Ativan (Lorazepam) Addiction: Signs, Side Effects and Treatment

Ativan is one of the most common benzodiazepines in the United States. It can help people manage several different types of health conditions, including anxiety. However, there is a downside. As a controlled substance, Ativan carries a risk of addiction. For this reason, it is important to be aware of the signs and symptoms of Ativan addiction if you or someone you love takes this medication.

What Is Ativan?

Ativan is the brand name for lorazepam, a benzodiazepine drug. The drug is a Schedule IV controlled substance that is FDA-approved to treat a variety of conditions, including anxiety disorders and seizures.

Ativan works by enhancing the activity of gamma-aminobutyric acid (GABA) in the brain. GABA is the brain’s main inhibitory neurotransmitter. By enhancing GABA activity, Ativan slows the brain down and makes you feel calmer and more sedate.

Is Ativan a Controlled Substance?

Ativan is a Schedule IV controlled substance in the United States, meaning it carries a risk for abuse, addiction and dependence. However, the risk is lower than controlled substances in Schedules I, II or III.

Ativan Uses

Ativan is FDA-approved to treat anxiety disorders and seizures. However, doctors sometimes prescribe Ativan off-label to treat other conditions, such as insomnia. Ativan is one of the most commonly prescribed benzodiazepines in the United States, with more than 10.8 million prescriptions dispensed in 2019 alone.

Is Ativan Addictive?

Ativan is a Schedule IV controlled substance, meaning that it is addictive. For this reason, the drug’s package labeling recommends using it at the lowest possible dose for the shortest possible time. Nonetheless, more than 17% of people who take benzodiazepines misuse them, which increases the risk of addiction.

To avoid Ativan addiction, you should only take the drug exactly as your doctor prescribes. Your risk of Ativan addiction can increase if you:

• Take Ativan more often than prescribed
• Take a higher Ativan dose than prescribed 
• Take Ativan that has not been prescribed to you 

Is Ativan Addictive in Small Doses?

Ativan is a controlled substance, no matter the dose. This means that even small doses are a risk for abuse and dependence. In addition, a person may start with a small dose of Ativan and end up increasing the dose over time as their body builds up a tolerance to the lower dose. For these reasons, Ativan is considered addictive even at small doses.

Signs of Ativan Addiction

When a person begins to develop an Ativan addiction, there can often be some signs that loved ones may notice. Many times, the person shows changes in behavior, especially in regard to Ativan. These signs include: 

• Changes in sleep habits
• Spending a lot of time trying to get Ativan
• Going to different doctors and pharmacies to get Ativan
• Exaggerating symptoms to get Ativan prescriptions
• Stealing or lying to get Ativan

Side Effects of Ativan Addiction

A person may start to show some side effects of Ativan use when they begin to struggle with the drug. Many of these side effects occur when the person is high on Ativan, and they can be physical or psychological in nature. Side effects of Ativan addiction can include:

• Sleepiness
• Slurred speech
• Coordination problems
• Euphoria 
• Problems concentrating 
• Memory problems
• Involuntary eye movements
• Lack of inhibition
• Slowed breathing 
• Low blood pressure
• Dizziness
• Low mood

Long-Term Side Effects of Ativan Addiction

Although Ativan’s package labeling recommends limiting Ativan use to the shortest possible duration, some people end up taking the drug for a long period of time. However, long-term Ativan use can lead to a variety of problematic side effects and risks. These can include an increased risk of:

• Cognitive impairment, which may be long-term
• Hip fractures
• Motor vehicle crashes

Further, as a controlled substance, continued Ativan use puts a person at risk of addiction over the long term. This is true even if they have been taking the drug for a long time.

Ativan Overdose

An Ativan overdose is a medical emergency and can be fatal. This is because Ativan overdoses typically occur when someone has taken other substances alongside Ativan, and polysubstance use raises the risk of dangerous complications during an overdose. 

The dangers of Ativan overdose are especially increased when the drug is taken with central nervous system depressants, such as opioids. For this reason, Ativan carries an FDA Boxed Warning against using the drug alongside opioids. 

If you suspect a person has taken too much Ativan, it is important to seek immediate medical attention.

Ativan Overdose Symptoms

Ativan overdose symptoms are similar to intoxication symptoms that occur with other central nervous depressants, such as opioids or alcohol. Signs of an Ativan overdose can include:

• Slurred speech
• Coordination difficulties
• Mental status changes
• Slowed breathing, especially if opioids or alcohol have been taken

Ativan Withdrawal

When you take a psychoactive substance like Ativan over the long term, you can become physically dependent on it. Physical dependence occurs when your brain and body adapt to the presence of a substance. 

If you are physically dependent on Ativan and suddenly stop it, you can go into withdrawal as your body struggles to adapt to the sudden absence of the drug. Withdrawal symptoms can be uncomfortable and sometimes even dangerous. 

Some people are more likely to experience Ativan withdrawal than others. Risk factors for Ativan withdrawal include long-term Ativan use and high doses. 

See More: How to Taper off Ativan?

Ativan Withdrawal Symptoms

Ativan withdrawal symptoms are similar to those of other benzodiazepines and often include:

• Sweating 
• Rapid heartbeat
• Tremor, especially in the hands
• Insomnia
• Nausea or vomiting 
• Hallucinations 
• Agitation 
• Anxiety 
• Seizures

How Long Does Ativan Withdrawal Last?

Ativan withdrawal symptoms often last around a week. Typically, symptoms start between six and eight hours after the last Ativan dose and peak within 48 hours. After the fourth or fifth day, symptoms tend to improve. However, benzodiazepine withdrawal symptoms can be unpredictable and may wax and wane during withdrawal, improving but then worsening before improving once more. 

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more