Table of Contents
I. Getting Help
Ativan Addiction, Abuse, and Symptoms

TABLE OF CONTENTS

I. The Basics

This guide explains the effects, trends, and dangers of Ativan use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for Ativan addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general prescription sedative use, which includes benzodiazepines such as Librium, Xanax, Valium, Klonopin, Dalmane, Halcion, and Restoril.

Primary Ativan Dangers

  • Addictiveness: On a chart produced by Nutt et al. for a 2007 study of the relative addictiveness of various substances, benzodiazepines scored 1.83 out of 3.0, making them more addictive than tobacco, cannabis, and ecstasy but less addictive than alcohol, cocaine, and heroin.
  • Risk of overdose: Because of their ability to depress the central nervous system, benzodiazepines taken in excess of therapeutic quantities can sometimes cause breathing issues. This is especially true when combined with other sedating or tranquilizing drugs like opioids. In fact, 30% of opioid overdoses also involve benzodiazepines. The use of benzodiazepines among patients with existing opioid prescriptions rose 8% from 2001 to 2013, and the risk of related emergency room visits or hospital admittance rose along with it.
  • Unintended side effects: Ativan use can lead to dizziness, drowsiness, muscle weakness, blurred vision, headaches, sleep disturbances, balance and coordination issues, forgetfulness/amnesia, nausea and vomiting, appetite changes, skin rashes, delirium, breathing issues, coma, and death.
  • Legal risks: The U.S. Drug Enforcement Administration categorizes Ativan as a Schedule IV controlled substance. While guidelines regarding possible penalties differ somewhat from state to state, a first conviction for possession of 1 gram or more of Ativan without a prescription as a first offense is generally a misdemeanor that carries a maximum penalty of a $1,000 fine and 180 days in jail.

Ativan Background Information

Derived FromMan-made ingredients, such as lactose monohydrate, magnesium stearate, microcrystalline cellulose, and polacrilin potassium
Ways UsedIngested, sublingual, topical (skin patch), injected
Scientific NameLorazepam
Slang/Street Names for Ativan/BenzodiazepinesBenzos, candy, sleeping pills, nerve pills, tranks, downers, Stupefy, roofies, R2, control, emotion, Heavenly Blues
How Long in Bodily SystemHalf-life: 12-18 hours

Most of the drug is eliminated from the body within 5 days of ingestion.

Punitive Legal Measures: Using/PossessionSince Ativan is a Schedule IV controlled substance, it is illegal to have possession without a prescription. Any possession of Ativan without a prescription or possession of the drug in amounts that exceed what is prescribed is a misdemeanor offense. Penalties differ from state to state but commonly amount to a maximum of 180 days in jail and a $1,000 fine. Penalties increase with repeat offenses.
Punitive Legal Measures: Selling/DistributingPossessing Ativan with intent to sell carries a greater penalty than pure possession for personal use. According to the DEA, intent to distribute a Schedule IV drug such as Ativan carries a maximum penalty of 5 years in federal prison and a $250,000 fine for a first offense. Subsequent offenses may be subject to stiffer penalties.
DEA Drug RatingSchedule IV

II. Signs of Abuse

Behavioral Symptoms of Ativan Usage and Abuse

How Ativan affects the brain

Ativan is formulated to act on a naturally occurring chemical called gamma amino butyric acid (GABA)-A. This neurotransmitter, the most common in the central nervous system, works by blocking certain signals between brain cells. Higher levels of GABA help decrease nervous system function and relax brain activity related to memory, emotions, logic, and autonomic functions like breathing, producing a calming effect. Taking Ativan exponentially increases GABA-related effects, ideally leading to increased feelings of peace and tranquility and the lessening of negative feelings like anxiety and fear.

With misuse, however, come troubling issues that could interfere with everyday cerebral function. Some studies indicated that benzodiazepines such as Ativan can cause concerning cognitive side effects. Long-term use has been linked to issues with verbal learning, cognitive processing speed, and visuospatial ability, as well as attention, concentration, learning, memory, and problem-solving abilities.

Users taking Ativan for anxiety may experience worsening symptoms including hyperventilation, nervousness, tension, feelings of impending dread or danger, heavy sweating, muscle twitches, trigger avoidance, gastrointestinal disturbances, insomnia, repetitive behaviors, and panic attacks. Abruptly stopping Ativan after long-term use may also cause bounce-back syndrome in users taking it to treat an underlying condition like anxiety, with symptoms coming back as bad or worse than before.

Behavioral signs of Ativan usage and abuse

Ativan is intended to have some behavioral effects as part of therapeutic use, but with long-term usage and/or dosages that exceed those recommended by the prescribing physician, users may exhibit concerning behaviors including poor judgment, clouded thinking, lethargy, mood changes or mood swings, risk-taking behaviors — for example, driving or gambling to excess while medicated — and using other drugs to amplify their high.

Individuals abusing Ativan may also exhibit common symptoms of addiction also found in other types of substance abuse. Users may bounce from doctor to doctor or frequent emergency rooms looking for additional prescriptions above and beyond what is considered therapeutic. They may seem desperate for medication, needing more and more Ativan to achieve the same high. To fulfill that need, they may ask friends and family for their prescriptions or go to great lengths to fund illegal drug purchases. Other behavioral signs include a decrease in performance at work or school, new secretive behaviors, lack of motivation, and poor personal hygiene.

Physical Symptoms of Ativan Abuse

How Ativan affects the body

To address anxiety and insomnia as intended, Ativan depresses the central nervous system, increasing levels of dopamine while lowering brain activity connected to memory and emotions. As a sedative, Ativan also causes muscle relaxation and can depress breathing, leading to general unsteadiness, dizziness, and, if abused, trouble breathing, loss of consciousness, and even death.

Early physical effects of Ativan

Ativan use comes with a range of short-term physical and psychological effects. Ativan is considered an intermediate-acting benzodiazepine, with most side effects occurring within 30-60 minutes of ingestion, but timing is dependent on a number of factors such as weight, length and frequency of use, and whether the substance is taken on its own or with another sedative or other drug. These side effects can be unsettling or even dangerous.

This table illustrates the possible short-term physical effects associated with Ativan.
Short-Term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.)Relaxation

 

Slowed breathing

Dry mouth

Slowed motor function

Vision problems

Loss of coordination

Loss of appetite

Lingering (within an hour of taking the drug)Fatigue

 

Confusion

Nausea

Relaxation

Post-Use (several hours to days after use)Fatigue

 

Slow reflexes

Loss of appetite

Dependence (more likely in higher doses)

Severe and long-term physical effects of Ativan

Long-term Ativan use is common given the propensity for tolerance, meaning the longer it’s used, the more of the substance is needed to achieve the same physical and psychological effects. This can lead to severe complications, ranging from confusion and disorientation to breathing problems and seizures.

Benzodiazepine abuse often runs concurrently with opioid abuse, with 17% of patients with opioid prescriptions in 2013 also prescribed benzodiazepines. Doubling up by taking Ativan with similarly acting sedatives in the opioid family, such as morphine, oxycodone, hydrocodone, and methadone, can be dangerous, leading to an increased risk of breathing problems and death. The same may be true of other prescription sedatives, as well as substances like alcohol that have a tranquilizing effect.

This table illustrates the possible long-term physical effects associated with Ativan.
Long-Term Physical Symptoms
CasualHeadaches

 

Sedation

Lethargy

Slowed reflexes

Depressed breathing

Muscle weakness

Chronic

Including all of the above effects for casual use

Mouth sores

 

Anxiety

Insomnia

Seizures

Abdominal pain

Kidney problems

Loss of appetite

WithdrawalIncreased heart rate

 

Restlessness

Headaches

Insomnia

High blood pressure

Nausea and vomiting

Generalized aches and pains

Sensory sensitivity

Abdominal pain

Sweating

Seizures

Further Resources

For more information on the symptoms and treatment options available for prescription sedative addiction, refer to these resources from the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

III. Ativan Usage

Global non-medical usage of benzodiazepines is increasing, especially in tandem with opioid use

The 2017 Global Smart Update from the United Nations Office on Drugs and Crime included an analysis of synthetic drug trends and market shifts in 110 countries and territories. This report focused particularly on the skyrocketing concomitant use of benzodiazepines like Ativan and opioids. Benzodiazepines contributed to 27% of drug-related deaths in Scotland in 2015 and 52% of the non-fatal overdoses that occurred in Australia in September and October of 2013.

The United States has similar numbers. Some 12.6% of adults in the United States used prescription benzodiazepines between 2015 and 2016, with 17% of those adults following usage patterns consistent with abuse. Of the 22,000 prescription drug overdoses in the United States in 2013, 31% involved benzodiazepines.

In Canada, prescription sedative use between 2013 and 2019 remained relatively steady overall, but non-medical use of sedatives among high-school-aged adolescents doubled from about 1.5% in 2014-2015 to 3% in 2016-2017.

Ativan Usage Demographics in the U.S.

Prescription sedative use is increasing in the United States, especially among adolescents

In 2016, roughly 497,000 Americans aged 12 or older were currently misusing sedatives like Ativan, representing approximately 0.2% of the total population. Sedative use was comparatively low compared to the misuse of stimulants (approximately 1.7 million people), tranquilizers (approximately 2 million people), and pain relievers (approximately 3.3 million people).

Of the 497,000 then-current sedative users, some 23,000 were adolescents aged 12-17, equating to 0.1% of the total adolescent population. Another 50,000 Americans aged 18 to 25, about 0.1% of that young adult demographic, followed similar patterns of sedative misuse. Of the final group of adults aged 26 and older, 425,000 (or 0.2%) were currently misusing sedatives.

Demographics of Prescription Usage
Past Year (2018)Lifetime
8th grade (14-15 yo)2%3.5%
10th grade (15-16 yo)3.9%6%
12th grade (17-18 yo)3.9%6.6%

IV. How to Find Help

Due to its direct effect on brain chemistry and propensity for psychological dependence, Ativan is known for losing efficacy over time and causing users to develop a tolerance. The longer Ativan use occurs, the more likely it is addicts will need to use more and more of the substance to achieve the same effects. The need to consume increasing amounts of Ativan may lead to an addiction, and abruptly stopping the drug could also have negative results as the body reacts to sudden withdrawal with a range of uncomfortable, debilitating, and possibly even dangerous symptoms.

The safest way to treat Ativan addiction and curb patterns of abuse is to taper off usage over time. By allowing the body to slowly adjust to progressively smaller amounts of the drug, Ativan users have a greater opportunity to address their addiction in a healthy manner while lowering the risk of relapse and receiving the medical, psychological, and emotional support they need.

To learn more about the multistep process behind treating Ativan addiction, read our Ativan rehabilitation guide, which provides a comprehensive resource for starting this process.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.