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What Is Librium?

Doctors and psychiatrists prescribe the benzodiazepine Librium as part of the treatment for anxiety that’s related to alcoholism and acute alcohol withdrawal. It’s often sometimes prescribed for treatment of anxiety disorder outside of an alcohol addiction scenario. (1)

When Librium is used to treat alcohol withdrawals, oftentimes there is a psychotherapeutic component to this treatment. This may not be introduced during the initial stages of detoxification.

Once the symptoms of acute alcohol withdrawal have been effectively managed, the recovering individual may very well continue to use Librium in order to help them maintain continued sobriety.

However, Librium should only be used for a short period of time and under the strict supervision of a physician. As a psychoactive drug, there is the potential that Librium itself can be abused.

Other names for Librium

In the same way that the benzodiazepine Alprazolam is marketed under the name Xanax, the chemical compound chlordiazepoxide is sold under the name Librium. However, it does have other names, and these include Mitran, Poxi and Librelease, just to name a few. (2)

When sold under these other names — which are all far less common than Librium — the exact composition of the drug may be slightly different, but with the same basic mechanism of action. When Librium is combined with clidinium bromide for the specific purpose of treating irritable bowel syndrome, it’s sold under the name Librax.

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Chlordiazepoxide

Chlordiazepoxide was first prescribed in 1962, which predates the availability of diazepam, another widely used benzodiazepine, by two years. At one point, it was reported that approximately one in six European adults had used a benzodiazepine in the previous year, although from the mid-1980s onward the figure has dropped to about one in 10 adults.

In the last 20 years, the rate at which chlordiazepoxide and other benzodiazepines are prescribed as hypnotics has fallen by more than 30%. Nonetheless, the rate at which they are prescribed for anxiolytic purposes has remained fairly consistent.

Librium and Addiction

Librium addiction is a twofold issue. On the one hand, when used as prescribed and used under the strict and vigilant supervision of a physician, this benzodiazepine medication can be used to treat the initial symptoms of alcohol withdrawal or anxiety.

Given the prevalence of alcoholism, this positive aspect of Librium ought not to be overlooked. On the other hand, however, Librium itself can be potentially abused, making it a potential risk factor.

Librium can cause physical dependency, even for someone who has used it appropriately to treat anxiety. Individuals typically can’t just quit Librium cold and must work with physicians to wean off the medication at the appropriate time. If someone has become fully addicted, this may prove difficult and require additional treatment or support.

What Is Librium Used For?

In addition to being used for treating the acute symptoms of alcohol withdrawal, Librium is also used to treat acute anxiety in the short term.

Librium differs from Xanax, Klonopin and other benzodiazepines in that its effects come on more slowly. The half-life of chlordiazepoxide — that is, the length of time it takes for the total amount of the medication in the blood to be reduced by half — ranges from 24 to 48 hours. In contrast, the half-life of Xanax is six to 20 hours. (3)

Librium, despite the fact that it affects the central nervous system more slowly, is addictive and should only be used in the short term to treat acute anxiety or panic attacks.

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Treatment of severe anxiety and distress

When it comes to treating anxiety, the dosage of Librium depends on the severity of the anxiety, its cause, whether it’s chronic or acute anxiety and the metabolism of the individual. Librium is usually taken in pill form, starting at 5 milligrams.

Occasionally a small dose of Librium will be administered to a person who’s just experienced a traumatic event and is experiencing an acute anxiety attack. A prescribed dose of Librium can range from 5 to 25 milligrams just to help the person deal with the immediate distress in a safer way for their body. (4)

In cases where Librium is prescribed as an ongoing medication for anxiety, it’s important for individuals to follow up with their medical providers. The medication may need to be adjusted to find the right dose, and any physical dependences should be documented to ensure the person can get off of Librium safely when it’s time.

Management of Acute Alcohol Withdrawal Syndrome

The symptoms of acute alcohol withdrawal syndrome usually appear approximately eight hours after an alcoholic has taken their last drink. However, these symptoms — the shakes, sweating, irritability and even hallucinations or delirium tremens — can appear later.

The symptoms of alcohol withdrawal reach their worst point between 24 and 72 hours after the last drink. From then, the discomfort of withdrawal can continue for weeks, depending on how bad the alcoholism has become.

The symptoms of acute alcohol withdrawal can be alleviated successfully with Librium, with the most common strategy to begin with a high dose and then quickly taper it off.

Ease Symptoms of Irritable Bowel Syndrome Combined with Clidinium Bromide – Librax

Clidinium bromide is an anticholinergic, a drug that inhibits the action of the neurotransmitter acetylcholine in order to control the involuntary motion and spasms of smooth muscles in the digestive tract.

The combination of chlordiazepoxide and clidinium bromide is sold as Librax, and it is used to treat gastritis, peptic ulcers, diverticulitis and irritable bowel syndrome. The two components of Librax taken together in a single capsule three or four times daily before meals and bedtime.

Chlordiazepoxide is thought to relieve the anxiety that often accompanies irritable bowel syndrome.

Amnesic

Even though its effects come on far slower than other benzodiazepines, Librium nonetheless shares the side effects that are common to all these drugs. For instance, in some individuals it appears to have amnesic effects. This is perhaps due to a blunted emotional response, which prevents new memories from forming.

In rare cases, taking Librium may even lead to a complete blackout for certain individuals, which is much more neurologically complex. Anyone taking Librium as part of their treatment for alcoholism should absolutely refrain from drinking, as the depressant effects of both are combined in a relationship that is often described as 1 + 1 = 3.

Anticonvulsant

The neurons in human bodies are in large part controlled by what are called voltage gated sodium channels. This means that these sodium channels in the neuron act as a sort of gate that opens when it is subjected to an electrical charge. Seizures and convulsions occur when there is an irregularity in the way this gate opens and closes.

Librium is a sodium channel blocker: It prevents convulsions by keeping this chemical gate closed. This makes the medication a potential use in treating convulsion or seizure disorders. Again, whenever Librium is used to treat any condition, it’s important for the individual to take it as prescribed and see their doctor regularly.

Anxiolytic

Adults who are in relatively good physical shape and are experiencing mild to moderate anxiety may be prescribed three or four daily doses of Librium, where each dose ranges between 5 and 10 milligrams. In situations where the anxiety is more severe, each dose may be increased to between 20 and 25 milligrams. (1)

What sets Librium apart from Xanax and other benzos is that its mechanism of action on the nervous system is much slower. It is also more commonly prescribed when anxiety is related to drug withdrawal and/or substance abuse issues. In these cases, Librium may be part of a medically assisted detox and recovery program.

When Librium is prescribed to help someone break a cycle of addiction, it’s generally not meant to be used forever. At some point, therapists and clinical staff help the person wean off the medication.

Hypnotic

A hypnotic is a prescription medication of which the only legitimate therapeutic use is as a sleep aid. Librium may be prescribed for an individual with severe insomnia, and primarily when the root cause of the inability to fall asleep is anxiety.

However, Librium should not be used on a continual basis to treat insomnia given its highly addictive nature. What’s more, there are other hypnotics (often referred to as soporifics) that don’t pose the same risk for addiction and may be more suitable for a chronic insomniac.

Individuals who are having trouble sleeping can talk to their medical providers to find out about options. Often, doctors and therapists will attempt nonmedical options before turning to these types of medications because of the risks of addiction.

Sedative

A sedative is a medication that decreases the activity of the central nervous system in order to produce a calming and relaxing effect.

It’s often the case that a single medication can be both a sedative and a hypnotic, and whether it’s being used as one or the other depends on the amount of the dose. A lower dose works as a sedative, while a higher dose causes drowsiness and sleep.

Small amounts of Librium are sometimes given to people who are about to undergo surgery in order to mitigate their nervousness. The sedative properties might also be used in post-traumatic situations or before someone engages in other types of activity that cause them serious distress, such as flying.

It’s critical that someone taking Librium as a sedative only take it in individual circumstances where a doctor has prescribed it. Taking it more regularly than these extreme situations can lead to addiction.

Skeletal muscle relaxant properties

Benzodiazepines in general have skeletal muscle relaxant properties, and Librium is no exception. Some individuals who have used Librium describe a weightless feeling, with some even going so far as to say that they literally felt as if their feet weren’t touching the ground.

It is precisely this agreeable and pleasant body high felt by some users that leads to them using more and more to try to achieve the same effect.

However, the mechanism of addiction with Librium is precisely that of drug addiction in general, and users find themselves unable to chase this high as they quickly slide into a debilitating and serious drug addiction.

Legal Status Class C

Under British law, drugs are divided into three different categories: Class A, Class B and Class C. The most dangerous drugs, which carry the most severe criminal consequences, are those in Class A, and these include cocaine, heroin, methamphetamine and other so-called hard drugs.

Class B drugs include ketamine, marijuana, synthetic marijuana and other recreational drugs. They are still problematic legally, but don’t come with some of the stricter consequences possession of Class C drugs comes with.

Librium falls under Class C, alongside anabolic steroids, khat and others. Class C drugs are viewed as the least serious from a legal perspective. Nonetheless, when Librium is abused, it can have disastrous consequences for the addicted individual.

How Addictive Is Librium?

Librium is a benzodiazepine and can create a physical dependency in the human body. This means that the body becomes used to the drug being in its system. Once someone stops using the drug, the body thinks the normal state of affairs has been disrupted and it begins to act out in response.

This acting out of the body is what causes withdrawal symptoms. Withdrawal symptoms associated with Librium can include muscle cramps, tremors, convulsions, vomiting or excessive sweating. The longer someone takes this medication or the more of it they use, the worse the withdrawal symptoms can be. (5)

It’s these withdrawal symptoms and not necessarily a high that brings people back to taking Librium. It can be difficult to quit using Librium all of a sudden because of these withdrawal symptoms, making the medication at least mildly addicting for some people.

Neurological Mechanism of Librium Dependence

Like other benzodiazepines, Librium acts specifically on certain receptors in the brain. Specifically, benzos remove or lift some of the body’s natural restrictions on dopamine production.

Naturally, the brain puts a stop to dopamine production after a certain amount so the body isn’t overly flooded with it. It also only allows dopamine to be released in certain situations, such as when the body is experiencing pleasure signals. Librium acts on the brain’s receptors to stop this control.

The result is that dopamine flows more freely through the body. That’s one reason why anxiety and pain might be diminished and how a type of high can occur if someone takes a lot of the medication at once. This is also one reason someone can easily become dependent on Librium: The body becomes used to the free-flowing dopamine.

Chemical formula C16H14ClN3O

The chemical formula for Librium or chlordiazepoxide is C16H14CIN3O, which breaks down to 7-chloro-4-hydroxy-N-methyl-5-phenyl-3H-1,4-benzodiazepin-2-imine. This is its International Union of Pure and Applied Chemistry denomination. (1)

This chemical compound was first synthesized in 1957, not as a result of medical research but by chemists who were actually working on a class of dyes. The muscle relaxant, hypnotic and anxiolytic effects were discovered after the fact, making C16H14CIN3O the first benzodiazepine to be synthesized.

Routes of Administration of Librium

Librium is almost always taken in pill form, with the exception being when someone has serious liver problems and needs to have the medication injected straight into the muscle (either in the leg or the buttocks).

In either case, it’s always advisable that the first dose be taken in the presence of a medical professional. That way, in the very rare case that there are serious adverse reactions, the person can receive immediate medical attention. Keep in mind that Librium is a relatively slow-acting benzo that is easily metabolized in most cases, and adverse reactions are uncommon.

Oral

Brand name prescription Librium usually comes as a hard gelatine capsule. A bottle will contain 100 of these pills, and a 5, 10 or 25 will be printed on the pill, indicating the number of milligrams.

The different strengths also come in different colours. The 5-milligram pills are opaque green and yellow, 10-milligram pills are opaque black and green and 25-milligram pills are opaque green and white.

In addition to the number that denotes the measurement of the pill, a proper Librium pill for oral administration will also have an ICN printed on it.

Intramuscular

When the gel cap is taken orally, chlordiazepoxide is first metabolized by the liver. However, when a person’s alcoholism has progressed to the point that they have cirrhosis or another form of alcoholic liver disease, then oral administration of Librium will not be effective. In this case, the medication will be delivered as an intramuscular injection.

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Librium Dependence vs Addiction

Although the terms may be used interchangeably, dependence and addiction have slightly different meanings. The former refers to the physical dependence on a substance; when a person has been using Librium for an extended period of time, they depend on it in order to produce GABA and regulate their mood.

In contrast, addiction is characterized by changes in behaviour as changes in brain chemistry become more entrenched. For the Librium addict, obtaining this powerful prescription medication becomes a priority, more important than family, work and other aspects of their life.

Simply put, whereas dependence is a physical problem, Librium addiction has both physical and psychological components. In either case, it is a dangerous substance abuse disorder.

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Why People Abuse Librium

People abuse Librium for any number of reasons. In some cases, the abuse is not purposeful at first. Someone may be taking the medication for anxiety and find they need more and more of it to get the same relief. They can quickly come to a point of abuse and addiction before anyone realizes there is an issue.

In other cases, people find out that Librium makes them feel a certain way and they begin using it outside of the prescribed purpose. They could use their own prescription for unintended recreational purposes or steal someone else’s medication for this purpose.

Someone who is using Librium to treat issues related to alcohol withdrawal is already dealing with an addictive background. If they aren’t careful or don’t follow up regularly with medical and therapy staff, they could fall into abusing the medication out of the same reasons and habits that caused them to abuse alcohol.

Causes of Librium Addiction

The causes of Librium addiction are as wide-ranging as the similar causes of Librium abuse. Someone may fall into the addiction without realizing it, just as someone might increase their alcohol consumption over time until it becomes an addiction that impacts their entire life.

In other cases, mental health issues or physical pain could lead someone to self-medicate with Librium and become addicted. While this is less likely to happen than it is with opiates (such as prescription painkillers), it is a possibility.

In still other cases, people may become addicted to Librium because of destructive behaviours born of problems with home life, career stressors or other social issues.

Risk Factors for Librium Abuse

Military veterans are one group that has been shown to be at a particularly high-risk for developing a serious Librium addiction. In addition to the severe trauma of combat, both veterans and active-duty military suffer from the stress of deployment and having to spend long periods of time away from loved ones.

Although Librium can help with anxiety and PTSD, continued use — even for a short period of time — can quickly turn into a serious substance abuse issue.

Genetic

There is undoubtedly a genetic component to alcoholism and substance dependence in general. For that reason, individuals who have been prescribed Librium to help them in their initial stages of recovery need to be mindful of the very real danger of in turn becoming addicted to this anti-anxiety medication.

It can’t be stressed enough that Librium should only be taken as prescribed and then only for a short period of time. This second caveat — that Librium should not be taken over a period of time that exceeds weeks and never months (with rare exceptions) — is crucially important.

Environmental

Anyone familiar with addiction and drug rehabilitation knows that in addition to the very real genetic component and the fallout from trauma, environmental factors also come into play.

There are far too many dubious doctors and so-called pain management centres that are willing to profit from the mental and physical pain of others, and Librium, despite its very real therapeutic uses, is also being overprescribed.

Although it hasn’t been widely reported, the abuse of Librium is really no different than what’s happened with Xanax and opiates. It even has its own street names: blue bombers or normies.

Signs and Symptoms of Librium Abuse and Addiction

Substance abuse and denial go hand in hand, but there are definitely tell-tale signs when someone has a Librium addiction. First, any use of Librium without a prescription is abuse and cause for alarm. The Librium addict will also resort to doctor shopping and even street dealers, as obtaining this benzo has become the main focus of their life.

Then, of course, there are the serious physical ramifications of a Librium addiction, which include but are not limited to the following symptoms:

  • Somnolence (difficulty staying awake)
  • Mental confusion
  • Hypotension
  • Hypoventilation
  • Impaired motor functions
  • Impaired reflexes
  • Impaired coordination
  • Impaired balance
  • Dizziness
  • Muscle weakness
  • Coma

Co-Occurring Disorders with Librium Addiction

The vast majority of benzodiazepine abuse is part of polydrug use, in which an individual has an unhealthy dependence on multiple substances. Librium in particular is often used in combination with alcohol, producing intensified stupor and sedation.

Used together with heroin and other opioids, Librium intensifies the euphoric effects. Cocaine addicts will use Librium to come down after a binge. When Librium is used with other drugs, there is an increased risk of respiratory failure and memory blackouts.

Health Risks with Librium Addiction

As with all prescription medications, Librium comes with potential side effects and health risks. When someone is taking Librium, they should be aware of these potential issues and report any to doctors as soon as possible. It may be that the medication dosage needs to be changed or the person doesn’t tolerate Librium and needs a different medicine.

Some of the health risks associated with Librium include weakness in the muscles, sleep issues, changes in mood, stomach pain and jaundice. (4) Long-term use of Librium is not typically recommended, especially at higher doses, as it can increase the risk of some chronic disorders or cause issues with certain organs.

The Effects of Librium Abuse and Addiction

Librium addiction wreaks havoc on the affected individual’s life as they begin to neglect their home life. Performance at school and/or work also begins to suffer dramatically on those days that the Librium addict manages to show up on time, or even show up at all.

People under the effects of Librium should not drive or operate heavy machinery, as the stupor and drowsiness caused by the drug increase the possibility of a serious accident. Aside from the possibility of serious injury to one’s self (or even a fatality), this risky behaviour could also have dire legal consequences.

More legal issues could arise when an addict resorts to stealing or forging prescriptions in order to procure Librium. Basically, getting hold of Librium to avoid the severe withdrawal symptoms and continue to self-medicate becomes the focus of an addict’s life at the expense of interpersonal relationships.

Short-term effects of Librium

Given that Librium is not as fast-acting as other benzodiazepines, it may be the case that an individual feels very little effect after their first low or moderate dose. However, other people — especially the elderly and those with compromised health — may notice one or more of these side effects of Librium in the short term:

  • Confusion
  • Constipation
  • Drowsiness
  • Fainting
  • Altered sex drive
  • Liver problems
  • Lack of muscle coordination
  • Minor menstrual irregularities
  • Nausea
  • Skin rash or eruptions
  • Swelling due to fluid retention
  • Yellow eyes and skin
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Long-term effects of Librium

One of the biggest long-term effects of Librium is physical dependence. The body simply becomes used to the extra dopamine in the system, and it doesn’t want to give that up easily.

Because medication must process through the body, including the liver, long-term use of Librium can have consequences for renal health. It’s especially important for doctors to be aware of existing health issues so they can help individuals navigate Librium use without excessive negative impact to health or existing treatments.

In younger patients, Librium can cause hyperactivity, including acute rage. In some individuals who have taken Librium for a long time, psychiatric issues may surface partially as a result of the way Librium impacts the body.

The effects of Librium addiction on the brain

Benzodiazepines interact with the GABA receptors in the brain in order to reduce anxiety by slowing neural activity. GABA, or gamma-amino butyric acid, is a neurotransmitter that regulates mood. It is your brain’s natural defence against anxiety; when GABA is released, it essentially tells your central nervous system to calm down. (5)

Librium increases the flow of GABA through the brain. When someone is addicted to Librium, their brain struggles to produce GABA without the drug.

Librium Overdose Explained

An overdose occurs when someone takes too much of a medication. Typically in the medical world, ‘too much’ is defined as the place where positive benefits give way to negative impacts. The best way to avoid an overdose is to take medications as prescribed and follow up regularly with medical providers to ensure medication is working well.

Librium overdose can be dangerous, especially given the sedative nature of the drug. Someone who has taken too much Librium could be unresponsive. Too much sedation can also cause someone not to breathe normally or impact other body functions, putting the entire body at risk of critical failure.

Teen Librium Abuse and Addiction

Teen Librium abuse and addiction can manifest in several ways. First, in cases where teens are prescribed Librium for any reason, they may not fully understand or be willing to take into account the risks associated with the medicine. That leads them to abuse it by taking it with other drugs or alcohol.

In these cases, teens may not treat the medication with the seriousness it deserves. That means they could take more of it than prescribed or take it outside of the parameters of their prescription. Consistent use of the medication in this manner can lead to addiction.

Librium Withdrawal and Detox

There are no hard and fast rules when it comes to Librium addiction, and physical dependence involving any benzodiazepine can occur with any dosage over any period of time. It all depends on the recovering addict’s unique metabolism and genetic profile. What’s more, although Librium can be used to effectively treat the symptoms of alcohol withdrawal, in a bitterly ironic twist, the withdrawal symptoms associated with Librium addiction are very similar to those associated with alcohol cessation. Nonetheless, successful Librium addiction detox is possible, and the odds of success increase with the guidance of addiction specialists.

Symptoms of withdrawal

The withdrawal symptoms experienced by people who are trying to get off Librium or other benzos are often so severe that they may need to be hospitalized. Thankfully, however, the intensity of these symptoms and the discomfort they cause can be greatly reduced with a supervised medical drug detox.

In fact, the chances of being able to successfully overcome the initial hurdle of withdrawal symptoms associated with Librium withdrawal and detox are greatly improved with hospitalization. This addiction is extremely difficult to overcome alone. The symptoms of Librium withdrawal include the following:

  • Depression
  • Anxiety
  • Agitation
  • Tremors
  • Seizures
  • Convulsions
  • Hallucinations
  • High blood pressure
  • Abdominal cramps
  • Vomiting
  • Sweating

Duration of withdrawal

Given its relatively long half-life, the withdrawal symptoms associated with Librium addiction tend to come on approximately two or three days after the last dose. These symptoms reach their peak of intensity about seven to 10 days after cessation.

Fortunately, the situation does improve after two to three weeks, and after four to six weeks, the symptoms are more manageable still. There is light at the end of the tunnel.

Why you should contact a professional for Librium detox

The possibility of successful recovery from a Librium addiction is heightened significantly with the proper professional help. It’s complicated, more so due to the fact that many seeking help for a Librium addiction are often also dealing with another substance dependency issue. Many can trace their problem with Librium back to when it was first prescribed to treat their alcoholism. Breaking free from a Librium addiction is difficult, but it can be done.

Librium abuse detox process

Librium addicts are likely also dealing with polysubstance abuse and this can complicate the detox process, but not to the point that a knowledgeable addiction medicine professional can’t carefully analyse the situation to implement treatment strategies that can work.

Before anyone can start their rehabilitation process, they first need to detox. Upon arrival at rehab, the client will undergo a full physical examination as part of their intake. In cases where an individual has developed a high tolerance to Librium over an extended period of use, they may need to taper off the drug gradually in order to detox.

Possible complications

There are serious medical issues that can arise when someone is in the process of detoxification from Librium that make the oversight of a doctor essential. Aside from the intense discomfort associated with withdrawal symptoms, there is also the possibility of psychosis and hallucinations that can lead to dangerous behaviour and self-harm. As the neurotransmitters in the brain adjust, there is also the possibility of seizures, which can tend to worsen without medical attention and even be fatal.

Librium Addiction Treatment

Librium addiction treatment must address both the physical component of dependence and the complex psychological aspects that underpin addiction. Librium addiction is particularly difficult given how often it overlaps with and is tied together with other substance abuse issues.

Inpatient Librium rehab

As the withdrawal symptoms worsen over the first few weeks after the last time a person has used Librium and/or other drugs, they may have to be given medications to help manage their discomfort. Valium is often used to help those with Librium addiction. Non-benzodiazepine medications that can help with insomnia and other rebound symptoms are eszopiclone, Vistaril, propranolol, melatonin and clonidine. When this is done with the help of a doctor in a proper inpatient rehab/detox facility, the transition from detox through to rehabilitation and then towards continued sobriety is much smoother.

Therapy for Librium Addiction

Given that its legitimate medical uses include alcoholism treatment, PTSD, and anxiety disorders, it could very well be the case that someone seeking treatment for a Librium addiction has been to a drug rehabilitation facility before. As a result, Librium addicts may feel a sense of shame for not having been able to maintain their sobriety.

There could also be a degree of scepticism as to whether treatment and therapy can really work this time around. Rehab centre therapists take into account each client’s individual story and past experiences in drug treatment and therapy.

Librium relapse prevention

After the initial, primarily physical symptoms of acute withdrawal are dealt with during the detox phase, and even after rehab has proved to be successful, Librium addicts must still be aware of PAWS, or post-acute withdrawal syndrome. It can take as long as two years to effectively deal with the psychological component of Librium addiction that can lead to a relapse. Rehab centres can provide resources to clients after the inpatient care that can help prevent a relapse.

What to Do if a Loved One is Struggling with Librium Addiction

If someone close to you has been abusing Librium, then they are in danger of developing serious further health conditions as their life continues to become unmanageable. Finding an appropriate drug rehabilitation centre can help the user rebuild their life.

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