Diastat is the brand name for diazepam rectal gel. The active ingredient, diazepam, is a schedule IV medication according to the DEA, meaning it has a low (but not zero) potential for abuse and dependence.
Article at a Glance:
- Diastat is normally used to treat seizures but can be abused if taken incorrectly
- Diastat may cause severe withdrawal symptoms that make it hard to stop using
- Symptoms of abuse include drowsiness, tremor, slurred speech and coma
- The Recovery Village has inpatient and outpatient programs available as well as medically supervised detox
Table of Contents
While Diastat is a beneficial and life-saving medication, there are risks associated with its use.
Benzodiazepines like Diastat are one of the most prescribed and misused drug classes in the U.S. Anyone with a history of substance use disorder should let their physician know before they are prescribed Diastat.
Diastat is commonly prescribed for at-home emergency use. After a seizure, the person may be unconscious and unable to swallow oral medication. It is administered rectally to a patient who cannot swallow.
Using it as prescribed will not lead to dependence or abuse because usage is rare and reserved for emergencies. However, when abused regularly, it can lead to dependence. Dependence can happen regardless of whether someone is addicted and describes when someone cannot stop taking the medication without experiencing withdrawal symptoms. Addiction — or substance use disorder — describes a pattern of behavior that may or may not include dependence.
Some people may experience euphoria or extreme levels of relaxation or sedation if they abuse the benzodiazepine. When someone becomes addicted, they cannot control their usage and may compulsively seek and abuse, even if they don’t want to.
When someone is misusing or is addicted to a drug like Diastat, they will display certain symptoms to people around them. Many people who are addicted to benzodiazepines will lose interest in things previously important to them, such as school, work or relationships with friends and family.
What is Diastat?
Diastat is a prescription medication, classified as a benzodiazepine, with the generic name diazepam. It’s intended to be used as an emergency medication to control breakthrough seizures. The adult formulation is known as Diastat AcuDial and the formulation for children is Diastat Pediatric.
People who take Diastat are already taking regular seizure-control medication. Diastat isn’t intended as an everyday medication.
All benzodiazepines work by increasing the effects of the GABA (a brain neurotransmitter). In doing so, it and other benzodiazepines slow activity in the central nervous system, including seizures.
How Is Diastat Used?
Diastat is given rectally because it can be given to an unconscious or seizing patient and is absorbed quickly. These characteristics are important when treating potentially life-threatening seizures.
After being administered, seizures should stop within 15 minutes. If seizures continue past 15 minutes, call for emergency services. Diastat will continue working beyond 15 minutes. Peak concentrations will usually occur in the bloodstream within 1.5 hours, but the effects can continue for nearly two days.
Signs, Symptoms & Side Effects of Abuse
Common side effects include drowsiness, dizziness, unsteadiness, sedation, slurred speech, coordination problems, memory problems, blurred vision and changes in coordination. Common side effects may occur with normal usage of the medication. Signs of substance abuse are different from the normal side effects of the drug.
Signs of Diastat abuse can include:
- Being preoccupied with the use of Diastat or other benzodiazepines
- Continuing to use Diastat, even when there are negative side effects
- Trying to stop using Diastat and being unsuccessful
- Being dishonest about drug use
- Experiencing symptoms of withdrawal when trying to stop taking the drug
- Emotional symptoms, such as anxiety, agitation, confusion and hostility
- Changes in cognition and memory
- Developing a tolerance for the drug and requiring more to get the same effects
Diastat abuse may also include mixing benzodiazepines with other types of drugs, such as alcohol or opioids.
It is possible to overdose on Diastat; however, if someone uses this medicine exactly as prescribed, the risk is very low. An overdose commonly occurs in one of two scenarios.
First, a person takes such a large amount of diazepam that they experience toxicity as a result. Their body isn’t able to eliminate the substance quickly enough based on the amount. They may experience extreme drowsiness, unconsciousness or difficulty breathing.
The second scenario involves combining multiple substances. When certain substances are combined, they can heighten each other’s effects and make an overdose more likely.
The riskiest substances to combine with benzodiazepines are opioids, alcohol and barbiturates. These substances shouldn’t be used together because they all depress the central nervous system. When the central nervous system is affected by multiple depressants, it can dangerously slow breathing and heart rate.
Signs of a Diastat overdose may include:
- Bluish tinted lips or fingernails
- Blurry vision
- Changes in mood, such as depression or excitability
- Loss of coordination
- Nausea or vomiting
- Rapid eye movement
- Slow or labored breathing
- Slow reflexes
Anytime an overdose is suspected, seek medical help immediately by calling 911.
Diastat and Alcohol
Do not drink alcohol while taking Diastat.
Both alcohol and Diastat suppress the central nervous system and breathing. When breathing is too slow, it can cause coma and death.
Benzodiazepines on their own don’t often cause overdoses, but mixing them with another substance increases the overdose risk.
Be honest with your doctor about your alcohol habits and whether you feel you can abstain from alcohol while using a prescription painkiller. If you feel you cannot avoid alcohol while taking this prescription, discuss other prescription medication options with your doctor.
Untreated addiction can lead to serious complications. These complications can include physical and mental health problems and broken relationships. If Diastat addiction goes untreated, it can also cause problems at school or work, criminal issues, financial problems, and increase the likelihood of polysubstance misuse.
Unfortunately, most people who don’t receive treatment for addiction are at a high risk of overdose and death. A full recovery is possible with proper treatment.
When someone is dependent on Diastat, they may experience withdrawal symptoms when they stop using them. Quitting “cold turkey” or suddenly can lead to worse withdrawal symptoms than if the medication is tapered slowly. For this reason, if a person is benzodiazepine-dependent, a physician will typically taper down their dosage of the medicine gradually to avoid withdrawal.
For most people with a benzodiazepine dependence, the recommendation is to participate in a medically-supervised detox program. Benzodiazepine withdrawal symptoms can be severe and difficult to manage without medical help. Psychological counseling during detox is also helpful for some people.
You never have to go it alone. If you need help with withdrawal symptoms, seek help.
Benzodiazepine withdrawal symptoms may include:
- Muscle aches, cramps or spasms
- Dry mouth
- Mood swings
- Impaired memory and concentration
- Hypersensitivity to stimuli
Severe withdrawal symptoms include seizures, depression, anxiety and tremors. If someone uses Diastat to treat seizures, they should be aware of the risk of rebound seizures during detox.
Withdrawal Timeline and Symptom Duration
Each benzodiazepine has a different half-life. Half-life describes the amount of time it takes the body to clear half of the drug. Diazepam, the active ingredient in Diastat, can begin working relatively quickly when used rectally. The mean half-life of the drug is around 46 hours to 71 hours. It takes about five half-lives to completely clear a drug from the body, so the initial detox symptoms may last for up to 14 days.
It can be several days or more before Diastat withdrawal symptoms occur. Withdrawal symptoms can vary in duration and severity, depending on factors such as how long someone took the medication and how heavily they used it.
Diastat can stay in your system for up to 14 days after it’s used therapeutically. If someone uses Diastat chronically or in large doses, the detection window can be significantly longer. In a urine screen, traces of the drug could be found anywhere from four to six weeks after the last use.
Diastat Addiction Treatment & Detox
Diastat addiction treatment focuses on both the physical and psychological aspects of addiction. There are different treatment settings, and programs can last for varying amounts of time.
It’s not uncommon for people who struggle with Diastat or benzodiazepine addiction to have other substance abuse issues as well. Treatment will often include behavioral therapy, medications to assist with withdrawal symptoms, and treatment for underlying mental health conditions.
Behavioral therapies provide individuals with coping mechanisms, techniques to avoid drug use, and strategies to deal with relapse. Many drug treatment programs also include supplemental therapies to help patients with relationships and communication.
Also relevant during addiction treatment are mental health conditions. Addiction often happens along with underlying mental health issues. When substance use disorder and a mental health diagnosis are both present, this is called co-occurring disorders.
Some of the individual factors that play a role in treatment success include motivation, family support, and external pressure from sources such as family or the criminal justice system.
Diastat Medical Detox
If a person is dependent on benzodiazepines and other substances, they can benefit from a medical detox. Medical detox is often necessary when the person reporting for treatment is still using the addictive substance.
During this process, the patient will be given proper medical care to keep them safe and comfortable. Once the drugs are eliminated from their system, they can move on to treatment. Treatment should not occur before detox and will be unsuccessful if tried. A person can not be currently abusing substances to be successful in a treatment program.
Substance use disorder (SUD) treatment is tailored to the level of care a person needs. Treatment may either happen in the inpatient (hospital or rehab facility) or outpatient settings.
Treatment should only be started once a person has either been medically detoxed or has stopped all substance use. At this point, we begin group therapy and individual therapy sessions. Our team also addresses any co-occurring disorders.
Inpatient rehab requires patients to live on campus at one of The Recovery Village designated inpatient centers during their addiction treatment. Inpatient treatment can benefit patients who have developed a severe addiction or may need to avoid the outside world’s distractions.
After completing inpatient rehab, patients will begin outpatient rehab, where they will live at home while they come to The Recovery Village for scheduled treatment appointments.
Some patients with less severe addiction may begin treatment with outpatient rehab and skip inpatient entirely.
Choosing a Diastat Rehab Center
If you’ve decided to get Diastat rehab treatment for yourself or your loved one, choosing a rehab center that will meet your needs is a valuable first step. When looking for treatment, consider your Diastat usage habits, dosage levels and how long you’ve been taking it.
The Recovery Village has treatment facilities in multiple states, with highly-qualified, experienced and compassionate clinical teams who will develop a personalized treatment plan for your specific situation. Contact us today to learn more about treatment options.
U.S. Food and Drug Administration. “Diastat C-IV.” December 2016. Accessed July 12, 2020.
Montana Department of Public Health and Human Services. “Diastat® Use for Seizures.” 2014. Accessed July 12, 2020.
Drug Enforcement Agency. “Controlled Substance Schedules.” Controlled Substance Schedules, 2019. Accessed July 12, 2020.
Brett, Jonathan; Murnion, Bridin. “Management of Benzodiazepine Misuse and Dependence.” Australian Prescriber, Oct. 2015. Accessed July 12, 2020.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with substance use disorder or a mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.