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Dangers of Mixing Lorazepam (Ativan) and Alcohol

For people who abuse drugs or alcohol, there is often a point at which experimentation with polydrug use – or using more than one drug at a time – becomes part of the picture. One of the most popular substances to combine with other drugs is alcohol. It’s relatively easy to get, and it can easily enhance or otherwise affect the experience of the other substance.

However, polydrug use can be even more dangerous than using single drugs individually—especially when it comes to combining other sedative type drugs with alcohol. One example of this is combining a popular benzodiazepine—lorazepam, which is also known as Ativan—with alcohol. Whether used together inadvertently or for recreational purposes, the interaction of these two substances can be extremely dangerous.1

Anti-Anxiety Medication: Lorazepam

Lorazepam is commonly prescribed under the trade name Ativan. Ativan a benzodiazepine sedative and anti-anxiety drug. Lorazepam has several approved and off-label uses, including:2

  • Anxiety treatment.
  • Pre-surgical anxiety management and sedation.
  • Seizure treatment in epilepsy.
  • Managing anxiety-worsened irritable bowel syndrome.
  • Easing nausea and vomiting during cancer treatment.

As with many other benzodiazepines, lorazepam can become addictive. Because of the manner in which it influences certain types of brain chemistry, it may be associated with reinforcing, euphoric effects. Especially when misused in doses that exceed prescription guidelines, lorazepam can lead to a rapidly mounting tolerance, dependence, and eventually addiction.

Alcohol’s Effects

Most people are familiar with alcohol’s effects. Alcohol has some sedative effects similar to benzos. Depending on your frequency and amount of alcohol consumption, you may be at risk of several adverse mental and physical health effects described by the National Institute on Alcohol Abuse and Alcoholism. These may include:3

  • Slurred speech.
  • Impaired reflexes.
  • Clumsiness and loss of coordination.
  • Impaired decision-making.
  • Loss of inhibition.
  • Sleepiness.
  • Decreased heart rate and breathing.
  • Memory loss or blackouts.
  • Upset stomach.

Some of these effects parallel those experienced when using lorazepam. In fact, it is for this reason, among others, that mixing Ativan and alcohol can be so dangerous.

Mixing Sedatives: The Short-Term

The effects of sedatives on the body include certain cognitive deficits and slowing of physiological processes, including vital ones like breathing and heart rate. Combining multiple sedating substances may intensify the effects of each, resulting in a further slowdown of physical and mental capabilities. As described by an article from American Family Physician, this is where the danger comes in with mixing lorazepam and alcohol: The combination is much more likely to result in symptoms of overdose than the use of either substance alone, and it is a common combination found in emergency room overdose cases.4

When these slowing effects are amplified, the individual may begin to have serious issues with the systems involved. For example, breathing can slow to the degree that the person becomes unconscious; breathing can even stop, leading to coma or death.1

Other potentially dangerous effects of combining lorazepam and alcohol include:1,4

  • Ataxia (a disorder where you have problems with voluntary movement, such as difficulty swallowing or walking).
  • Hypotonia (decreased muscle tone).
  • Hypotension (low blood pressure).
  • Heart arrhythmia.
  • Memory loss or blackouts.
  • Passing out while in dangerous situations, such as while driving.
  • Slowed or stopped breathing.
  • Non-responsiveness or coma.
  • Death.

Any signs or symptoms of overdose could indicate the need for immediate medical help. When high doses of lorazepam are combined with large quantities of alcohol, an individual risks severe physical injury or even death.

Long-Term Risks of Using Ativan with Alcohol

Even if an overdose is not experienced, using lorazepam with alcohol can result in deteriorating mental or physical health over time. Long-term issues that may develop in association with chronic lorazepam or alcohol abuse can include:

  • Heart or circulatory disease.
  • Liver damage.
  • Hypoxia: low oxygen that can damage various parts of the brain and body.
  • Depression.
  • Increased anxiety.
  • Addiction.

These risks may arise when using either lorazepam or alcohol alone at high doses for a long time.1,5 However, using Ativan and alcohol together increases the chances of developing these issues and of experiencing an extreme event, such as overdose, in the future.1

Signs of Mixing Lorazepam and Alcohol

Signs that an individual is abusing alcohol with lorazepam may include:1

  • Groggy feeling.
  • Inability to focus or concentrate.
  • Muscle weakness or lack of coordination.
  • Slurred speech.
  • Slowed heart rate or breathing.
  • Loss of consciousness.
  • Non-responsiveness.
  • Coma.

Again, these combined effects may be similar to those experienced after using large amounts of either drug on its own. Other signs of polysubstance use involving both alcohol and prescription drugs might include:6

  • Finding pill bottles and alcoholic beverages together.
  • Pills missing from a prescription or going through the medication at a faster-than-expected rate.
  • Increased isolation and trouble with relationships.
  • Excessive focus on getting access to both lorazepam and alcohol.

When a person is abusing both substances at the same time, they may be at higher risk of severe intoxication and overdose, as described above and in a Treatment Improvement Protocol from the Substance Abuse and Mental Health Services Administration.7 It is important to seek treatment for substance use disorders involving multiple substances to pre-empt such dangerous and potentially-devastating eventualities.

Getting Help

Recognizing that a person is abusing Ativan and alcohol is only the first step. The next is to find a reliable, research-based treatment program that is experienced in dealing with polydrug abuse. As described in the Treatment Improvement Protocol, abuse of more than one drug can make it highly difficult to stop use of each individual substance.7 Treatment professionals who are trained, certified, and experienced in dealing with abuse of multiple substances can develop a personalized plan that can be more likely to result in a positive treatment outcome.

Finding the right recovery program can provide the best chance for the individual to undergo medical detox and safe, comfortable withdrawal management, appropriate treatment, and ongoing aftercare planning for sustained recovery from combined abuse of lorazepam and alcohol.With proper treatment, the individual is more likely to achieve and maintain recovery for the foreseeable future.

 

References

  1. U.S. Food and Drug Administration. (2016). Ativan® C-IV.
  2. U.S. National Library of Medicine. (2017). Medline Plus, Lorazepam.
  3. National Institute on Alcohol Abuse and Alcoholism. Overview of Alcohol Consumption.
  4. Longo, L. & Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61(7), 2121-2128.
  5. National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol’s Damaging Effects on the Brain.
  6. Robinson, L., Smith, M. & Segal, J. (2019). Drug Abuse and Addiction.
  7. Center for Substance Abuse Treatment. (2005). Treatment Improvement Protocol (TIP) Series, No. 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  8. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction.