Most people understand the importance of being careful when taking prescriptions such as Ativan (lorazepam). Doctors always provide warnings about what to do when taking Ativan, and people can usually notice its effects once they begin to take it. But what happens if you take Ativan along with alcohol or other substances?
Ativan is a mild tranquilizer that helps people feel calm. It is a benzodiazepine and similar in function to other medications you may have heard of, such as Xanax and Valium. It does this by making brain functions slow down, according to the U.S. National Library of Medicine.
The medication is available only to people who have a prescription, and it must be taken exactly as prescribed. Ativan is usually prescribed for anxiety, insomnia, and pain associated with alcohol withdrawal.
Things can get murky when one takes Ativan. Mixing the medication with any drug is not recommended, but alcohol seems to be everywhere we go. Society seems to run on happy hours, networking events with free booze, or special occasions that require a toast. This makes it easy to slip up and mix the two substances, even if a person is doing their best to stay safe.
Ativan and alcohol are both depressants (downers). Each person’s tolerance to both alcohol and Ativan is different. For some people, only one or two drinks can create a bad reaction when consumed with Ativan.
Benzodiazepines of all kinds have been linked to overdose deaths, according to CNN. In fact, the number of deaths has increased steadily from 1999 to 2010. These days, there are four times more deaths linked to benzos than in the late 1990s. Some reasons for this might be:
Reasons For Benzo Overdose Deaths
Ativan’s most potent effects occur within two hours of taking it in the liquid or tablet form. If receiving an injection instead, it will take between 15 minutes and 30 minutes to start feeling the drug’s effects. The injectable form of Ativan causes reactions that can be felt for up to 24 hours.
Ativan has a half-life of 12 hours. This means that every 12 hours, its concentration decreases by half. The body gets rid of it through urine after it has been metabolized (chemically altered or broken down).
Ativan is metabolized in the liver. Its metabolites, substances that result from its metabolism or break down, are eventually excreted by the kidneys. These major metabolites have a half-life of about 18 hours.
Depending on how long you have been taking Ativan, it may take between one and six weeks for your body to fully get rid of it. So, what happens if you take other drugs while some form of Ativan is still in your body?
Using Ativan with other drugs is risky. Although many things should not be mixed with Ativan, some of the riskiest substances to mix with the drug are:
Riskiest Substances to Mix with Ativan
When used with Ativan, these medications or their street drug equivalents could increase the chances of coma or life-threatening respiratory issues. Tell your doctor if you have been prescribed any of the above medications or if you take other drugs, including street drugs.
The National Institute on Drug Abuse (NIDA) says benzodiazepines are often combined with opioids. Both of these types of drugs are considered “downers,” or drugs that slow down the nervous system. Mixing these types of substances is very dangerous, as the practice can suppress breathing to dangerous levels.
Ultimately, your doctor needs to be aware of any substances you are taking before you are prescribed a benzodiazepine.
Tell the physician if you take any of the following:
Combining Ativan with any of the medications above could cause side effects that require medical assistance. These include:
Ativan should not be mixed with alcohol. The relationship between alcohol and benzos gets complicated because benzodiazepines such as Ativan are commonly used to treat alcohol misuse, according to the Journal of Clinical and Diagnostic Research.
In fact, they are considered the best treatment when dealing with mild-to-severe symptoms of alcohol withdrawal. Not everyone who experiences withdrawal because of alcohol needs to be hospitalized, but those who do usually receive benzodiazepines for up to three days and may receive other medications if necessary.
Taking Ativan with alcohol is even riskier. This usually happens when people are using one or both substances for recreational reasons. We need more research on Ativan (lorazepam) specifically, but there is some knowledge about what happens when alcohol is mixed with Xanax (alprazolam). Since it is a similar medication, there are some ways that Ativan may work similarly to Xanax.
According to Columbia University’s Go Ask Alice, taking alcohol with benzos may cause alcohol’s depressant qualities to work faster because both substances are downers. Because both drugs slow down your central nervous system, taking benzos with alcohol makes it easier to go into cardiac or respiratory arrest. The risk of alcohol poisoning also increases with this mixture, especially if taking an extended-release version of benzodiazepines.
Factors that influence how your body reacts when alcohol is mixed with benzos include:
Factors that influence how your body reacts
The liver and kidneys help you metabolize everything you put into your body. Health issues with any of these organs make it hard to get rid of Ativan or alcohol. If either drug is present in the body because of a metabolic issue, it could cause both of them to flood your system.
Mixing Ativan and alcohol in any amount is not advisable. One drink will probably not cause complications in most people, but it’s best to avoid this combination altogether.
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(November 2018) How Does Ativan (Lorazepam) Work? Verywell Mind. from https://www.verywellmind.com/ativan-lorazepam-2584283
Ativan CIV Tablets. Federal Drug Administration. from https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/017794s034s035lbl.pdf
(September 2015) Management of benzodiazepine misuse and dependence. Australian Prescriber. from https://www.nps.org.au/australian-prescriber/articles/management-of-benzodiazepine-misuse-and-dependence-5
(April 2018) How Long Does Lorazepam Stay in Your System? Verywell Mind. from https://www.verywellmind.com/how-long-does-ativan-stay-in-your-system-80222
(September 2015) Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. Journal of Clinical and Diagnostic Research. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/
(May 2012) Treating Alcohol Withdrawal With Benzodiazepines—Safe if Mindful. Psychology Today. from https://www.psychologytoday.com/us/blog/all-about-addiction/201205/treating-alcohol-withdrawal-benzodiazepines-safe-if-mindful
(February 2016) Benzodiazepine overdose deaths soared in recent years, study finds. CNN. from https://edition.cnn.com/2016/02/18/health/benzodiazepine-sedative-overdose-death-increase/index.html
Mixing alcohol and Xanax (benzodiazepines)? Go Ask Alice, Columbia University. from https://goaskalice.columbia.edu/answered-questions/mixing-alcohol-and-xanax-benzodiazepines-0
(March 2018) Benzodiazepines and Opioids. National Institute on Drug Abuse (NIDA). from https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids