Ativan is a medication in a class of drugs called benzodiazepines. While benzodiazepines are best known for treating anxiety, some are also prescribed as anti-epileptic medications and muscle relaxers. Ativan is most commonly prescribed to treat generalized anxiety and panic disorders on a temporary basis.
If used responsibly and monitored by an attentive medical professional, it’s possible to have an Ativan prescription with no ill effects. But the medication causes chemical dependence very quickly, and long-term exposure nearly always means an unpleasant physical withdrawal process.
How Ativan Works on the Body and Mind
All benzodiazepines function by affecting the brain and surrounding the central nervous system, generating a calming effect. The body naturally produces a chemical called GABA, and this medication enhances the effects. GABA is a neurotransmitter that helps to regulate your sleep cycle, your anxiety responses, and your experience of relaxation. When Ativan affects these receptors, the central nervous system slows down.
This slowing of the central nervous system reduces excitement and agitation inside the brain. It reduces the amount of electrical activity happening and forces the thought processes to become less scattered. If you’re trapped in spiraling trains of thought or obsessive loops, the medication reduces your brain’s ability to continue down those paths. Slowing down the CNS also leads to more manageable physical symptoms of panic attacks and anxiety.
The medication is most commonly prescribed to be used as needed for panic attacks and physical anxiety attacks. It works within minutes of taking the dose, so it’s used as an emergency medicine rather than a maintenance one. You can think of it in the same way that asthmatics have rescue inhalers for unexpected asthma symptoms.
How Does Ativan Addiction Happen?
Benzodiazepines have a significant effect on the brain, and long-term use will cause the brain’s natural chemical levels to be affected. If you develop a physical dependence on the drug, you’ll need to taper off in very small increments because your brain isn’t making as much natural GABA as it used to. Since you now have a GABA deficiency, stopping “cold turkey” would lead to horrible mental and physical symptoms.
Some people develop a chemical dependence without a mental dependence, though. Addiction is another beast. The problem is that Ativan works very well in reducing anxious thoughts and feelings. It can also provide vague feelings of euphoria and relaxation. For people who have trouble soothing their minds, it’s tempting to chase that relaxed feeling. Other people might not have anxiety at all but crave a positive feeling because they’re unhappy.
Risk Factors for Ativan Abuse
Any mental health condition can put you at an increased risk of developing an Ativan addiction. Some physical conditions that cause muscle tension and pain can also make you prone to chasing the medication’s relaxation effects. Ativan is often used as a way to escape stress or to cope with unhappiness.
Some mental health conditions do predispose you even more strongly than others:
- Anxiety. People with anxiety disorders, panic disorders, and OCD may be desperate to experience relaxation and a lack of fear. You’re more susceptible if you rarely experience a moment free of fear, and if you feel like substance abuse is the only way you’ll ever feel safe.
- Depression. Ativan produces relaxed and happy feelings. Low doses won’t create a “high,” but higher ones will. Higher doses also have more intense crashes, which can make you want to take more to offset the unpleasantness. Depressed people often use Ativan to experience fleeting pleasure, especially if they’ve lost interest in taking care of themselves.
- Trauma. Some people develop trauma responses from a single event, while others have heightened fear instincts due to living in unsafe long-term conditions. Trauma changes the body’s physical responses, heightening your adrenal activity and your norepinephrine levels. Basically, your body is always tensed up in fight-or-flight mode. It can be both mentally and physically painful, and people with PTSD sometimes turn to Ativan to shut it off.
Symptoms of Ativan Dependence and Addiction
One of the first signs of Ativan dependence is feeling more anxious and strung-out and erratic when you’re off it than you did before you began taking it. This happens because your brain reduces the amount of GABA it naturally produces in response to the artificial substance.
If you allow yourself to taper off and stop the medication use at this stage, that’s as unpleasant as it gets. Your brain will “reset” in a few days. But for some people, their response is to take higher medication doses to get the same effects they did at first. This leads to a more significant GABA deficiency in the brain, which leads to a higher tolerance and dependence. It’s a vicious cycle.
The longer you take Ativan and the higher the dose, the harder the withdrawal is. You will eventually reach a point where the medication doesn’t have a euphoric effect unless you take dangerous levels.
Mental addiction will present in your thought processes. You’ll find yourself preoccupied with taking the medication, and with figuring out when your next dose is, and with finding ways to make the medicine last or to get more illegally. You’ll become increasingly more focused on being high because not being on the medication feels intolerable.
This is the point at which you might find yourself doing and saying things you never imagined. You might construct elaborate schemes to hide your drug use, steal money to pay for more medication, steal controlled medications from your friends and family, and start suffering noticeable performance problems at work and home.
Indicators That a Loved One Might Have an Ativan Addiction
Spotting an Ativan addiction isn’t easy because a lot of the time, the person will continue acting very similar to how they always do. The “high” doesn’t escalate. They’ll appear to experience the same effects each time – but they’ll need a dangerously high dose to get there.
If you notice anxious and erratic behavior, a loss of interest in activities, a preoccupation with being alone, or anxiety surrounding their medication, you might want to ask if something’s up gently.
Ativan withdrawal comes with varied symptoms depending on how much of the drug you were taking and how long. A detox program helps remove the physical substance from your body and treat the chemical dependence so that your brain will begin producing its neurotransmitters again.
Medically-assisted detox can help lessen the severity of mental agitation and physical pain. Common physical withdrawal symptoms include:
- Inability to sleep
- Body shaking
- Joint and muscle pain
- Confusion and lack of focus
- Irritability, anxiety, panic, and mood swings
- Volatile pulse and blood pressure
- Vomiting, nausea, diarrhea, cramping
A medically supervised detox is the safest and easiest way to manage these symptoms and get the support you need through the withdrawal process.
Rehab Programs for Addiction
After you’ve gone through withdrawal, you’ll need to address the mental addiction and the mental health issues underscoring it.
You’ll have a few rehab program options:
- Residential inpatient care, which is indefinite.
- Concrete inpatient program, usually 28 to 90 days.
- Intensive outpatient program, same intensity as inpatient but you sleep at home
- Ongoing outpatient treatment, involving appointments and gatherings several times weekly around your usual work and social life