Ativan Addiction, Withdrawal, and Treatment
- Ativan Addiction
- Signs and Symptoms of Abusing Ativan
- Ativan Withdrawal and Detox
- Treatment for Ativan Dependency
Ativan is a trade name for the commonly abused prescription drug Lorazepam. The drug is a benzodiazepine used to treat anxiety, sleep disorders, and seizures. It can also be used to treat alcohol withdrawal, nausea associated with chemotherapy treatments, or during surgery or mechanical ventilation to sedate and cause amnesia. While not a comprehensive list, similar drugs include Alsuma, Ambien, Amerge, Aptiom Belsomra, Buspar, Dexedrine Spansule, Diazepam, Dilantin, Dilaudid, Doral, Flexeril, Halicon, Imitrex, Klonopin, Librax, Librium, Limbitrol, Lortab, Luminal, Lunesta, Maxalt, Nembutal, Niravam, Onfi, Oxazepam, Oxtellar, Phenobarbital, Prosom, Savella, Sonata, Trileptal, Valium, Vimpat, Xanax, Xeomin, and Zonegran, along with their generic counterparts. Street names for these drugs might include: Benzos, downers, tranks, BZDs, control, silence, chill pills, goofballs, roofies, R2, moggies, candy, Z bars, heavenly blues, sleepers, school bus, valley girl, Qual, supefy, and dead flower powers, among others. All benzodiazepines are central nervous system depressants that act as sedatives or hypnotics, having similar effects to alcohol, barbiturates, sleeping pills, and gamma-hydroxybutyric acid (GHB).
Ativan is typically prescribed as a tablet that is taken orally for rapid onset anxiety (panic attacks), sleep disorders, or nausea related to chemotherapy. The drug is a small white or off-white tablet that is placed under the tongue for a short time before being swallowed. An injectable solution is also available, but is administered only in healthcare settings to treat all other conditions for which Ativan is approved. Injectable Ativan is considered a first line drug in the treatment of a potentially life-threatening condition known as status epilepticus, where a patient seizes for more than five minutes straight, or has multiple seizures close together without recovering.
It is most commonly prescribed to those suffering from acute panic, and should not be used for longer than a four-week period. For long-term conditions, it is recommended that something less habit-forming be prescribed. The street value for the tablet form is typically $1 to $5, depending on the geographic location and dosage. Those abusing the drug may take it orally, crush and snort it, or dissolve it in liquid and inject it. Snorting or injecting Ativan provides a quicker high, and is much more dangerous than taking it orally at a therapuetic dose.
There are a large number of pop culture references glamorizing Ativan use, including the following songs and lyrics, for example:
- Artist(s): Blue October; Song: “HRSA;” Lyric: “My belly aches blue, Lorazepam flu”
- Artist(s): Brazil; Song: “Escape;” Lyric: “All is lost on me, Lorazepam, Says it will set me free”
- Artist(s): Minus the Bear; Song: “Electric Boogaloo;” Lyric: “And don’t say no to pills, Ativan won’t kill”
- Artist(s): Ted Leo & the Pharmacists; Song: “Ativan Eyes;” Lyric: “But I still want to be gazed on by your Ativan eyes”
- Artist(s): Gym Class Heroes; Song: “Pillmatic;” Lyric: “This world is crazy so I stay medicated, Percocet, Ativan, and Klonopin”
- Artist: Rick Moranis; Song: “I Ain’t Goin’ Nowhere;” Lyric: “Zithromax, Avelox, Flexeril, Topamax, Prozac, Ativan, Adderall, I take ‘em all”
A number of lesser-known artists and non-English language songs also reference the drug. Additional pop culture references include the popular Showtime show “Nurse Jackie,” which focuses on a nurse with a benzodiazepine addiction.
Signs & Symptoms of Abusing Ativan
According to a study by the Substance Abuse and Mental Health Services Administration (SAMSHA), the majority of abusers of Ativan and other benzodiazepines are young white men and women. Those who abuse these drugs are also significantly more likely to abuse other drugs. Risk factors for dependency include taking more than the prescribed dose, taking the drug longer than recommended, and using the drug recreationally. Tolerance and dependence can develop as quickly as after one week of use. Unfortunately, it can be extremely difficult to tell if someone is abusing or becoming dependant upon Ativan.
Possible signs of abuse or frequent use include:
- Blurred or double vision
- Memory loss
- Lack of focus
- Swollen hands or feet
- Nausea or vomiting
- Lack of coordination
- Slurred speech
- Dry mouth
- Chest pain
- Sexual dysfunction
- Suicidal thoughts
- Compulsive behavior
Other signs that someone is abusing Ativan include visiting multiple doctors in an attempt to secure another prescription or purchasing the drugs illegally. Purchasing benzodiazepines illegally is especially dangerous, as it is difficult to confirm with absolute certainty exactly which drug you are buying or if the substance is even benzodiazepine.
The long-term consequences of using Ativan, or using it with alcohol, other prescription sedatives, prescription stimulants, and illegal stimulants, can be deadly. When used with other sedatives, the drug can decrease respiration and heart rate to the point of coma and death. When used with stimulants, the effects of the two drugs together can often lead to accidental overdose and death.
Signs of overdose might include:
- Loss of motor control
- Respiratory failure
- Extreme relaxation
- Slurred speech
Indicators of an overdose will vary based on a number of factors, and may be mild or severe. Factors affecting metabolization of the drug include weight, ethnicity, amount of the drug taken and in what time frame, along with what else the liver is attempting to metabolize at the same time. Ativan, like other benzodiazepines, is also frequently used by perpetrators in the commission of crimes. Sexual assault, rape, or robbery is committed after dosing the victim with or without consent. The amnestic effects of the drug make it difficult for the victim to remember what happened, and therefore difficult for the criminal to be caught and prosecuted for the offense. If an overdose, dosing without consent, or a crime is suspected, seek medical assistance immediately.
Ativan Withdrawal & Detox
Withdrawal from Ativan typically begins within 24 hours following the last dose. Physical and psychological symptoms can last for an extended period of time, and users may suffer from abstinence syndrome if they stop taking the medication abruptly.
Symptoms may include:
- Elevated heart rate
- Abdominal cramps
- Sensory hypersensitivity
- Heightened anxiety
- Difficulty concentrating
- Mood swings
- Panic attacks
Medical detoxification is highly recommended for those who have become dependant on Ativan. Under the supervision of a physician, the drug should be tapered over a period of time to help minimize the withdrawal symptoms. The length of time to detox is determined by the dosage, frequency, and amount of time spent on Ativan. If the addiction is severe, the treatments and psychological resources available at a medical detox center may increase the chances of recovery. Those who abuse Ativan in conjunction with other drugs face the greatest recovery challenges.
Treatment for Ativan Dependency
Though no drugs are approved for the treatment of Ativan addiction at this time, Ativan (in a tapered dosage), melatonin, and/or the selective serotonin reuptake inhibitor (SSRI) Paxil may be used as medicinal recovery aids to help reduce symptoms and cravings. Behavioral therapies, such as individual or group counseling, finding a sponsor, support group, or relying on loved ones, can help those in recovery avoid relapse.
After detoxification, it is extremely important for those who had a legitimate medical need for Ativan to find alternative ways to manage their condition without benzodiazepines. Finding a therapy pet, creating a safe zone, and avoiding known triggers are all great ways to help manage anxiety. Continuing to participate in behavioral therapies, particularly cognitive behavioral therapy (CBT), can also reduce the risk of panic attacks. Eating a nutritious diet and maintaining a healthy weight can also help manage both anxiety and sleep disorders.
- Commonly Abused Drug Chart – National Institute on Drug Abuse (NIDA)
- Drug Fact Sheet (Benzodiazepines) – US Drug Enforcement Administration (DEA)
- Status Epilepticus – Epilepsy Foundation
- Ativan – Lyrics.com
- Nurse Jackie – Internet Movie Database (IMDB.com)
- The Teds Reports – Substance Abuse and Mental Health Services Administration (SAMHSA)
- Prescription Drug Abuse – National Institute on Drug Abuse (NIDA)
- Misuse of Prescription Drugs – National Institute on Drug Abuse (NIDA)
- Lorazepam – US National Library of Medicine
- Treatments for Substance Use Disorders – Substance Abuse and Mental Health Services Administration (SAMHSA)