Lorazepam, brand name Ativan, is a prescription medication intended to treat seizure disorders like epilepsy. It also doubles as an antianxiety/antidepressant medication. Ativan is a member of the benzodiazepine category of drugs. These particular drugs are incredibly potent and have a strong impact on the brain.
Ativan acts in the brain to produce a calming effect. It operates like other benzodiazepines by enhancing the effects of the neurotransmitter (brain chemical) gamma-aminobutyric acid (GABA).
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It induces a sedative state. The individual will begin to experience sleep-inducing effects, a decrease in anxiety, relaxation of muscles, as well as anticonvulsant effects. Ativan is safe in short-term use. Those who are on the medication for elongated periods of time, as well as those who use the medication illicitly, will inevitably develop a physical dependence on the drug. Over time, the brain’s chemistry is altered by the presence of the Ativan in the system.
In response to the stimulation of GABA, the brain begins to develop neural adaptations, essentially meaning that the body is building a tolerance to the medication. This means that more of the medication is required to achieve the same effects, thus increasing the physical dependence.
People who abuse Ativan are looking to achieve the sedative effect of the drug. Taking large amounts of it at one time floods the brain with GABA and dopamine, stimulating the reward center of the brain.
After the body becomes dependant on the drug, the individual must take Ativan regularly to avoid experiencing the uncomfortable, potentially dangerous, and life-threatening side effects of Ativan withdrawal.
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What Are the Ativan Withdrawal Symptoms?
If a person who is addicted to Ativan attempts to stop taking the drug, they’ll encounter a number of nasty withdrawal symptoms. Both physically and psychologically addictive, the cessation of Ativan causes the body to go through an adjustment period as it attempts to return to normalcy without the presence of the Ativan in its system. The brain must balance out chemically since Ativan directly impacts the way to brain operates.
Some of the Ativan withdrawal symptoms that may be experienced are:
- Abdominal cramps
- Loss of appetite
- Memory loss
- Suicidal ideations
Some of these withdrawal symptoms are worse than others, with seizures presenting even life-threatening complications. The withdrawal process can begin quickly, and it’s crucial to understand the timeline associated with the symptoms so you can be prepared.
What Are the Stages of the Ativan Withdrawal Timeline?
Obviously, the withdrawal process is different for everyone. The strength, severity, and duration of symptoms all depend on the amount of Ativan that was taken as well as the frequency of the dose. If an individual used larger amounts of Ativan more frequently, they would experience more intense withdrawal symptoms for a longer period of time than someone who was an infrequent, low dose user.
Symptoms may begin to present themselves as quickly as 10 to 24 hours after the final dose is administered. This window of time varies and depends on the amount that was taken in correlation to the severity of the dependence on the substance. The beginning stages of the withdrawal process will include more acute symptoms, and, as you reach the end of the withdrawals, begin to subside over time.
Typically, acute withdrawals will be experienced for approximately 10 to 14 days, with lingering symptoms lasting up to a few months. The physical symptoms will subside in the initial weeks with the psychological withdrawal symptoms being the most persistent.
Acute withdrawal symptoms will present themselves during the first 72 hours. Symptoms such as headache and nausea will begin within the first 24 hours, with the following two days symptoms like anxiety and insomnia beginning.
Between the 4th and 7th day, symptoms will peak. The individual may encounter tremors, cravings for Ativan, and irritability.During the first and second week, symptoms will begin to subside, slowly decreasing in severity.
Insomnia and anxiety should begin to fade completely. Beyond the two week mark, acute withdrawal symptoms should have vanished entirely. Whatever remaining withdrawals exist will be mild.
Although it takes approximately two weeks to overcome the majority of Ativan withdrawal symptoms, it is vital to know that symptoms may present themselves for upwards of several years following addiction to the medication. Depending on the severity of physical and psychological dependence, an individual may be subject to a more intense and longer withdrawal timeline than others.
Rebound Anxiety and Insomnia
Rebound symptoms are common during this period. Rebound symptoms may only be temporary but can be severe enough to push someone back into using Ativan. Rebound symptoms are considered an enhanced return of symptoms, such as anxiety or insomnia, that led the person to use Ativan in the first place. Rebound symptoms typically occur two to three days after the acute withdrawal phase of detox.
Many of those who attempt to detox alone will relapse due to their inability to manage rebound symptoms. Estimates highlight that 10 to 35 percent who detox from Ativan will experience rebound symptoms. A taper from Ativan is the best option when managing rebound symptoms until you’ve decided your treatment options.
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Factors Influencing Ativan Withdrawal
The length of time Ativan is abused, and the amount consumed at one time can affect dependency levels. The route of administration can also influence the severity of withdrawal as well as the length. Snorting or injecting Ativan may lead to increased dependency levels faster than ingestion.
A person with a co-occuring mental health problem who abuses Ativan can experience more intense withdrawal symptoms for more extended periods.
In addition to these factors, abusing other drugs or alcohol with Ativan can increase dependency and lengthen withdrawals. Biological and genetic makeup can play a role in the timeline, as no two people will experience withdrawal in similarly.
Ativan detox will be the first step in managing this addiction.
Why Should I Detox?
Detoxing safely when it comes to a benzodiazepine addiction is crucial. Since seizures are very common among detox patients, going cold turkey off of Ativan can be potentially life-threatening. Seizures can cause long term brain damage, and in worst-case scenarios, death.
In order to avoid an uncomfortable withdrawal experience, entering a medical detox facility for Ativan withdrawals is also important.
Many people find that they cannot resist the cravings or that the withdrawal symptoms are too much for them to handle on their own. Subsequently, they will return to the drug to find relief from the withdrawal pain. Relapse is most common within the first week of recovery, and without any medical or psychological support, it can prove to be too challenging to quit on your own.
To avoid going through medical detox with professional help, many people suffering from an addiction or chronic drug abuse will go cold turkey. Cold turkey is abruptly stopping the use of a substance to quit extremely fast.
Quitting cold turkey is one of the most dangerous things you can do. For nearly all physically addictive drugs, quitting cold turkey is not only ineffective but even counterproductive. Immediate quitting of a substance will usually result in severe withdrawal symptoms, posing many health risks for the victim.
What Is the Next Treatment Step?
If you decide it’s time to quit Ativan, there are certain steps you can take to safely detox from the medication and start on the road to recovery. Going to a medical detox facility is always advised, mainly due to the potentially threatening withdrawal symptoms you may encounter when getting off of Ativan.
Upon your arrival to the medical detox facility, you will be assessed by the medical team who will provide around the clock surveillance to track your progress and condition. You will also be provided a regime of detox prescription medications designed to ease the detox process and help you endure the withdrawal process with little to no discomfort.
In addition to medical professionals, many detoxes also provide psychological support in the form of counselors, therapists, and case managers. Detox can be a mentally and emotionally difficult time for many people, so having the extra support available can make these withdrawal symptoms more comfortable to endure.
Therapy will also be provided on a lesser scale at many detoxes. This way, you can begin to take a look at your addiction and the underlying causes that may have led you to abuse substances in the first place.
After successful and safe completion of medical detox, it is advised that you complete the full continuum of care by attending an inpatient residential treatment facility. Your length of stay will vary on an individual basis, but the standard stay is anywhere from 30 to 90 days.
While here, more intensive therapy begins on a full-time schedule. Since the difficult portion of treatment is completed (detox), more attention can be on the therapeutic aspect. By attending an inpatient facility, you will give yourself more time away from the drug and stay in a safe space that fosters recovery.
After inpatient treatment is over, it is recommended that you enter an intensive outpatient program (IOP). Therapy becomes part-time as you begin to make the adjustment back into the routine of daily life outside of treatment. IOP acts as a buffer between treatment and the outside community, keeping you accountable to your recovery and sobriety by attending therapy sessions and submitting drug tests.
Acclimating to life as a sober person can be a foreign concept for most people who spent perhaps years addicted to Ativan. It’s important to learn how to function in your life and the community without the use of drugs. IOP can help give you further support, increasing the likelihood of your success during this transitional period.
By completing the full continuum of treatment, you not only lay a more solid foundation in recovery for yourself but increase the likelihood of achieving long-term sobriety.
Without utilizing detox and treatment, you run the risk of not only suffering terrible withdrawal symptoms but continually relapsing without having the proper physical or emotional care.
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Herman, J. B., Brotman, A. W., & Rosenbaum, J. F. (1987, October). Rebound anxiety in panic disorder patients treated with shorter-acting benzodiazepines. Retrieved from from https://www.ncbi.nlm.nih.gov/pubmed/2889722
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