Ativan is one of the brand names for the controlled substance lorazepam, a benzodiazepine.
Withdrawal from Ativan usually begins one to three days after a person has stopped using the drug and can last two weeks or longer.
Ativan has a relatively quick onset of action and remains in the system relatively long. For most people, the half-life is between 10 and 20 hours. This means the drug is useful in addressing panic attacks or consistent levels of anxiety that occur throughout the course of the day, such as the anxiety associated with generalized anxiety disorder.
It should not be used as an anesthetic or to help you relax and go to sleep.
All benzodiazepines have a similar mechanism of action, but they differ in the length of time it takes them to work, the length of time they remain in the body, and their abilities to affect specific types of situations.
There are so many different types of benzodiazepines because different chemical formulations work more effectively in some individuals. Multiple options give physicians the opportunity to pick the medication that best suits the needs of the individual.
Abuse of Ativan
Although the majority of individuals prescribed Ativan for anxiety disorders do not wind up abusing them, abuse of the drug has increased over the past several years.
When there are more prescriptions written for a drug, it becomes more readily available to individuals who could obtain the drug illicitly and abuse it.
The majority of individuals who abuse benzodiazepines do not use them as their primary drug of abuse. Instead, they use them in conjunction with other drugs of abuse, like prescription opioids, alcohol, and other benzodiazepines or sedatives.
It is rare to find an individual who is chronically abusing Ativan alone.
Individuals who abuse multiple drugs together for lengthy periods will experience significant issues with complicated withdrawal.
Symptoms of Ativan Withdrawal
Because Ativan has a relatively long half-life, a person who has abused the drug and developed physical dependence may not feel withdrawal symptoms as soon as they stop using the drug.
The withdrawal symptoms associated with discontinuing Ativan can vary from person to person. They may include the following:
- Difficulties with breathing
- Rapid or irregular heartbeat
- Increased blood pressure, body temperature, and perspiration
- Muscle aches, muscle spasms, and/or tremors
- Flulike symptoms, such as headaches, dizziness, nausea, vomiting, stomach cramps, and/or diarrhea
- Mood swings, irritability, jitteriness, restlessness, and significant cravings for Ativan
- Numbness and tingling in the extremities
- Decreased appetite and trouble sleeping
- Rebound anxiety (symptoms that the drug typically controls begin to reappear with more intensity)
- Depression and/or suicidal thoughts
- Drug cravings or urges to use Ativan
- Hallucinations and/or paranoia
- Potential comatose states, in rare cases
Compared to other benzodiazepines, withdrawal from Ativan is associated with a higher risk for insomnia.
Factors Influencing Withdrawal
A person’s pattern of Ativan abuse is the major influence of onset, intensity, and length of the withdrawal syndrome. Other influences include:
- Higher amounts of Ativan– People who take it more frequently for lengthy periods will typically experience more intense withdrawal symptoms.
- An individual’s body weight and metabolism
- Stopping use of the drug abruptly– This will typically lead to more intense symptoms and a quicker onset of withdrawal than slowly trying to discontinue use by taking smaller and smaller amounts of the drug over time.
- An individual’s psychological makeup– People who have other types of co-occurring mental health disorders will often experience symptoms more intensely than individuals who do not.
Undergoing an unsupervised withdrawal from Ativan or other benzodiazepines results in a similar timeline.
The withdrawal timeline will vary, depending on numerous factors. Overall, withdrawal from Ativan will follow a general timeline.
- Within one to three days after discontinuation, acute symptoms will appear and often increase in intensity.
- Within four to seven days following discontinuation, the symptoms peak.
- Once the symptoms peak, they typically begin to decrease in intensity. Symptoms might remain up to two weeks after the person has stopped using the drug, but this timeline can vary and may extend for longer periods in some individuals.
- After two weeks following discontinuation of Ativan, the majority of the withdrawal symptoms will have significantly subsided. There may be residual symptoms, but the withdrawal period will have run its course.
Despite this generalized timeline, some individuals may continue to experience withdrawal symptoms for several weeks after discontinuing Ativan.
In some cases, these symptoms may wax and wane in intensity for several weeks.
Many sources still refer to an extended withdrawal syndrome that is often identified as post-acute withdrawal syndrome.
This lasts for months or even years following the elimination of Ativan from the person’s system.
The symptoms are typically emotional and include apathy or depression, problems with motivation, significant cravings to use Ativan or other drugs, and other emotional symptoms.
These extended symptoms may represent the effects of the physiological and neurological changes that occurred in the person due to extended drug abuse or pre-existing factors that have been exacerbated by discontinuing drug abuse. They are not believed to be directly due to the withdrawal process.
Using a Medical Detox Program
Not every person who abuses Ativan will experience significant withdrawal symptoms when they discontinue the drug.
There is no way to determine if a person will experience seizures or psychosis during the withdrawal process from any drug. Because Ativan is typically not the primary drug of abuse, a more complicated situation could ensue when the person stops using Ativan.
Individuals undergoing withdrawal will experience heightened urges or cravings to use Ativan. When these cravings are complicated by emotional distress and problems with judgment, the potential to overdose is significantly increased.
Thus, becoming involved in an assisted medical detox or withdrawal management program is the safest approach. It is strongly recommended that anyone who wishes to discontinue their use of Ativan discusses this with their physician.
How Medical Detox Works
The standard approach to withdrawing from benzodiazepines like Ativan is for a physician to prescribe a long-acting benzodiazepine like Ativan or Valium and administer it on a tapering schedule.
The physician will start with the dose that best controls withdrawal symptoms and then lowers it at one-week to two-week intervals.
This allows the system to adjust to smaller amounts of the drug.
Eventually, the drug will be discontinued altogether, and the person will be able to function normally without taking the drug. This process results in an extended period of recovery, but it is far safer and more comfortable for individuals in recovery.
Other medications may also be used, depending on the needs of the individual.
These medications might allow the person to get a foothold in their recovery, avoid potentially dangerous issues, and begin to develop a long-term recovery program.
Withdrawal from Ativan is potentially serious and could be a life-changing event for someone who is not adequately prepared to undergo it.
It is strongly recommended that anyone wishing to stop using Ativan for any reason seek advice from a physician before discontinuing the drug.