Last updated: 04/23/2019
Author: Addictions.com Medical Review
Reading Time: 3 minutes
The rising number of people suffering with a prescription painkiller addiction or an illicit drug addiction isn’t news. But, the number of people addicted to benzodiazepines (BZD) and specifically Ativan is surprising.
One reason it might be surprising is that Ativan—and benzodiazepines as a whole—is classifies by the United States Drug Enforcement Administration (DEA) as a schedule IV drug. The DEA defines this class of drug as those “with a low potential for abuse and low risk of dependence.” Nonetheless, the number of people misusing their Ativan is increasing.
An article titled “Abuse and Dependence Liability of Benzodiazepine-Type Drugs: GABAA Receptor Modulation and Beyond” reports the following findings. These come from data included in the Treatment Episode Data Set (TEDS), an annual compilation of patient characteristics in substance abuse treatment facilities in the United States, and reports prepared by the Drug Abuse Warning Network (DAWN), in which yearly estimates of drug abuse-related emergency department visits from a large network of hospitals in the United States are compiled.
- The number of emergency room visits associated with the use of sedative/hypnotics in 2005 was 34% of the total visits involving non-medical use of prescription drugs
- The number of benzodiazepine-related emergency department visits in 2005 were comparable to those involving misuse of prescription opiates (approximately 29% of sedative/hypnotic visits).
- Substance abuse treatment facility admissions due to “primary tranquilizer” use (including, but not limited to, benzodiazepine-type drugs, like Ativan) increased 79% from 1992 to 2002.
Clearly, people are struggling with benzodiazepine addiction regardless of the drug’s schedule number, and the amount of people struggling is growing. This is alarming for a number of reasons.
A factor that many fail to take into consideration is that Ativan dependence and abuse are generally part of a larger pattern of polydrug use: the use of two or more psychoactive drugs in combination to achieve a particular effect. Studies acknowledge benzodiazepine “polydrug abuse for the purpose of getting high is readily recognized as a significant social problem.”
Benzodiazepine-type drugs like Ativan are often used alongside opiates and/or alcohol. Data shows over one-third of opiate-addicted individuals report using benzodiazepines in combination with opioid drugs; methadone is particularly popular choice for polydrug abuse. Evidence submits BZDs enhance the effects of opiates; essentially the combination enhances the high.
Likewise, people with a history of moderate-to-heavy alcohol use have a tendency to have a higher degree of long-term benzodiazepine use (frequently without a prescription) and seem more susceptible to the effects of these drugs.
Ativan addiction isn’t just about recreationally using a prescription medication. Often, it is about facing multiple addictions.
A big part of developing an Ativan addiction is tolerance. Over time, people do become tolerant to various Ativan effects and they choose to change their dosage and/or to engage in polydrug abuse. One difficulty with tolerance is the role it plays in withdrawal.
Tolerance develops speedily to the sleep-inducing effects of Ativan, while the anticonvulsant and muscle-relaxant effects last for a few weeks before tolerance develops for most people. The body develops tolerance at different speeds which means some effects take longer than others to become tolerant to and some withdrawal symptoms take longer than others to end.
Because of dependence that develops due to tolerance, a specific benzodiazepine withdrawal syndrome often occurs after Ativan use is reduced or stopped. Alcohol has a very similar pattern of tolerance and withdrawal to benzodiazepines.
Patients who try to stop using benzodiazepines independently should be prepared to deal with withdrawal and would likely benefit from the assisted detoxification offered in an inpatient treatment facility.
Studies have shown that repeatedly experiencing withdrawal from Ativan and other benzodiazepines leads to increasingly severe withdrawal symptoms. This process is known as kindling and it is most often linked with alcohol withdrawal.
Symptoms can range from a mild and short-lasting to prolonged and severe. Fear of these symptoms can lead users to continue taking Ativan for years after it has corrected the original problem. Many people know that their use of the medication is not necessary, but they continue using to avoid withdrawal.
The time needed to withdrawal depends upon each individual patient, but can vary from a couple of months to a year or more depending on: length of use, dosage taken, lifestyle, health, and social and environmental stress factors.
Ativan addiction is no joke and it isn’t any safer to take on or easy to end just because it is a medication or one with a low risk of dependence.