Ativan is a powerful medication that is prescribed for anxiety, seizures, and panic attacks. As a benzodiazepine-class drug, Ativan affects the central nervous system, leading to a sense of calm. However, due to Ativan’s potency and fast-acting effects, it is easy to build up a tolerance and become addicted to this drug. Therefore, Ativan is usually only prescribed for short-term use.

Prescriptions for Ativan have skyrocketed in recent years, largely because benzodiazepine use is on the rise. This is also due to the increasing prevalence of mental health conditions, such as insomnia and anxiety.

While Ativan is extremely addictive, there is hope for recovery. With multiple treatment options available, individuals can restore their health and lead new lives free from addiction.

Before going into the available treatment methods for Ativan addiction, this article will provide an outline of what Ativan is, why it is so addictive, and what the long-term effects are.

What Is Ativan?

Ativan is a powerful benzodiazepine (also known as a “benzo”) that is often prescribed to treat anxiety disorders, panic attacks, seizures, and insomnia. It can also be used as an anesthetic, a muscle relaxant, an anti-nauseant (e.g., vomiting during chemotherapy), and as an aid for withdrawal from alcohol and other drugs.

The main active ingredient in Ativan is lorazepam. It also contains other inactive ingredients, such as monohydrate, magnesium stearate, and microcrystalline cellulose.

Ativan was first developed in 1977 by D.J. Richards of Wyeth Pharmaceuticals and was released under the brands Ativan and Temesta. Currently, Ativan is the official brand name of lorazepam and is considered to be a “classic benzodiazepine.” Other related benzos include:

  • Xanax
  • Klonopin
  • Valium
  • Ambien
  • Halcion
  • Lunesta
  • Phenibut

Like most benzos, Ativan works by attaching to the gamma-aminobutyric acid (GABA) receptors in the brain, effectively controlling the neurotransmitters that contribute to anxiety and stress. Its general purpose is to create a sense of calm and relaxation in the individual taking it.

Due to its potent and fast-acting effects, Ativan is highly addictive. Doctors often recommend that individuals only take the drug for 2 to 4 weeks, as addiction can quickly set in. The College of Psychiatrists, for example, has noted that addiction can occur in 4 out of 10 patients if the drug is used longer than 6 weeks.

Why Are Benzo Use Rates so High?

While other drugs like opioids have been declining over time, benzo prescriptions continue to rise. In fact, between 1996 and 2013 it is estimated that these prescriptions rose by over 67% (from 8.1 million to 13.5 million).

Part of the reason for this increase in prescribed use pertains to the increase in sleep problems and anxiety conditions. For instance, the Anxiety and Depression Association of America estimates that 40 million Americans suffer from an anxiety-related condition, which amounts to 18% of the population. In addition, the National Institute of Health reports that 30% of the general U.S. population suffers from some form of sleep disturbance or insomnia.

These staggering statistics demonstrate how a large number of mental health issues and physical conditions are leading to high rates of prescriptions for benzos like Ativan.

Ativan Addiction Statistics

According to the Centers for Disease Control, Ativan was the third-most prescribed benzodiazepine in 2013. In 2011, 27 million prescriptions for the drug were written, and around 50,000 Americans ended up in emergency due to Ativan complications.

Other statistics include:

  • Between 1999 and 2013 the rate of benzodiazepine-related deaths quintupled.
  • In 2012, more than 17,000 people who cited Ativan or another benzo as their drug of choice were admitted to addiction treatment centers.
  • Approximately 3% of all hospital admissions due to Ativan were the result of intravenous use of the drug.
  • Benzodiazepine use is highest among women and it increases with age:
    • 8% of women aged 65-80 use benzos.
    • Among 80-year-old women, the rate is 11.9%.
  • General use of benzos such as Ativan increases with age:
    • 18-35: 2.6%
    • 36-50: 5.4%
    • 51-64: 7.4%
    • 65+: 8.7%

Why Is Ativan Addictive?

Ativan is one of the most potent benzos on the market and it causes strong dependence in a couple of ways. The first is that the body easily develops a tolerance to the drug, which means that the person needs to take higher and higher doses to achieve the desired effect. The second is that this increased tolerance also results in intense drug cravings if the Ativan is discontinued. This cycle of tolerance and cravings can create an addiction loop that is difficult to break without intervention.

Ativan is also addictive for emotional and psychological reasons. Many people take this drug to ease anxiety and to feel calmer and more relaxed. The idea of re-experiencing anxiety or panic can cause individuals to form a psychological addiction to the drug. This is where intervention and therapy can be effective for helping individuals wean themselves off the drug while dealing with the underlying causes of their mental health conditions.

How Ativan Is Taken

Ativan is prescribed as a tablet that is usually taken orally. Intravenous administration via an IV drip is rare and should only be done under the supervision of a doctor. When taken orally, Ativan will usually start working within 45 minutes to 2 hours. Depending on the dose, the effects of Ativan can last for up to 8 hours.

A typical Ativan dose contains 0.5 mg, 1 mg, or 2 mg of lorazepam. This will vary depending on age and the reason for taking it, as seen in the examples below.

Anxiety

An initial adult dose is typically 2 to 3 mg, two or three times per day. After that, a maintenance dose is usually 1 to 2 mg, two or three times per day.

For the elderly population (65 and above), 1 to 2 mg are usually prescribed in divided doses.

Insomnia

For adults, 2 to 4 mg is recommended at bedtime. For elderly individuals, the dose is the same as anxiety at 1 to 2 mg per day in divided doses.

The Effects of Ativan

In terms of effects, Ativan helps balance the brain chemicals that cause anxiety. If the drug is taken in high doses, it can create a fleeting, intense high, which is often followed by a state of calm. Some of the other short-term effects include:

  • A euphoric high
  • Calmness
  • Muscle relaxation
  • Drowsiness

Side Effects

Ativan can also cause a range of uncomfortable side effects, which vary according to the individual. They include:

  • Cognitive dysfunction (difficulty with mental tasks)
  • Dizziness
  • Nausea (although Ativan is also used to treat nausea)
  • Drowsiness
  • Headaches
  • Loss of appetite
  • Vomiting
  • Confusion
  • Sweating
  • Dysarthria (a motor speech disorder)
  • Muscle weakness
  • Poor coordination
  • Memory impairment
  • Sedation
  • Irritability
  • Depression

Common Ativan Combinations

Like most drugs, Ativan is used recreationally with other substances to enhance its effects and achieve a greater high. Some of the most common Ativan combinations include:

Alcohol

Alcohol is commonly used with Ativan. What makes the mix so potent is that both alcohol and Ativan are tranquilizers that affect the GABAergic system. Therefore, when the two drugs are mixed, it produces a quick, intense high. The danger of this combination is that it depresses the central nervous system and can lead to respiratory failure, over-sedation, coma, and death.

Cocaine

Ativan is often used to help individuals manage a comedown from cocaine. Also, due to cocaine’s stimulative effect, Ativan can also be used to achieve a more unique high. However, the danger of mixing these two drugs is they can mask the effects of each other. In other words, it can lead to overdose if an individual thinks they are more sober than they are. Another danger of mixing cocaine and Ativan is that it can increase the side effects of each drug.

Amphetamines

Like cocaine, amphetamines are highly stimulating, which is what leads individuals to take benzos like Ativan to assist the comedown. Many people rely on Ativan to help them relax and sleep after taking amphetamines, but again, there are dangers associated with mixing the two. There is a high risk of overdose due to the masking effect.

Methadone

Methadone is a painkiller that is also used to help wean individuals off heroin. Many people will take Ativan to boost the effects of methadone, either for pain-relieving reasons or to increase the high. However, mixing two central nervous system depressants is very dangerous, because it can lead to respiratory failure, coma, and death.

Signs & Symptoms of Ativan Addiction

Because Ativan is a prescription drug, many individuals may not realize that they are abusing it. However, taking more than the prescribed dose, continuing the drug longer than the prescribed timeline, and obtaining the drug without a prescription are all signs of abuse.

It is also worth noting that when it comes to Ativan, there is a difference between dependence and addiction. Some individuals who are dependent on the drug may not necessarily go on to be addicted. However, people who form an addiction to Ativan will exhibit specific physical, psychological, and behavioral signs which negatively impact their personal and social lives.

Physical Signs of Addiction

Individuals who regularly take Ativan at high doses (or for long periods) can exhibit physical signs of abuse such as:

  • Anxiety
  • Loss of appetite
  • Headaches
  • Sweating
  • Confusion
  • Hallucinations
  • Dizziness
  • Nausea and vomiting
  • Insomnia or sleep issues
  • Weakness
  • Anorexia
  • Tremors
  • Passing out
  • Tolerance – needing to take higher doses
  • Difficulty breathing
  • Lack of coordination
  • Slurred speech
  • Weakness

Psychological Signs

Individuals who regularly abuse Ativan will also exhibit emotional changes and psychological signs of dependence the longer they take the drug. Individuals can experience issues such as:

  • Needing Ativan to function
  • Agitation
  • Poor decision-making
  • Mood changes
  • Irritability
  • Memory loss or reduced memory
  • Impaired cognition
  • Depression
  • Exacerbation of existing mental health conditions
  • Taking Ativan to relieve stress or tension

Behavioral Signs

Any sudden changes in behavior or signs of withdrawal can be clear indicators of a problem. While some of the behavioral signs of Ativan addiction also apply to other drug dependencies, there are specific abuse indications for this drug. These include:

  • Over-sleeping
  • Lying about Ativan use
  • Taking more than the prescribed amount of Ativan
  • Using Ativan as a coping mechanism
  • Running out of an Ativan prescription early
  • Having multiple prescriptions for Ativan
  • Faking symptoms to obtain Ativan
  • Legal or financial problems
  • Isolation from work, family, and social life
  • Hiding Ativan use
  • Continuing to use Ativan despite its negative side-effects
  • Spending a great deal of time using, obtaining, or recovering from Ativan
  • Abusing other substances (“poly-substance use”)

Other Abuse Signs

Aside from the signs above, there are a few other significant things to watch out for if you suspect someone has an Ativan addiction.

“Doctor Shopping”

Most doctors will restrict the amount of Ativan a person can obtain and will only prescribe a certain amount. For people who are addicted to Ativan, they will often resort to finding multiple doctors who can give them prescriptions for the drug. This can be a more extreme sign of Ativan addiction, as the individual is taking desperate measures to acquire more than the prescribed amount. As part of this doctor shopping, individuals will also tend to travel great distances to different pharmacies to remain undetected.

Financial & Legal Problems

While insurance may cover prescriptions for Ativan, the costs can mount up if the individual is buying it frequently or in large quantities all at once. With heavy use over time, individuals may begin to steal to finance their addiction and to cover their monthly bills.

Other legal problems can include frequent DUIs (driving while under the influence of alcohol or other substances). Individuals who are intoxicated or on high doses of Ativan can be pulled over and charged for this offense.

Taking Ativan for Months and Years

Ativan is intended for short-term use and should therefore only be extended under special circumstances. If someone you know has been regularly taking Ativan for longer than a month then they could be dependent or addicted. Some individuals find ways to take Ativan for months or even years by doctor shopping and hiding their actual use.

No Longer Needing Ativan for the Original Issue

If an individual’s original condition is no longer the “loudest voice in the room” and they simply take Ativan for its effects, then this can also signal a problem. For example, if someone started taking Ativan for anxiety but they no longer take it for that issue, then it’s a clear sign that they’re addicted.

Painful Withdrawal Symptoms

Individuals who are addicted to Ativan can experience painful withdrawal symptoms within a few hours of missing their required dose. These can include:

  • A severe rise in body temperature
  • Muscle aches and cramps
  • Fever and chills
  • Tremors
  • Accelerated heartbeat
  • Extreme restlessness and agitation
  • Irritability
  • Anxiety and panic
  • Severe depression
  • Headache
  • Difficulty concentrating/confusion
  • High blood pressure
  • Dilated pupils
  • Excessive perspiration
  • Insomnia
  • Nausea/vomiting/diarrhea
  • Sensitivity to light, sound, smell, and touch
  • Nightmares

If someone exhibits the above withdrawal symptoms after missing a dose, it is generally a clear sign that they’re addicted.

Long-Term Health Consequences

Long-term Ativan use can leave lasting and damaging effects on a person’s health, especially when it comes to memory and cognition. The physical consequences of long-term use include, but are not limited to:

  • Memory loss (including an inability to make new memories)
  • Chronically low blood pressure
  • Increased drowsiness or sedation
  • Physical and mental fatigue
  • Increased anxiety
  • Confusion and disorientation
  • Learning difficulties
  • Slow, shallow breathing
  • Pale or bluish skin
  • Mouth sores
  • Bleeding in the digestive tract
  • Kidney problems
  • Sleep cycle disruption
  • Headaches
  • Appetite loss
  • Insomnia
  • Tremors
  • Seizures

The long-term psychological consequences of Ativan use include:

  • Mania
  • Sexual dysfunction
  • Psychosis
  • Risk of dementia or Alzheimer’s
  • Violent mood changes
  • Aggressive behavior
  • Suicidal ideation

Another important thing to look out for is a potential Ativan overdose. Key signs and symptoms of an overdose include:

  • Mental confusion
  • Slurred speech
  • Lack of energy
  • Loss of control of body movements
  • Muscle weakness
  • Low blood pressure
  • Slow breathing
  • Passing out
  • Coma

Ativan Addiction Resources

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on RehabAid.com

About the Author

Jenn Tomomitsu, PhD

Jenn is a Canadian writer and poet with a background in psychology, sociology, and natural health. She is the founder of The Master in You, a mental wellness site that provides information about the role that thoughts and emotions play in our physical and emotional health. Jenn is passionate about inner growth and the power of the mind-body connection, and this informs her writing and research on addiction treatment. On Rehabaid, Jenn aims to write accessible, informative content and provide resources that can help people make empowered and informed decisions about their recovery.

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