Ativan is one of the most prescribed benzodiazepine (“benzo”) drugs in the U.S. This potent medication is used to treat a range of conditions, such as anxiety, insomnia, panic attacks, seizures, and more. However, Ativan is also highly addictive. Individuals quickly develop a tolerance for this drug and end up requiring higher doses to attain the desired effects. This results in uncomfortable withdrawal symptoms if Ativan use is ceased.
Luckily, there are plenty of options when it comes to recovering from Ativan addiction. In this article, we cover the typical symptoms encountered during withdrawal from Ativan and the approximate timeline for recovery. We also address the range of treatment options available.
Overview
Eliminating an addiction to Ativan generally involves multiple stages of rehab that target the physical, psychological, and emotional causes of addiction. However, the first stage is to detox from the drug itself. This requires an individual to stop taking Ativan, and this is best done through medically supervised detox.
During detox, an individual will experience withdrawal symptoms, which can vary between each person. This is also dependent on several factors, such as:
- Individual physiology
- Duration of use
- Dose and frequency of use
- “Poly-drug use” (using multiple drugs at once)
- Co-occurring conditions or mental health issues
Why Does Ativan Withdrawal Occur?
Regular use of benzodiazepines results in high levels of tolerance. This occurs because benzos increase inhibitory brain signaling, resulting in a state of calmness in the nervous system. When an individual regularly uses Ativan, the body adapts to this interruption of its normal functioning, which results in diminished effects of the drug. As this tolerance sets in, individuals often take higher doses and will experience withdrawal when they stop taking the drug.
Once Ativan is stopped, the brain is forced to rebound and adapt to this sudden change in the body. This generates uncomfortable withdrawal effects, and can also exacerbate a person’s underlying conditions, such as anxiety.
Ativan Withdrawal Symptoms
Ativan withdrawal symptoms are also visible signs of addiction. The symptoms are usually predictable and can include the following:
- Headache
- Tremors
- Rapid heart rate
- Irritability
- Mood Swings
- Anxiety
- Vertigo
- Confusion or difficulty concentrating
- Short-term memory loss
- Depression
- Panic attacks
- Sweating
- Insomnia
- Depersonalization (dissociation from one’s body or mental processes)
- Hallucinations and delirium
- Derealization
- Seizures
Withdrawal Timeline
Ativan withdrawal symptoms can appear as soon as a few hours after a missed dose. In general, symptoms reach their peak within a week of discontinuation and then steadily decline thereafter.
Withdrawal symptoms can also be affected by a person’s underlying conditions. For example, if they are taking Ativan for anxiety, this condition will be intensified after they miss a dose. Therefore, it’s highly recommended that a person is put under medical supervision if they decide to stop taking Ativan.
While the duration will vary from person to person, an approximate withdrawal timeline can look like the following:
First Phase
During the first phase, individuals will start to experience symptoms from the underlying conditions that triggered their Ativan use to begin with. Some of these can appear as early as 6 to 8 hours after the missed dose, or within the first 24 hours. These initial symptoms typically last for 3 to 7 days and can include:
- Panic attacks
- Increased anxiety
- Irritability
- Cravings and compulsion to take another dose
Second Phase
Like many other drugs, stage 2 is considered the “acute withdrawal” phase, and is often the most unpleasant. For benzos like Ativan, this stage can last anywhere from 2 to 4 weeks. Some of the symptoms may include:
- Intense cravings for Ativan
- Sweating
- Irritability
- Mood swings
- Anxiety
- Heart palpitations
- Increased heart rate
- Headache
- Panic attacks
Third Phase
The third phase consists of a longer period, where the individual experiences psychological withdrawal once the acute phase is over —usually within a 12-month period.
Post-Acute Withdrawal Syndrome (PAWS)
If withdrawal symptoms last longer than 12 months or more, this is referred to as “post-acute withdrawal syndrome” (PAWS). This differs from other drugs such as stimulants which enter the PAWS period after only 14 days.
According to the British Journal of Clinical Pharmacology, it is estimated that 10% to 25% of people who use benzos for extended periods experience withdrawal symptoms for 12 months or more. While the PAWS period is not physically dangerous, the psychological effects can lead to risky behavior and other symptoms like:
- Depression
- Inability to feel pleasure (anhedonia)
- Anxiety
- Sleep problems
- Difficulty concentrating
- Rebound symptoms from the individual’s original condition (anxiety, insomnia, etc.)
Medical Complications
The primary concern when it comes to detoxing from Ativan is a relapse. The severity of withdrawal will depend on how long an individual has been taking Ativan, at what dose, and how frequently. Also, if individuals are taking multiple substances at once, such as alcohol, the withdrawal can be more severe.
While Ativan can be safely discontinued under clinical supervision, medical complications can also arise during detox. These are rare, but can include:
- Difficulty with regular body processes such as temperature, blood pressure, breathing rate, and heart rate.
- Psychotic symptoms such as loss of touch with reality (de-realization) and a feeling of disconnection from one’s body or thoughts.
- Perceptual disturbances such as visual, auditory, and tactile hallucinations, which can result in confusion and delirium.
- Seizures, which are the most serious of all life-threatening effects and can appear quickly without notice. These can range from single to multiple seizures, and may lead to fatal complications. Individuals who have pre-existing seizure conditions or who take other substances are at greater risk of seizures.
The long-term complications of Ativan are more extensive, and will depend on several factors such as the duration and intensity of use.
Ativan Treatment Programs
The good news is that treatment for Ativan addiction is readily available. While every individual is unique and will have different needs, many centers provide tailored recovery plans. Below is a list of the most common forms of treatment programs and what they entail.
Detox Programs
Detox programs are available at certain clinics and medical facilities where they supervise a person’s drug withdrawal and provide supportive medications where necessary. These clinics are usually staffed with a team of doctors and nurses who have experience with addiction and drug withdrawal.
The advantage of going to a detox center is that medical assistance is readily available. A detox center will place you in comfortable surroundings where you can be assured of help in case of emergencies. These clinics also provide medications to ease some of the symptoms.
Short-Term Inpatient (Residential)
Short-term inpatient centers typically start with medical detox and are followed by a program of addiction treatment, such as therapy or counseling for 30 to 90 days. These programs range from basic inpatient to luxury options, all varying in terms of their amenities and types of therapy. These facilities usually provide 24-hour medical support and are often led by a team of counselors, clinicians, and doctors. Short-term inpatient rehab is ideal for individuals who need detoxing and therapy, but who don’t require long-term treatment.
Long-Term Inpatient
Long-term inpatient treatment varies in length but typically ranges between 3 to 18 months. This type of rehab is best suited to individuals with long-term chronic addictions, especially those who have co-occurring mental health issues.
Depending on the severity of the addiction, long-term treatment may be a good option, especially as many programs address the underlying emotional causes of one’s drug abuse. Long-term treatment also provides ample time for the individual to physically withdraw from Ativan while they focus on their mental and emotional rehabilitation. These centers also vary in terms of their provision of amenities which range from basic to luxury options.
Partial Hospitalization Programs (PHP)
For individuals who are seeking intensive treatment but still prefer to live at home, partial hospitalization (PHP) or day treatment programs are also available. PHP typically consists of hospital treatment 5 to 7 days a week for 4 to 8 hours per day. Like inpatient treatment, clinical staff are on hand to assist with detox, medication management, and withdrawal symptoms. PHP also involves counseling and group therapy as well as specialized services that focus on skill-building, relapse prevention, and employment assistance.
Intensive Outpatient Programs (IOP)
Intensive outpatient programs are less involved than partial hospitalization programs and typically take place at a treatment center or outpatient clinic. Clients receiving intensive outpatient treatment will usually visit the center 2 to 5 days per week for 2 to 4 hours per day. IOP is well suited to clients who have just completed inpatient rehab and who wish to receive intense treatment while living off site.
The programs vary between centers, but they often involve a mixture of individual and group therapy, case management, 12-Step programs, experiential therapies, cognitive-behavioral therapies (CBT), and services that cover topics like skill-building, goal setting, and relapse prevention.
Standard Outpatient Programs
Standard outpatient programs are suited to individuals who have just completed an inpatient program and want to continue some form of therapy. Standard outpatient is also ideal for people who may be juggling other responsibilities, such as work or school. Individuals typically report to a treatment center or clinic 1 or 2 days per week. These programs can include counseling, group therapy, 12-step groups, skills development, goal setting, and relapse prevention training.
Cold Turkey
While it can be tempting to go cold turkey and detox from Ativan at home, it is not recommended. Ativan withdrawal symptoms can be very uncomfortable and there are potential medical complications and risks associated with it. Detoxing from Ativan should be safely done while under medical supervision where clinicians will be able to keep you safe and comfortable.
Ativan Therapy Options
During rehab, centers and clinics will provide a range of treatments such as medications, counseling, and behavioral therapies. Below are some of the more effective therapy options for Ativan addiction.
Dual Diagnosis
Rehab facilities that offer dual diagnosis are often staffed with psychiatrists or clinical therapists that can diagnose and/or treat co-occurring mental health conditions. Many people who have drug addictions have underlying issues such as depression, anxiety, and post-traumatic stress disorder (PTSD), so it’s important to address these conditions alongside withdrawal from the drug itself.
Cognitive-Behavioral Therapy (CBT)
Due to the psychological effects of Ativan withdrawal, cognitive-behavioral therapy (CBT) is one of the most effective therapies. CBT helps individuals change negative cycles of thought and behavior into more positive ones. Clients receiving CBT for addiction often learn:
- how to recognize “automatic thoughts” (i.e., dysfunctional thinking patterns and their origins);
- how to understand the behavior and motivation of others;
- how to develop a greater sense of self-understanding and confidence.
In essence, CBT helps clients learn new, drug-free ways to cope with triggers that might encourage them to use Ativan again. This includes an understanding of how situations, people, or the environment can trigger an addictive desire to take Ativan, or how to introduce healthy behaviors that can steer them away from using. CBT is known to be effective and long-lasting, as clients can continue utilizing these strategies once their therapy sessions have ended.
Dialectical-Behavior Therapy (DBT)
Dialectical-behavior therapy is a type of cognitive-behavioral therapy that focuses on mindfulness, how to live in the moment, how to cope with stress, and improve relationships. DBT also helps clients identify negative influences in their lives and learn how to develop healthy coping skills. This kind of therapy is useful for people who have been addicted to Ativan, especially those who have underlying conditions, such as anxiety or depression. DBT is also effective for PTSD and for people who exhibit self-destructive behaviors.
The Matrix Model
The Matrix Model is another form of therapy that has shown to be effective in treating substance abuse. This 16-week approach is comprehensive and consists of a mixture of behavioral therapy, individual counseling, 12-Step support, family education, drug testing, and encouraging non-drug-related activities. Through guided therapy, patients learn about issues connected to addiction and relapse. These sessions are designed to promote self-esteem and self-worth while the patient and therapist work together to reinforce positive behavioral changes.
Contingency Management
Contingency management is another effective treatment for addiction, and is based on a reward system. In most cases, the therapist provides incentives to the patient in exchange for ongoing abstinence and acceptance of treatment. One well-known contingency approach is Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR), which is effective for teaching individuals that it is possible to achieve abstinence using self-control. Participants who continue to abstain receive rewards, such as prize draws for money or in-demand objects.
Medications
Unlike opioids which have a range of approved medications for withdrawal, there are currently no specific drugs for benzodiazepine addiction. However, there are a few medications that have proven to be helpful during the rehabilitation process.
Librium (Chlordiazepoxide) or Klonopin (Clonazepam)
Drugs such as Librium or Klonopin are less intense and long-acting benzodiazepines. During detox, doctors will sometimes swap the Ativan for these medications and then gradually wean the patient off as they produce less intense withdrawal symptoms.
Paxil (Paroxetine)
Paxil is a common anti-depressant that is used to treat anxiety disorders, depression, and PTSD. This drug can be useful during the detox process, as many clients experience depression and increased anxiety when they wean off Ativan.
Melatonin
Melatonin is a natural hormone that is produced in the brain and is responsible for setting the body’s sleep-wake cycle. As Ativan causes sleep disruption, this supplement can help ensure that clients are able to get adequate and sustained sleep.
Alternative or Holistic Therapies
Many rehab centers also provide holistic therapies. The purpose of these therapies is to treat the whole person and not just the symptoms. These can be incredibly beneficial for providing calmness, spiritual support, emotional expression, improving physical health, and teaching valuable skills. Some of the popular holistic therapies include:
- Nutritional therapy
- Animal-assisted therapy (e.g., emotional support dogs)
- Massage
- Adventure therapy (e.g., hiking or rock climbing)
- Mindfulness and meditation
- Art therapy
- Yoga
- Equine-assisted therapy
Lifestyle Adjustments
Recovering from Ativan addiction can be challenging, but there are ways to make this process easier. Along with treatment, lifestyle adjustments and self-care can ease the symptoms while transitioning to a new life.
Exercise
Exercise is great for improving cardiovascular health, which is especially important following substance abuse. Exercise also stimulates endorphins, which can help with depression and low mood. Good forms of exercise include a mix of low- and high-intensity exercises, such as walking, running, swimming, cycling, or yoga.
Meditation
Meditation is known to help calm anxious or racing thoughts. Meditation can also stimulate the pleasure centers of the brain and improve cognitive function. Additionally, research has shown that meditation can be useful for easing tension and calming the nervous system.
Eating Well
Getting adequate nutrition after detoxing from substances is vitally important. The right diet can help repair any damage incurred following sustained drug use and lead to improved immunity, cognitive function, and energy. Nutritionists or doctors can provide tailored food plans specific to addiction recovery.
Avoiding Triggers
Learning to avoid triggers is vital during the recovery period. This can include people, situations, or circumstances that can prompt a desire to take drugs. Techniques such as CBT can help individuals learn to identify and avoid their triggers by developing alternative coping strategies.
New Hobbies
While cravings can be difficult to manage, hobbies such as sports, art, music, or crafts can be useful distractions. These activities can help someone redirect their cravings and focus on something positive and fun.
Ativan Withdrawal 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.
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