Ativan (Lorazepam) Addiction and Abuse

Last Updated: September 21, 2023

Ativan is a benzodiazepine classified as a Schedule IV controlled substance. This type of medication slows signaling between the body and brain, and it is FDA-approved for treating anxiety, seizures and several other conditions. However, benzodiazepines like Ativan also carry the risk of abuse, dependence and addiction. It’s important to be aware of Ativan’s addictive potential and know where to turn if addiction treatment is necessary, especially if you or someone you love takes this medication.

Is Ativan Addictive?

Ativan is a benzodiazepine commonly used to treat anxiety, insomnia, sleep difficulty and status epilepticus (continuous seizures). It is also used as a medication given right before anesthesia. Ativan is classified as a Schedule IV medication under the Controlled Substances Act, meaning it has approved medical uses but a potential for abuse and addiction.

Ativan works as a central nervous system (CNS) depressant, meaning it works to slow down signals between the brain and the body. Compared to other benzos, Ativan works more quickly than most and is typically regarded as being more addictive. Ativan carries a risk of dependence and addiction, especially if taken over longer periods or used differently than prescribed.

How Long Does It Take To Get Addicted to Ativan?

The addictive potential for Ativan can vary from person to person. Some of the influencing factors include age, genetics and history of addiction to other drugs or alcohol.

To minimize the risk for addiction, a person should take Ativan exactly as prescribed and avoid using it over the long term. Generally speaking, long-term Ativan use is described as four weeks or longer. Doctors will typically write short-term prescriptions to help reduce addictive risks.

Ativan Dosage

Ativan is available in a variety of strengths and formulations, including:

  • Ativan
    • Immediate-release tablet: 0.5 mg, 1 mg, 2 mg
    • Injection: 2 mg/mL, 4 mg/mL
  • Loreev XR
    • Extended-release tablet: 1 mg, 2 mg, 3 mg
  • Lorazepam Intensol
    • Liquid concentrate: 2 mg/mL solution

In addition to the listed brand names, these formulations are also available as generic medications.

Ativan Dosage for Sleep

Ativan can be used to treat sleep problems caused by anxiety or situational stress. In these cases, doctors typically prescribe 2 to 4 mg of Ativan to be taken at bedtime.

Ativan Dosage for Anxiety

Initially, doctors may prescribe 0.5 to 2 mg Ativan to be taken two or three times daily for anxiety. However, because Ativan tolerance can develop over time, doctors may increase patients to a maintenance dosage of up to 10 mg daily (total).

Ativan Dosage for Panic Attacks

There is limited research regarding what Ativan dosages are effective for treating panic attacks. In general, patients will start with the lowest effective dose and increase it according to their doctor’s instructions.

How Long Does Ativan Stay in Your System?

There are many factors that can influence how long a drug remains in your system. Some of these factors include your amount and frequency of Ativan use, age and overall health. For example, if your liver or kidney function is poor, you can accumulate Ativan more than the average person would.

Typically, drug tests detect either the drug or its metabolites. How long these are present can vary depending on what the test is looking for and what type of sample is taken. You can expect Ativan to be present for 50 to 100 hours after a dose is taken. Examples of detection windows based on sample type include:

  • Urine: Ativan can be detected for one to seven days.
  • Blood: Ativan is detectable for nine to 16 hours.
  • Hair: Ativan does not always show up in hair, but substances can typically be detected in hair for up to 90 days.
  • Saliva: Ativan can be detected after about 15 minutes, and some tests can detect it for up to eight hours.

Ativan Addiction and Abuse

On their own, benzos usually carry a low risk of toxicity. However, medications like Ativan can become dangerous when mixed with other substances, such as opioids or alcohol. Other risk factors for Ativan addiction and abuse include long-term use (usually longer than four weeks), taking higher doses and having a history of addiction.

If Ativan is used in higher doses or over the long term, you might experience Ativan withdrawal if you try to stop. It’s important to speak with your health care professional if you are thinking about stopping this medication. This can help ensure you have a safe and effective plan in place for managing potential withdrawal symptoms.

Ativan Addiction and Abuse Statistics

Research suggests that benzodiazepine use is high, but the number of people with benzodiazepine use disorder is relatively low compared to some other drugs. Still, 12.5% of adults in the U.S. reported using benzos in 2016, and 2.1% misused them.

Nationally, an estimated 17% of all drug overdose deaths between January 2019 and June 2020 involved a benzo. This highlights the danger of combining medications like Ativan with other drugs and alcohol. In Florida specifically, 85% of deaths involving benzos in 2018 resulted from a combination of benzodiazepines and opioids.

Ativan Addiction Symptoms, Signs and Side Effects

Psychological and physical symptoms of Ativan addiction can include drug cravings and abnormal behaviors that occur from withdrawal. Common symptoms can include:

  • Cravings for Ativan
  • Anxiety
  • Irritability
  • Depression
  • Suicidal thoughts or behaviors
  • Erratic behavior
  • Confusion
  • Paranoia
  • Panic attacks
  • Heart palpitations (racing heart)
  • Sweating
  • Trembling
  • Dizziness
  • Muscle weakness
  • Forgetfulness and memory problems
  • Difficulty concentrating
  • Nausea and vomiting
  • Tingling in fingers or toes
  • Muscle aches or cramps
  • Loss of appetite

Ativan Overdose

Symptoms of Ativan overdose can include confusion, impaired coordination, slow reflexes, coma or even death. If you suspect that someone is experiencing an Ativan overdose, call 911 immediately. Although there is a benzodiazepine reversal agent called flumazenil, it can only be given through an IV at the hospital and can result in seizures. Careful monitoring is required whether flumazenil is given or not.

Ativan Withdrawal

The Ativan withdrawal process varies from person to person. It can depend on how much Ativan someone uses, how long they have used it and whether they use other substances. Always speak with your health care professional before quitting Ativan to make sure you stop in the safest way possible.

In severe cases of Ativan addiction, abruptly stopping or tapering down too fast can result in dangerous withdrawal symptoms like hallucinations, seizures or death. In more mild cases, Ativan withdrawal can lead to bothersome symptoms like trouble sleeping, tremors or irritability.

Ativan Withdrawal Symptoms

It is important to talk with your health care provider if you are considering stopping Ativan. If Ativan is stopped abruptly or too quickly, withdrawal can occur. Symptoms of Ativan withdrawal include:

  • Difficulty sleeping
  • Hallucinations
  • Headaches
  • Irritability
  • Seizures
  • Stomach or muscle cramps
  • Tremors
  • Unusual behaviors
  • In severe cases, death

Medical Detox for Ativan Withdrawal

Typically, there are three phases of Ativan detox. In the first few days, there can be “rebound” anxiety and insomnia. After this, the second phase typically lasts 10 to 14 days and can be when withdrawal symptoms are at their worst. Symptoms can vary from mild headaches and difficulty sleeping to hallucinations, tremors or seizures. In the final phase, anxiety can return and may persist if left untreated.

At Orlando Recovery Center, we can support you throughout the Ativan detox and withdrawal process. During detox, our medical professionals provide supervised care for your safety and comfort by monitoring for symptoms and treating them. We can also help create an individualized Ativan tapering schedule to help minimize the risk of dangerous or uncomfortable symptoms. In addition, our experts can evaluate and treat many other conditions, such as anxiety or sleeping problems.

Ativan Addiction Treatment

At Orlando Recovery Center, we offer a variety of evidence-based treatment options to fit your needs and lifestyle. Our full continuum of care includes services ranging from medical detox and inpatient rehab to partial hospitalization programs and outpatient care. We also offer dual diagnosis treatment for co-occurring disorders and long-term aftercare resources.

If you are concerned that you or someone you love is facing an Ativan use disorder, the Orlando Recovery Center can help. Contact us today to learn more about Ativan addiction treatment plans and programs that can work well for your situation.


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