Lorazepam (Ativan) abuse can have serious consequences, and can lead to the development of physical dependence and addiction. Understanding what Ativan is, how it works, its risks, and why detoxing on your own could be dangerous is an important part of staying safe and finding help.
What Is Lorazepam (Ativan)?
Lorazepam (marketed under the brand name Ativan) is a benzodiazepine medication, or benzo. It is available legally with a prescription from a doctor, but many people abuse the medication for the relaxing sedative effects it brings about.
Ativan belongs to a class of drugs that decrease excitatory neurological activity in the brain that, when excessive, is associated with problems like anxiety, seizures, and muscle spasms.1 Lorazepam's ability to slow certain brain processes results in feelings of calm, relaxation, and drowsiness.1 However, these desired effects may also be accompanied by a number of potentially dangerous side effects, such as slowed breathing. Benzodiazepine-associated respiratory depression can be serious and, in some instances, deadly, especially when the drug is misused and/or taken in combination with other substances that affect the brain in a similar manner.
Nearly 5.5 million people reported abusing benzodiazepines like lorazepam in 2015.2 This means using them outside of prescription guidelines or without a prescription altogether. Abusing benzodiazepine tranquilizers like lorazepam puts the user at an increased risk of suffering severe consequences. In fact, benzodiazepines were responsible for almost 9,000 overdose deaths in 2015, a tragic 11% increase from the previous year.3
What Are the Short-Term Effects?
Ativan can have very powerful effects, depending on the dose and the user's tolerance for the drug. Some of the intoxicating effects will be obvious to an outside observer, while others may only be noticed by the user. These effects include:1
- Muscle weakness.
- Extreme sleepiness.
- Significant relaxation.
- Sense of overall calmness.
Unfortunately, the lorazepam high also comes with some adverse and, in some cases, dangerous short-term side effects that include:1
- Slowed breathing.
- Impaired reflexes.
- Vision problems.
- Dry mouth.
- Extreme dizziness.
- Poor coordination.
- Speech problems.
- Memory problems.
- Rapid mood swings.
- Reduced ability to think clearly.
- Unpredictable, or hostile, behavior.
While benzodiazepines on their own have several associated risks, when used in combination with other substances, their effects are much more likely to turn lethal. In 2011, almost 426,000 emergency department visits involved benzodiazepines, and 29% of those involved the combination of alcohol and benzos.4 Taking a benzo along with another drug that slows down the central nervous system (like alcohol or opioids such as OxyContin or heroin) can result in a compounding of effects, meaning the dangerous effects are amplified.
The combination of lorazepam and alcohol or opioids can enhance the very serious effects of Ativan, including reduced heart rate and slowed or stopped breathing, increasing the risk of a lethal overdose situation.1,5,6
Signs of a Lorazepam Overdose
Lorazepam overdose can be serious, even fatal. If you or someone you know is taking Ativan and experiences the following signs and symptoms of an overdose, get help immediately:7,12
- Severe confusion
- Very slowed reflexes
- Extreme impairment in coordination
- Irregular heartbeat
- Significantly slowed, or stopped, breathing
You can die from a lorazepam overdose. Calling 911 right away can save your life or the life of someone you love.
Are There Long-Term Effects?
Abusing Ativan is not only dangerous during the period where you feel high. You could suffer long-term consequences that may affect you for years if you don't get help. Some of the most concerning of these effects are those that impact your brain functioning. Some studies have indicated that long-term benzodiazepine use can cause problems with:8,9
- Attention and concentration.
- Verbal memory and learning.
- Hand-eye coordination.
- Body movement control.
- Sensory processing.
Fortunately, there is evidence that sustained abstinence from lorazepam use may result in improvement of some of these cognitive impairments.9 Professional treatment can help you learn how to maintain abstinence, even in the face of intense cravings.
If a person uses benzos with other drugs, the long-term consequences on their brain and body may be amplified. The damaging effects of each drug could compound and accumulate over time, leading to an even worse prognosis for the user. A polysubstance user may even suffer the worst long-term consequence of all: overdose death.
Abusing a benzodiazepine can also pave the way for a person to develop an addiction. The more you use benzos outside of prescription guidelines, the more you will find that the same dose doesn't get you high anymore. Abusing lorazepam can lead the user down a path of increasing doses and alternative methods of use to achieve the same fleeting high as before. This is known as building a tolerance to lorazepam, and it is often the starting point for an addiction, which can have extreme life consequences beyond those on your physical health.
Does It Cause Dependence and Addiction?
Escalating patterns of use (e.g., taking higher doses to overcome tolerance) may quickly bring about a state of dependence, wherein you have to take the drug in order to avoid unpleasant and sometimes dangerous withdrawal symptoms. Both tolerance and dependence are indicators of an Ativan addiction, though they can both be present among people taking Ativan as prescribed.
The damaging effects of each drug could compound and accumulate over time, leading to an even worse prognosis for the user.
Benzodiazepines are known to have a high potential for addiction development. If you find yourself identifying with any of the following symptoms, you may be suffering from a lorazepam addiction:10
- Taking more than you intended.
- Lying about your benzo use.
- Using lorazepam for longer than you planned.
- Craving lorazepam.
- Continuing to use despite social or interpersonal problems related to your use.
- Feeling defensive when questioned about your use.
- Using lorazepam in physically dangerous situations, e.g., while driving.
- Spending a lot of time trying to obtain, use, or recover from lorazepam.
- Wanting to cut back or stop using but being unsuccessful.
- Neglecting responsibilities in your work, home, or school life because of your use.
- Experiencing tolerance to or dependence on lorazepam.
Being dependent on lorazepam means that your body and brain have adjusted to the increased presence of lorazepam, to the point where you have to use it in order to feel functional or normal.
If a person who has built up a dependence on Ativan does not use, they will experience withdrawal symptoms, which can range from uncomfortable to downright deadly. They include:11
- Increased anxiety.
- Panic attacks.
- Trouble sleeping.
- Difficulty concentrating.
- Hand tremors.
- Nausea or dry heaving.
- Weight loss.
- Irregular heartbeat.
- Excessive sweating.
- Muscle stiffness or pain.
- Psychotic symptoms.
The acute withdrawal syndrome can begin as soon as 1-4 days after quitting and can then last as long as 10-14 days.11 Quitting cold turkey puts the user at the most risk of developing significant and potentially lethal withdrawal complications, which is why many treatment programs will set a specially tailored tapering dose schedule for you as you get clean, also known as medical detox. It is extremely important that that if you are trying to quit using lorazepam that you get professional medical help during the detox and withdrawal phase.
Getting Help for Ativan Addiction
Lorazepam addiction can take hold of your life and destroy it if you let it, but help is available. There are many different treatment options that you can explore to find your own path to recovery. Finding the program that works best for your own personal situation can help you find success in treatment and maintaining abstinence. Here are some of the program types available to you:
- Inpatient programs: These involve an extended stay at a treatment facility where you will have 24/7 care and emotional support as you transition to a life free from lorazepam.
- Outpatient programs: You can continue to live at home throughout the program, checking in on a regular basis for treatment sessions.
- Partial hospitalization programs (PHP): You will attend treatment sessions for 4 to 8 hours per day and check in for medical care. These programs prevent full hospitalization, generally run for about 3 months, and can help with the transition between inpatient and outpatient care.13
- Intensive outpatient programs (IOP): These are heavily structured outpatient programs. They require you to attend 9 to 20 hours of treatment sessions per week, and can last anywhere between 2 months to 1 year, depending on your needs.13 These are a great option for you if you cannot live away from home but still need the structure of a 24/7 program.
- Therapy or counseling: Some people do not like the rigidity of traditional treatment programs. In this case, finding a therapist or counselor that specializes in addiction to work with individually or in a group can help you adjust to your new sober life.
- Recovery groups: These are free support groups of recovering peers where you can find a sobriety support community to build interpersonal relationships that encourage, rather than hinder, your abstinence.
Many people who have a problem with lorazepam abuse also struggle with anxiety issues, so a valuable component to any treatment program would be stress management and other non-pharmaceutical, behavioral interventions for anxiety or panic disorders. All of these treatment options can be helpful in your efforts to curb your lorazepam use. Make sure you take the time to find the approach that works best for you, and don't be afraid to travel somewhere new to get the best help possible.
Once the treatment program is complete, your work isn't over. Recovery is a lifelong process that takes consistent hard work and dedication to staying clean. It can be challenging to go through this alone. Fortunately, there are many aftercare support options that can help you as you work to maintain sobriety.
Outpatient counseling can be a very helpful aspect of aftercare living. Continuing to strengthen your relapse resistance skills and build a better understanding of your own drug use triggers can contribute to better long-term maintenance of your sobriety. Counseling can take place in a group setting for those that like the community aspect of recovery, or in an individual setting for those that would prefer one-on-one care.
Recovery is a lifelong process that takes consistent hard work and dedication to staying clean.
Sober living is a great option for people who are concerned about the potential temptations or triggers of returning to day-to-day life. These are communities of people in recovery that maintain a sober living area to reduce the number of relapse risks for the community members. Sober living can help you build strong friendships with other people in recovery, which can help fuel your own desire to stay clean.
Support groups (such as 12-step groups like Narcotics Anonymous and non-12-step groups like SMART Recovery) represent another aftercare option. These groups offer regular meetings with others who are committed to finding recovery. Available for those both currently in treatment and those seeking to keep their focus on sobriety once they’ve completed a treatment program, these groups are a great place to find support in recovery.
No matter what route you choose to begin your recovery journey, there is help available. Reach out for a guiding hand to get you to the addiction-free life that you want. It's never too late to get help, and the sooner you reach out, the better. There are many different types of treatment programs that can fit your individual needs, and help is only a phone call away.
- Center for Substance Abuse Research. (2013). Benzodiazepines. University of Maryland.
- Center for Behavioral Health Statistics and Quality. (2016). Results from the 2015 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.
- National Institute on Drug Abuse. (2017). Overdose Death Rates.
- Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.
- Linnoila, M. I. (1990). Benzodiazepines and alcohol. Journal of Psychiatry Research, 24 Suppl 2, 121-127.
- U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning.
- National Alliance on Mental Illness. (2016). Lorazepam (Ativan).
- Stewart, S. A. (2005). The effects of benzodiazepines on cognition. Journal of Clinical Psychiatry, 66 Suppl 2., 9-13.
- Barker, M.J., Greenwood, K. M., Jackson, M., & Crowe, S. F. (2004). Cognitive effects of long-term benzodiazepine use. CNS Drugs, 18(1), 37-48.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Petursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455-1459.
- U.S. National Library of Medicine. (2017). Lorazepam.
- Substance Abuse and Mental Health Services Administration. (2008). What Is Substance Abuse Treatment? A Booklet for Families.