Ativan Overdose

man with his hand on his forehead after taking too much Ativan

Ativan, also known by the generic name lorazepam, is a benzodiazepine commonly prescribed as an anti-anxiety drug. Recreational Ativan use has become popular because high doses elicit feelings of euphoria. Unfortunately, misuse of Ativan can cause potentially lethal overdoses. Many people who use Ativan recreationallyrecreational users ingest Ativan with other drugs or alcohol, which dramatically increases the likelihood of overdose. Therefore, it is important to be aware of the symptoms of Ativan overdose and what the treatment options are.

How Do Overdoses Occur?

Ativan is a powerful sedative that inhibits brain activity and triggers feelings of euphoria. Although the molecular mechanisms of benzodiazepine-induced euphoria are quite complex and are still an area of active research, it is thought that the overall pathway is mediated by two important chemicals in the brain: GABA and dopamine. GABA plays a key role in preventing hyperexcitability in the brain, and GABA is also involved in regulating dopamine levels. Dopamine is responsible for regulating the brain’s reward circuit; when dopamine is increased, the reward circuit is activated. 

The reward circuit underlies addiction because chemicals that increase dopamine produce pleasurable feelings, that people seek to experience again and again. Low doses of benzodiazepines enhance the effects of GABA only enough to affect brain hyperexcitability, but high doses of benzodiazepines cause a GABA-dependent increase in dopamine levels, thus activating the reward circuit and producing the pleasurable high that is associated with drugs of addiction. 

Overdoses occur because people taking Ativan for the euphoria-inducing dopamine rush are also causing a robust increase in GABA levels, and too much GABA can lead to respiratory depression, slowed heart rate, coma and death. When Ativan is used in conjunction with other drugs or alcohol, the risk of overdose is substantially increased. 

Ativan Overdose Symptoms

Ativan overdose in the absence of other drugs or alcohol generally resembles alcohol intoxication, characterized by impaired balance, slurred speech, memory impairment and loss of coordination. Rarely will Ativan overdose in the absence of other drugs or alcohol cause severe or lethal impairments. However, isolated reports have suggested that delirium and hallucinations can occur following ingestions of large amounts of Ativan. 

When Ativan is used with opioids or alcohol, the results can be far less predictable and may be associated with lethal consequences. Like Ativan, alcohol and opioids are central nervous system depressants. Concurrent use of multiple central nervous system depressants significantly increases the risk of dangerous overdose symptoms, including respiratory depression, slowed heart rate, coma and death.

What Does Overdose Feel Like?

People who have recovered from Ativan overdose frequently have foggy or no memory of the timeframe surrounding the overdose, so it is difficult to describe what an overdose “feels” like accurately. People misuse Ativan for its sedative effects and associated pleasurable feelings, but it is unlikely that overdoses cause pleasurable experiences. 

Ativan Overdose Statistics

Among the benzodiazepines, Ativan (lorazepam) is generally not considered to be the most toxic, although cases of Ativan overdose certainly exist. Data from the 2015–2016 National Surveys on Drug Use and Health found that 12.5% of adults in America used benzodiazepines. Encouragingly, they found that the rate of occasional misuse was only 2.1%, and only 0.2% met criteria for benzodiazepine use disorder.

Ativan Overdose Deaths

According to the CDC’s National Center for Health Statistics, deaths attributed to benzodiazepines in the absence of other drugs remain relatively infrequent. The number of cases was fairly stable between 1999–2017, with approximately one thousand deaths per year associated with only benzodiazepines. However, deaths resulting from benzodiazepine and opioid use increased precipitously during that time, from a low of approximately 1,000 deaths in 1999 to over 10,000 deaths in 2017. Data specific to Ativan overdose deaths is unavailable; the data collected by the CDC represent deaths associated with the benzodiazepine drug class as a whole. 

Ativan Overdose Treatment

Treatment for Ativan overdose may vary typically depending on the severity of symptoms. For minor overdoses, supportive care and observation by medical professionals are standard. Severe overdoses may require artificial ventilation to allow the patient to breathe. Flumazenil is a drug that can be administered in a hospital to counteract Ativan overdose, but it can sometimes cause negative side effects. Its use is generally restricted to serious overdoses (unconsciousness or coma) that are not associated with polysubstance use.

Even a “minor” Ativan overdose can quickly become a medical emergency. If you suspect an overdose, call 911 immediately. 

Ativan Overdose Prevention

The most effective way to prevent Ativan overdose is to abstain from use. If you have not been prescribed Ativan, do not take it. For people who have been prescribed Ativan to control anxiety or panic attacks, use Ativan precisely as directed and with caution, and make sure your prescriber is aware of any other prescription or over-the-counter drugs that you take. Never combine Ativan with other drugs or alcohol.

Ativan is a common prescription drug and a popular recreational drug that can rapidly cause dependence and addiction. If you or a loved one is struggling with Ativan use disorder, call The Recovery Village Ridgefield today. “Lorazepam.” Updated November 2017. Accessed August 4, 2019.

Tan, Kelly R., et al. “Hooked on benzodiazepines: GABAA receptor subtypes and addiction.” Trends in Neuroscience, April 2011. Accessed August 4, 2019. “Lorazepam Side Effects.” January 2019. Accessed August 5, 2019.

National Institute on Drug Abuse. “Research suggests benzodiazepine use is high while use disorder rates are low.” October 2018. Accessed August 5, 2019.

National Institute on Drug Abuse. “Overdose Death Rates.” January 2019. Accessed August 4, 2019.

Shoar, Nazila Sharbaf, et al. “Flumazenil.” NCBI StatPearls, December 2018. Accessed August 5, 2019.

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