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What is Ativan (Lorazepam)?

Ativan is the brand name for the drug Lorazepam, which belongs to a class of medications called benzodiazepines (also known as benzos). Ativan is prescribed to treat anxiety and sleeping problems that are related to anxiety. Ativan is also used to help patients relax before an operation or medical treatment. 

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Ativan comes as tablets and as a liquid that users can swallow. It can also be given as an injection in hospitals for patients with epilepsy who are having seizures.

Like other benzodiazepines, Ativan has a high potential for misuse due to its sedative properties. They can produce highly pleasurable feelings. Ativan users can rapidly reach a point where their frequency of consumption and dosages constitute severe substance misuse.

Side Effects of Ativan

Common side effects of Ativan include:

  • Drowsiness or tiredness
  • Muscle weakness
  • Problems with coordination
  • Dizziness
  • Weakness
  • Dry mouth
  • Diarrhea
  • Nausea
  • Changes in appetite
  • Restlessness or excitement
  • Constipation
  • Difficulty urinating
  • Frequent urination
  • Blurred vision
  • Changes in sex drive or ability

These common side effects happen to more than 1 in 100 people. If you experience any of these side effects, you should keep taking the medicine and speak to a doctor.

Serious side effects of Ativan include:

  • Slow or shallow breathing
  • Yellowing skin or eyes 
  • Amnesia
  • Hallucinations
  • Delusions
  • Mood changes 
  • A shuffling walk
  • Tremors
  • Fever
  • Severe skin rash
  • Irregular heartbeat

These severe side effects rarely happen in less than 1 in 1000 people. If you experience any of these severe side effects while taking Ativan, contact your doctor immediately.

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Is it Dangerous to Mix Ativan and Alcohol?

You should not take any street drugs or alcohol while taking Ativan. It is dangerous to mix Ativan and alcohol. Ativan causes side effects, including drowsiness, which the use of alcohol can worsen.

Alcohol and Ativan are both central nervous system (CNS) depressants. It is dangerous to mix two or more depressants because they compound each other’s effects, including sedation, lowered blood pressure, and respiratory depression. 

Ativan and alcohol both affect the neurotransmitter gamma-aminobutyric acid (GABA), which influences bodily functions. Ativan mixed with drinking alcohol can increase the likelihood of seizures, panic attacks, insomnia, and other side effects.

Ativan is generally safe but becomes dangerous when combined with alcohol consumption. Between 2005 and 2011, about 1 million emergency department admissions involved benzodiazepines, but most of them occurred while the user was also on opioids, alcohol, or both. It is rare for overdoses to be caused solely by benzodiazepines like Ativan.

Side Effects of Mixing Ativan and Alcohol

Common side effects caused by combining Ativan and alcohol include:

  • Extreme drowsiness
  • Dizziness
  • Slowed, irregular, shallow, or difficult breathing
  • Impaired cognition
  • Impaired balance and physical control
  • Memory problems
  • Unusual behaviors
  • Passing out
  • Overdose

Serious side effects caused by combining Ativan and alcohol include:

  • Increased intoxication
  • Respiratory depression
  • Blackouts
  • Increased risk of brain damage over time due to changes in brain structures
  • Increased risk of triggering a mental health disorder
  • Much higher risk of physical dependence and tolerance, which may lead to addiction
  • Struggles associated with addiction, like strained relationships with loved ones, job loss, financial and legal problems, and damage to health

Dangers of Mixing Ativan and Alcohol 

Long-term use of Ativan and alcohol can intensify damage to the stomach, liver, heart, and brain. This is because benzodiazepines increase how effectively alcohol can cause intoxication.

Chronic drowsiness is also a side effect of long-term Ativan and alcohol use. There is an increased risk of oxygen deprivation from depressed breathing, causing damage to the brain and body.

Treatment for Ativan (Lorazepam) Overdose 

If you suspect someone you know has overdosed on Ativan, look for the following symptoms:

  • A sudden lack of physical coordination
  • Severe confusion or disorientation
  • Extreme drowsiness or passing out
  • Languid, delayed movements and reflex responses
  • Extremely slow breathing

What to do if you observe an Ativan overdose:

If you observe any of these symptoms, call 911 immediately for help. Any of these symptoms are life-threatening, and someone with any of these symptoms requires emergency medical attention.

You should not leave the person alone while waiting for medical personnel to arrive. If the individual appears unconscious, try to get their attention and provide light physical stimuli to rouse them and keep them engaged.

You should let the emergency responders know any other drugs or medications the person is taking, including over-the-counter drugs.

Alcohol and Ativan Withdrawal Symptoms

Physical dependence or addiction occurs due to an individual taking certain drugs over relatively long periods. 

When someone chronically uses or misuses certain classes of drugs, their system becomes acclimated to having the drug present and learns to function at a steady level only when the drug is present in their body. 

Once they abruptly stop taking the medication, their system is thrown off balance, and this produces several physical symptoms known as withdrawal symptoms.

Symptoms of Ativan withdrawal include:

  • A rush of anxiety
  • Increased blood pressure
  • A rapid heart rate
  • Difficulty sleeping
  • Headache
  • Sweating
  • Tremors (especially in the hands)
  • Difficulty concentrating
  • Confusion
  • Heart palpitations
  • Nausea
  • Abdominal cramps
  • Vomiting
  • Weight loss
  • Irritability
  • Mood swings
  • Panic attacks
  • Seizures 
  • Depression
  • Cravings for Ativan

Ativan withdrawal can be potentially dangerous and even fatal due to the potential to develop seizures during the withdrawal process. 

Symptoms of alcohol withdrawal include:

  • Nausea and vomiting
  • Headache
  • Auditory disturbances
  • Agitation
  • Paroxysmal sweating
  • Visual disturbances
  • Tremor
  • Clouding of sensorium
  • Orientation
  • Anxiety
  • Low blood pressure

Because alcohol and Ativan share some of the same withdrawal symptoms, withdrawal from both simultaneously can cause these symptoms to worsen. 

Signs of Alcohol and Ativan Misuse

Signs of alcohol and Ativan misuse include:

  • Strong cravings to consume more of the drug than prescribed. If you keep upping your dose without discussing it with your doctor, you may be becoming physically dependent on it. 
  • Feeling sick when not taking the drug. If you experience withdrawal symptoms when not on the drug, you may be addicted to it.
  • Inability to avoid alcohol while on Ativan. Alcohol interacts poorly with Ativan. If you can’t resist alcohol while on Lorazepam, you may be addicted to both drugs.

Treatment for Ativan Use & Misuse

If you suspect a loved one may be misusing Ativan, you should contact an addiction specialist to discuss the situation and get advice on how you might proceed.

Treatment options for Ativan misuse include inpatient, outpatient, partial hospitalization, and detox programs. Addiction treatment includes therapy that can be provided in various formats and models and in both one-to-one and group settings.

Withdrawal from benzodiazepines can be fatal, and you mustn’t attempt to detox on your own. Speak with a healthcare professional to find out how to detox safely. 

Treatment for Ativan and Alcohol Misuse (Polydrug Abuse)

If you suspect a loved one is misusing Ativan and alcohol, you should contact an addiction specialist immediately for advice on the best treatment program.

It’s dangerous to quit Ativan cold turkey, especially if you’re mixing the drug with alcohol. Abruptly stopping your Ativan use can lead to damaging physical and psychological symptoms, ranging from nausea and fatigue to hallucinations and suicidal thoughts. 

The safest treatment for Ativan addiction involves gradually tapering the medication over an extended period. Users must do this type of detoxification under the care of a doctor.

Drug addiction treatment options for polydrug abuse include inpatient, outpatient, detox, and partial hospitalization programs. The proper treatment program depends on each individual’s needs and will factor in any other drug abuse or mental illnesses present.

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Resources

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“Benzodiazepines in Combination with Opioid Pain Relievers or Alcohol: Greater Risk of More Serious ED Visit Outcomes.” The Dawn Report, SAMHSA, 14 Dec. 2014, www.samhsa.gov/data/sites/default/files/DAWN-SR192-BenzoCombos-2014/DAWN-SR192-BenzoCombos-2014.pdf

“Harmful Interactions.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines

Kattimani, Shivanand, and Balaji Bharadwaj. “Clinical management of alcohol withdrawal: A systematic review.” Industrial psychiatry journal vol. 22,2 (2013): 100-8. doi:10.4103/0972-6748.132914 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/

“Lorazepam: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, https://medlineplus.gov/druginfo/meds/a682053.html#:~:text=Do%20not%20drink%20alcohol%20or,%2C%20life%2Dthreatening%20side%20effects.

Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. [Updated 2020 Dec 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/

NHS Choices, National Health Service, www.nhs.uk/medicines/lorazepam/

Storrs, Carina. “Benzodiazepine Overdose Deaths Soared in Recent Years, Study Finds.” CNN, Cable News Network, 18 Feb. 2016, https://edition.cnn.com/2016/02/18/health/benzodiazepine-sedative-overdose-death-increase/index.html

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