Key takeaways:

  • Ativan, consumed orally via a colorless liquid, is also often prescribed during alcohol detoxification to manage withdrawal symptoms
  • Ativan overdose can occur when the drug is taken in larger doses on its own but the risk of an overdose occurring and severity of it is greatly increased when combined with other drugs and alcohol
  • As benzodiazepines are often obtained on prescription as anti-anxiety medication, the ability to abuse them is heightened for those who fall under certain diagnoses. Some users may not realize they have formed a dependence as it is possible to do so even on a prescribed amount

Ativan is a brand name for the benzodiazepine, Lorazepam. Ativan is used primarily to treat disorders such as general anxiety but can also be used to treat conditions like insomnia. Like other forms of benzodiazepine, abusing Lorazepam can lead to addiction.

Understanding Ativan (Lorazepam)

Lorazepam, commonly found under the brand name Ativan, is a long-acting benzodiazepine used to treat severe anxiety disorders as well as insomnia and occasionally epilepsy. The prescription drug Ativan works by blocking gamma-aminobutyric acid (GABA) neurotransmitters, slowing hyperactive mental processes. Due to the drug's high potency and addictive properties, Ativan is seldom prescribed for periods longer than four months. 

Ativan, consumed orally via a colorless liquid, is also often prescribed during alcohol detoxification to manage withdrawal symptoms. It is often only used to treat short-term anxiety disorders and its use as a long-term form of treatment for anxiety disorders is not yet known. 

Ativan takes effect over a period of time between 45 minutes and 2 hours after taking and will typically stay in a person’s system for 10-20 hours. Another long-acting prescription benzodiazepine such as Valium can take up to 100 hours to leave the body. 

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Effects of Ativan abuse

As with most forms of prescription medication, if Ativan is taken outside of the prescribed amount it is considered abuse. This includes taking more than the prescribed amount, mixing prescriptions with other substances, and taking for longer than recommended. Abuse of Ativan is more common as it is legal to use it without a prescription.  

The properties of Ativan that inhibit brain receptors that cause anxiety can cause other effects when abused in large doses. This is often characterized by a brief but powerful high following by a long period of calm, as well as muscle relaxation and drowsiness. 

Abusing Ativan can also cause adverse effects that can be harmful to physical and mental health.

Physical signs of Ativan abuse

  • Loss of appetite
  • Headaches
  • Blurred vision
  • Tremors
  • Sweating
  • muscle spasms
  • Confusion
  • Nausea and vomiting
  • Dizziness

Psychological and behavioral signs of Ativan abuse

  • Hallucinations
  • No longer participating in former activities
  • Using Ativan as a coping mechanism
  • Legal problems
  • Isolation
  • Lying about Ativan use
  • Doctor shopping

Ativan overdose

Like other forms of benzodiazepine abuse, Ativan is often abused with other substances, such as alcohol and opioid medication, that amplifies the relaxing effect of the drug. As both act as a central nervous system depressant, taking too much of either in combination with each other can potentially lead to overdose. Ativan overdose can occur when the drug is taken in larger doses on its own but the risk of an overdose occurring and severity of it is greatly increased when combined with other drugs and alcohol. 

Warning signs of an Ativan overdose include:

  • Slurred speech
  • Apathy
  • Heightened agitation
  • Weakness
  • Confusion
  • Involuntary muscle contraction
  • Low blood pressure
  • Lowered breathing rate
  • Passing out
  • Coma

In severe cases, Ativan overdoses can be fatal

Ativan addiction

Like other benzodiazepines, Ativan has a high potency and prolonged abuse can change the brain’s neurochemistry. Abusing the drug can lead to a tolerance forming in the user's body, which eventually causes a psychological or physical dependence on the drug to create the same high. 

As benzodiazepines are often obtained on prescription as anti-anxiety medication, the ability to abuse them is heightened for those who fall under certain diagnoses. Some users may not realize they have formed a dependence as it is possible to do so even on a prescribed amount. An addiction occurs when the negative effects of drug abuse become moderate to severe. 

The mental health community uses the term hypnotic, sedative, or anxiolytic use disorder to describe benzodiazepine abuse or addiction. [1] This term comes from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) which is also used to measure the criteria for addiction. Here are some examples of addiction criteria:

  1. Hazardous use: You have used the substance in ways that are dangerous to yourself and/or others (i.e., overdosed, driven while under the influence, or blacked out).
  2. Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.
  3. Neglected major roles to use: You have failed to meet your responsibilities at work, school, or home because of substance use.
  4. Withdrawal: When you stop using the substance, you experience withdrawal symptoms.
  5. Tolerance: You have built up a tolerance to the substance so that you have to use more to get the same effect.
  6. Used larger amounts/longer: You have started to use larger amounts or use the substance for longer amounts of time.
  7. Repeated attempts to control use or quit: You've tried to cut back or quit entirely, but haven't been successful.

These criteria are measured by the negative impact the substance has on a person's life; including physical, psychological, and behavioral measures, and are classified as mild, moderate, and severe. The criteria are measured against the previous 12 months of substance use and a score of 2-3 is considered mild, 3-5 moderate, and 6 or more severe. [1] Even severe benzodiazepine addictions can be treated and overcome.

Symptoms of Ativan withdrawal

Like other benzodiazepine drugs, it is recommended that a person with an Ativan addiction not attempt to quit cold turkey. Benzodiazepine withdrawal includes physical, psychological, and behavioral symptoms which can be extremely uncomfortable and in severe cases harmful. Those withdrawing from Ativan abuse may experience seizures, psychotic reactions, and hallucinations. Most addiction specialists advise that those with an Ativan abuse disorder taper off the drug, preferably in an inpatient or outpatient rehab facility under a medically supervised detox. 

Benzodiazepine withdrawal symptoms usually have two forms; acute withdrawal and post-acute withdrawal symptoms (PAWS). Acute withdrawal symptoms are the most commonly felt and can start within 48hrs of last use and typically last no longer than two weeks. The early acute Ativan withdrawal symptoms are the most hazardous and uncomfortable and can be life-threatening if not treated properly. 

PAWS on the other hand can last for months or even years. Benzodiazepine PAWS can cause adverse mental health conditions as well as impairing cognitive faculties.

Ativan acute withdrawal symptoms

  • Insomnia
  • Rapid heart rate
  • Palpitations
  • Weight loss
  • Panic attacks
  • Irritability
  • Tremors
  • Headache
  • Muscle pain or stiffness
  • Mood swings
  • Sweating
  • Confusion
  • Nausea or vomiting
  • Abdominal cramps
  • Blood pressure changes

Ativan post-acute withdrawal symptoms

  • Anxiety
  • Difficulty sleeping
  • Difficulty concentrating
  • Depression or dysphoria
  • Constant tiredness
  • Memory impairment

Ativan detox

To ensure that withdrawal symptoms are managed safely and to ensure that ongoing recovery is successful, those suffering from Ativan addiction should always attend a medical detox facility. 

During medical detox, patients may be prescribed medications such as propranolol, clonidine, or levetiracetam to manage painful or uncomfortable withdrawal symptoms and will have a range of counseling sessions to identify the source of the addiction and help to develop an ongoing addiction recovery plan. 

Those who are attending a residential treatment facility will also begin treatment after detox, with a range of therapy and further medication treatment if needed and those who are in an outpatient treatment plan will begin a similar course of treatment.

Ativan addiction treatment

Ativan addiction can be difficult and even dangerous to overcome on one's own. Luckily, there are a range of inpatient and outpatient treatment centers that can provide all the help you need to detox safely and begin the road to recovery from Ativan addiction