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Ativan (Lorazepam) Abuse, Addiction, And Treatment Options

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

February 1, 2019

Ativan abuse and addiction can happen quickly without the user even knowing. Treatment options for Ativan (lorazepam) abuse may differ, depending on whether someone is taking Ativan for a medical purpose or is using it recreationally.

Ativan (lorazepam) is one of the most potent benzodiazepine medications available. Due to its potent effects, this medication carries a higher risk of abuse, which increases the chances of developing a physical dependence on the drug.

Benzodiazepines are one of the most abused drug classes in the United States and some of the most commonly prescribed medications. Medications like Ativan are prescribed for the management of anxiety disorders or short-term relief of anxiety-related symptoms. However, even individuals who take Ativan for a legitimate medical purpose can become physically dependent.

Once someone becomes physically dependent, they can develop an addiction. People who have a history of drug and alcohol abuse or mental health disorders are at a higher risk for developing an Ativan addiction.

People who are physically dependent on Ativan will experience withdrawal symptoms if they suddenly stop taking the medication. When someone abuses and becomes addicted to Ativan they will likely need to enroll in a formal addiction treatment program to come off of the drug safely.

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Ativan (Lorazepam) Side Effects And Signs Of Abuse And Addiction

Individuals who are under the influence of high doses of Ativan can appear to be drunk and have slurred speech and poor physical coordination. Physical signs of Ativan abuse can include:

  • drowsiness
  • dizziness
  • tiredness
  • weakness
  • dry mouth
  • diarrhea
  • nausea
  • changes in appetite
  • restlessness or excitement
  • constipation
  • difficulty urinating
  • frequent urination
  • blurred vision
  • changes in sex drive

In more severe cases of Ativan abuse, individuals may also experience symptoms such as:

  • shuffling walk
  • persistent, fine tremor or inability to sit still
  • fever
  • difficulty breathing or swallowing
  • yellowing of the skin or eyes
  • irregular heartbeat

People who are addicted to Ativan can experience cravings and continue to use the drug despite the increased risk of self-harm and harm to others. Abusing Ativan can cause significant changes in an individual’s behavior. These behavioral changes can include:

  • issues with family and friends
  • failing to follow-up on work, school, or home responsibilities
  • participating in risky behavior
  • social isolation
  • financial issues

Risks Of Ativan (Lorazepam) Abuse And Addiction

Because Ativan is a legal, prescription medication, many people believe that is is a safe drug. However, abusing Ativan (lorazepam) can be very risky due to its highly addictive nature. Typically, benzodiazepines like Ativan are only recommended for short-term periods of two to three weeks. Using Ativan for more than three weeks can significantly increase the risk of becoming addicted to the drug.

Overdose is another risk associated with Ativan abuse. However, it is rare for someone to fatally overdose on Ativan alone. Most Ativan-related fatal overdoses involve another depressant. Taking more than one sedative at a time can have compounding effects and make it very difficult to breathe.

Severe side effects can occur when someone consumes large doses of Ativan, especially if they mix it with another depressant such as alcohol or opioids. Potential risks of Ativan abuse can include:

  • extreme respiratory depression
  • excessive sedation
  • seizures or muscular tremors
  • memory impairment
  • coma

Extended and chronic use of Ativan can also cause changes in brain functioning. Research indicates that long-term benzodiazepine use can result in cognitive impairment, including loss of short-term memory.

Individuals who have a pre-existing depression disorder should not take Ativan as it can cause depression symptoms to worsen, increasing the likelihood of suicidal thoughts and tendencies.

How Ativan (Lorazepam) Works On The Brain

Ativan (lorazepam) affects a key chemical in the brain called GABA (gamma-aminobutyric acid). GABA levels influence motor function and slow down brain activity while also producing a sense of calm and relaxation. Once GABA levels are high enough, they effectively slow nerve impulses throughout the body.

Combining Ativan With Other Depressants

Ativan (lorazepam) may increase the risk of severe or life-threatening breathing problems, sedation, or coma is used with other depressants. Between 2005 and 2011, almost one million Americans sought emergency treatment for Ativan-related abuse. A large percent of these individuals not only had Ativan in their system but other substances like alcohol or opioids, according to the Drug Abuse Warning Network (DAWN).

More than 30 percent of opioid-related overdoses also involve benzodiazepine medications like Ativan. Combining these medications can be dangerous because both of these substances sedate users, suppress breathing (leading to overdose), and impair cognitive function, according to the National Institute on Drug Abuse (NIDA).

Ativan (Lorazepam) Withdrawal Symptoms

Benzodiazepine withdrawal is typically defined by two phases, acute and post-acute withdrawal. Acute withdrawal occurs within hours of the last dose of Ativan and can include symptoms such as:

  • Ativan cravings
  • insomnia
  • irritability
  • hand tremors
  • sweating
  • difficulty concentrating
  • confusion
  • nausea and vomiting
  • abdominal cramps
  • headaches
  • blood pressure changes
  • panic attacks
  • weight loss

Post-acute withdrawal symptoms, also sometimes referred to as (PAWS), tend to be more psychological in nature and can include:

  • anxiety
  • depression or dysphoria
  • inability to feel pleasure
  • constant fatigue
  • obsessive-compulsive tendencies
  • memory problems

When people reduce the amount of Ativan they take quickly, they increase the risk of developing rebound anxiety. Rebound anxiety is the return of anxiety-related symptoms the individuals initially started taking Ativan to treat, but much more intense.

Typically, rebound anxiety happens within the first five days of the last dose. However, tapering off of Ativan can help manage rebound symptoms until an alternative is in place.

How To Withdraw From Ativan (Lorazepam) Safely

Unpleasant withdrawal symptoms can come about quickly in those who abuse or are addicted to Ativan (lorazepam) because their bodies have gotten used to constantly having the drug in its systems. Because of Ativans extreme potency, sometimes people who take it as instructed can also experience physical withdrawal symptoms.

Individuals who want to stop abusing Ativan safely should slowly taper off their dose, as suddenly stopping the medication can increase the severity of withdrawal symptoms. Gradually weaning off the medication by reducing the daily dose over an extended period can give the body time to adjust to being without the drug. Highly addicted individuals may require the assistance of a medically supervised detoxification program to come off the medication successfully.

Treatment Options For Ativan (Lorazepam) Abuse And Addiction

Recommended treatment options for Ativan (lorazepam) abuse and addiction can vary, between individuals who started taking the medication for a medical reason and people who abuse the drug to experience its side effects.

Individuals who take Ativan as a way to help them deal with anxiety are more likely to need more intense addiction treatment because of their increased chances of psychological symptoms. People who take Ativan without a medical purpose are less likely to experience psychological symptoms unless they have abused the drug at high doses for a long time.

Most of the time, benzodiazepine addiction treatment options include comprehensive approaches including behavioral therapies and medication-assisted treatments. Ativan is a short- to- mid- acting benzodiazepine so people with Ativan use disorders may be placed on a long- acting benzo like Valium to help them wean off the medication.

Behavioral therapies like Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT), have been shown to be effective in treating the psychological aspects of Ativan abuse and addiction.

National Center of Biotechnology Information: Yale Journal of Biology and Medicine - Prescription Sedative Misuse and Abuse

U.S. National Library of Medicine: MedlinePlus - Lorazepam

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