What to Know About Treatment & Addiction to Ativan
What is Ativan Addiction and Treatment?
There are no medicines approved by the U.S. Food and Drug Administration (FDA) for the treatment of addiction to benzodiazepines like Ativan, but there are other therapies that can help. Cognitive behavioral therapy, motivational enhancement therapy, and contingency management are all therapy styles that can help people with addictions to recognize and change the thought processes and beliefs that contribute to substance abuse. Twelve-step programs can reinforce those lessons, too, helping to sustain recovery.
Ativan is the trade name for the generic drug lorazepam and part of the drug category known as benzodiazepines.
This class of drugs is also called sedatives or tranquilizers. Like other benzodiazepines, Ativan works by attaching to GABA (gamma-aminobutyric acid) receptors in the brain. One effect of Ativan is to slow down the chemical signals nerve receptors receive, which causes an overall calming effect, usually without impairing the cardiovascular or respiratory system.
Ativan is mainly used to treat anxiety; though, in medical practice doctors have found that Ativan can have therapeutic benefits across a range of different conditions.
- Manic bipolar disorder (as an adjunctive treatment)
- Vomiting associated with cancer drugs and chemotherapy
- Chronic sleep problems
- Muscle spasms
- Symptoms associated with alcohol withdrawal
- Psychosis associated with abrupt withdrawal from alcohol
Ativan is highly addictive. For this reason, prescribing doctors should inquire with patients about their history of drug abuse, if any, or whether addiction issues are common in their families.
To prevent physical and mental dependence on the medication, many doctors will only prescribe Ativan as a short-term treatment for 3-4 months.
Ativan abuse can affect people differently. The Internet is full of personal accounts ranging from Ativan being good for the treatment of panic attacks to long-term users feeling desperate to get off this sedative. Although unverified, some users report pleasurable, calm feelings while others report hallucinations (a rare side effect). While Ativan abusers may experience different effects, it is clear that this prescription medication is a recreational drug of abuse.
Other Benzodiazepines & Related Drugs
Dependence and Addiction
Ativan, like many drugs, can cause physical dependence. There are two main hallmarks of physical dependence on Ativan. First the body develops a tolerance to the drug and the person requires increased amounts to get the desired therapeutic effect or recreational “high.” Unfortunately, as tolerance builds and dosage increases, the risk of overdose also increases. Secondly, due to increased tolerance, people abusing Ativan will often have withdrawal symptoms when they stop using or significantly reduce the familiar amount. Physical dependence is distinguishable from addiction. Dependence is a component of addiction, but not all persons who are physically dependent will become addicted. A person who becomes addicted to Ativan will generally show mental and behavioral signs. For instance, there is often an increased amount of time, energy, and resources dedicated to getting and taking Ativan, which in turn negatively impacts work, family, school, and/or personal obligations.
Ativan withdrawal symptoms include:
- Short-term memory loss
- Panic attacks
- Hallucinations and delirium
Withdrawal symptoms from Ativan can be particularly dangerous. For this reason, high dose and/or long-term users are strongly encouraged to undergo medically supervised detox. In general, withdrawal from Ativan requires a tapering process, as suddenly stopping this drug can lead to the above symptoms as well as more serious complications. Harrowing personal accounts of benzodiazepine withdrawal abound online. Sophie Saint Thomas, a freelance writer, shared her Ativan withdrawal story with the substance abuse informational site The Fix. She describes how she was working on her yoga teacher certification when she abruptly stop taking her daily 1 mg pill of Ativan. Despite her good health and advanced daily yoga practice, Saint Thomas had a severe panic attack that she mistook for a heart attack. Saint Thomas shares that she initially got a prescription for Ativan to treat her general anxiety. After this experience, she resumed taking Ativan but only to avoid withdrawal. After another cold-turkey detox attempt, she ended up in the emergency room with seizure-like symptoms. Ultimately, Saint Thomas accepted that she could not be impulsive about ending her Ativan dependence and instead needs to taper off the drug.
Recognizing substance abuse is not always easy or straightforward. As Ativan is a prescription medication, a person who abuses the drug may fall into any one of the following relevant categories:
- Has a legitimate need and prescription for Ativan
- Has feigned symptoms to procure a prescription for Ativan
- Sources Ativan from other people with prescriptions
- Buys Ativan illegally on the street
- Engages in “doctor shopping”to get multiple prescriptions
In most of the above situations, Ativan prescription bottles may be found in the person’s home, car, or workplace. A person who is using Ativan in compliance with a doctor’s instructions will only have one prescription per month (and generally not for more than four months) from one doctor. If you see many prescription bottles, with overlapping months, that is a strong signal that Ativan abuse is occurring. In addition, when Ativan abusers go doctor shopping, they also fill prescriptions at different pharmacies to avoid detection. It is helpful to pay attention to where prescriptions are being filled.
Ativan abuse can also have apparent physical side effects. For this reason, it is valuable to learn about the side effects associated with high doses of benzodiazepines, such as:
- Poor decision-making ability
- Blurred vision
- Difficulty breathing
- Lack of coordination
- Cessation of breathing, leading to death
- Slurred speech
In some instances, Ativan abusers may not consume a high dose but rather a heavy dose over a long period of time. These individuals are considered to be chronic abusers. Symptoms of frequent consumption of Ativan include:
- Memory problems
Even still, there is another level to benzodiazepine abuse. Many individuals who abuse benzodiazepines like Ativan do so as part of a more broad drug abuse routine. These persons are considered to be poly-drug users who consume a varying range of drugs at once. A research paper published in the journal Drug and Alcohol Dependence reviewed 200 research studies related to co-occurring benzodiazepine and opioid abuse. It appears that these two substances are a common pair not only in the US, but also around the globe. The researchers sought to understand why these two drug types are often paired together.
Among their findings, they noted that benzodiazepines are mainly abused for their recreational value. In other words, opioid abusers who also abuse benzodiazepines may not be trying to self-medicate insomnia, mania, or anxiety. Rather, co-users of these drugs reported that they liked benzodiazepines because of their potential to boost the effects of the opioid “high.” The researchers called for further study in the area of the interaction between opioid and benzodiazepine abuse, especially because the mixture can be particularly lethal and present greater challenges in the treatment context.
A comparative review of drug rehab centers will show that there is a core set of treatment services and also complementary services designed to support the core recovery plan.
In Principles of Drug Addiction Treatment, published by the National Institute on Drug Abuse, core addiction treatment methods include pharmacological interventions and psycho-behavioral therapy. Pharmacological intervention refers to medication-assisted treatment (MAT). The FDA has approved certain drugs for the treatment of addiction to certain drugs of abuse. Today, most MAT services work on opioid abuse. At present, there are no medicines specifically approved to treat benzodiazepine abuse (other than using benzodiazepines in the tapering process). However, it is crucial to take note of MAT for opioid abuse in conjunction Ativan abuse because of the high co-occurrence of abuse of these two drug types.
A core set of services focused on psycho-behavioral therapy is a pillar of drug addiction rehab. Different psycho-behavioral therapy techniques are based on varying theories about what causes psychological stress leading to addiction, and the most effective approaches to achieve and maintain a drug-free mind.
Some of the most widely used psycho-behavioral therapies in drug rehabs are:
- Cognitive behavioral therapy
- Community reinforcement approach
- Motivational enhancement therapy
- Contingency management interventions
- Dialectical behavior therapy
In rehab, psychotherapy is provided on both an individual and group level. For example, in a one-on-one cognitive behavioral therapy (CBT) session, the therapist will work with the recovering individual to identify the thought processes and beliefs underlying the substance abuse. CBT has a strong focus on learning processes and posits that drug abuse is a maladapted way of coping with stress. After the underlying causes of the Ativan abuse are acknowledged, the next step is to develop new drug-free strategies to cope with stressor (e.g., triggers that cue the person to abuse drugs rather than engage in other behaviors, such as taking a walk or calling a friend for support). CBT has proven to be effective and long-lasting; even after sessions end, recovering persons report they still use the strategies they learned in CBT to maintain abstinence and make healthier life choices in general.
Twelve-step programs are such an integral part of the recovery framework that these meetings are often considered to be synonymous with recovery. Twelve-step programs may be considered ancillary therapy options, although many would say that they belong at the core of all rehab programs. These programs are distinct from psychotherapy group work. In a 12-step program, the members organize and lead the group, not a psychotherapist. For this reason, a drug rehab center can serve as a host of a 12-step group but does not actually manage it. Also, the sober sponsors who work with members of 12-step groups are not compensated by a rehab center, as their role is entirely voluntarily. Twelve-step work is not just integral to the recovery process during inpatient or outpatient rehab, but also after graduation, as part of an effective aftercare system.
The importance of family therapy, when available, cannot be overlooked. Families and other concerned individuals are often credited with the being the interventions who got the substance abuser into treatment in the first place. Drug rehab centers offer different types of family-focused services, including, for example, group therapy for the family, drug education for family members, and on-site “family day” social events. Family members and other loved ones are urged to seek individual psychotherapy to heal from co-dependency (if present) as well as the painful ripple effects of a loved one’s drug abuse.
There are numerous examples of other ancillary resources available at drug rehab centers. Much of the time, the type of complementary services depends on funding. A large subset of ancillary services revolve around wellness. Some examples of ancillary wellness services on offer at drug rehabs include:
- Animal-assisted therapy
- Adventure therapy (such as hiking)
- Art therapy
- Equine-assisted therapy
- Physical training at an on-site gym
Even a recovering person with a supportive family may need additional help from public systems that offer help with housing, free or low-cost legal services, transportation, public benefits, childcare, and/or job placement.
If case management services are not offered on site at the rehab center, a staff counselor may have guidance about how to find social workers at a local advocacy group or nonprofit that can provide assistance.