Ativan (also known by the generic name “lorazepam”) is an anti-anxiety medication that belongs to the class of drugs known as benzodiazepines. Doctors can prescribe benzodiazepines for a variety of different reasons, most commonly to treat anxiety disorders, sleep problems and panic disorders.
As with any doctor-prescribed drug, it can be tempting to label the use of benzodiazepines like Ativan as “safe”. However, just because something is helpful doesn’t mean it can’t be abused. And drug abuse leads to dependence, which can very quickly lead to an addiction.
The Anxiety & Depression Association of America (ADAA) has issued a recommendation that benzos such as Ativan (lorazepam) and Xanax (alprazolam) should only be issued as second-line treatments for anxiety or panic disorders, due to their high risk of abuse and addiction.
This would mean doctors would only prescribe one of these medications when first-line treatments have already been tried with no success. Some first-line medication treatments for anxiety or panic disorders can include the use of selective serotonin reuptake inhibitors (SSRIs).
Ativan works by interacting with our brain and central nervous system (CNS) to produce calming effects by enhancing our brain’s GABA neurotransmitters – which is the body’s natural way of reducing anxiety and controlling stress levels. Along with boosting our GABA neurotransmitters, Ativan will also reduce brain activity, which in turn relaxes the whole body.
The prescribed dose of Ativan is decided by your medical professional and is based on things like your age, medical condition(s) and response to the prescription. Your doctor may adjust your dose if he/she feels it’s too much or too little.
If you’re interested in discontinuing your use of Ativan, consult your doctor before stopping use as your dose may need to be gradually lowered to avoid uncomfortable withdrawal symptoms and worsening mental state.
The History of Ativan
Benzodiazepines were discovered in the early 1950s by Austrian chemist by the name of Dr. Leo Sternbach. Interestingly enough, this creation was thought to be a failed experiment and was left on a shelf for over a year, until a colleague of Sternbach’s decided to run more tests with new theories.
This is how the first benzodiazepine (Librium) was invented. Ativan followed later, in the late 1970s, and was FDA approved as an anti-anxiety medication.
Ativan Signs and Symptoms of Use
The FDA has currently approved Ativan to treat anxiety disorders, insomnia, seizures and also as a premedication for anesthesia.
In a study including about 3500 patients who were being treated with Ativan for anxiety, the most frequent reactions to Ativan included:
- Sedation (15.9% of participants experienced this)
- Dizziness (6.9% of participants experienced this)
- Unsteadiness (3.4% of participants experienced this)
Some other side effects of Ativan use can include:
- Amnesia or memory impairment
- Lower inhibitions
- Changes in sex drive
- Sleep apnea
- Skin reactions (rash, allergic reaction)
Ativan Timeline, Abuse, and Overdose Symptoms
Ativan is usually administered as a tablet but can also be a liquid or given by injection. Each form has its own timeline.
Ativan tablets or liquid drinks can peak about 2 hours after administration. An injection begins much quicker, making the Ativan effects known within 15-30 minutes. This is why benzodiazepine abuse is commonly done by injecting because it’s much faster. However, this is also more dangerous.
The half-life of Ativan is 12 hours – meaning after 12 hours the concentration decreases by half. Ativan gets metabolized by the body and leaves the body through urine. Although, it can take about 5-6 days for the drug to be completely out of your system.
Even when a person follows their prescription precisely, it is possible to develop a dependence on Ativan. This is why Ativan is suggested to be a short-term prescription rather than a long-term solution to anxiety issues.
The risks of dependency and addiction to Ativan increase significantly if you take Ativan for longer than the prescribed amount of time or take higher doses than recommended.
Signs of Ativan abuse can include:
- Loss of appetite
- Losing consciousness
- Withdrawal syndrome when missing a dose
If you suspect a friend or someone you know is abusing their Ativan prescription, there are signs you can watch for including “doctor shopping” to get more prescriptions for Ativan, being withdrawn/no longer participating in things they used to enjoy, as well as using Ativan as a coping mechanism if things are stressful.
A person who is becoming dependent on Ativan may also experience hallucinations and become paranoid.
The prolonged physical and mental side effects of Ativan abuse can include:
- Respiratory depression (breathing difficulties)
- Excessive sedation
- Memory impairment or memory loss
- Loss of consciousness
Ativan abuse can be linked to a variety of medical issues including skin irritations, impaired muscular coordination, and profound memory loss.
Studies have shown long-term abuse of benzodiazepines such as Ativan can cause cognitive impairment. While the cognitive dysfunction in some of the patients in this study did improve after stopping the benzodiazepine use – not all patients were able to regain cognitive functioning to the level they had prior to their benzodiazepine addiction.
Ativan Overdose Risks
While it’s well-known that drug overdoses can happen by the user taking too much of a dose, did you know you can also overdose if too much of the drug is in your system? This means it’s possible the dose you took wasn’t enough to induce overdose, but along with the already-stored Ativan in your system, it is too much.
Benzodiazepines like Ativan are stored in body fat, which means they can remain in your body for a longer amount of time than you may think. If too much accumulation occurs, your body’s Ativan level can reach toxicity and it can be lethal.
A study published in American Family Physician has concluded that 80% of benzodiazepine abuse occurs in combination with other drugs – most notably opioids.
Combining Ativan with other central nervous system depressants (such as alcohol or opioids) can intensify the sedation effect, causing respiratory difficulties that can result in loss of consciousness, coma or even death.
Ativan overdose can cause serious complications that could lead to potentially fatal results, which means recognizing an overdose and finding help immediately can truly be lifesaving.
Symptoms of Ativan overdose can include:
- Blurred vision
- Extreme vertigo
- Anxiety or panic
- Confusion and memory loss
- Cognitive impairment
- Dangerously slow breathing
- Dramatically decreased heart rate
- Slurred speech
- Low blood pressure
If you notice any of these symptoms in yourself or someone you know who is using or abusing Ativan, contact 911 immediately. Keep the person awake until medical professionals arrive – you can do this by sitting them upright and getting them to keep a conversation going (for example, counting to 200, talking to you about work). If the user loses consciousness, lay them on their side.
Ativan and Mental Health
While Ativan is used to treat anxiety, it’s not without risk to our mental health over time.
Many people, including doctors, believe the negative effects of long-term anxiety disorders can be more dangerous to us than the side effects of medications like Ativan that relieve those anxiety issues.
However, when the drug being abused is one like Ativan, where the effects are considered helpful – it can be a big shock when dependency and addiction set in. Because Ativan is used to regulate our brain function, if this is done for an extended period of time, the brain eventually stops naturally controlling GABA and allows the drug to take control.
This is what makes it very difficult for an Ativan addict to stop their use – their body has essentially forgotten how to self-soothe because it’s been reliant on the help of the drug to do that. This kind of mental dependence is extremely difficult to overcome, which is why a rehabilitation center could be the answer to quitting your Ativan use for good.
Ativan can cause cognitive issues and can even lead to an inability to speak properly due to slurred speech. Ativan has been linked to an increased chance of dementia and Alzheimer’s disease, as well.
While some of the negative mental effects can be reversed once a person stops their use of Ativan, this isn’t always the case – sometimes the damage done is permanent, such as impaired memory or changes in cognitive behaviour.
Ativan Harm Reduction
Combining Ativan with other substances can be extremely dangerous.
Some of the more commonly known risks involved mixing Ativan with alcohol.
Mixing Ativan with alcohol can compound the effects of Ativan, causing slowed breathing, loss of consciousness and possibly even coma or death. Even as much as one drink can be dangerous, so the safest thing to do is to completely abstain from alcohol while taking Ativan.
Mixing Ativan with other drugs can also pose certain risks – for example, mixing Ativan with a stimulant can counteract some of the effects of Ativan while affecting your heart rate or altering your breathing rates. To be sure you are taking your Ativan prescription safely, it’s important to be completely honest with your health care provider about any other drugs you may be taking (even over-the-counter medications).
Users should never crush and snort Ativan tablets. Since Ativan is a fast-acting drug, allowing it to travel to the brain even quicker can do quite a lot of harm. Snorting Ativan can also severely damage your nasal tissue.
Ativan Addiction Treatment Options
If you or someone you know is struggling with Ativan addiction, there are many different treatment options that can help. One of the biggest reasons why treatment doesn’t work for some users is because the treatment option isn’t compatible with their lifestyle, which leads to unrealistic expectations. When reality falls short of expectations, relapse is never far behind.
So, choosing the best treatment option for you that will give you the best chance at staying sober is step number one to your recovery.
First, you can enter a medical detox facility, where your withdrawal from Ativan will be monitored and you will be made as comfortable as possible throughout the withdrawal period. From there, many detox facilities are able to help you choose a treatment program.
Outpatient treatment programs are suitable for those who are still capable of living at home and want to attend treatment sessions throughout the day. The frequency of these sessions can vary depending on your treatment plan.
Inpatient treatment programs are best for those who need more intensive help to kick their Ativan addiction because they not only offer the daytime sessions you can have with an outpatient program, but you are in a community of people who have the same end goal as you: to live a healthy, substance-free life.
Inpatient programs also allow you to participate in 12-step programs, life skills training and both individual and group counselling.