Ativan (lorazepam) is an addictive prescription medication that slows down the central nervous system. This long-acting benzodiazepine is commonly used to treat insomnia in patients with daytime anxiety.1 People frequently misuse Ativan without a prescription or to get high, and this Ativan misuse can lead to addiction.
Ativan ranks among the top 200 most commonly prescribed drugs in the United States.3 It is also used to reduce muscle spasms, reduce seizure activity, and produce a relaxed mood. On the street, benzodiazepines are sometimes called “benzos” or “downers,” and they are highly addictive when misused along with other illicit substances.1,4
In this article, you’ll learn what makes Ativan addictive, which factors increase the risk for developing dependence, and how to seek treatment for Ativan addiction. If you have concerns about your use of Ativan, effective treatments are available.
How Addictive is Ativan?
Physical or physiological dependence on Ativan can occur after just 2 weeks of daily use, even when used as prescribed.5 That means your body has grown accustomed to the presence of this medication and you’ll experience Ativan withdrawal symptoms when you suddenly quit.
Here’s an example of how addiction to Ativan can occur: You’ve heard that Ativan helps calm your nerves, so you take a dose to see what happens. You feel less anxious, so you decide to take it again the next day. Soon, you’re taking Ativan every day. As time goes on, the same amount of Ativan may not help you feel calm anymore, so you take an extra dose. Over time, your body adjusts to the higher doses of Ativan, and you begin to develop a dependence. At this point, you may notice that if you miss a dose, you experience symptoms of Ativan withdrawal. In order to avoid or alleviate these withdrawal symptoms, you may “doctor shop” or buy Ativan on the street to ensure you don’t run out. This can quickly progress to an Ativan addiction, which is characterized by compulsive drug use and drug-seeking behaviors.
Ativan’s Effects on the Brain
Misusing sedatives like Ativan can be particularly dangerous. For example, research suggests that driving a vehicle while using benzodiazepines poses the same risk as driving with a blood-alcohol level between 0.05% and 0.079%.6
Addictive drugs increase dopamine levels in the mesolimbic dopamine system, also known as the “reward system.”3 Repeated use of drugs like Ativan can interrupt normal dopamine signaling mechanisms, effectively overriding your reward system. This disruption in your brain’s reward system is what leads to Ativan addiction.
Benzodiazepines are contraindicated in patients who misuse alcohol or other drugs, as well as patients who are in substance recovery.2 If you plan to stop taking Ativan, consult with your physician first for guidance. When you stop taking benzodiazepines abruptly, you may experience intense withdrawal symptoms.5
Risk Factors for Ativan Addiction
The following risk factors may increase the likelihood of developing an addiction to Ativan:
- Prescription Use of Ativan: Merely having a prescription for Ativan increases the risk for addiction. In 2017, tranquilizers such as benzodiazepines were the third most commonly used drug in the United States, representing 2.2% of the population.7
- Concurrent Use of Other Drugs: People who use Ativan to “come down” from other stimulant drugs like cocaine or amphetamines are at a higher risk for misuse and addiction.8 Ativan misuse is also more common among heroin and cocaine users because it can enhance the euphoric nature of stimulants.1
- Misuse of Alcohol: People who misuse alcohol are at 3 to 4 times greater risk for misusing benzodiazepines.7
- Early Refills: Requesting early prescription refills may be an early indicator of misuse.9
- Temperament: People who are impulsive or seek novel experiences are at a higher risk for developing substance use disorders.8
- Co-occurring Psychiatric Disorders: People with co-occurring anxiety and mood disorders are at a higher risk for benzodiazepine misuse. Similarly, people who have co-occurring personality disorders are also at a higher risk for Ativan dependence.7, 10
- Longer Duration of Use: The risk for Ativan dependence increases with higher doses and longer duration of use.10
- Age of First Use: Earlier onset of Ativan use is associated with greater risk of a misuse disorder.8
- Age of Current Use: Elderly people experience higher incidences of negative side effects related to Ativan.10 Evidence also suggests a 50% increased risk for hip fractures in older persons who use benzodiazepines.6 Likewise, benzodiazepine misuse and dependence are more common among older adults treated in psychiatric settings.7
People who use Ativan regularly may experience negative side effects, such as amnesia, hostility, irritability, or vivid, disturbing dreams.1 Some people use Ativan as a form of co-medication to reduce withdrawal symptoms, which can further increase their risk of dependence and addiction.
If you are experiencing any of these symptoms, connecting with a treatment specialist can help guide you through the recovery process. If you are concerned that you may be misusing Ativan, contact a recovery support specialist right away.
Signs and Symptoms of Addiction
According to the DSMV-5, a problematic pattern of Ativan misuse, or Ativan addiction, is defined by at least two of the following criteria, occurring within a 12-month period:8
- You take Ativan in larger amounts or over a longer period of time than intended.
- You have an ongoing desire to cut down on, or control, your use of Ativan.
- You spend excessive amounts of time obtaining, using, or recovering from Ativan.
- You crave Ativan.
- You are unable to follow through with personal or professional obligations.
- You continue to use Ativan despite the negative impacts it has on your life.
- You neglect important social, professional, or recreational activities you once enjoyed because of your Ativan use.
- You frequently use Ativan in situations that put you in danger, such as driving a car.
- You continue to use Ativan despite knowing that it causes recurrent physical or psychological problems.
- You have established a tolerance to Ativan.
- You experience withdrawal symptoms when you stop using Ativan or use Ativan to relieve or avoid withdrawal symptoms.
What is the Difference Between Ativan Dependence and Ativan Addiction?
Ativan addiction is described as a constellation of behavioral, cognitive, and physiological occurrences. People who experience addiction have a strong desire to take the prescription drug, have difficulty controlling their use of a drug, and/or have possible tolerance or physical dependence on a drug.4
Dependence occurs due to physiological adaptations related to repeated Ativan use.4 When dependence develops, Ativan withdrawal signs and symptoms may occur if you discontinue the drug abruptly. This can occur even if you are taking your Ativan exactly as prescribed by a doctor.
Key differences between Ativan dependence and addiction.11
- Dependence: With physiological dependence, your body adapts to Ativan. This is why you may feel that you only function normally when using the substance. If you experience symptoms of withdrawal when you stop using Ativan, it may be a sign that you’ve developed a dependence.
- Addiction: With an Ativan addiction, there is a clear pattern of behaviors that result in chronic use. Most people who struggle with addiction have also developed a dependence. Even so, it is still possible to be dependent on Ativan without becoming addicted to it.
Find the Best Rehab for Ativan Addiction Treatment
Ativan addiction is treatable, and getting help early is critical to reducing the risk of serious health problems.
In 2019, 15% of overdose deaths that involved opioids also involved benzodiazepines.12 Further, 82.1% of benzodiazepine-related treatment program admissions are due to secondary use of benzodiazepine.7 This demonstrates that polysubstance use is higher in people who use benzodiazepine.
Recovery and rehab programs can help you heal from an Ativan addiction. A variety of treatment approaches, such as cognitive-behavioral therapy and interoceptive exposure-based treatment, can enhance Ativan treatment and recovery outcomes.7
The five levels of Ativan addiction treatment outlined by the American Society of Addiction Medicine (ASAM) include the following:13
- Early Intervention: Education programs to prevent misuse for people at elevated risk for substance use disorders.
- Outpatient: A combination of treatment approaches (less than 9 hours per week) for people who are appropriate for outpatient settings.
- Intensive Outpatient/Partial Hospitalization: A combination of treatment approaches (more than 9 hours per week) for people who benefit from more intensive treatment, including partial hospitalization.
- Residential/Inpatient: Various levels of clinical care, medical monitoring, or residential services for people who require intensive treatment.
- Medically Managed Intensive Inpatient: 24/7, round-the-clock care, including behavioral therapy and medical treatment for people with severe substance misuse disorder or medically unstable conditions.
A treatment support specialist is available now to help guide you through the treatment options.
Call our 24/7 helpline at 1-800-429-7690 to speak with a specialist who can help you find the resources you need for Ativan addiction treatment.
Frequently Asked Questions About Ativan
Can You Take Ativan if You’re Pregnant?
Ativan is contraindicated during pregnancy or when breastfeeding. Benzodiazepines like Ativan can increase the risk of low birth weight, premature births, floppy baby syndrome, and neonatal withdrawal.5,14
Can You Overdose on Ativan?
When paired with alcohol, benzodiazepines increase the risk for accidental overdoses.8 Signs and symptoms of Ativan overdose include excessive drowsiness, confusion, poor coordination, reduced respiratory function, coma, and death. If you suspect an overdose, call 911 immediately for medical care.1
Is Ativan Safe to Take Every Day?
If you use Ativan, always consult with your health care provider to determine the dose and frequency that is right for you. The physical dependence on Ativan can occur in as little as 2 weeks of daily use, so it’s important to understand the warning signs of dependence and communicate any concerns to your doctor.5
What are the Long-Term Effects of Ativan?
Benzodiazepines are only intended for short-term use, and the long-term effects of taking Ativan are unknown. The use of Ativan for more than four months has not been extensively studied, and medical providers should use caution when prescribing for long-term use.10
1. United States Drug Enforcement Administration (DEA). (April 2020). Benzodiazepines Drug Fact Sheet.
2. Longo, L. P., & Johnson, B. (2000). Addiction: Part I. Benzodiazepines–side effects, abuse risk and alternatives. American family physician, 61(7), 2121–2128.
3. Tan, K. R., Rudolph, U., & Lüscher, C. (2011). Hooked on benzodiazepines: GABAA receptor subtypes and addiction. Trends in neurosciences, 34(4), 188–197. https://doi.org/10.1016/j.tins.2011.01.004
4. U.S. National Library of Medicine. (updated February 2021). DailyMed – Ativan – lorazepam tablet
5. National Alliance on Mental Illness (NAMI). (September 2021). Lorazepam (Ativan).
6. Johnson, B., & Streltzer, J. (2013). Risks associated with long-term benzodiazepine use. American family physician, 88(4), 224–226.
7. Votaw, V. R., Geyer, R., Rieselbach, M. M., & McHugh, R. K. (2019). The epidemiology of benzodiazepine misuse: A systematic review. Drug and alcohol dependence, 200, 95–114.
8. American Psychiatric Association. DSM-5. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
9. Weaver M. F. (2015). Prescription Sedative Misuse and Abuse. The Yale journal of biology and medicine, 88(3), 247–256.
10. U.S. Food & Drug Administration (FDA). (September 2016). Ativan® C-IV (lorazepam) Tablets Fact Sheet.
11. O’Brien C. (2011). Addiction and dependence in DSM-V. Addiction (Abingdon, England), 106(5), 866–867.
12. National Institutes of Health (NIH). National Institute on Drug Abuse. (February 2021). Benzodiazepines and Opioids.
13. American Society of Addiction Medicine (ASAM)). ASAM Criteria.
14. Igarashi M. (2004). Floppy infant syndrome. Journal of clinical neuromuscular disease, 6(2), 69–90.
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