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Ativan Withdrawal Timelines: How Long Will it Take?

Patients often come into contact with benzodiazepines such as Ativan (lorazepam) because they received a prescription from their doctor. This authorizes a person to use the medication for various conditions, such as panic disorders, anxiety, and even vomiting caused by chemotherapy.

However, anyone who uses benzodiazepines puts themselves at risk of dependency and/or addiction. Even though benzos are considered safe, the risk of misuse is higher for people who have a history of previous drug or alcohol misuse.

The medical community has shown concerns about benzodiazepine misuse since the 1980s, so the drugs are usually only prescribed for short-term use.

According to an ABC News report, benzodiazepines and alcohol are some of the riskiest drugs to withdraw from. Some symptoms of withdrawal, such as seizures, can be life-threatening. A tapered approach to withdrawal is generally recommended to avoid such issues.

AVERAGE WITHDRAWAL TIMELINES

It generally takes a few months to safely taper off benzodiazepines like Ativan, but in some instances, it can take even longer. Ultimately, a supervising physician will gradually lower the dosage of Ativan at regular intervals, often every two weeks. The amount by which the dosage is lowered will depend on the severity of the individual’s dependence.

People who have only taken Ativan for a shorter period may be able to safely withdraw from the drug in weeks, but withdrawal may take months or even years for some people. With each dose reduction, the physician will monitor the person for any withdrawal symptoms. The taper may need to be slowed if withdrawal symptoms present themselves.

The withdrawal timeline will be influenced by a variety of factors, including:

  • The average dose of Ativan that was taken
  • How long the person took Ativan
  • Polysubstance use
  • Dual-diagnosis
  • The person’s support system

According to Tonic, even people who take years to completely taper off benzos see an improvement in their quality of life as soon as their dosage is reduced. Ongoing therapy is recommended during the entire tapering process.

QUITTING ATIVAN USE

Once dependence has formed, it can be very difficult to stop taking Ativan, and it is not recommended to do this without medical supervision. Benzodiazepine withdrawal can result in life-threatening withdrawal symptoms. Medical supervision and a tapered approach are needed.

In a personal essay for Tonic, Harriet Brown wrote about her experiences with quitting Ativan. Brown was prescribed a small dose of lorazepam after a tough emotional year to relieve her feelings of panic. After taking the drugs for eight years, she knew she wanted to stop. Quitting cold turkey was not an option for her.

Brown could not find a doctor that would help her taper. This situation prompted her to research withdrawal symptoms so that she could understand what she might go through as she cut her use of Ativan. Even though she took Ativan as prescribed, she needed 10 months to fully taper off the medication. In general, fully tapering off a drug can take varying amounts of time depending on personal variables.

WHO USES ATIVAN?

Ativan and other benzodiazepines have gotten the public’s attention because prescriptions for these medications have increased 67 percent between 1996 and 2013, according to CNBC. The same news report mentions that up to 13.5 million adults in the United States are now using benzos.

Part of why prescription rates shot up is that anxiety affects up to 40 million Americans, creating a demand for solutions to this problem. Benzos were linked to 8,791 overdose deaths in 2015.

Age, sex, and ethnicity can influence how many people are exposed to Ativan. A study published on Comprehensive Psychiatry shows that women are more likely to use Ativan for longer periods, resulting in a higher likelihood of addiction.

A CBS News report further discusses the demographics of people who report using psychiatric drugs, including benzos. The data from 2013 details the number of people using such medications by ethnicity.

  • 21 percent of Caucasian adults
  • 8.7 percent of Hispanic adults
  • 9.7 percent of African-American adults
  • 4.8 percent of adults of Asian descent

Ativan use also increases with age. Only 3 percent of users are between the ages of 18 and 35, and

9 percent of users are age 65 or older.  Another concern highlighted in the study is that up to 80 percent of adults taking benzos said they were using them on a long-term basis. The medical recommendation is to prescribe benzodiazepines for only short periods to prevent dependency and misuse.

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DEPENDENCY AND TOLERANCE

Physical or psychological dependence and tolerance are not the same things. They are also not the same as addiction.

In an interview with Rolling Stone, Dr. Stuart Gitlow explained that using Ativan for too long or misusing it could cause a person to become tolerant to the drug. Tolerance means that higher doses are needed to feel the same effects. As a person increases their dosage, dependence forms more quickly.

Psychological or physical dependence is the result of consistently taking a drug. The body gets used it and needs it to perform some basic everyday functions. Dependency does not automatically make a person an addict, but it does increase the chances of addiction.

Suddenly quitting or decreasing one’s dose of Ativan triggers withdrawal symptoms after dependency has formed. Factors that affect the severity of withdrawal symptoms include:

  • How much Ativan one has been taking
  • How long the drug has been taken
  • Whether or not a person has taken Ativan as directed
  • Recreational use of Ativan (misuse)
  • How Ativan is taken (orally, snorted, or injected)

ADDICTION

Abusing Ativan is dangerous because it causes a person to crave the drug. Getting a steady supply of Ativan suddenly becomes a person’s sole concern, causing them to use more and more to feel pleasure. Misusing Ativan can affect judgment and decision-making, leading to dangerous situations.

  • Changes in personal relationships
  • Problems at work or school
  • Legal issues
  • Various health problems
  • Financial issues

WITHDRAWAL SYMPTOMS

Suddenly quitting or decreasing your dosage of Ativan is not recommended.

Stopping Ativan use or reducing your dose requires help from a physician because even three to four weeks of use can cause dependency.

Even if a person does not intend to misuse Ativan, dependence can form.

In addition to regular withdrawal symptoms after use is suddenly stopped, some people may struggle with interdose withdrawal.

Man sitting by a window in black and white

These are small-scale withdrawal periods between doses of Ativan. Interdose withdrawal presents with some of the usual symptoms of withdrawal such as:

  • Anxiety
  • Difficulty sleeping
  • Stomach pains
  • Muscle cramps
  • Tremors
  • Hallucinations

If you experience any of these symptoms, talk to your doctor promptly. If you have been abusing Ativan, do not suddenly stop taking the drug. Medical supervision is needed to safely taper off Ativan.

Withdrawal can be more severe for people who have been taking Ativan for longer than the suggested period.

TREATMENT: WHAT TO LOOK FOR

The safest way to detox from Ativan is with medical supervision, and this can often be found in a comprehensive addiction treatment program. The National Institute on Drug Abuse (NIDA) says a good treatment center will:

  • Offer medically supervised detox services
  • Tailor treatment to your specific needs
  • Conduct a formal intake assessment
  • Teach you how to manage triggers
  • Offer activities that will teach you new skills
  • Offer dual diagnosis treatment

While there is a lot of variation in how long Ativan withdrawal will take, a physician can give you a better idea of your specific withdrawal timeline. The medical professional will assess your factors at an intake interview and give you an overview of what to expect.

Sources

(May 2017) Lorazepam. U.S. National Library of Medicine from https://medlineplus.gov/druginfo/meds/a682053.html

(June 2016) Benzodiazepines: Addiction and Dependence. Verywell Mind from https://www.verywellmind.com/addiction-and-dependence-benzodiazepines-2584274

(July 2011) Addiction to benzodiazepines and codeine. Government Digital Service, United Kingdom from https://www.gov.uk/drug-safety-update/addiction-to-benzodiazepines-and-codeine

(March 2017) Frequently Asked Questions. National Institute on Drug Abuse from https://www.drugabuse.gov/about-nida/frequently-asked-questions#help

(January 2017) I Tried to Get Off Ativan. Tonic from https://tonic.vice.com/en_us/article/nzn8dq/i-tried-to-get-off-ativan

(December 2008) Tranquilizer Detox Withdrawal Can Last Years. ABC News from https://abcnews.go.com/Health/DepressionNews/story?id=6354685&page=1

(May 2015) The Daily Nightmare of Benzo Withdrawal. Huffington Post from https://www.huffpost.com/entry/the-daily-nightmare-of-be_b_7866700

(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

(May 2017) Ativan: What You Need to Know About Chris Cornell’s Anxiety Pills. Rolling Stone from https://www.rollingstone.com/culture/culture-news/ativan-what-you-need-to-know-about-chris-cornells-anxiety-pills-124013/

(June 2012) The Use of the Minor Tranquilizers: Xanax, Ativan, Klonopin, and Valium. Psychology Today from https://www.psychologytoday.com/us/blog/fighting-fear/201206/the-use-the-minor-tranquilizers-xanax-ativan-klonopin-and-valium

(August 2016) Socio-demographic and clinical characteristics of benzodiazepine long-term users: Results from a tertiary care center. Comprehensive Psychiatry from https://www.ncbi.nlm.nih.gov/pubmed/27423363

(June 2012) The Use of the Minor Tranquilizers: Xanax, Ativan, Klonopin, and Valium. Psychology Today from https://www.psychologytoday.com/us/blog/fighting-fear/201206/the-use-the-minor-tranquilizers-xanax-ativan-klonopin-and-valium

(December 2016) Study reveals how many U.S. adults are taking psychiatric drug. CBS News from https://www.cbsnews.com/news/psychiatric-drugs-study-reveals-widespread-use-women-men/

(March 2016) Is addiction a ‘brain disease’? Harvard Medical School from https://www.health.harvard.edu/blog/is-addiction-a-brain-disease-201603119260

Lorazepam (Oral route). Mayo Clinic from https://www.mayoclinic.org/drugs-supplements/lorazepam-oral-route/precautions/drg-20072296

(August 2018) Antianxiety drugs — often more deadly than opioids — are fueling the next drug crisis in US. CNBC from https://www.cnbc.com/2018/08/02/antianxiety-drugs-fuel-the-next-deadly-drug-crisis-in-us.html

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