This Page was last reviewed and changed on May 21st 2022
As a benzodiazepine drug, the risk of abuse and addiction is high with Ativan. While taking such a drug is classed as safe over a short period of time, prolonged use can lead to an increased tolerance followed by a physical dependence.
Those who allow their use of Ativan to progress to abuse are at risk of developing a full-blown addiction and would then require a programme of detox and rehabilitation to get their life back on track.
Addiction is a disease that is not necessarily limited to alcohol and illicit drugs. Prescription drugs can also be a foundation for addiction. For example, Ativan is a prescription medication that increasingly more addiction treatment centres are finding themselves dealing with.
The emergence of Ativan as a catalyst for addiction has led to an increase in the amount of available abuse and addiction help for this drug. Treatment providers are developing programmes to help addicts deal with Ativan abuse with the goal of achieving and maintaining permanent abstinence.
What is Ativan?
Ativan is a brand name referring to a benzodiazepine known as lorazepam. It is a drug routinely used to treat insomnia, anxiety disorders, and conditions involving active seizures. These conditions would include things like epilepsy, alcohol withdrawal, and the like. Its usefulness in combating seizures makes it a highly attractive medication for treating alcohol dependence.
Unfortunately, Ativan is addictive. Improper use of the medication can create a problem that ends up being worse than the problem it was intended to help solve. Therefore, it must be used with discretion.
The roots of Ativan go back to the 1970s when a number of pharmaceutical companies were actively developing a family of drugs known as benzodiazepines. The medication’s generic parent, lorazepam, was introduced by Wyeth Pharmaceuticals after extensive development by the company’s president of research. The medication was released in 1977 under the brand names Ativan and Temesta.
How Does Ativan Work?
As a benzodiazepine, Ativan is a psychoactive drug that directly affects a neurotransmitter known as gamma-aminobutyric acid (GABA) and its associated receptor. For the purposes of clarity, a neurotransmitter is a brain chemical that transmits certain signals to different areas of the brain.
GABA is an inhibitory neurotransmitter, which is to say that its main role is to reduce excitability within the central nervous system. It helps to keep you calm, in other words. Ativan and other benzodiazepines work by enhancing the natural effects of GABA on its associated receptor.
When Ativan is introduced into the system, it improves the way the receptor utilises GABA by improving the efficiency of the chemical. In some cases, it might even enhance the amount of GABA the body produces. The end result of this interaction is central nervous system sedation. It produces symptoms that include sleepiness, muscle relaxation, and reduced anxiety.
In terms of treating seizures, the medication reduces the likelihood of occurrence by relaxing the nervous system. How well it works depends on the kinds of seizures being experienced. It should be noted that the chances of becoming addicted to Ativan increase the longer the drug is used.
Ativan Abuse Causes
Medical science has yet to discover an exact cause behind Ativan abuse. However, there is some evidence to suggest a few contributing factors – beginning with a genetic predisposition. Individuals with a family history of substance abuse and addiction seem to be more likely to tend toward Ativan abuse if the drug is made available to them. Genetic predisposition seems to be strongest in first-degree relatives (i.e., parents).
Other contributing factors include:
It is not uncommon for people struggling with mental illness to also develop an addiction to Ativan. Remember, this medication can be used to treat anxiety disorders. It could be that the patient’s mental health contributes to abuse and addiction when Ativan is being used to treat a mental disorder.
Certain environmental conditions can induce stress in people who turn to benzodiazepines and other sedatives to help them cope. It is not unheard of for a person using Ativan as a means of coping to gradually become dependent on the drug.
Because Ativan works on the central nervous system by influencing chemicals in the brain, it is believed that it can also have a profound effect on the brain’s reward system. If that is the case, individuals who abuse Ativan may be doing so because their brains reward them with feelings of pleasure.
Science strongly leads toward genetic predisposition and brain chemistry as the two most important contributing factors to Ativan abuse and addiction. However, more research needs to be done to determine why some people who use Ativan have no trouble with it while others tend toward abuse.
Ativan dependence is no different than dependence on any other substance, at least from a mechanical standpoint. Developing dependence begins with the physical condition known as tolerance.
Whenever you take a medication, like Ativan for example, the body has to adapt to having that substance in the system. Ativan forces the brain to adapt to its enhancing the effects of GABA on the GABA receptor. Adapting is a matter of producing additional chemicals to overcome the effects of the drug.
The conflict between Ativan and what the brain is trying to do to compensate produces some of the side effects of the drug. But over time, the brain becomes more adept at handling Ativan. Less conflict occurs which, in turn, results in a lessening of the intensity of drug’s effects. In order to produce the same effects, the user has to take more. This is tolerance.
Once tolerance begins, the user is on the road to dependence. Tolerance grows with each use of the drug moving forward. Finally, the user arrives at the place where regular doses of Ativan are necessary just to maintain normal function. This is the point at which a person is considered dependent.
If you are dependent on Ativan, both your mind and body need it on a daily basis. You cannot function without it. As such, Ativan has become the controlling factor in your life. Everything you do is centred around you having a steady supply of the drug.
Please understand that Ativan dependence can be broken. It is a matter of putting the body and mind through the necessary treatments to return everything to normal. Breaking Ativan dependence may not be easy, but it is very possible.
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Short-Term Effects of Ativan
The short-term effects of Ativan are what make this medication useful for treating seizures, anxiety disorders, and the like. Those effects include:
increased feelings of euphoria
a heightened sense of well-being
reduced physical stress
reduced psychological anxiety
drowsiness, weakness, and sedation
light-headedness and dizziness
loss of motor skills.
How long these short-term effects last depend on dosage and the half-life of the formulation. A single dose typically taken for medical purposes produces short-term effects that last between six and eight hours. However, it is possible for some of the euphoric effects of the drug to last 10 hours or longer.
Long-Term Effects of Ativan
Taking Ativan for an extended amount of time is likely to cause some long-term effects, most of which are extreme exacerbations of short-term effects. These include, but are not limited to:
significant cognitive impairment
acceleration of dementia-related illnesses
confusion, disorientation, and hallucinations
periods of hyperactivity
decreased seizure threshold
gradually increased tolerance.
The long-term effects of Ativan can lead to other problems including dependence and co-occurring disorders. Because of the addictive nature of this medication, long-term use is not recommended except in extreme cases of seizure management.
Doctors have a number of medications at their disposal should the need to substitute Ativan with another drug become necessary. Ativan substitutes depend on the condition for which the medication is prescribed. In terms of benzodiazepines, there are dozens to choose from. These include:
The Royal College of Psychiatrists says that when Ativan is being used to treat anxiety, SSRI antidepressants can be used as a substitute. The same antidepressants may be more effective for treating cases of anxiety triggered by obsessive-compulsive disorders.
When insomnia is an issue, a good substitute is any one of the ‘Z’ class drugs that interact with the GABA system. These include medications like zaleplon, zolpidem and zopiclone. Because there is no evidence to suggest that ‘Z’ class drugs are less addictive than benzodiazepines, the recommended use is similar. They should be used with caution and for no longer than four weeks at a time.
Unfortunately, there are few other drugs that can effectively substitute for Ativan. If long-term treatment is necessary, doctors have to utilise a combination of medications in order to prevent dependence on any one of them. This may be a contributing factor to the increasing rate of Ativan abuse worldwide. Medical science lacks enough substitute medications to keep people away from benzodiazepines.
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The Dangers of Ativan
It should be obvious that one of the primary dangers of Ativan is its addictive nature. Like all benzodiazepines, people with a genetic predisposition toward addictive behaviour are especially at risk with this medication. But there are additional dangers above and beyond addiction.
A good place to begin this portion of the discussion is talking about accidental injuries. People who use Ativan long enough to begin experiencing more extreme cognitive impairment and loss of motor function are more prone to injuring themselves.
Long-term use of the drug puts you at greater risk of accidental falls, household accidents (cutting yourself in the kitchen, etc.), workplace accidents involving machinery and equipment, and even accidents as a pedestrian, bike rider, or driver.
The dangers of Ativan are enhanced when the drug is combined with alcohol. Ativan and alcohol together can inhibit your breathing, interrupt your normal heartbeat, and induce vivid hallucinations that could cause you to behave in dangerous ways.
Lastly, Ativan is a dangerous drug in terms of its ability to induce long-term depression. If you were taking the drug to treat anxiety, you could eventually end up with clinically diagnosed depression on top of it. If you are combining Ativan and alcohol together, you could end up with co-occurring disorders requiring specialised treatment.
The Cost of Ativan Addiction
The cost of Ativan addiction can be measured in numerous ways: financially, relationally, and mentally. Beginning with the financial, feeding a steady Ativan habit can be very expensive. You could spend hundreds of pounds per day trying to obtain Ativan on the street. The result could be financial ruin.
You could lose your job, your house, and all the material possessions you own. Relationally speaking, Ativan addiction is bound to disrupt your personal relationships. If you are married or in a civil partnership, plan on Ativan addiction coming between you and your partner. It will harm your relationships with your children (if you have them) as well.
Ativan addiction will interrupt the relationships you have with your friends and co-workers, too. As with any addiction, an addiction to Ativan may influence you to leave behind the friends you have had for years in favour of new friends who share your addictive behaviour. Alternatively, Ativan addiction could have the opposite effect. It could leave you completely isolated and alone.
The cost of Ativan addiction from a mental standpoint is related to the drug’s ability to produce cognitive impairment and feelings of depression. It is very common for Ativan addicts to experience a permanent reduction in cognitive ability, even if some of that ability is restored following treatment. As for long-term depression, that speaks for itself.
Hopefully, you understand that Ativan addiction has the potential to completely ruin your life. From robbing you of your finances to destroying every relationship you hold dear, nothing good can come from using this drug long-term. It is time for you to seek help if you are addicted to Ativan.
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Ativan Brand & Street Names
You learned earlier in this guide that Ativan is a brand name for a generic drug known as lorazepam. The only other brand name associated with this medication is Temesta. Unlike illicit drugs like heroin and cocaine, Ativan does not have any particular street names. Rather, the most commonly used street names apply to the entire class of benzodiazepine drugs. These include:
Dead Flower Powers.
If you were to buy Valley Girl on the street, for example, you might be getting a benzodiazepine known as diazepam (Valium). But there is no guarantee. You could also be purchasing Ativan or any of the other drugs in this class. This is a concern among doctors who cannot necessarily trust a street name when dealing with a benzodiazepine overdose.
Management of Ativan Misuse and Dependence
There is a philosophy of management within the sphere of treating Ativan misuse and dependence. Management becomes a strategy when a patient clearly demonstrates an Ativan problem but is not willing to consider a change. The goal of management is to prevent both doctor-shopping and a worsening of the problem.
Doctors look to manage Ativan misuse and dependence through a number of different therapies. Interviewing techniques look to help the patient understand his or her problem form the starting place. Through interviewing techniques, the doctor can try to establish either a maintenance therapy or a new Ativan prescription regimen that slowly withdraws the patient.
How a doctor approaches management depends on the level of risk presented by the patient. Low-risk patients can be treated with a maintenance regimen until they are ready to see the change. Patients at high risk of dependence or additional problems have to be treated more cautiously.
A good management tool that doctors have at their disposal is something known as ‘staged dispensing’. Dispensing prescription medication in stages is essentially administering it in small doses with regular follow-up. For example, rather than giving the patient a prescription lasting for 30 days, the patient may receive a single dose for a single day, followed by a visit with the doctor on the following day.
Another good management tool is benzodiazepine substitution. Where Ativan is concerned, it is highly addictive because it has such a short half-life. Ativan management might be more effective in some patients by substituting diazepam, another benzodiazepine with a longer half-life.
The most important thing to remember in this regard is that, once dependence is established, the only cure is abstinence. Treatment providers may vary in the methods they use to lead an addict to the place of abstinence, but abstinence is the ultimate destination in every case. As such, maintenance and management are not long-term goals. They are intended to be short-term strategies employed until an addict is ready to make a change.
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Ativan and Other Substances
Mixing Ativan with alcohol is never a good idea as is can lead to undesirable consequences. Those consequences include episodes of amnesia (blackouts), loss of consciousness, difficulty breathing, confusion, slurred speech, and loss of motor function. In the most severe cases, mixing Ativan with alcohol can lead to coma.
Here are some of the consequences of mixing Ativan with other substances:
Reduced mental function, dizziness, weakness, confusion, difficulty breathing, loss of motor function, and dangerously low blood pressure.
Slowed respiration, loss of motor function, loss of consciousness, reduced heart rate, sedation, and coma. If the two substances are taken in high enough doses, they can kill you.
It is not unusual for addicts to mix Ativan with both prescription sedatives and opiates in order to enhance the effects of the secondary drug. But know this: combining drugs is a dangerous habit that can be fatal. Benzodiazepines, alcohol, prescription sedatives, and opiates all have similar effects that are exaggerated when substances are combined.
If you are mixing Ativan with other substances, you are playing with your life. Don’t do it. If you have to get professional help in order to stop, do so right away.
Overdosing on Ativan is a serious situation that could lead to death if not immediately treated. The strange thing about Ativan addiction is that it can produce paradoxical psychological and physical symptoms. By paradoxical we mean symptoms that run counter to the normal effects of the drug.
Someone who has overdosed on Ativan would be expected to exhibit many of the following symptoms:
Increased anxiety or agitation
Involuntary eye movements combined with blurred vision
Involuntary muscle contractions
Disorientation and drowsiness
Loss of strength
Loss of normal reflex
Extremely low blood pressure
Severely impaired breathing
Unresponsiveness and possible coma.
It is important to get someone overdosing on Ativan to a hospital right away. If it is not possible to transport that person yourself, you need to call on emergency services for help.
Overdosing on Ativan is unfortunately fairly common. Having said that, it must be noted that lethal overdoses are rare in comparison to the number of people who use the drug both recreationally and through a doctor’s prescription. This does not mean that there are no risks involved, though. Overdosing on any drug can be harmful.
One of the more critical risks of overdosing on Ativan is respiratory distress. In simple terms, too much Ativan in your system is likely to cause breathing trouble. Your breathing could become impaired to the extent that your body just does not get enough oxygen. This can lead to all sorts of issues, including eventual respiratory arrest (you stop breathing).
Another risk of overdose is dehydration. Because high doses of Ativan can cause excessive perspiration, it is possible that the effects of the drug could lead to dehydration unless you are drinking a lot of liquids. Dehydration can lead to its own complications.
Perhaps the biggest risk of Ativan overdose is not being treated right away. There are cases where an overdose has resulted in serious injury and death, cases in which the drug itself was not entirely responsible. Rather, the drug-induced symptoms led to the injury because they were not treated.
Understand that while lethal Ativan overdose is rare comparatively speaking, overdosing on this drug is still risky. All the dangers associated with Ativan are exacerbated when the drug is combined with alcohol, opiates, or other substances.
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Co-Occurring Disorders of Ativan Abuse
As discussed earlier, Ativan is a benzodiazepine that interacts with GABA and its associated receptor. Because some mental illnesses are also associated with GABA production and efficiency, it is believed that co-occurring disorders involving Ativan are more common than currently reported.
Available research does not explain whether co-occurring disorders of Ativan abuse are first triggered by one condition over the other. But definite links have been shown. Research has uncovered evidence that suggests Ativan addiction frequently occurs along with:
antisocial personality disorder.
Research has further shown that long-term use of benzodiazepines and/or alcohol can produce depressive symptoms or clinical depression in people with a predisposition to such mental disorders. In that sense, it could be construed that Ativan can trigger a co-occurring disorder in some individuals.
Unfortunately, we still do not know a lot about the mechanisms of co-occurring disorders. This lack of understanding leaves treatment providers to do their best to treat both conditions without exacerbating either of them. One example would be to treat Ativan addiction and co-occurring depression by gradually phasing out the use of Ativan in favour of an SSRI antidepressant. The antidepressant would address both the clinical depression and the Ativan abuse.
There is a growing belief in addiction treatment that benzodiazepines should be avoided during substance withdrawal in order to prevent the onset of co-occurring disorders. Treatment providers are gradually coming to understand that Ativan and other benzodiazepines should be a measure of last resort to prevent seizures during drug withdrawal.
Ativan Abuse Treatment Self-Care at Home
While experts strongly recommend against self-care at home for Ativan abuse, attempting to quit on your own is entirely possible. Just do it safely. This section of our guide is intended to help you understand the basics of self-care at home. The first thing to note is that you will undergo withdrawal.
If you have been taking Ativan for any length of time, your body has likely developed at least some level of tolerance. As you use the drug less, your body has to compensate accordingly. You will experience withdrawal symptoms that include cravings, insomnia, anxiety, mood swings, abdominal cramps, nausea, and more.
You should also note that there are two kinds of Ativan withdrawal: acute and protracted withdrawal. The former describes what is normally considered routine withdrawal and includes the symptoms listed above. It is usually over within 10 to 15 days.
Protracted withdrawal occurs when certain withdrawal symptoms persist even after acute withdrawal is over. These persistent symptoms are almost always psychological rather than physical.
As withdrawal symptoms can be extremely uncomfortable, it is best to withdraw gradually. Rather than quitting Ativan cold turkey, it is better to step down the amount of the drug used gradually. Withdrawal symptoms may last longer this way, but they will be less severe. They should also be easier to fight through so as to not succumb to the temptation to use more Ativan.
Some of the co-occurring disorders that can worsen your detox process are:
If you attempt self-care only to realise you are not going to be able to push through, don’t simply give up and resume your normal Ativan habit. That is the point to immediately seek professional help. You have already begun the recovery process; it is best to continue it with a medically-supervised treatment programme. If you abandon your self-care programme and resume your normal habit, you may make a bad situation worse.
When to Seek Medical Care
You should not take the risk of Ativan dependence lightly. Seek out medical care at the first sign that you might be developing tolerance. Remember what you already read about tolerance: it begins when your body starts getting used to the drug, requiring you to take more in order to experience the same effects.
Once tolerance begins setting in, you are but just a few steps from dependence. Any possibility that your body might be developing tolerance to Ativan is motivation to get medical care.
If you are a long-term user who relies on daily doses just to function, you are already addicted. Now is the time to seek medical care. Addiction is a condition that is very difficult to break without medical assistance and psychotherapeutic treatment. Get the professional help you need.
Lastly, let us talk about seeking medical care under a self-care scenario. You are doing fine with self-care if you are successfully reducing the amount of Ativan you use without harmful side effects. If you find that you are getting close to abandoning your self-care in order to start taking more Ativan, seek out medical care. If your self-care attempt is causing you to feel violently ill, that is also a good reason to get professional help.
Ativan Addiction and Possible Treatments
Ativan treatment is similar to treatment for other sedatives. It involves a period of physical detox followed by psychotherapeutic treatments that include counselling and group support. The most important thing for you to know in this regard is that medically-assisted treatments are generally more successful.
By medically-assisted we mean doctors and nurses coming alongside patients and using every tool possible to help them quit. A doctor might continue prescribing Ativan in smaller and smaller doses in order to facilitate gradual withdrawal. A substitute medication might be used to reduce the severity of withdrawal symptoms.
Detoxing from Ativan by way of gradual withdrawal can extend the detox process to two weeks or longer. How long it takes in your case would really depend on your overall health and the tapering schedule your doctor decided on. Rest assured that your health would be monitored throughout the detox process and you would be made as comfortable as possible.
Once detox is concluded, the next step is to enter rehab. The goal of rehab is to address the psychological issues linked with Ativan abuse and addiction. A treatment centre may address your situation using several different therapies, including:
cognitive behavioural therapy (CBT)
group support and counselling
relapse prevention strategies.
Treatment centres have access to an extensive list of tools for treating Ativan addiction. As such, not every provider does things the same way. The treatments you would receive at any given centre would be determined by what that centre offers, and the customised treatment plan created for you by your doctors and therapists.
Detox is a necessary part of the process of coming clean from Ativan. It is necessary because the mind and body of the addicted person is dependent on the drug. The only way to break that dependence is through detox.
The extreme discomfort of Ativan withdrawal symptoms is such that modern treatments are almost always based on gradual withdrawal. We have already discussed what that means. Gradual withdrawal is accomplished through prescription medications given over a distinct period of time. Throughout the detox period, medical personnel are on hand to monitor patient health.
In many detox facilities, the care provided for Ativan detox is available around the clock. Patients are never left completely alone until the most severe withdrawal symptoms significantly fade. If any medical emergencies do arise, trained personnel are on hand to address them.
What about Withdrawal?
We wish we could say that Ativan withdrawal is easy, but we cannot. Withdrawal symptoms can be very uncomfortable and difficult to deal with. As you use less Ativan, your body is having to shift from a depressed state to a more excited one. The result is often symptoms that are paradoxically opposed to the effects of the drug itself.
Where you might feel very relaxed and calm while you are on Ativan, withdrawal may produce excessive anxiety and a tendency toward hyperactivity. Where Ativan normally helps you sleep, withdrawal could induce prolonged insomnia. The unfortunate reality is that there is no easy way to withdraw from Ativan. But it has to be done to beat addiction.
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Do You Need to Go into Rehab?
It is not absolutely necessary to go into rehab following Ativan detox. We highly recommend it, though. The thing about detox is that it only addresses the physical aspects of addiction. Detox will help you break the physical cycle of dependence; it will not help with the psychological aspects of your problem.
Ativan addicts willing to undergo comprehensive rehab are significantly more likely to avoid future relapse. This is due to the fact that rehab teaches recovering addicts effective coping strategies for the future. It teaches them the mechanisms behind their addictive behaviour so that triggers can be avoided.
In short, rehab equips the recovering addict to live without Ativan in the weeks, months, and years following treatment. Detox alone cannot do that. So while it is not absolutely necessary to go into rehab, it doesn’t make sense to undergo detox and then skip rehab treatments.
Ativan Addiction Statistics
Though there are no hard and fast numbers specifically relating to Ativan, we do know that benzodiazepine addiction is a significant problem. According to the DrugWise charity, roughly 40% of people who use benzodiazepines for more than six weeks eventually become addicted.