Ativan Withdrawal, Detox, And Treatment

What Is Ativan Withdrawal?

Ativan withdrawal is marked by uncomfortable and even life-threatening symptoms that occur when a person who is dependent on Ativan (the brand name of lorazepam) stops taking it or cuts down on the dosage.

Even those who follow a prescription and only take the recommended dosage can develop a dependency and, therefore, are at risk of experiencing withdrawal symptoms. Ativan dependency can develop as soon as 2-4 weeks, with most people being unaware they are dependent on Ativan until they begin to experience withdrawal symptoms.

Ativan (lorazepam) is a benzodiazepine that works on the gamma-aminobutyric acid (GABA) receptors in the brain to enhance the effects of this inhibitory neurotransmitter. Because GABA is an inhibitory neurotransmitter, it helps calm the nervous system and the body by preventing overstimulation. GABA creates a tranquil state, decreases anxiety, and regulates sleep and relaxation.

Ativan enhances the calming effects of GABA, and with continued use, the brain adapts to this tranquil state, reducing the amount of naturally produced GABA because it is dependent on Ativan.

When Ativan is suddenly stopped or greatly reduced, the brain is left with a deficit of naturally occurring GABA. Without this inhibitory neurotransmitter, the brain immediately enters an overexcited state, commonly referred to as rebound hyperexcitability. This can create intense physical and psychological symptoms known as benzodiazepine withdrawal, which can be extremely dangerous.

Symptoms Of Ativan Withdrawal

Ativan withdrawal symptoms are uncomfortable and sometimes dangerous, which is why treatment for the withdrawal phase is important. People with a history of taking higher doses or chronic users of lorazepam have a higher risk of uncomfortable and dangerous withdrawal symptoms.

Ativan withdrawal symptoms are highly variable and often come and go. They may vary in severity and frequency throughout all phases of the withdrawal process. There are two stages of benzodiazepine withdrawal: acute withdrawal and protracted withdrawal; however, not everyone will experience the protracted withdrawal phase.

Common acute withdrawal symptoms usually last up to 10 days and include:

Protracted withdrawal, also known as post-acute withdrawal syndrome (PAWS), is the presence of withdrawal symptoms, typically psychological and emotional, after acute withdrawal is over. This phase can begin a few weeks after the last dose of Ativan and can last several months, even up to a year. Some people may not experience protracted withdrawal.

Common Ativan protracted withdrawal symptoms include:

• Anxiety
• Depression
• Cravings
• Sleep difficulties
• Difficulty concentrating
• Reduced interest or lack of initiative
• Inability to feel pleasure
• Constantly feeling tired
• Obsessive-compulsive tendencies
• Memory problems

Rebound Anxiety And Insomnia

​​Rebound symptoms are common during Ativan withdrawal. Rebound symptoms are the temporary, enhanced return of the symptoms, like anxiety or insomnia, that led the person to take Ativan in the first place. Sometimes they can be worse than before the person started taking Ativan.

Rebound anxiety and rebound insomnia usually occur a few hours or days after the last dose of Ativan and can last a few days or up to two weeks. The difference between rebound effects and withdrawal is that rebound effects are the return of previous symptoms that were in existence before Ativan use began. In contrast, withdrawal symptoms are caused by the body struggling to adapt to the absence of Ativan in the body.

Many individuals may relapse due to their inability to manage this rebound anxiety. Therefore, a taper plan is an important step that can help manage rebound symptoms until an alternative treatment is determined.

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How Long Does Lorazepam Withdrawal Last?

The duration of Ativan withdrawal is different for everyone. Typically, those who take higher doses of Ativan, use Ativan more frequently, or use it for longer periods of time experience longer, more severe withdrawal side effects.

Acute withdrawal from lorazepam can begin within 10 to 24 hours after the last dose; however, timing varies by person due to many factors, including metabolism. Acute withdrawal symptoms usually peak within 5-7 days and then begin to lessen by week two.

Protracted withdrawal symptoms can begin 2-3 weeks after the last dose of Ativan and can last several months up to one year. The psychological impact of protracted withdrawal can sometimes make people feel their life is not as enjoyable without Ativan, and it is important to address protracted withdrawal symptoms and include this potential phase in the recovery treatment plan.

Ativan Withdrawal Timeline

How To Detox From Ativan

Those who are dependent on Ativan and are at risk of withdrawal will likely benefit from an Ativan detox plan, which often involves administering a benzodiazepine taper until the person is no longer at risk of Ativan withdrawal symptoms.

A taper involves administering a long-acting benzodiazepine and gradually decreasing the dose until there is no risk of dangerous withdrawal side effects, specifically seizures. The taper allows the brain time to reach equilibrium and re-adjust to the new GABA levels. Tapering not only helps to reduce Ativan withdrawal symptoms but also makes the detox process more comfortable and reduces the person’s risk for relapse.

It’s also safer to detox with a physician’s oversight, as they can monitor the Ativan user during detox and intervene if any of the withdrawal symptoms become life-threatening.

Should I Taper Off Ativan?

The decision to taper off Ativan should be discussed with your healthcare provider, as this decision depends on each individual and their risk for dependency and withdrawal.

Factors such as how much Ativan you were taking, for how long, and how frequently you were taking it are the main determinants of whether you should taper off Ativan.

Those who have taken Ativan very occasionally, such as only when they are having heightened anxiety symptoms, typically do not need to taper off it. People who take Ativan regularly are usually the ones who may need to taper off it.

How Is An Ativan Addiction Treated?

Ativan addiction treatment depends on the severity of addiction, the person’s support system, and whether any other substances, such as alcohol or other drugs, are also being abused.

If a person has a mild dependency on Ativan, but is not diagnosed with an addiction, then they can benefit from an outpatient taper regimen or an inpatient detox taper regimen, where a taper is given until they are no longer at risk of dangerous side effects. Tapering in an inpatient vs. an outpatient setting depends on insurance coverage, the risk of dangerous withdrawal effects, and the person’s support system at home.

An individual who is dependent on Ativan and who is also diagnosed with an Ativan addiction or who uses alcohol and other drugs alongside Ativan may need a higher level of care that not only addresses the Ativan detoxification but also addresses the underlying addiction. They may benefit from an inpatient detoxification where a taper is administered.

After they have completed the detoxification process, they can undergo structured psychotherapy sessions that can address healthy coping strategies, urges, and cravings. Treatment for Ativan addiction should address both the physical and psychological aspects of addiction.

In severe cases, hospitalization may be warranted where a benzodiazepine taper is administered intravenously because the person is at high risk of very dangerous withdrawal effects, such as life-threatening seizures.

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Aftercare And Relapse Prevention Strategies

Ongoing treatment has proven to be very effective in helping people stay sober in recovery. Continuing therapy and support groups allow Ativan users to connect with like-minded people, remain accountable for their actions, and express their feelings in a safe environment. Having a community of supporters is essential to recovery and helps avoid relapse.

Tips for avoiding relapse include:

Joining A Support Group

There are numerous support groups for those in recovery from Ativan addiction, such as Narcotics Anonymous, which is centered around the 12-step program approach, or SMART Recovery™, which uses its own 4-point program.

Have A Support System

A support system can include family, friends, a sponsor, a recovery mentor, or others you meet in a support group. These people will inspire you, hold you up when you’re feeling down, and help keep you on the path to recovery.

Know Your Triggers And Avoid Them

Knowing the triggers that make you want to use is key to maintaining sobriety. Once you identify the people, places, or things that make you crave Ativan, you can set boundaries and avoid putting yourself in risky situations. You can also let your support system know about these triggers so they can help you avoid them.

Talk To A Counselor

Speaking with a therapist or counselor is a great way to manage anxiety and stress you may face during recovery. They’ll also be able to give you professional advice and help you learn to cope with cravings.

Stick To A Schedule

Maintaining a schedule will help to fill your day and mind, preventing too much downtime to think about using Ativan.

Take Care Of Your Body

A healthy body leads to a healthy mind. Getting the proper amount of sleep, exercise, and nutrition can help you to feel your best both physically and mentally.

How Do I Find A Detox Center For Ativan Dependency?

​​Treatment in an inpatient or outpatient program will give Ativan users their best chance at a successful recovery. These programs can help with the detox process, making it both safer and more comfortable. They’ll also teach the skills necessary to remain sober during recovery.

Getting treatment for Ativan addiction can help users connect with support that will be essential during recovery. The relationships built and lessons learned in treatment can help people in recovery lead a full, happy, and addiction-free life. For help finding an Ativan addiction treatment program, visit our rehab directory or contact a treatment provider today.