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Ativan Addiction

Posted on January 26, 2013 in Prescription Drug Addiction

Ativan AddictionAtivan works as both a tranquilizer and a sedative at the same time. Its active ingredient, Lorapezam, slows down the central nervous system and produces feelings of relaxation and calmness that last six to 12 hours. Ativan is one of 15 benzodiazepines marketed in the United States – an additional 20 more are sold worldwide. These drugs are extremely popular and commonly prescribed. One in four American women are taking psychoactive medicines, one in ten American adults take such drugs to get to sleep, and half the students seen at their college clinics receive either benzodiazepines or antidepressants, according to the New England Journal of Medicine. American doctors write about 30 million prescriptions for benzodiazepines every year, and Ativan always takes second place among the most frequently prescribed.

The U.S. government classifies Ativan as a Schedule IV Controlled Substance, which means it is somewhat addictive but has medical uses. Some experts believe it should be moved up to a Schedule II or III Controlled Substance as “highly addictive” because it is possible to become dependent on Ativan within a week. Doctors are supposed to prescribe Ativan for only two to four weeks at a time, re-evaluate their patients before providing more, and never prescribe it for more than four months. Since these rules are not always followed, Ativan is widely abused. Between 1998 and 2008, the number of people admitted for treatment for benzodiazepine addictions tripled from 22,400 to 60,200, and that number is increasing today with Ativan always near the top as a reason for admissions.

What Is Ativan?

First discovered in the 1970s as a seemingly safer and less addictive alternative to barbiturates, Ativan is a white powder soluble in water. Pfizer drug company manufactures Ativan in pill or liquid form, and as an injectable. The pills have five sides and are white. The 0.5mg pill says A on one side, and BPI and 64 on the other; the 1mg is marked A and 2 on one side and BPI and 65 on the other; and the 2mg is marked A and 2 on one side and BPI and 65 on the other. The usual dosage is two to six milligrams taken more than once a day for anxiety, and two to four milligrams for insomnia.

Ativan’s chemical formula is7-chloro-5-(o-chlorophenyl)-1,3-dihydro-3-hydroxy-2H-1,4-benzodiazepin-2-one.

Like all benzodiazepines, Ativan has a benzene ring fused to a seven-member diazepine ring. It depresses the central nervous system by enhancing the chemical GABA. GABA inhibits certain neurons in the brain that affect the release of dopamine, a chemical associated with pleasure. Ativan’s effect on dopamine levels is therefore similar to that of other addictive chemicals, including opioid painkillers, but scientists have only recently discovered that.

What Are The Medical Uses Of Ativan?

Ativan is most often prescribed to treat anxiety, particularly what doctors call “transient situational stress,” the kind that is not supposed to last a long time. It is also prescribed for irritable bowel syndrome, epilepsy, insomnia, alcohol withdrawal syndrome, nausea from cancer treatments, the rapid sedation of violent individuals, delirium, and catatonia. It is sometimes given before a general anesthetic to reduce anxiety and induce amnesia.

The most common side effects are drowsiness, relaxation, and sleepiness. Less common side effects are confusion, depression, hyperactivity, hostility, lightheadedness, muscle weakness, nausea, and amnesia. Adverse reactions to Ativan may include hallucinations, suicidal ideation, fainting, and agitation. Some people have paradoxical reactions and express extreme hostility and anger after taking Ativan. These patients should stop taking the drug and consult their physicians.

Ativan causes birth defects in unborn children and can harm babies through breast milk. It can elevate cholesterol levels and so those who take it long-term have to undergo blood and liver tests. Ativan does not cause cancer in animals.

People with glaucoma, kidney or liver diseases, sleep apnea, seizures, depression, emphysema, bronchitis, chronic obstructive pulmonary disease, and histories of drug abuse, alcoholism, or attempted suicide should not take Ativan.

Ativan and Drug Interactions

Ativan interacts with any drug that slows down the central nervous system, and any that cause drowsiness. Do not take Ativan with barbiturates, MAO inhibitors, psychiatric medications such as Haldol and Thorazine, narcotics, opioid painkillers, antidepressants such as Zoloft and Celexa, oral contraceptives, medications for Parkinson’s disease, medications for colds, flu, allergies or asthma, sleeping pills, sedatives, or muscle relaxants. If you take Ativan with these medications, you risk overdosing and depressing your breathing to the point that it stops.

Ativan Overdoses

If you take too much Ativan, you may experience symptoms that include changes in speech, slurred speech, unsteadiness, trembling, nervousness, low blood pressure, sweating, loss of energy, irritability, shakiness, and weakness. Drowsiness can become extreme and lead to a coma. The breathing and heart rates of some people will slow down to dangerous levels, and they may be unable to control their muscles. At this point, they need emergency treatment. Doctors usually administer norepinephrine bitartrate to counteract Ativan overdoses.

The majority of people who die with Ativan in their bodies used it in combination with other drugs. This was true in the recent deaths of celebrities Michael Jackson and Whitney Houston.

How Do People Become Addicted To Ativan?

Ativan is widely available, so it is widely abused. The government estimates that 20 million Americans over age 12 years old have experimented with benzodiazepines like Ativan. The vast majority of benzodiazepine addicts –95%– abuse it in combination with other drugs, with 47% of them abusing it every day, most often to enhance the effect of alcohol or for sedation after “coming down” from stimulants like cocaine or methamphetamine. The most common drugs used with Ativan are alcohol, cocaine, opiates, and marijuana.

Fifty-six percent of benzodiazepine addicts are male, and they are most likely to be white and between 18 and 34 years old.

Some people start by taking Ativan in an appropriate way, such as for anxiety caused by job loss or some other temporary stress, but they find they like the euphoric feeling the drug produces and cannot give it up. Young people often become dependent on Ativan after first obtaining it from friends. Once addicted, the person will “doctor shop” to get a supply of Ativan, buy it illegally through Internet pharmacies, or turn to street dealers, who sometimes sell drugs laced with harmful substances. Criminals use Ativan in crimes such as date rape or robbery because it can produce amnesia.

Ativan abuse can cause long-lasting changes in the brain’s “architecture,” according to Dr. Christian Luscher, a professor at the University of Geneva in Switzerland, who first proved that Ativan is addictive. His laboratory animals given a choice of sugar water or water laced with Ativan preferred drug mixture three times over. Dr. Luscher was the one who also discovered that what causes an Ativan addiction is a similar process to that of opiate painkillers, heroin, and cannabinoids.

Long-term abuse of Ativan is also linked to muscle and sensory problems, phobias, and chronic fatigue.

Signs You Are Addicted To Ativan

If you can answer yes to one or more of these questions, you may want to consult with your family physician about your Ativan abuse.

  • Did you start using Ativan for medical reasons, and now find you cannot live without it?
  • Have you been using Ativan for more than four months?
  • Are you using Ativan without a doctor’s prescription or do you fake or exaggerate symptoms in order to obtain it?
  • Do you find you need to take more Ativan to achieve the results you want?
  • Do you experience withdrawal symptoms when you stop taking Ativan?
  • Do you have trouble fulfilling your obligations at home, school or work because of your drug problem?
  • Do you abuse Ativan in combination with stimulants or alcohol?
  • Do you feel out of control, guilty or ashamed of your use of Ativan?
  • Is your dependency on Ativan putting you at risk for financial and legal problems?
  • Are your friends or family members complaining about your drug use
  • Are you experiencing symptoms such as insomnia that you know are connected with your use of Ativan?
  • Have you tried unsuccessfully to quit Ativan?
  • Do you know that you need help for your Ativan dependency, but do you put off asking for help?

Ativan Withdrawal Syndrome

Once you decide to quit using Ativan and obtain professional help, your first step in recovery will be chemical detoxification. This is the actual process of stopping the drug, experiencing withdrawal symptoms, and becoming physically free of Ativan. The Internet is full of advice from former addicts about how to quit on your own, but none of it is worth reading. You should quit using Ativan only under medically supervised conditions, because you could have seizures, hallucinations, and other symptoms that are difficult or impossible to manage on your own. Some people also experience a “rebound effect.” This means that anxiety, insomnia or other symptoms originally controlled by Ativan return stronger when you stop taking it.

The withdrawal syndrome for Ativan is similar and can be just as difficult as the withdrawal syndrome for alcoholism, depending on how much Ativan you have used and how long you used it, as well as individual factors such as your weight, age, and general health. Ativan is considered more addictive than most other benzodiazepines, and one-third of the people who use it longer than a month experience withdrawal symptoms.

Withdrawal symptoms of anxiety and insomnia will begin one to four days after stopping Ativan, and then on days ten to 14, the full-blown withdrawal syndrome occurs. Symptoms can be headache, anxiety, sweating, dizziness, depression, insomnia, depersonalization, vomiting, cramps, confusion, delirium, vertigo, loss of memory, and panic attacks. How long your syndrome lasts depends on individual factors. Physicians can sometimes gradually reduce the amount of Ativan to control withdrawal symptoms.

Ativan Addiction Treatment

About 44% of people addicted to benzodiazepines like Ativan have psychiatric problems, which is twice the rate as that of people with other types of addictions. The vast majority are also addicted to alcohol or other drugs. Typical psychiatric problems that accompany Ativan addictions can be unresolved childhood trauma, anxiety, depression, unwillingness to put your own needs first, bipolar disorder, and so forth. You have to address these problems in treatment protocols separate from the Ativan addiction, although the same staff of psychologists and medical professionals can usually treat all these problems once you enter a treatment facility.

Residential treatment is preferable because it has the highest success rates and can actually save you time in the long run. Women in particular may encounter difficulty entering residential treatment because of childcare and career issues, but if these difficulties can be overcome, successful treatment can benefit everyone in the long-run.

Residential treatment is the most intense because it is done on a 24-hour basis. Once you start your program, you will be working with an entire staff of medical professionals, such as case managers, counselors, psychologists, teachers, nutrition experts, physical fitness trainers, and so forth. You may need to set new career goals or otherwise break radically with your past. Your relationships with your loved ones may need healing. You will have to learn skills to deal with situations and people who can trigger a relapse into drug use once you get home. Outcome-based studies have proven that learning relaxation techniques such as meditation and yoga, exploring your emotions through art, music or drama, and taking better care of yourself through diet and exercise are effective in recovery from drug addictions.

Once you return to your home, your residential treatment center staff will continue to help you with follow-up care. Your aftercare program might include continued psychological counseling and attending 12-step support meetings in your local community.

Sources:

“Lorazepam (Ativan),” The Mayo Clinic, http://www.mayoclinic.com/health/drug-information/DR602797
“Benzodiazepines,” the United States Drug Enforcement Agency, see http://www.justice.gov/dea/concern/benzodiazepines.html
Bekiempis, Victoria. “America’s Prescription Drug Addiction Suggests a Sick Nation,” The Guardian (United Kingdom), April 10, 2012.
Dobkin, Bruce (MD). Sleeping Pills, The New York Times, February 5, 1989.
Harmon, Amy, “Young, Assured and Playing Pharmacist to Friends,” The New York Times,
November 16, 2005. (A new generation writes its own prescriptions)
“Benzodiazepines,” Drugs and Chemicals of Concern, December 2011, the United States Drug Enforcement Agency, see http://www.justice.gov/dea/concern/benzodiazepines.html
“Ativan,” The RxList, The Internet Drug List, see http://www.rxlist.com/ativan-drug.htm
“Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties,” The National Institute on Drug Abuse, April 2012, see http://www.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties
“Benzodiazepines Abuse Has Tripled from 1998 to 2008,” News Release June 9, 2011, from the Substance Abuse and Mental Health Services Administration, see http://www.samhsa.gov/newsroom/advisories/1106082530.aspx
“Ativan,” The RxList, The Internet Drug List, see http://www.rxlist.com/ativan-drug.htm
Ibid.
“Lorazepam (Ativan),” The Mayo Clinic, http://www.mayoclinic.com/health/drug-information/DR602797
“Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties,” The National Institute on Drug Abuse, April 2012, see http://www.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties
“Benzodiazepines,” Drugs and Chemicals of Concern, December 2011, the United States Drug Enforcement Agency, see http://www.justice.gov/dea/concern/benzodiazepines.html
“Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties,” The National Institute on Drug Abuse, April 2012, see http://www.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties
“Ativan,” The RxList, The Internet Drug List, see http://www.rxlist.com/ativan-drug.htm
“Benzodiazepines,” the United States Drug Enforcement Agency, see http://www.justice.gov/dea/concern/benzodiazepines.html
Lorazepam, Medline Plus, A service of the National Institute of Health and the U.S. National Library of Medicine, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682053.html
Lorazepam, Drugs.com, see http://www.drugs.com/lorazepam.html
“Lorazepam (Ativan),” The Mayo Clinic, http://www.mayoclinic.com/health/drug-information/DR602797
“Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties,” The National Institute on Drug Abuse, April 2012, see http://www.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties
“Ativan,” The RxList, The Internet Drug List, see http://www.rxlist.com/ativan-drug.htm
“Lorazepam Tablets,” Material Data Safety Sheet, Pfizer Drug Company, http://www.pfizer.com/files/products/material_safety_data/WP00037.pdf
“Ativan,” The RxList, The Internet Drug List, see http://www.rxlist.com/ativan-drug.htm
“Lorazepam (Ativan),” The Mayo Clinic, http://www.mayoclinic.com/health/drug-information/DR602797
Lorazepam, Drugs.com, see http://www.drugs.com/lorazepam.html
“Lorazepam (Ativan),”PubMedHealth, U.S. National Library of Medicine, see http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000560/
Ibid.
“Ativan,” The RxList, The Internet Drug List, see http://www.rxlist.com/ativan-drug.htm
“Benzodiazepines,” Drugs and Chemicals of Concern, December 2011, the United States Drug Enforcement Agency, see http://www.justice.gov/dea/concern/benzodiazepines.html
“Substance Abuse Treatment Admissions for Benzodiapezine Abuse,” The TEDS Report, the Substance Abuse and Mental Health Services Administration, see http://www.samhsa.gov/data/2k11/WEB_TEDS_028/WEB_TEDS-028_BenzoAdmissions_HTML.pdf
“Benzodiazepines,” Drugs and Chemicals of Concern, December 2011, the United States Drug Enforcement Agency, see http://www.justice.gov/dea/concern/benzodiazepines.html
Harmon, Amy, “Young, Assured and Playing Pharmacist to Friends,” The New York Times,
November 16, 2005.
Michel L, Lang JP (2003). “[Benzodiazepines and forensic aspects]” (in French). L’Encéphale 29 (6): 479–85.
“Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties,” The National Institute on Drug Abuse, April 2012, see http://www.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties
Ibid.
Scharf MB; Kales A, Bixler EO, Jacoby JA, Schweitzer PK (February 1982). “Lorazepam-efficacy, side effects, and rebound phenomena”. Clinical Pharmacology and Therapeutics, 3(2): 175–9.
1
“Ativan,” The RxList, The Internet Drug List, see http://www.rxlist.com/ativan-drug.htm
“Substance Abuse Treatment Admissions for Benzodiapezine Abuse,” The TEDS Report, the Substance Abuse and Mental Health Services Administration, see http://www.samhsa.gov/data/2k11/WEB_TEDS_028/WEB_TEDS-028_BenzoAdmissions_HTML.pdf
Ibid.

 

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