Diazepam and Alcohol: Why the Combination Is Risky
Diazepam and alcohol together increase drowsiness, slow breathing and impair coordination. Learn who is most at risk, what to do if you have mixed them, and where to get help.
By Reece Douglas · Founder, FreshPlate
Do not drink alcohol while taking diazepam. Both slow the brain and body, and together they do more than either does alone: heavier sedation, poorer coordination and, at worst, dangerously slow breathing.
This guide explains how the combination works, who is most at risk, what to do if you have already mixed them, and where to find support if cutting back on alcohol feels hard.
Can you drink alcohol while taking diazepam?
No, you should avoid alcohol completely while taking diazepam. The NHS says: "Do not drink alcohol or grapefruit juice while taking diazepam as it can increase the risk of side effects." The US prescribing information advises that concomitant use with alcohol is not recommended because it enhances the sedative effect.
Diazepam is a sedative that calms the nervous system, and so is alcohol. Taken together, the effects stack, sometimes unpredictably. A drink you would normally handle can hit much harder when diazepam is already in your system.
This applies whether you take diazepam for anxiety, muscle spasm, seizures or short-term sleep problems. It also applies the next day: diazepam stays in the body for a long time, so alcohol can interact with it well after your last dose.
- Alcohol — avoid — it enhances diazepam's sedative effect and raises the risk of side effects
- Grapefruit juice — avoid — it can increase the risk of side effects with diazepam
- Coffee, tea, cola, energy drinks — take care — caffeine can sometimes reduce diazepam's effects
- Antacids — take care — keep them a few hours from your dose, as they lower absorption by about 30%
- Food in general — fine — you can take diazepam with or without food
What the experts say
“Do not drink alcohol or grapefruit juice while taking diazepam as it can increase the risk of side effects.”
What does alcohol do to diazepam's effects?
Alcohol makes diazepam's sedative effect stronger, so you get more drowsiness, slower reactions and less control than either substance would cause alone. The effects below follow from this.
There is no reliable number of drinks that is "safe" on diazepam. Body weight, age, dose, how long you have been taking it, liver health and other medicines all change how strongly you respond. The sensible advice is to avoid alcohol altogether rather than try to find a limit.
Heavy drowsiness and confusion
Diazepam already makes some people sleepy, especially in the first days of treatment or after a dose increase. Alcohol deepens that. You may feel unusually sedated, foggy or confused, and some people cannot recall parts of the evening afterwards.
Slowed breathing
This is the most serious risk. Both substances depress the part of the brain that controls breathing. Together, breathing can become shallow and slow enough to be dangerous, particularly during sleep. The risk rises with larger doses of either substance, and is higher in people with lung conditions or sleep apnoea.
Poor coordination and falls
Unsteadiness, slurred speech and slowed reactions all get worse with the combination. Falls are a particular concern for older adults, where a fracture can permanently change independence. Dizziness on standing can also be worse, so even a short walk to the bathroom at night carries more risk.
Mood and judgement
Alcohol is a depressant, and diazepam can flatten mood in some people. Together they can lower mood further and loosen inhibitions. If you are already low or anxious, this can make things worse, even though a drink may feel like relief in the moment.
Is it safe to drive after drinking on diazepam?
No, it is not safe to drive after drinking alcohol while on diazepam. Each slows your reactions and impairs judgement, the combined effect is greater than either alone, and you may feel more capable than you are.
Diazepam on its own can make driving unsafe. The NHS advises not to drive or use tools or machines if you feel sleepy, dizzy or unable to concentrate. In the UK it is an offence to drive if a drug, including a prescribed one, impairs your driving, and there is a specific limit set for diazepam. Check the gov.uk guidance on drug driving and speak to your pharmacist if you are unsure.
If you have had any alcohol, do not drive, cycle or operate machinery. Plan a lift, taxi or public transport instead. Impairment can last into the next day, particularly if you took a dose before bed.
- Driving after any alcohol on diazepam — avoid — combined sedation slows reactions and impairs judgement
- Driving on diazepam alone — only if clear-headed — do not drive if you feel sleepy, dizzy or unable to concentrate
- Next-morning driving — take care — diazepam lingers in the body, so check how alert you really are
Who is most at risk from mixing diazepam and alcohol?
Anyone can be harmed, but some groups face a higher risk of serious problems. If you are in one of these groups, avoid alcohol and speak to your prescriber if you find that difficult.
If you take other sedating or interacting medicines, the same principle applies; our guide to amitriptyline and alcohol covers a similar situation.
- Older adults — the body clears diazepam more slowly with age, so effects last longer and falls are more likely
- People with breathing problems — conditions such as COPD or sleep apnoea leave less margin if breathing slows
- People with liver disease — the liver processes both alcohol and diazepam, so effects can build up
- People taking other sedating medicines — opioids, some antidepressants, sleeping tablets and sedating antihistamines all add to the effect
- People with a history of alcohol or drug dependence — benzodiazepines carry a risk of dependence, and mixing can quickly escalate use
- Those who are pregnant or breastfeeding — speak to your prescriber before taking diazepam and avoid alcohol
What should you do if you have mixed diazepam and alcohol?
If you have had a small amount of alcohol and feel normal, stop drinking, do not take more diazepam to "even it out", avoid driving, and stay with someone or tell them what you have taken. If you feel unwell in any way, get help rather than waiting to see how it goes.
Do not try to sleep it off alone if you feel very drowsy. Do not induce vomiting, and do not give the person coffee or a cold shower, as neither reverses the effect.
Call 999 straight away if you see these signs
- Very slow, shallow or noisy breathing, or pauses in breathing
- Cannot be woken, or is difficult to rouse
- Blue or grey lips or skin
- Collapse or loss of consciousness
- Severe confusion or unresponsiveness
- Seizure
If symptoms are milder
If you feel dizzy, unusually sleepy or unwell but are conscious and breathing normally, call NHS 111 or speak to a pharmacist or your GP the same day. Stay somewhere safe, lie on your side if you feel drowsy, and have someone check on you. Tell the clinician exactly what and roughly how much you took.
Where can you find support and how does FreshPlate help?
Talk to your GP, pharmacist or prescriber first. If you are finding it hard to cut down on alcohol, they can help without judgement. Never stop diazepam suddenly if you have been taking it regularly, as withdrawal can be serious; your prescriber will plan a gradual reduction.
If alcohol or benzodiazepine use feels out of control, your GP can refer you to local drug and alcohol services, and the NHS has information on alcohol support and on getting help for drug dependence. In Scotland, NHS inform has equivalent guidance. If you are struggling with anxiety or low mood, tell your prescriber, because there may be other ways to manage it.
FreshPlate's free food–medication interaction checker lets you look up diazepam and see at a glance which foods and drinks to avoid, such as alcohol and grapefruit juice, and which need care, such as caffeinated drinks and antacids. If you add diazepam to your profile, FreshPlate builds recipes and meal ideas that already take these interactions into account. If you also take medicines that interact with grapefruit, our guide to carbamazepine and foods to avoid shows how that works in practice.
Frequently asked questions
Can I have just one drink on diazepam?
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The NHS advises not to drink alcohol while taking diazepam, and no amount has been shown to be guaranteed safe. Responses vary with dose, age, weight and health, so avoiding alcohol altogether is safest.
How long after taking diazepam can I drink alcohol?
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There is no simple waiting time, because diazepam stays in the body for a long time and its effects can linger. Ask your pharmacist or prescriber how this applies to your dose and circumstances.
What happens if you mix diazepam and alcohol?
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Alcohol enhances diazepam's sedative effect, so you can become very drowsy, confused and uncoordinated. At worst, breathing can slow dangerously, which is a medical emergency.
Can I drive the morning after drinking on diazepam?
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It may not be safe. Both alcohol and diazepam can impair reactions into the next day, so do not drive if you feel sleepy, dizzy or unable to concentrate, and use other transport if in doubt.
Can I stop diazepam so I can drink?
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Do not stop diazepam suddenly, especially if you have taken it regularly, as withdrawal can be serious. Speak to your prescriber, who can plan a safe, gradual reduction if appropriate.
Sources
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