pull this rule out, you need to be following it yourself and you aren't. And Phill's GP had no idea how he would react, how could he?
I'd like to see a GP recommending mixing alcohol with benzos. I'd really love to.
This is just getting silly at this point. If Phil wants to be mixing benzos and alcohol together, good for him I couldn't care less, but he shouldn't be telling people that it's good practise because it isn't, period.
Also Phil, I'm not trying to deny the OP from the pleasure of drinking beer, LOL. I'm just informing. Informing isn't being an alarmist, it's, like I said in my FIRST POST, being purely objective.
MyNameIsTerry
17-02-16, 09:43
http://www.drugs.com/food-interactions/diazepam,valium.html?professional=1
The levels on both need to be high in most of the situations, but there has also been anecdotal evidence of people who got issues by using a lower level combination of benzos and alcohol.
That's a Moderate drug interaction but it does admittedly state avoid. The same level of interaction can be seen on many antidepressants but they usually state avoid or limit, so a difference there.
Interactions can be managed though, something that falls out in using that interaction checker. For instance, switching from Citalopram to Mirtazapine is a cautious cross-taper but the interaction is Major. Whilst this is medically managed, all that means is you are left to look for Serotonin Syndrome yourself after your GP shoves you out the door with a new prescription.
So, interactions do need some reading and some will be overridden by a doctor on the basis of need outweighing risk. Not that "need" is relevant in the case of alcohol, of course.
But really you wanted the Pro section that explains more, and about the risks of respiratory depression since the interactions section states nothing about it. The bit that caught my eye was this:
Warnings
Valium is not recommended in the treatment of psychotic patients and should not be employed instead of appropriate treatment.
Since Valium has a central nervous system depressant effect, patients should be advised against the simultaneous ingestion of alcohol and other CNS-depressant drugs during Valium therapy.
As with other agents that have anticonvulsant activity, when Valium is used as an adjunct in treating convulsive disorders, the possibility of an increase in the frequency and/or severity of grand mal seizures may require an increase in the dosage of standard anticonvulsant medication. Abrupt withdrawal of Valium in such cases may also be associated with a temporary increase in the frequency and/or severity of seizures.
Now does that mean at the same time as the therapy or the administration? Probably the therapy given the liver enzyme impact.
There is a reference to respiratory depression:
A lower dose is recommended for patients with chronic respiratory insufficiency, due to the risk of respiratory depression.
About alcohol:
Alcohol
Concomitant use with alcohol is not recommended due to enhancement of the sedative effect.
It is also interesting to see that the same enzyme inhibition seems to occur with some known meds including Prozac:
Compounds Which Inhibit Certain Hepatic Enzymes
There is a potentially relevant interaction between diazepam and compounds which inhibit certain hepatic enzymes (particularly cytochrome P450 3A and 2C19). Data indicate that these compounds influence the pharmacokinetics of diazepam and may lead to increased and prolonged sedation. At present, this reaction is known to occur with cimetidine, ketoconazole, fluvoxamine, fluoxetine, and omeprazole.
Now a doctor may have an idea of the impact of alcohol if they have monitored Prozac alongside Diazepam? Maybe? They will use Diazepam with med start up.
All I can on respiratory depression is the above plus a mention about use in pregnancy and overdose. I covered those earlier on in the thread though so pregnancy is the new one.
I think you could have used details about the interaction and warnings, but not the respiratory depression since it's not mentioned in cases of alcohol here so where are you seeing it?
And you might as why I'm bothering on respiratory depression. The answer is because someone posted a thread terrified of it not that long ago and they weren't aware of how it is restricted to certain conditions and forms of delivery.
---------- Post added at 09:43 ---------- Previous post was at 09:41 ----------
I'd like to see a GP recommending mixing alcohol with benzos. I'd really love to.
This is just getting silly at this point. If Phil wants to be mixing benzos and alcohol together, good for him I couldn't care less, but he shouldn't be telling people that it's good practise because it isn't, period.
Also Phil, I'm not trying to deny the OP from the pleasure of drinking beer, LOL. I'm just informing. Informing isn't being an alarmist, it's, like I said in my FIRST POST, being purely objective.
Did you mean to reply to Phill? Nothing in this is response to what I have said.
Since that is Phill's experience, I suggest you accept it as so otherwise you are indicating he is being deliberately misleading or lieing and I doubt Phill would be either. Just because you don't believe him doesn't mean it has not happened. And I don't think the GP would be recommending drinking alcohol, which they wouldn't for any human being, but answering a question from Phill whether it would be ok.
Post
The only thing I wanted is to not entice a person who I don't know to do a mix which, while technically "safe" in low doses, can also bring undesired results. These undesired results don't even need to be respiratory depression by any stretch, they can simply be increased sedation and calmness and that's it.
It's my "responsability" as someone who is not medically trained to try to advice people against not doing a mix like this because it's general consensus in the medical field, so in reality, I am just echoing what any doctor with a little bit of common sense would tell you if he/she didn't know you well enough, for example if it was the first time you made an appointment.
Read my first post again, I didn't say that "If you mix 2 mg diazepam with 3 beers, you will suffer from respiratory depression", I said that the mix, while in theory OK in these low levels, can be POTENTIALLY bad. This is called informing people of the possible results of their actions. It's on them to evaluate if those results are likely to happen to THEM or not. And if people can't read information without suffering from a panic attack then perhaps they shouldn't be worried about mixing alcohol and benzos and they should be trying to seek therapy to treat their extreme anxiety which doesn't let them inform themselves without overreacting.
I'm done with this thread too. Whoever wants to do benzos with alcohol, do whatever you want. I give up.
MyNameIsTerry
17-02-16, 10:05
The only thing I wanted is to not entice a person who I don't know to do a mix which, while technically "safe" in low doses, can also bring undesired results. These undesired results don't even need to be respiratory depression by any stretch, they can simply be increased sedation and calmness and that's it.
It's my "responsability" as someone who is not medically trained to try to advice people against not doing a mix like this because it's general consensus in the medical field, so in reality, I am just echoing what any doctor with a little bit of common sense would tell you if he/she didn't know you well enough, for example if it was the first time you made an appointment.
Read my first post again, I didn't say that "If you mix 2 mg diazepam with 3 beers, you will suffer from respiratory depression", I said that the mix, while in theory OK in these low levels, can be POTENTIALLY bad. This is called informing people of the possible results of their actions. It's on them to evaluate if those results are likely to happen to THEM or not. And if people can't read information without suffering from a panic attack then perhaps they shouldn't be worried about mixing alcohol and benzos and they should be trying to seek therapy to treat their extreme anxiety which doesn't let them inform themselves without overreacting.
I'm done with this thread too. Whoever wants to do benzos with alcohol, do whatever you want. I give up.
You just swerved my points. The 4-5 days? Perhaps I see it as my responsibility to ask where you derive this from because I believe it to be incorrect. And the anecdotal reports? Were they validated by anyone in a medical field or just user stories which are unreliable?
Your points about not mixing are valid, but like I said I don't see the point in using rare outcomes to strengthen my point. It's informing if it's valid, but I don't see how it's valid. :shrug: Someone taking a Benzo could just as easily fall down the stairs from the sedation but we aren't going to list things like this, surely? Other than this, I don't see how what you are saying is incorrect other than the 4-5 days issue.
Fair point over enticing but Phill only provided his experience and was shot down for it when it could have been discussed to understand it came from a doctor hence it's not someone just saying 'yeah, down some booze'. So whilst it feels unfair to you, it must feel the same to Phill in that respect.
BIB - that is just ridiculous. This site is full of people who are triggered by what they read.
venusbluejeans
17-02-16, 11:55
closed pending admin review
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