Diazepam and Alcohol - Staying safe

[Jonnyboy1973]

Hi all

I have GAD. I usually need to take 10mg of Diazepam to get on a flight. I’ve got my best mates stag do this weekend which will obviously involve alcohol, I’m both terrified to go and terrified to miss it! (First flight without my partner)

- If I take diazepam at 5am for my Friday morning flight, will it be safe to have a few drinks the same evening?
- or if I wait til the Saturday night to have a drink, is it then safe to take diazepam the Sunday morning after for my flight home?

I have never even considered the effect the two have on each other til now as I’m not a big drinker. If holidaying with my girlfriend I usually have 2-3 drinks the night of arrival with diazepam still in my system and never felt side effects except being a bit tired. It is only now reading up on it ahead of this trip I am wondering if I have been/will be putting myself in danger

Apologies if this subject has been done to death on the forum, but any honest advice/your own experiences would be massively appreciated

Jonny

[Cherryade]

I'm sure you will be fine with a few drinks on the night you arrive. But I would consider taking just 5mg before leaving home and then another 5mg at the airport if you still feel very anxious. I think with all your mates around you, the lower dose would be enough. Same on the way home. Wait and take them until you really really need them. Amazing what the support of some good friends can do to your nerves!
Have fun.

[Jonnyboy1973]

I'm sure you will be fine with a few drinks on the night you arrive. But I would consider taking just 5mg before leaving home and then another 5mg at the airport if you still feel very anxious. I think with all your mates around you, the lower dose would be enough. Same on the way home. Wait and take them until you really really need them. Amazing what the support of some good friends can do to your nerves!
Have fun.

Thanks so much for your advice. I will try to space out 2 doses as suggested, hopefully that stops any panic escalating in the airport

Unfortunately though, it’s going with my friends that’s making me most nervous! It’s my first trip without my partner so not having that support is really worrying me. My friends aren’t aware of my mental health problems and I want to keep it that way if I can. (They’re good friends but not the most mature!)

[ankietyjoe]

You might be surprised at how mature one or two of them might be if you told them, and it would make your life a WHOLE lot easier if they knew.

[Jonnyboy1973]

You might be surprised at how mature one or two of them might be if you told them, and it would make your life a WHOLE lot easier if they knew.

Yeah I guess. I suppose part of me likes them not knowing and treating me any different, so on my good days with them I can be back to feeling how I used to before i developed GAD.

Either way, the diazepam/alcohol thing is still going to be an issue for me so any advice/personal experience from anyone would be a huge help :)

[ankietyjoe]

Well mixing booze and benzo's is a bad idea in my opinion. I think the effects are unpredictable and potentially (very) dangerous.

I know you've come here to reduce your anxiety about mixing these two things, but I have first hand experience of somebody who used to do the same.

If it were me, I'd choose one or the other. Mixing them is a bit of a lottery.

[Jonnyboy1973]

Well mixing booze and benzo's is a bad idea in my opinion. I think the effects are unpredictable and potentially (very) dangerous.

I know you've come here to reduce your anxiety about mixing these two things, but I have first hand experience of somebody who used to do the same.

If it were me, I'd choose one or the other. Mixing them is a bit of a lottery.

Thanks for honest advice. Much appreciated.

Do you think there would be enough diazepam in my system to warrant avoiding alcohol the following evening? So 36 hours after taking it.

[ankietyjoe]

Thanks for honest advice. Much appreciated.

Do you think there would be enough diazepam in my system to warrant avoiding alcohol the following evening? So 36 hours after taking it.

I would imagine the risk there would be extremely low to the point of being irrelevant.

I would also suggest spacing your drinks out to maybe one unit every hour or so and a maximum of three drinks? Maybe tell your mates you're taking some medication and can't get drunk? They don't need to know what it is.

I would be mindful of having a 'reaction' to both chemicals in your system which might freak you out, on top of being abroad without your partner. If you start to feel weird or dizzy, that might really spike the chances of having a bad panic attack, it would for me anyway! To be honest you'll probably be ok if you take a small dose at 5am then drink later than evening...if you keep the volume of alcohol low. I would just prefer to err on the side of caution. And make sure you eat loads during the day! :yesyes:

Kudos for going too, I'm sure you'll be fine.

[Jonnyboy1973]

I would imagine the risk there would be extremely low to the point of being irrelevant.

I would also suggest spacing your drinks out to maybe one unit every hour or so and a maximum of three drinks? Maybe tell your mates you're taking some medication and can't get drunk? They don't need to know what it is.

I would be mindful of having a 'reaction' to both chemicals in your system which might freak you out, on top of being abroad without your partner. If you start to feel weird or dizzy, that might really spike the chances of having a bad panic attack, it would for me anyway! To be honest you'll probably be ok if you take a small dose at 5am then drink later than evening...if you keep the volume of alcohol low. I would just prefer to err on the side of caution. And make sure you eat loads during the day! :yesyes:

Kudos for going too, I'm sure you'll be fine.

Yeah I was thinking of trying to space drinks out in that way. Maybe ordering a few shandies or soft drinks and hope they don’t notice! Ill be disciplined with my intake, I know my limits quite well and am experienced now with diazepam, it just shocked me to read some of the warnings about mixing online when no GP has mentioned this to me before!

( And trust me, eating won’t be a problem! )

It doesn’t feel brave to be going at the moment, more insanely stupid. It’s all I can think about at the moment, lots of irrational thoughts about what could happen and how my friends would react etc. Very concerned about sleep, or lack of, and how that might affect me.

Doing my very best to stay in as positive frame of mind as I can, you’ve certainly helped with that so thanks!

[ankietyjoe]

One thing I've learned over the years is to trust in other people to look after you if it all goes to shit (which it never does....).

There's an in built compassion in all people and if your friends see you struggling, they will help you.

The issue, is in US! The issue is that we don't want to feel vulnerable.

It's the thinking about it that's always worse than the actual event! :doh:

Whatifitis!

[Jonnyboy1973]

One thing I've learned over the years is to trust in other people to look after you if it all goes to shit (which it never does....).

There's an in built compassion in all people and if your friends see you struggling, they will help you.

The issue, is in US! The issue is that we don't want to feel vulnerable.

It's the thinking about it that's always worse than the actual event! :doh:

Whatifitis!

Very true. I’m trying to remind myself constantly that 99.99% of these scenarios in my head never come to fruition.

Just seems so daunting at the moment, not done anything this far out of my comfort zone for a long time. I’m only going for 2 days and I’ve been stressing out to the point of not sleeping for about 21!

I’ve just got back from my GP and he’s reassured me about the alcohol issue. He said half of it will be out of my system within 8 hours, so the risks involved in drinking after that time are very minimal. Will still take your advice and sneak in soft drinks and take it as easy as I can get away with!

[MyNameIsTerry]

I’ve just got back from my GP and he’s reassured me about the alcohol issue. He said half of it will be out of my system within 8 hours, so the risks involved in drinking after that time are very minimal. Will still take your advice and sneak in soft drinks and take it as easy as I can get away with!

The half life of the active drug in Diazepam is 48 hours. This is the time it is just in your body. But elimination is a cycle of half lives so don't think a further 48 hours means the rest is out because it takes a number of half lives for the body to eliminate it (5 to get under 5% and 7 to get to 0%, it drops 50% by each half life cycle). This is based on the basic model in pharmacokinetics but each drug differs in speed of elimination and it's individual too as the body and hydration play a part.

But something to also remember about a drug like a benzo is that unlike a sustained release type med (like a typical SSRI) it is eliminating the active drug whilst it's doing nothing anymore. For instance, the Distribution phase of this med is 1 hour but can be up to 3 therefore it's actual effects are long gone before the 48 hours to eliminate it are up.

I'm not sure where your GP is getting that information from, the above is on available on drug databases that professionals use as well as being listed in many medical resources. It's a strategy in benzo withdrawal to switch people on short half life benzo's to Diazepam simply because it has such a long half life as it will make withdrawal less harsh.

https://www.drugs.com/pro/valium.html#s-34090-1

Elimination
The initial distribution phase is followed by a prolonged terminal elimination phase (half-life up to 48 hours).

If you want to play safe I would ask a pharmacist as they are trained in this area unlike doctors who have less knowledge. Given the time involved it sounds ok to me but this being a safety issue I would always say ask a pharmacist.

I think we perhaps need to be more careful during the hours this type of med is actually giving effects as alcohol amplifies the CNS depressant side. But then there is a big difference between downing a ton of booze on top of a ton of benzo's and having a few beers many hours after the effects have worn off. And many a doctor has been giving these meds out for flying and must know those going on their hols are likely to have a few drinks.

I hope this doesn't trigger any anxiety but I think you need to be made aware of this.

[Jonnyboy1973]

The half life of the active drug in Diazepam is 48 hours. This is the time it is just in your body. But elimination is a cycle of half lives so don't think a further 48 hours means the rest is out because it takes a number of half lives for the body to eliminate it (5 to get under 5% and 7 to get to 0%, it drops 50% by each half life cycle). This is based on the basic model in pharmacokinetics but each drug differs in speed of elimination and it's individual too as the body and hydration play a part.

But something to also remember about a drug like a benzo is that unlike a sustained release type med (like a typical SSRI) it is eliminating the active drug whilst it's doing nothing anymore. For instance, the Distribution phase of this med is 1 hour but can be up to 3 therefore it's actual effects are long gone before the 48 hours to eliminate it are up.

I'm not sure where your GP is getting that information from, the above is on available on drug databases that professionals use as well as being listed in many medical resources. It's a strategy in benzo withdrawal to switch people on short half life benzo's to Diazepam simply because it has such a long half life as it will make withdrawal less harsh.



Elimination
The initial distribution phase is followed by a prolonged terminal elimination phase (half-life up to 48 hours).

If you want to play safe I would ask a pharmacist as they are trained in this area unlike doctors who have less knowledge. Given the time involved it sounds ok to me but this being a safety issue I would always say ask a pharmacist.

I think we perhaps need to be more careful during the hours this type of med is actually giving effects as alcohol amplifies the CNS depressant side. But then there is a big difference between downing a ton of booze on top of a ton of benzo's and having a few beers many hours after the effects have worn off. And many a doctor has been giving these meds out for flying and must know those going on their hols are likely to have a few drinks.

I hope this doesn't trigger any anxiety but I think you need to be made aware of this.

Thanks for the information. Not nice to hear, but you’re right right, it’s kuch better that I know.

Do you know anything about the other way round? So if I wait til the following night to drink and have quite a few, will I be safe to take diazepam for flight home about 12-15 hours later? Or will there be too much alcohol in my system?

(Very aware that it sounds like I’m trying to have my cake and eat it! But just want to be as prepared as poss)

[ankietyjoe]

I think the important thing to understand about data is that when it's applied to the human body it is subject to regular and sometimes enormous variation. A lot of the effects of any chemical are subject to hormonal levels in the body (which is just one point of potential data variance) and therefore side effects and interactions can change.

This is why people like Prince die from a medication he'd been taking for years, simply because the thing he did yesterday that didn't kill him, unfortunately did today.

Now I think the OP is way, way outside the window of danger, but the problem with mixing benzo's and booze is that when people use them together they tend to push the boundary of dosage that they found acceptable the day before. They assume that if dose x combined with dose y was safe yesterday, just a little bit more will probably be ok today.

[Jonnyboy1973]

I think the important thing to understand about data is that when it's applied to the human body it is subject to regular and sometimes enormous variation. A lot of the effects of any chemical are subject to hormonal levels in the body (which is just one point of potential data variance) and therefore side effects and interactions can change.

This is why people like Prince die from a medication he'd been taking for years, simply because the thing he did yesterday that didn't kill him, unfortunately did today.

Now I think the OP is way, way outside the window of danger, but the problem with mixing benzo's and booze is that when people use them together they tend to push the boundary of dosage that they found acceptable the day before. They assume that if dose x combined with dose y was safe yesterday, just a little bit more will probably be ok today.

Yeah I get that. It’s just thrown me , because I have been prescribed this drug so many times for trips and never once been warned about alcohol by the GP. Feel a bit paranoid about how I might have put myself in danger in the past, or still could at the weekend.

Everything seems so overwhelming at the moment. The thought of having no support, how will I sleep, if I have a drink can I be sure if it will calm me or send me the other way, how will I react if I panic etc etc. Still thinking of backing out but just know I will have that sinking regret as soon as I do so. Either that or 48 hours of the complete discomfort. Horrible!

[MyNameIsTerry]

Thanks for the information. Not nice to hear, but you’re right right, it’s kuch better that I know.

Do you know anything about the other way round? So if I wait til the following night to drink and have quite a few, will I be safe to take diazepam for flight home about 12-15 hours later? Or will there be too much alcohol in my system?

(Very aware that it sounds like I’m trying to have my cake and eat it! But just want to be as prepared as poss)

You eliminate about 1 unit of alcohol per hour. So, that could be 12-15 units of alcohol (various factors such as weight, food intake, meds, etc all affect this) which with a 3.6% pint (2 units, stronger ones are 3) you may eliminate 6-7+ pints.

That's a pretty big gap to me.

I think whilst your GP got the half life wrong their gut feel is still right. They know people flying with benzo's will be drinking. And remember that we are always talking about scary interactions (CNS depression) yet how often do you hear about it? So, perhaps it's not very common and more so in those drinking a hell of a lot and knocking back high strengths of benzo's? I can't put anything scientific behind that, it's just my gut feeling when so many people take them, including many drinkers, yet how often do we hear about it all (The Daily Mail would love printing stories about it "evil docs giving out evil pills, boo!!!" :winks:)

[venusbluejeans]

Hi

This is just a courtesy reply to let you know that your post was moved from its original place to a sub-forum that is more relevant to your problem.

This is nothing personal - it just enables us to keep posts about the same problems in the relevant forums so other members with any experience with the issues can find them more easily.

[Benjammin69]

My personal experience is that whilst not recommended and absolutely not safe to do so - no one can tell you how you will react to the mix. I have mixed benzo with alcohol unintentionally and it just made me drunk quicker and have amnesia... I have taken many different benzo and diazepam is a very mild benzo.

In terms of half life MNIT is absolutely spot on with his guidance on elimination etc I think your Dr means the ‘effects’ of diazepam will be gone in 8 hours. Whilst it has a very long half life it’s mode of action is moderate compared to lorazepam or clonazepam where their half lives are shorter their mode of action is much longer.

Good luck with the flights your be fine and just don’t drink too much at the airport before hand