What Are the Risks of Combining Diazepam and Alcohol?

Diazepam and alcohol are a potentially dangerous combination. Both substances create central nervous system (CNS) depression. Additionally, they affect breathing, tending to make breaths shallower or increase the length of time between them. Taken together, these two drugs create a much stronger set of adverse effects.

There are differences between diazepam and alcohol. Diazepam belongs to a class of drugs called benzodiazepines, and alcohol is normally considered a depressant. The similarity of these two substances is noted in the way they impact brain neurotransmitters. Both drugs affect GABA receptors, and their action is often compared to each other since they achieve similar effects.

Given this comparable action, it isn’t hard to see why a combination of diazepam and alcohol is potentially dangerous. As the two drugs, in part, accomplish the same thing, taking both is analogous to taking a much larger dose of either one alone. They are likely to cause a much stronger reaction when used together.

Some of the symptoms that might accompany simultaneous use of diazepam and alcohol include increased drunkenness, dizziness, strongly impaired motor skills, and excess sleepiness. Individuals taking both drugs might notice that they feel intoxicated sooner, even with smaller amounts of alcohol. Given this combined effect, people may exercise poor judgment about their own abilities. They should definitely not consider themselves able to operate a vehicle or other machinery when they use these two drugs together.

The greatest risk of combined stimulation of the GABA receptors is that death will occur. Such a death isn’t related to alcohol toxicity. Instead, it may result from suppression of breathing and CNS depression.

When people use these drugs together, they may experience sleep apnea or stop-breathing episodes. While these ordinarily result in a person waking enough to re-establish breathing, excess sedation and sleepiness may mean people won’t wake up enough when sleep apnea occurs. Under these circumstances, it is quite possible to die while sleeping.

Ordinarily, small amounts of both substances are unlikely to be fatal. Large amounts can be, however. Adding other substances, like pain medicines, other benzodiazepines, and cough syrups that contain opioids, increases this danger. Moreover, even if the threat is low, it is still present. Some people experience greater sedation side effects with low amounts of both drugs, and may be at an unknown, elevated risk.

In most instances, it is unwise to combine diazepam and alcohol. Paradoxically, some physicians recommend the combination, and might especially prescribe it to address a single anxious event. For example, doctors might suggest a patient with a fear of flying use a low dose diazepam with a glass of wine before boarding a plane. This suggestion isn’t necessarily without merit because it takes advantage of the combination's effectiveness. Still, patients are advised to avoid using these two drugs together, unless a physician expressly recommends it.