Millions of people who struggle with anxiety, depression, panic disorders, and other conditions are prescribed powerful sedatives to address these conditions to help make their lives more manageable. Ativan, a legal drug, is one of those medications. Here, we take a look at Ativan addiction, what it is, and how to treat it.

What is Ativan?

Ativan (generic name lorazepam) is a brand-name prescription medication that is used to treat anxiety disorders, acute alcohol withdrawal, and seizures. It also is prescribed for manic bipolar disorder and chronic sleep disorders among other medical conditions. The medication also can be used to treat nausea, vomiting caused by chemotherapy, drugs given during cancer treatment, and psychosis that occurs with abrupt withdrawal from alcohol.

Ativan is part of a powerful class of drugs known as benzodiazepines, which includes Xanax, Valium, and Klonopin. The fast-acting sedative is addictive and is typically prescribed for short-term use. It is an intermediate benzodiazepine, which means it stays in the system anywhere from 10 to 20 hours or possibly longer. The drug’s effects take about two hours after users consume it. Ativan addiction potential increases when it is used for longer than four weeks.

Ativan, like other benzodiazepines, depresses brain activity and affects the central nervous system. It acts on the gamma-aminobutyric acid (GABA) receptors in the brain and stimulates the release of the GABA neurotransmitter, which is a naturally occurring chemical that calms activity in the brain. This, in turn, results in a calming, relaxing effect for people who use it.

While Ativan eases stress and anxiety, prolonged use of the drug makes it ineffective over time. Eventually, the body’s GABA function is diminished, and the body becomes dependent on Ativan to produce the GABA neurotransmitter. When this happens, Ativan users notice the drug no longer works the way it used to, which may prompt them to take more of it to feel the same effects they once did. Long-term use and abuse can lead to a physical or psychological dependence to the drug that is challenging to break.

Nicknames for Ativan include benzos, goofballs, and downers.

What are the Signs of Ativan (Lorazepam) Addiction?

Ativan addiction can happen to people who abuse it recreationally as well as those who have a legitimate prescription for it. Users can quickly develop a high tolerance for Ativan and soon find themselves feeling unable to go without it. The risk of developing Ativan addiction increases if the users have a substance use disorder (SUD). As the Substance Abuse and Mental Health Services Administration explains, the diagnosis of an SUD “is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria.” Examples of substance use disorders include alcohol use disorder (AUD), which involves excessive alcohol use, cannabis use disorder, stimulant use disorder, and opioid use disorder, among others. Read more about these disorders here.

People Who Abuse Ativan may Exhibit the Following Symptoms:

  • Confusion
  • Erratic or hostile behavior
  • Slurred speech, stuttering
  • Tremors
  • Memory, concentration problems
  • Slowed reflexes

Some of these symptoms are similar to those of alcohol abuse, which is common in anxiety medications. Alcohol and benzodiazepines like Ativan both affect the same neurotransmitters in the brain, which increases the level of intoxication the user feels.

Signs of Ativan Addiction Include:

  • Strong, seemingly unbearable Ativan cravings
  • Constantly thinking about Ativan
  • Going to great lengths to get the drug, including engaging in “doctor shopping
  • Isolation from others; strained relationships
  • Taking the drug outside of what is prescribed
  • Experiencing withdrawal symptoms 24-48 hours after the drug is last taken
  • Taking the drug to avoid withdrawal symptoms
  • Hiding Ativan use from family, friends, colleagues
  • Inability to stop using the drug despite repeated attempts to quit
  • Feeling like you can’t function without the drug
  • Mixing Ativan with alcohol or other drugs (polysubstance abuse)
  • Using the drug despite the negative consequences that result from doing so, such as job loss

If you or someone you know is taking Ativan and decides to stop using it, do not do so abruptly. Suddenly quitting the drug without a doctor’s consultation can worsen conditions and trigger uncomfortable withdrawal symptoms. These symptoms include seizures, nausea, vomiting, diarrhea, insomnia, numbness, and tingling in the extremities, fever, and mood changes, among others. It is worth noting that gradually decreasing Ativan dosage under a doctor’s supervision could help properly end Ativan use.

What is Involved in Ativan Addiction Treatment?

Recovery from Ativan addiction is possible with substance abuse treatment from a licensed drug rehabilitation facility. Clients who seek help with Ativan withdrawal symptoms from a drug rehabilitation center typically start with a medical detoxification.

During this process, they are monitored by medical professionals around-the-clock as they are safely weaned off the drug. This may include tapering off Ativan, which is when doses are gradually reduced over a set period to allow the body time to adjust to not having the drug in its system. Some clients may be given a longer-acting benzodiazepine in place of Ativan as they get through their withdrawal period. Detox can last anywhere from three to seven days or longer if needed.

After a medical detox is completed, clients are advised to enter a treatment program that helps them properly address their addiction, both physical and psychological. These treatment programs can be tailored to an individual’s needs and preferences. Inpatient treatment, which can last anywhere from 28 days to 90 days in a facility, depending on the program, involves therapies that can help the person work through and overcome their drug dependence.

One approach is cognitive behavioral therapy, (CBT), which is used to help recovering Ativan clients. CBT raises clients’ awareness of inaccurate, negative, or distorted thinking and teaches them coping skills and strategies. These tools help them identify and process their thoughts and emotions and respond to challenges in effective ways that support them during recovery. Treatment also can incorporate 12-step programs, holistic therapy, which includes yoga, art therapy, acupuncture and other activities, and individual counseling and group counseling.

There is also outpatient treatment for clients who may be in the early stages of Ativan addiction or have a mild case of it. Outpatient therapy does not require an on-site stay at a treatment center, giving clients more flexibility as they work drug treatment into their schedules. However, clients who do outpatient treatment are still required to attend structured sessions three to five times a week or more, depending on the situation. Outpatient clients are completely responsible for keeping their environment free of any negative influences that can set back their recovery.

Recovering Ativan users may want to consider using aftercare services to help them focus on their recovery goals and reduce their chances of relapse. Some people pursue follow-up medical care and ongoing therapies to help manage post-acute withdrawal symptoms, known as PAWS, that can happen long after dependence on the drug has passed.

How Dangerous is Ativan?

Ativan, one of the most potent benzodiazepines on the market, is highly addictive and habit-forming. People who extend their use far beyond these guidelines do so at their own risk. Misuse and abuse can lead to long-lasting cognitive impairment and other unfavorable conditions and potentially affect one’s physical and mental health over time.

Another danger is an accidental overdose, which can happen if a user takes too many Ativan tablets to achieve a stronger high. Signs of overdose include shallow respiration, clammy skin, dilated pupils, weak and rapid pulse, coma, and possibly death. Overdose can also follow a relapse. In fact, the risks of an accidental overdose are highest during relapse.

“Users who stop using Ativan may suddenly use again to escape or manage uncomfortable withdrawal symptoms that came back stronger, such as rebound anxiety, insomnia, and other conditions. The amount taken can overwhelm the body and lead to a state of unconsciousness, coma, and death. ”

Increased suicide risk is a rare side effect of Ativan, but it is one that recently pushed the drug into the spotlight.

In May 2017, the death of late Soundgarden frontman Chris Cornell put Ativan into the spotlight as his wife, Vicky, said Cornell might have taken more than the dose of Ativan that was prescribed to him, which she thinks could have played a role in his death. The medical examiner of Wayne County, Mich., later determined from the singer’s autopsy and toxicology report that although Cornell had a significant dose of Ativan in his system, as well six other drugs, “drugs did not contribute to the cause of death.”

Ativan Drug Combinations Raise Drug’s Risk

Polydrug use is common among benzodiazepine users. Users who engage in this practice are motivated to combine substances to experience a stronger high. However, using Ativan in this way with other drugs, whether legal or illegal, is discouraged.

Other Ativan drug combinations include:

Ativan and alcohol. Benzodiazepines are commonly used with alcohol, a dangerous combination that can lead to coma and death. Users combine Ativan and alcohol to intensify the high, which is quick and strong. Ativan becomes even more dangerous when alcohol is involved. Both substances depress the body’s central nervous system, which is highly dangerous and potentially fatal. According to a 2011 Substance Abuse and Mental Health Services Administration (SAMHSA), 95 percent of all patients admitted to rehab centers for benzodiazepine abuse also abuse another drug. In 25 percent of those cases, alcohol was the other drug used.

Ativan and amphetamines. Ativan, a depressant, counters the effects of amphetamines, which are stimulant drugs. People use the two together to help ease the process of coming down from the high. Examples of amphetamine drugs include methamphetamines, ADHD drugs such as dextroamphetamine, Adderall, Dexedrine, and Vyvanse.

Ativan and cocaine. Some users pop an Ativan to counter the effects of the stimulant cocaine for the same reasons they use the benzodiazepine with amphetamines.

Ativan and methadone. Ativan is sometimes taken with the pain reliever methadone to increase its pain-relieving effects.

Ativan Abuse Statistics

  • The rate of overdose deaths linked to benzodiazepine use in the U.S. rose substantially between 1996 and 2013, according to the American Journal of Public Health report.
  • Benzodiazepines were involved in 30 percent of prescription opioid deaths in 2013, second to opioids.
  • Nearly 1 million emergency room visits in the U.S. involved benzodiazepines alone or in combination with opioid pain relievers or alcohol between 2005 and 2011.
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