Key Points

  • Diazepam is a muscle relaxant from the benzodiazepine category.
  • It is used to treat anxiety and muscle pain, and it may be prescribed off-label for other uses.
  • The elimination half-life of diazepam is about 46 hours.
  • It can take your system 8 to 16 days to fully eliminate the medication and its metabolites.
  • Diazepam is a central nervous system depressant.
  • It is a Schedule IV controlled substance.
  • Common effects of diazepam include drowsiness and tremors.
  • Using diazepam in a way other than prescribed by a healthcare provider can lead to addiction.
People with muscle spasms and stiffness often find that over-the-counter medications aren’t enough to control their pain. Prescription drugs like diazepam are frequently recommended because they help relax the muscles and reduce discomfort. In addition to treating muscle pain, diazepam is a widely used medication for anxiety disorders and alcohol withdrawal symptoms. It is approved by the U.S. Food and Drug Administration (FDA). Because diazepam is taken orally, it needs to travel through the bloodstream before its effects are felt. How quickly it works depends on factors such as the dosing schedule and an individual’s metabolism. Keep reading to discover more about diazepam, including how long it stays in the body, how long its effects last, and when it will reach peak concentrations.

What Is Diazepam Used For?

Diazepam, commonly known by the brand name Valium, is a benzodiazepine with sedative, anticonvulsant, amnesic, and muscle relaxant properties.[1] It is prescribed to treat mental health conditions, including anxiety disorders and panic disorder. Individuals in medical detox programs for alcohol addiction may receive diazepam as a treatment option for alcohol withdrawal symptoms.[1] It is also used to combat muscle spasms, stiffness, and certain types of seizures.[2] In addition to Valium, diazepam is available under other brand names, including Diastat, Libervant, and Valtoco.

Diazepam Dosing

Diazepam is prescribed in different doses depending on the condition being treated and other factors, including age, weight, and kidney function.[3] They are as follows:
  • Oral tablets: 2 mg, 5 mg, and 10 mg
  • Oral solution: 5 mg / 1 mL, 5 mg / 5 mL
  • Rectal gel (Diastat): 2.5 mg, 10 mg, and 20 mg
  • Injectable solution: 5 mg / 1 mL
The oral form is typically marketed as Valium, while the rectal gel is sold as Diastat.

How Does Diazepam Work?

Benzodiazepines work by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that helps calm the central nervous system (CNS). According to an article in StatPearls, benzodiazepines like diazepam bind to an allosteric site located at the interface between the alpha and gamma subunits of the GABA-A receptor’s chloride ion channels.[4] This binding increases the effects of GABA, leading to reduced neuronal excitability. In simpler terms, Valium enhances the brain’s natural calming chemical (GABA), helping to slow down overactive nerve signals and promote relaxation.

How Long Does it Take for Diazepam to Clear the System?

It takes approximately four to five half-lives for diazepam to be fully metabolized and eliminated from the body. A drug’s elimination half-life is the time it takes for its concentration in the system to decrease by half. When oral diazepam is taken, it is broken down in the liver and converted into an active metabolite called desmethyldiazepam. The elimination half-life of oral diazepam is about 46 hours, while the half-life of its active metabolite is approximately 100 hours.[4] Because it takes four to five half-lives for both the drug and its metabolites to be removed, diazepam can remain in the system for anywhere from 184 to 400 hours (about 8 to 17 days).[5] This figure can vary depending on factors such as dosage, frequency of use, and individual metabolism.

For How Long Do You Feel Diazepam’s Effects?

Valium is rapidly absorbed, with peak concentrations occurring within one to two hours after taking a dose.[6] During this period, users may experience common side effects such as shakiness, unsteady walking, or general unsteadiness.[7] The peak effects of Valium — which include both its therapeutic effects on anxiety and pain and its side effects — typically last around 4 hours.[6] However, according to Drugs.com, the duration of these effects may be longer in some individuals.[6]

How Long Is Diazepam Detectable on a Drug Test?

Drug test bottle. Valium can be detected on any drug test that screens for benzodiazepines or their metabolites. However, detection varies depending on the type of test and frequency of use. According to the FDA, home drug tests can detect benzodiazepine use within 2–7 hours of taking the medication, with a positive result possible for 1–4 days afterward.[8] In cases of chronic use, benzodiazepines can remain detectable for up to 30 days.[9] Blood tests offer greater accuracy than urine tests because blood tests are harder to adulterate and must be performed by trained medical professionals. A blood test may be necessary to confirm a positive urine test. However, blood tests have the shortest detection window, and they typically identify benzodiazepines for only up to 24 hours after the last dose, according to Keystone Laboratories.[10]  Older adults and those with liver disease may test positive beyond this time frame and show higher-than-usual therapeutic doses in their bloodstream.[11] Additionally, detection times in saliva are 2–3 days, and in hair, up to 90 days.[10]

Can Quitting Benzodiazepines Cause Withdrawal?

Long-term use of benzodiazepines can result in physical dependence.[12] This causes the user to experience withdrawal symptoms when attempting to stop the medication. These symptoms can affect every aspect of a person’s life, and in some cases, they can be life-threatening. Withdrawal symptoms usually begin within 24 hours of discontinuing use, though they can sometimes start several days later.[12] Symptoms typically peak around seven days later. However, the duration of withdrawal depends on factors such as the patient’s ability to handle stress and the underlying reason for benzodiazepine use. Rapid discontinuation can increase the severity of withdrawal symptoms. Benzodiazepine withdrawal symptoms include:[12]
  • Sleep disturbances
  • Restlessness
  • Anxiety
  • Weakness
  • Irritability
  • Blurred vision
  • Tremors
  • Panic attacks
  • Sweating
  • Nausea and vomiting
  • Headaches
  • Seizures
  • Psychosis
  • Hallucinations
To avoid withdrawal symptoms when stopping Valium, it is best to taper off the medication gradually. Since every person is different, the tapering process can take anywhere from 4 weeks to 6 months.[12] In some cases, especially for long-term users or those on higher doses, it may take more than a year to safely discontinue the medication.

How Long Does it Take to Detox From Diazepam Use?

Although diazepam may leave the system within a few days, it can take individuals anywhere from a few weeks to more than a year to withdraw from the medication. Those with a substance use disorder or a tendency to misuse or abuse medications may require a monitored detox program to help them stay clean and prevent relapse. Repeated cycles of detoxing, restarting use, and withdrawing can increase the risk of developing an addiction. Addiction is a relapsing disease that causes individuals to experience strong cravings for a drug and withdrawal symptoms when attempting to quit.[13] For those struggling with addiction, quitting can be even more difficult due to changes in the brain caused by prolonged or abusive use of drugs like Valium. Inpatient detox programs are overseen by medical professionals and other licensed staff who will observe the patient to make sure they are comfortable and safe during the natural detox process. They may provide medications during this time to curb cravings (particularly if alcohol or opioids were also involved) and to prevent relapse. There isn’t a set timeframe for this program, as it is highly individualized. However, many programs last 30 to 90 days and involve therapy and other treatment services following detox.

Finding Evidence-Based Addiction Treatments for Valium Addiction 

When individuals affected by diazepam abuse attempt to abstain on their own, they may experience intense cravings for the substance and become consumed with thoughts of using it. Unfortunately, this can prompt them to continue using the substance despite wanting to remain clean. Researchers have found that people struggling with drug abuse have a much better chance of achieving lasting sobriety when receiving a combination of detoxification and psychotherapy from a treatment center.[14] Trained therapists, like the ones here at Southeast Addiction Center TN, can assist clients in working through the causes of their addiction and learn healthy approaches to overcoming them. If you’re ready to take the next step on your path to recovery, contact Southeast Addiction Center TN today.