Nitrazepam: Uses, Interactions, Mechanism of Action

Diazepam—better known by the trade name Valium—is a prescription medication that belongs to a group of chemically similar sedative and anxiolytic (anti-anxiety) drugs called benzodiazepines (sometimes abbreviated as ‘BZDs’ or ‘benzos’).Legit Nitrazepam vendor Bitcoin Accepted

Diazepam is used to treat:

• Anxiety.
• Muscle spasms.
• Seizures.

It is also sometimes used to manage the potentially severe symptoms of alcohol withdrawal. In the past, diazepam was also often prescribed to treat insomnia; however, newer, safer hypnotics (sleep-inducing drugs) have largely replaced diazepam for this purpose today.

Origins of Benzodiazepines

Sedatives and tranquilizers have a long history of medicinal and recreational use—starting with alcohol, the original sedative drug. Bromides, chloral hydrate, and paraldehyde were developed in the 1800s, followed by barbiturates and meprobamate in the first half of the 20^th century. All of these substances are limited by their high potential for abuse and dependence and their potentially fatal consequences of overdose. Legit Nitrazepam vendor Bitcoin Accepted

In 1954, Leo Sternbach—a pharmacist and chemist working at the Hoffmann-La Roche pharmaceutical company—was tasked with developing

a safer alternative to barbiturates and meprobamate. Over the next few years, Sternbach created about 40 new compounds, but none of them had any effects in animal tests. In 1956, he chemically modified one of these 40 compounds to make it more stable, labeled the resulting white powder Ro 5-0690, and placed it on the shelf where it was forgotten.

By pure chance, the container of Ro 5-0690 was found during a laboratory cleanup a year later and sent to be tested for drug activity. The tests showed that it had similar effects to meprobamate—exactly what Sternbach had been trying to discover for 3 years. The compound was renamed chlordiazepoxide and introduced in the US in 1960 as a new anxiolytic drug under the trade name Librium. This was the world’s first clinically useful BZD.

Abuse Potential of Valium

Like alcohol, barbiturates, chloral hydrate and virtually all other sedatives and hypnotics, diazepam increases the effect of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. By binding to GABA receptors in the central nervous system, Valium decreases, or inhibits, overall neural activity in the brain.

In patients, this increased level of inhibition:

• Reduces feelings of anxiety and panic.
• Relieves painful muscle spasms.
• Helps prevent seizures and convulsions.

However, when it is taken at high doses or in combination with alcohol or other sedative drugs, Valium can produce a euphoric high, leading some individuals to abuse it. Although initially most people in the medical community considered BZDs to have a low potential for dependence, many people experience withdrawal symptoms if they take these drugs for an extended period of time—even when taking them as prescribed by a physician. Because of this, doctors usually instruct patients to taper off of Valium gradually rather than stopping the use of this drug suddenly.

Relative to other BZDs, Valium is thought to actually have lower potential for dependence. It is therefore used to mitigate withdrawal symptoms from other BZDs and alcohol, including potentially dangerous seizures and convulsions. Once the addicted individual is safely weaned off of alcohol or another drug, they can more easily be tapered off of Valium.

Who’s Abusing Valium?

The number of admissions to addiction treatment centers for tranquilizer use increased approximately sevenfold in the decade from 2003 to 2012, and admissions for diazepam use have increased by a similar amount. This suggests that whatever factors are increasing sedative abuse overall are affecting levels of Valium abuse as well.

Abuse statistics for Valium are mixed, giving both positive and negative indications about whether rates of misuse of this drug are declining or not. Treatment admissions for Valium use leveled off between 2012 and 2013 but remain high relative to previous years.

Some important statistics about Valium abuse from the National Survey on Drug Use and Health (NSDUH) include:

• The number of people who reported ever using diazepam for non-medical purposes declined from more than 13 million in 2012 to under 12.5 million in 2013.
• Diazepam is the 3^rd most widely abused tranquilizer in the US behind alprazolam (Xanax) and lorazepam (Ativan).

In 2007, the National Center on Addiction and Substance Abuse (CASA) at Columbia University reported that benzos were the most frequently offered prescription drugs on websites selling controlled substances. BZDs were available from 79% of the Internet sites surveyed.

Online Interest in Valium

Using the Google Trends tool to examine the number of Internet searches including the terms “Valium” or “diazepam” reveals that interest in this drug has remained relatively stable over the past decade. The searches using these terms also have a fairly even geographic distribution in the US, though many of the states with the most searches are in the South.

Searches for diazepam have increased slightly over the past several years relative to searches for Valium and may be related to Roche’s recent decision to stop producing and distributing diazepam under the Valium brand. Although Valium and diazepam refer to the exact same substance, patients and abusers accustomed to taking branded Valium sometimes feel trepidation about switching to a generic form of diazepam, and the uptick in searches for diazepam may reflect this anxiety.

The Market

Legitimate prescriptions for all benzodiazepines increased by 17% between 2006 and 2012. In that same time, the increase in diazepam prescriptions was lower—at only 6%. The population of the US only increased by 1.6% during these years, meaning that the number of patients taking these drugs is still increasing. Indeed, it held its place as the 9^th or 10^th most prescribed psychiatric medication in the US from 2005 to 2011.Buy Valium (diazepam) powder Online

Because generic diazepam is available, costs for legal prescriptions are very low, ranging from $9 to $14 for 30 5 mg tablets, or between $0.30 and $0.46 per pill.

The street cost of diazepam varies significantly by region, but it has been reported to be between $1 and $5 per 5 mg tablet.

The large profit margin available for selling diazepam to non-medical users provides a strong incentive for legitimate patients to sell their prescriptions.

Furthermore, the profit motive can also induce pharmacists and others involved in the legal supply chain to divert pills to the illicit market, which has resulted in diazepam being one of the most commonly available prescription drugs on the black market.

Valium and the Law

Valium is a legal substance with legitimate medical purpose; however, the Justice Department first designated diazepam as a Schedule IV controlled substance in 1975, which indicates that the government considers this drug to have real potential for abuse or dependence. Most other drugs that are designated as Schedule IV substances are also BZDs, like alprazolam and lorazepam, or other tranquilizers such as carisoprodol (Soma).Buy Valium (diazepam) powder Online

Doctors, pharmacists, and others involve in the prescribing and distribution of control substances such as diazepam  required to keep detailed records for law enforcement purposes. Scientists who use diazepam in their research may also need to obtain special licenses to obtain and possess the drug.

The increased levels of prescription drug abuse reported over the last 10 years has led to efforts to further restrict their availability. Tennessee, for example, has enacted rules requiring doctors to:

• Check patients’ drug histories in a statewide database before prescribing drugs such as diazepam.
• Dispense no more than a 30-day supply at one time.

Ireland is also preparing stricter controls on BZDs, including diazepam. These new policies  aimes at limiting the supply for legitimate, necessary purposes, so that less can be in divertion to the black market.

How Dangerous Is Valium?

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As discussed above, the reason that Leo Sternbach and Hoffmann-La Roche first developed BZDs and diazepam in the 1950s was to create sedative, anxiolytic agents that were safer and more effective than the drugs in use at the time, including barbiturates and meprobamate. By many measures, they succeeded in this effort; diazepam treats anxiety disorders more effectively than barbiturates, has fewer side effects, and is less dangerous to those who overdose on this drug.

However, diazepam still carries very real dangers for those who use it, particularly abusers who are not under doctors’ supervision.

Alarmingly, the majority of abusers combine diazepam with other drugs. Abusers that combine Valium with other sedating substances—such as alcohol, prescription sleeping pills or painkillers—are at significant risk of overdose. Such ill-advised combinations can produce fatal results.

Whether it is use alone or as part of a drug cocktail, the number of emergency room visits resulting from the use of diazepam or other BZDs increase nearly sixfold between 1999 and 2011, confirming the danger inherent to using these drugs.

Effects of Valium Overdose

• Slurred speech.
• Hallucinations.
• Amnesia.
• Respiratory depression.
• Coma.

Finally, although diazepam  initially viewes as having little potential for abuse and dependence, the evidence today clearly shows that taking this drug—as with all other BZDs—can result in dependence and addiction.

Like in the case of all other drug addictions, dependence on diazepam can compel individuals to continue taking the drug despite negative consequences for their personal lives and finances. Attempts to stop on their own can cause addicts to suffer from anxiety, panic, or depression, and may even lead to suicide or other dangerous behaviors.

If you have a problem with Valium, help is available. Call for free at 406-285-7393

or get a text to speak to someone confidentially about how to find treatment for Valium addiction.

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Have you ever have the temptation to buy your medicines from an online pharmacy or another website?

You can protect yourself and your family by being cautious when buying medicine online. Some pharmacy websites operate legally and offer convenience, privacy, cost savings and safeguards for purchasing medicines.

Not all websites are the same. The U.S. Food and Drug Administration warns that there are many unsafe online pharmacies that claim to sell prescription drugs at deeply discounted prices, often without requiring a prescription. These internet-based pharmacies often sell unapproved, counterfeit or otherwise unsafe medicines outside the safeguards followed by licensed pharmacies.

Many unsafe online pharmacies use fake “storefronts” to mimic licensed pharmacies or to make you think their medicines come from countries with high safety standards. But the medicines they sell could  be manufacture anywhere, with little care or concern for safety and effectiveness. Also, these drugs could be fake, expired or otherwise unsafe for you and your family.

How can you tell if an online pharmacy is operating legally? The FDA’s BeSafeRx page has resources and tools to help you make safer and more informed decisions when buying prescription medicines online.

Warning Signs of an Unsafe Online Pharmacy

Beware of online pharmacies that:

• Do not require a doctor’s prescription.
• Are not license in the U.S. and by your state board of pharmacy.
• Do not have a licensed pharmacist on staff to answer your questions.
• Send medicine that looks different than what you receive at your usual pharmacy, or arrives in packaging that is of bad shape, damage, in a foreign language, has no expiration date, or is expire.
• Offer deep discounts or prices that seem too good to be true.
• Charge you for products you never ordered or received.
• Do not provide clear written protections of your personal and financial information.
• Sell your information to other websites.

These pharmacies often sell medicines that can be dangerous because they may:

• Have too much or too little of the active ingredient you need to treat your disease or condition.
• Not contain the right active ingredient.
• Contain the wrong ingredients or other harmful substances.

The active ingredient of an approve drug product is what makes the medicine effective for the illness or condition it is  to treat. If a medicine has unknown active ingredients, it could fail to have the intended effect, could have an unexpected interaction with other medicines you are taking, could cause dangerous side effects, or could cause other serious health problems, such as serious allergic reactions.Legit Nitrazepam vendor Bitcoin Accepted

Also, these drugs may not  be store properly, such as in a warehouse without necessary temperature controls, which may cause the medicine to be ineffective in treating your condition.

Know the Signs of a Safe Online Pharmacy

There are ways you can identify a safe online pharmacy. These pharmacies:

• Always require a doctor’s prescription.
• Provide a physical address and telephone number in the U.S.
• Have a licensed pharmacist on staff to answer your questions.
• Are license with a state board of pharmacy.

Another way to help ensure you are using a safe and legal online pharmacy is to check the pharmacy’s license in the state’s board of pharmacy license database by using the location tool on the FDA’s BeSafeRx website. If your online pharmacy is not in the list, don’t use that pharmacy.Buy Valium (diazepam) powder Online

Resources to Shop Safely Online

• Learn more about the risks of buying prescription medicine from unsafe online pharmacies.
• Report sales of medicine on the internet by unsafe online pharmacies to the FDA.
• Report adverse effects caused by any medicine to the FDA’s MedWatch program.
• Visit the FDA’s web page on counterfeit medicine for more information.

Benzodiazepines (e.g. Diazepam/ Lorazepam/Temazepam/Alprazolam/ Clonazepam) are drugs which have been in use since the 1960s

for treatment of a wide range of conditions including alcohol withdrawal, agitation and restlessness, anxiety,

epilepsy and seizures, neurological disorders. muscle spasms, psychiatric disorders and sleep disturbance

Initial use of benzodiazepines, including the well-known Diazepam also known as ‘Valium’,

which is enthusiastic and is hail as a wonder drug. However, it became increasingly clear that, as well as having short term deleterious effects on memory,

co-ordination, concentration and reaction times, they were also addictive if used for a long time,

with withdrawal leading to fits, hallucinations, agitation and confusion, and further had long-term effects on cognition and balance.

Unfortunately benzodiazepines have also become a widely used drug of abuse since they first came on the market. Because of these reasons the use of benzodiazepines has been a lot more controlled

around the world since the 1980-90s, especially in the UK. Diazepam in the UK is a Class C/Schedule IV control drug. The following short guide outlines the issues surrounding its use

with regards to flying and why the surgery no longer prescribes such medications for this purpose.Buy Valium (diazepam) powder Online

People often come to us requesting the doctor or nurse

to prescribe diazepam for fear of flying or assist with sleep during flights. Diazepam is a sedative, which means it makes you sleepy and more relaxed. There is a number of very good reasons why prescribing this drug is not in recommendation.

• According to the prescribing guidelines doctors follow (British National Formulary) diazepam is  (not allow) in treating phobic states.[i] It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.”[ii]
• Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensedshort term for a crisis in generalise anxiety. If this is the case, you should be getting proper
• care and support for your mental health and not going on a flight.
• NICE guidelines suggest that medication should not be use for mild and self-limiting mental health disorders[iii]. In more significant anxiety relative states, benzodiazepines, sedating antihistamines or antipsychotics should not be prescribe. Benzodiazepines is only advise for the short term use for a crisis
• in generalise anxiety disorder in which case they will not  be fit to fly. Fear of flying in isolation is not a generalise anxiety disorder
• Although plane emergencies are a rare occurrence there are concerns about reduced awareness and reaction times
• for patients taking Diazepam which could pose a significant risk of not being able to react
• in a manner which could save their life in the event of an emergency on board necessitating evacuation.
• The use of such sedative drugs can make you fall asleep,
• however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at an increased risk of developing a blood clot (Deep Vein Thrombosis – DVT)
• in the leg or even the lungs. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours,
•  the amount of time which is obvious to increase the risk of developing DVT
• whether in an aeroplane or elsewhere.Buy Valium (diazepam) powder Online
• Whilst most people find Diazepam sedating, a small number have paradoxical agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you would not
• normally which can pose a risk on the plane. This could impact on your safety as well as that of other passengers and could
• also get you into trouble with the law. A similar effect,you  can see in  alcohol, which leads to people being remove from flights.
• A study published in 1997 from the Stanford University School of Medicine[iv]
•  showed that there is evidence use of Benzodiazepines
• stops the normal adjustment response that would gradually lessen anxiety over time and therefore perpetuates
• and may increase anxiety in the long term, especially if used repeatedly.
• Diazepam and similar controlled drugs are illegal in a number of countries[v]. They may be seize or you may find yourself in trouble with the police. The passenger may also need to use a different strategy for the
• homeward bound journey and/or other legs of the journey.
• Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.
• It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.

Given the above we will no longer be providing Diazepam or similar drugs

for flight anxiety and instead suggest the below aviation industry recommended flight anxiety courses.

Flight anxiety does not come under the remit of General Medical Services,

as define in the GP contract and so we are not oblige to prescribe for this.

 Patients who still wish to take benzodiazepines for flight anxiety get advises

to consult with a private GP or travel clinic.

For further information:

https://thefearofflying.com/programs/fly-and-be-calm/

https://www.fearlessflyer.easyjet.com/

https://www.britishairways.com/en-gb/information/travel-assistance/flying-with-confidence

https://www.flyingwithoutfear.com/

[i] British National Formulary; Diazepam – https://bnf.nice.org.uk/drug/diazepam.html

[ii] British National Formulary; Hypnotics and anxiolytics – https://bnf.nice.org.uk/treatment-summary/hypnotics-and-anxiolytics.html

[iii] Generalised anxiety disorder and panic disorder in adults: management. NICE Clinical guideline [CG113] Published date: January 2011 Last updated: July 2019 https://www.nice.org.uk/guidance/cg113

[iv] Acute and delayed effects of Alprazolam on flight phobics during exposure. Behav Res Ther. 1997 Sep;35(9):831-41

[v] Travel Health Pro; Medicines and Travel; Carrying medication abroad and advice regarding falsified medication – https://travelhealthpro.org.uk/factsheet/43/medicines-abroad