Lorazepam, a benzodiazepine also known by the brand name Ativan, is a drug commonly prescribed to alleviate symptoms of anxiety. Due to its ability to produce feelings of calmness and relaxation, lorazepam has a high potential for abuse. It is known to be habit-forming and can result in tolerance 1. According to a report published in the American Family Physical Journal, lorazepam is listed as one of the most commonly prescribed medications 2.
With its ease of availability and pleasurable effects, many people who abuse lorazepam have a hard time trying to quit. And more dangerously, lorazepam abuse and addiction can lead to overdose, especially if combined with other substances, such as alcohol. According to a 2011 report published by the Drug Abuse Warning Network (DAWN), benzodiazepines were involved in 123,572 of the 606,653 emergency room visits in 2011 that involved drugs and alcohol taken together 3, and the National Institute for Drug Abuse reports a 4.3-fold increase in the total number of deaths between 2002 and 2015 due to benzodiazepine overdose 4.
Signs and Symptoms of Lorazepam Overdose
Someone who has overdosed on lorazepam may experience a wide range of physical and psychological symptoms and exhibit telltale signs including 3,5:
- Paradoxically increased anxiety or agitation.
- Involuntary eye movements.
- Blurry vision.
- Involuntary muscle contractions.
- Reduced muscle strength.
- Decreased reflexes and impaired reaction time.
- Profoundly lowered blood pressure.
- Severely slowed breathing.
- Death, especially if combined with opioid drugs, such as codeine or morphine.
Even just a few of these symptoms may indicate that someone has overdosed on lorazepam.
Certain conditions and actions may increase your chance of a lorazepam overdose. For instance, overdose risks are very high if you use lorazepam in combination with other substances. Alcohol and other drugs—including other benzodiazepines like Valium—can increase the risk of dangerous effects such as respiratory depression and may easily lead to overdose 5.
The presence of significant drug tolerance is another risk factor for overdose. It occurs when your body adapts to lorazepam and needs more of the substance to produce the same results; lorazepam can produce tolerance in as little as 2 weeks 5. So, if you have developed a tolerance, you may increase your dose to experience the pleasurable sensations you did when you first started taking the drug, resulting in an accidental overdose.
If you stop using lorazepam for a certain period, your tolerance to the drug will likely decrease. Therefore, if you resume taking the same high dose after your tolerance has subsided, you may also be at higher risk of overdose.
What to Do If You Overdose on Lorazepam
If you or someone you love overdoses on lorazepam, you should:
- Seek immediate medical care at your nearest hospital by either calling 911 or driving your friend or loved one to the emergency room.
- Bring the drug container with you (even if it’s empty) to the ER or hand it over to EMTs. If possible, bring along the containers to any other drugs or medications (including over-the-counter drugs or supplements) the person may be taking.
- Do not leave the person alone while waiting for medical personnel to arrive. If the individual appears unconscious, try to get their attention. Ask them to tell you their name and provide light physical stimuli to rouse them and keep them engaged.
- Reassure the person and try to remain calm. Don’t criticize the person or offer your opinion.
- Stay at the hospital to answer any questions medical staff may have if you are caring for a friend or loved one.
- Inform medical staff if you or a loved one have consumed any other drugs or substances, including alcohol, legally prescribed or over-the-counter medications, or herbal supplements.
- Provide as much information as possible about the drug, including the dose and when the drug was last taken.
Lorazepam overdose can be treated with a specific benzodiazepine antidote medication known as flumazenil. This medication may be intravenously administered to help to reverse the effects of lorazepam overdose, but it may contribute to seizure risks—its use must be closely monitored by medical personnel 5.
Preventing Lorazepam Overdose
Asking for help isn’t a sign of weakness but a sign of strength.
Preventing a lorazepam overdose requires the ability to self-monitor and have restraint, factors that tend to be impaired in those who abuse substances. The most advisable method of preventing a lorazepam overdose is to avoid using lorazepam recreationally, without a prescription from your doctor, or more than the dosing schedule provided on a prescription.
Aside from ceasing drug abuse, the best way to prevent a lorazepam overdose is to seek treatment for your addiction or to assist your loved one in getting help. Getting treatment for a drug addiction isn’t as daunting as it might first seem. And asking for help isn’t a sign of weakness but a sign of strength that you want to take back control of your life.
You can choose from a number of professional, caring treatment facilities to help you break free of your addiction and start living a clean and sober lifestyle. Some of the more common recovery options include:
- Detox. Detox is designed to gradually clear your body of the drug. The initial step is to taper the drug dose or, in some cases, use a longer-acting benzodiazepine to first replace the lorazepam before tapering it. Medications help to minimize the risks of dangerous withdrawal effects, making early recovery safer and more comfortable. Throughout the withdrawal period, you receive close monitoring and medical supervision to maximize safety and minimize any unpleasant withdrawal symptoms.
- Inpatient Treatment. You live at a recovery center for several weeks to several months, depending on the extent of your addiction and the services you require. Services you might receive include individual and group therapy, drug testing, psychoeducational classes, relapse-prevention education, and 12-step group therapy. This option is beneficial for people with chaotic home lives, serious addictions, or those who need or prefer a high level of care and support.
- Luxury Treatment. This form of residential treatment provides standard treatment modalities complemented by luxurious, 5-star amenities and services, such as private rooms, spa treatments, and gourmet meals.
- Executive Treatment. Suited for busy professionals and those in highly demanding careers, executive treatment offers top-notch care and amenities but allows time for professionals to work and even travel, if necessary.
- Partial Hospitalization. This is a form of outpatient treatment where you attend treatment as often as 5 days a week in a medical facility but return home in the evening. Treatment is highly structured and usually revolves around group therapy. You may also receive medication if necessary.
- Intensive Outpatient. You live at home but attend treatment several days per week for several hours per day.
- Standard Outpatient Treatment. You attend group therapy and psychoeducational classes 1 to 2 days per week for as long as a year—maybe longer in certain cases.
- Gender-Specific Treatment. Many people feel more comfortable attending treatment with those of their own gender or feel they will benefit from recovering without the distraction of others of the opposite sex.
- Veteran Treatment. People who have served in the armed forces often struggle with dual diagnoses and may benefit from specialized services to treat co-occurring disorders, such as Post-Traumatic Stress Disorder (PTSD) or depression. Veteran treatment facilities provide expert care and support to help meet these unique needs. Additional services, such as vocational rehabilitation, are also available at these facilities.
- 12-Step Groups. People may supplement their treatment by attending 12-step groups based on the original model provided by Alcoholics Anonymous (AA). These groups offer the support of others who have walked in your shoes, combined with the structure of working the 12 steps of recovery with a sponsor’s help.
Addiction to benzodiazepines may be treated through a combination of medication and psychotherapeutic interventions 6. As treatment continues, you will benefit from a range of various psychotherapeutic techniques, including:
- Cognitive-Behavioral Therapy (CBT). You might work one-on-one or in a group with a trained CBT therapist to help you identify and replace dysfunctional thoughts and beliefs and the behaviors that result from them.
- Individual Psychotherapy. You work one-on-one with a trained substance abuse counselor to help you identify and work through issues that may have led to your addiction, learn healthier coping skills, and help you recognize potential relapse triggers so you have the optimal chances of leading a clean and sober life.
- Group Therapy. Under the guidance of a qualified counselor, you work with and gain support from others who are going through the recovery process.
Regardless of the type of treatment you choose, it’s essential to start the road to recovery as soon as possible to reduce your chances of an overdose.
- U.S. National Library of Medicine: Medline Plus. (2016). Lorazepam.
- Longo, L. and Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61(7), 2121–2128.
- Gresham, C. (2016). Benzodiazepine Toxicity.
- National Institute on Drug Abuse. (2017). Overdose Death Rates.
- National Alliance on Mental Illness. (2016). Lorazepam (Ativan).
- Brett, J. and Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152–155.