The Dangers of Mixing Ativan with Alcohol

Medically reviewed by

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

January 17, 2019

Alcohol is a central nervous system depressant with a high potential for abuse often leading to negative outcomes. Ativan and other benzodiazepines are also central nervous system (CNS) depressants and commonly used to treat anxiety, epilepsy, and insomnia. A lesser known issue is the danger of mixing alcohol with prescription medicines like opioids, amphetamines, and benzodiazepines. A combination of CNS depressants has the potential to worsen mental stability and often leads to other adverse health complications.

Ativan is among the benzodiazepines most commonly mixed with alcohol. This combination may lead to serious side-effects, worsening mental health conditions, polysubstance dependence, and even overdose.

What Is Ativan And Can It Be Habit Forming?

Ativan, also known as lorazepam, is a central nervous depressant used to treat irritable bowel syndrome, insomnia, epilepsy, nausea from cancer treatments, but it’s most commonly used for anxiety. Anxiety is characterized by feelings of worry, uneasiness or uncertainty. It can lead to tension headaches, stress, insomnia, difficulty concentrating, and panic attacks. Ativan and other benzodiazepines work on a person’s nerves and reduce brain activity to help them to feel relaxed.

Affirmed by the U.S. Library of Medicine – NLM, “lorazepam can be habit-forming. Do not take a larger dose, take it more often, or for a longer time than your doctor tells you to. Tolerance may develop with long-term or excessive use, making the drug less effective.” They further precaution, “do not take lorazepam for more than 4 months or stop taking this medication without talking to your doctor. Stopping the drug suddenly can worsen your condition and cause withdrawal symptoms”

Why Do People Mix Ativan With Alcohol?

Ativan can cause intense euphoria when taken in large doses. Mixing alcohol with Ativan can intensify the calming feeling that each drug creates, and also creates a high of its own. Someone with a substance use disorder or drug-seeking behavior might intend to achieve this euphoria, but not everybody consciously mixes the two depressants. In either case, it’s important to understand the potential for danger.

Do Alcohol And Ativan Make Each Other Less Effective?

When alcohol and Ativan are mixed together, it will actually decrease a person’s tolerance to both of the drugs, and make them more likely to experience a blackout or lapse in memory. This is because alcohol and Ativan share a lot of the same effects, and the euphoria is actually amplified, rather than deemed less effective. Ativan will, however, no longer serve the same purpose of treating anxiety, and once mixed with alcohol can lead to more side-effects.

Side-Effects Of Ativan With Alcohol

A lot of mood-altering medications can cause certain side-effects when mixed with alcohol—such as nausea and vomiting, loss of coordination, or severe headaches. Even over the counter drugs like Tylenol, Benadryl, and Robitussin should be used with caution, and can be dangerous to mix with alcohol. Prescriptions like Ativan are no different, and can lead to a dangerous reaction and side-effects like:

• Drowsiness
• Dizziness
• Increased Risk for Overdose
• Slowed or Difficulty Breathing
• Impaired Motor Control
• Unusual Behavior
• Memory Problems

(National Institute on Alcohol Abuse and Alcoholism)

Ativan And Alcohol Overdose Symptoms

Overdose from Ativan is possible, but more likely to happen if alcohol or other drugs are involved. According to the Food and Drug Administration (FDA), “overdosage of benzodiazepines is usually manifested by varying degrees of central nervous system depression ranging from drowsiness to coma.”

“In mild cases, symptoms include drowsiness, mental confusion, paradoxical reactions, dysarthria, and lethargy. In more serious cases, and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, cardiovascular depression, respiratory depression, hypnotic state, coma, and death.”

Is It Ever Safe To Drink Alcohol After Taking Ativan?

Not really. Drinking alcohol can be dangerous even when there is a trace of lorazepam left in the system. It’s always best to consult with a physician concerning the safety precautions of Ativan, and the length of time that you should wait before consuming alcohol or using other medications.

Understanding Ativan And Alcohol Dependence

Ativan has the potential to help a lot of people with anxiety and has actually been used in medicine to help with acute alcohol withdrawal symptoms. It isn’t our mission to diminish the use of benzodiazepines or any other medications for their intended purpose. We simply want to convey the potential for dangerous reactions that come with polysubstance abuse, and if needed, how to get help for a drug problem.

Further on that note, from the FDA, “the use of benzodiazepines, including lorazepam, may lead to physical and psychological dependence. The risk of dependence increases with higher doses and longer term use and is further increased in patients with a history of alcoholism or drug abuse or in patients with significant personality disorders. The dependence potential is reduced when lorazepam is used at the appropriate dose for short-term treatment.”

Ativan And Alcohol Withdrawal Symptoms

When used properly, Ativan has been prescribed to help treat acute alcohol withdrawal symptoms, but it doesn’t necessarily work for everybody. Ativan can have withdrawal symptoms of its own, and should never be practiced for treatment outside clinical settings. “It needs to be based upon the severity of withdrawals and time since last drink. For example, a person presenting after 5 days of abstinence, whose peak of withdrawal symptoms have passed, may need a lower dose of benzodiazepines than a patient who has come on the second day of his (or her) withdrawal syndrome” (NLM).

The same source goes on to suggest that Ativan is actually a better alternative to other benzodiazepines like diazepam (Valium) for preventing delirium tremens seizures. Alcohol abuse can lead to withdrawals which can be more or less severe depending on the person and their age, amount consumed, diet and weight, and length of time drinking alcohol. From NLM:

Common symptoms include:

• Anxiety or nervousness
• Depression
• Fatigue
• Irritability
• Jumpiness or shakiness
• Mood swings
• Nightmares
• Not thinking clearly

Other symptoms may include:

• Clammy skin
• Enlarged (dilated) pupils
• A headache
• Insomnia (sleeping difficulty)
• Loss of appetite
• Nausea and vomiting
• Pallor
• Rapid heart rate
• Sweating
• A tremor of the hands or other body parts

A severe form of alcohol withdrawal called delirium tremens can cause:

• Agitation
• Fever
• Seeing or feeling things that aren’t there (hallucinations)
• Seizures
• Severe confusion

Treating A Substance Use Disorder

Substance use disorders can lead a person to do things that they normally wouldn’t do, like experimenting with drug mixtures. Unfortunately, this combination has the potential to open the door to other serious problems. An addiction treatment facility may be able to help avoid any further hurt or health issues. By teaching self-awareness, mindfulness and stress management, and other treatment programs, a rehab treatment can teach a person about their thoughts, feelings, and actions—and give them a better understanding of addiction.

How To Find A Treatment Center

If you or a loved one is struggling with an addiction, we understand the weight that it can carry and would like to help. Contact us to find out more about treatment for alcoholism or addiction. Success is within reach; our addiction specialists can help you pave the road to recovery, and ensure a brighter future.