Lorazepam Addiction Explained
Lorazepam – often known by brand names including Ativan – is a medication in the benzodiazepine class used to treat a range of disorders including anxiety and alcohol withdrawal. A prescription-only medicine in the UK, lorazepam is recognised as being habit-forming and a growing number of people around the world are succumbing to its addictive qualities; nevertheless, like many other benzodiazepines it is also commonly used recreationally.
What is Lorazepam Addiction?
Addiction is a psychological phenomenon whereby an individual continues to engage compulsively in a certain behaviour despite an awareness of the adverse consequences of such behaviour; in the case of lorazepam addiction specifically, the behaviour in question is the consumption of lorazepam (normally, at least initially, for the pleasurable effects it produces). Addiction is distinct from, but closely related to, dependence (see below); both conditions mean an affected individual will struggle to stop taking lorazepam, and indeed may be unable to do so without help.
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Trade names for lorazepam
Lorazepam is the generic name for a drug also sold under trade names including Ativan, Tavor, Temesta and others. It has the chemical formula C15H10Cl2N2O2.
What is lorazepam used for?
Lorazepam is most commonly used in the short-term management of severe anxiety. It is also frequently prescribed to treat conditions resulting in seizures, including epilepsy and alcohol withdrawal syndrome; as a sedative for people receiving mechanical ventilation or who are extremely agitated and/or delirious; and as a pre-medication prior to surgery. Less frequently, lorazepam may be used to treat catatonia, and to reduce nausea and vomiting in patients undergoing chemotherapy.
How addictive is lorazepam?
Lorazepam is considered to be one of the more potent benzodiazepines, and its addiction potential is similarly considered to be greater than that of many other drugs in its class. Generally speaking, approximately one third of people who take benzodiazepines for longer than four weeks will develop dependence to them; this proportion is likely to be higher in the case of lorazepam specifically.
Neurological mechanism of lorazepam dependence
Anyone taking lorazepam over a period of time is at risk of developing dependence, which is a phenomenon by which the affected individual’s system becomes used over time to the presence of lorazepam and adjusts accordingly, so that it becomes unable to function normally in the absence of lorazepam. Upon stopping taking lorazepam, someone who has become dependent will suffer withdrawal symptoms: the manifestation in the body and mind of the abnormal functioning of the brain and central nervous system due to the absence of lorazepam.
Routes of administration of lorazepam
Lorazepam is usually taken orally in tablet form, but can also be administered via intravenous or intramuscular injections, given under the tongue, or by transdermal patch.
Lorazepam Dependence Versus Addiction
Dependence and addiction are concepts often conflated in the public mind. As discussed above, addiction is a psychological phenomenon in which an individual is driven to repeat potentially damaging behaviour, whilst dependence is a physical issue resulting from the individual’s system becoming reliant upon a particular substance to function normally. These conditions very often go hand-in-hand, but it is important to note that either can occur independently.
Why People Abuse Lorazepam
As with other benzodiazepines, lorazepam’s sedative properties can produce extremely pleasurable feelings in the user, and both people who have been prescribed lorazepam and people who take it purely recreationally can rapidly reach a point where their frequency of consumption and dosages constitute serious substance abuse.
Recreational use of lorazepam
Lorazepam is widely used recreationally around the world because of the pleasurable “high“ it produces in the user. Unfortunately, it is also used in various criminal activities, including as a date rape drug and to facilitate robbery.
Causes of lorazepam addiction
Although medical science has not yet fully explained the phenomenon of addiction, it is understood that both genetic and environmental factors play a role. What is clear is that anybody who consumes lorazepam for more than a few weeks is at risk of developing physical dependence to the substance, while psychological addiction can manifest even earlier.
Risk factors for lorazepam abuse
Genetic: anyone who has a family history of either substance abuse and addiction, or mental health issues (especially including depression) is significantly more likely than the average to abuse lorazepam.
Environmental: risk factors for lorazepam abuse include the experience of trauma and/or challenging life experiences (such as bereavement or divorce); having a peer group with members who abuse the drug; and taking lorazepam for longer or at higher doses than recommended by a doctor.
Co-Occurring Disorders with Lorazepam Addiction
As lorazepam is used to treat numerous mental health issues, it is understandably more likely than many other substances to be an element of cases of dual diagnosis (when mental disorders cooccur with substance abuse disorders). Dual diagnosis usually renders addiction treatment significantly more complex, and specialist care is typically required.
The Neurological Effects of Lorazepam Addiction
The most commonly cited negative neurological effect of long-term lorazepam consumption is dependence. However, although a good degree of uncertainty remains, it is also thought that taking lorazepam over a long period may result in physical neurological damage; it is certainly the case that various behavioural and other psychological changes may manifest, and that these may be the result of brain damage.
Relationship between Lorazepam and Other Substances/Contraindications
Lorazepam is known to have dangerous interactions with various substances including alcohol, opioids, rifabutin, carbamazepine, lamotrigine, phenobarbital, phenytoin, rifampin, sedative antihistamines and some antidepressants. People suffering from allergies or hypersensitivity to benzodiazepines; respiratory failure; acute intoxication; ataxia; glaucoma; sleep apnoea; and myasthenia gravis should all avoid consuming lorazepam. It is also advised that
pregnant and breastfeeding women, children, the elderly, those with comorbid psychiatric disorders, and drug and/or alcohol-dependent individuals all approach lorazepam with particular care.
Health Risks with Lorazepam Addiction
Addiction generally can have catastrophic consequences for a person’s physical and mental health, as a result of a decrease in their quality of life and the mental and emotional stresses which accompany addiction. The long-term use of lorazepam specifically also poses numerous health risks, outlined below.
Effects of Lorazepam
Many of the intended effects of lorazepam (ie, its sedative, antianxiety and muscle relaxant properties) can become challenging when unwanted. Some of the most prominent adverse effects of lorazepam include:
- low blood pressure
- decreased effort to breathe
- suicide with a history of depression
- cognitive impairment
- decreased motor control
- behavioural disinhibition
Lorazepam Abuse Signs and Symptoms
The abuse of any substance can be difficult to identify due to the stigma surrounding addiction and substance abuse, and the consequent efforts to hide their actions made by individuals engaged in such abuse. Nevertheless, some signs which may indicate the abuse of lorazepam include: regular intoxication (with symptoms such as slurred speech, impaired motor control and drowsiness); much higher levels of intoxication when consuming alcohol or other substances of abuse; being constantly preoccupied with obtaining and consuming lorazepam; visiting multiple doctors to obtain prescriptions (“doctor shopping”); the manifestation of withdrawal symptoms upon cessation of use; and long-term symptoms including cognitive impairment, anxiety, insomnia and depression.
Lorazepam Overdose Explained
- mental confusion
- paradoxical reactions
- hypnotic state
- cardiovascular depression
- respiratory depression
If any of these symptoms are observed in someone who is known to have consumed lorazepam, emergency services should be contacted straightaway.
Cost of Lorazepam Addiction to Families and Society
An addiction to lorazepam can be devastating for a family whose members have to witness their loved one’s struggles and deal with the emotional consequences of both that trauma and any deceit and other unwanted behaviour which may manifest. Socially, the cost of lorazepam addiction includes millions of pounds spent by the NHS on addiction treatment, and the deployment of police and social health resources.
Teen lorazepam abuse and addiction
Because of its low cost and ubiquity, lorazepam is a popular drug for young people. Speak with an addiction specialist if you believe that a young person close to you may be abusing or addicted to lorazepam.
What to do if a loved one is struggling with lorazepam addiction
Though it can be extremely distressing to observe someone close to you wrestling with an addiction, and you may feel a strong urge to take action, doing so could cause more harm than good. Contact an addiction specialist to discuss the situation and to get advice on how you might proceed.
What to Do If You Need Help to Detox
Withdrawal from benzodiazepines can be fatal, and it is crucial that you do not attempt to detox without medical support, no matter how urgently you may feel the need to stop taking lorazepam. Speak with your GP and/or an addiction specialist to find out how you might detox safely.
Benzodiazepine withdrawal is widely considered one of the most unpleasant and perilous forms of withdrawal syndrome. However, it is unavoidable for anyone who has developed a dependence to lorazepam and who wishes to stop taking the drug. Happily, some of the most distressing symptoms can be alleviated with the help of medication.
Symptoms of withdrawal
Though each instance of withdrawal from lorazepam is unique, some of the most commonly observed withdrawal symptoms include:
- numbness/tingling of extremities
- hypersensitivity to light, sound, and smell
- perceptual distortions
- appetite loss
- stomach cramps
- panic attacks
- short-term memory loss
Duration of withdrawal
Typically, withdrawal from lorazepam dependence will last between two and four weeks, with acute withdrawal beginning around three days after the last dose and usually lasting for around a week; however this is a rough guide and some cases of withdrawal last significantly longer. Moreover, some individuals will develop protracted withdrawal syndrome (also known as post-acute withdrawal) with symptoms which might last many months or even several years.
Why You should Contact a Professional for Detox
As discussed earlier, benzodiazepine withdrawal can be very dangerous. Never attempt to go through detoxification from lorazepam independently: contact your GP and/or an addiction specialist about the dangers of lorazepam withdrawal, and medical assistance which may be available to you.
Lorazepam Addiction Treatment
Various facilities now operate across the UK treating lorazepam addiction. Addiction treatment usually consists of two phases: detoxification/withdrawal (with the assistance of medical professionals); and therapy.
Therapy for Lorazepam Addiction
As with every type of addiction, therapy lies at the core of treatment for lorazepam addiction. Whilst detoxification removes the immediate physical challenges of dependence, only therapy can identify and tackle the underlying psychological causes of a person’s substance abuse and addiction and without therapy it is likely that an addict will go on to resume their substance abuse after “cleaning up” through detox. Addiction therapy is provided in various formats and models, and in both one-to-one and group settings.
Lorazepam Abuse Detox Process
The detoxification process varies from one facility to another, and from one patient to the next. Some facilities may require a period of tapering prior to the commencement of detox. Some patients may be provided with medication during the detox period. If you are contemplating a lorazepam detox, make sure you get as complete an understanding as possible of the process ahead of you from your doctor, so you know what is expected of you and what you might expect.
Possible complications in lorazepam rehab
Because of the danger associated with detoxification from benzodiazepines, it is vital that you are completely candid with the doctors at any rehab facility you may be considering visiting about your medical history, physical condition, and the severity of your lorazepam abuse, in order to minimise the risk of any potentially deadly complications during your stay at that facility.
Lorazepam Relapse Prevention
Although avoiding relapse is key to the recovery from lorazepam addiction, you should always bear in mind that if you do relapse it does not mean that you have immediately failed in your recovery and that you will inevitably slide back into addiction. Combating relapse is an ongoing process, and you can pick up tools and defence mechanisms from therapy such as that you may receive in rehab. Meanwhile, participation in self-help groups, and ongoing counselling, can also be hugely beneficial. Discuss relapse prevention measures with an addiction specialist.
Lorazepam Addiction Statistics
- Over 12 million prescriptions for benzodiazepines are issued each year in the UK.
- In 2016 over 400 people died in England and Wales as a result of benzodiazepine abuse.
- More than 250,000 Britons have currently been taking benzodiazepines for a period exceeding that which was advised by their doctors.
- According to a study in the British Journal of Psychiatry, almost 8% of Britons have misused benzodiazepines at some point in their lives.
- Over 40% of people taking lorazepam for over six weeks will become addicted.
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