Lorazepam Symptoms and Warning Signs

Lorazepam is one of the most difficult drugs to quit. It is a benzodiazepine and marketed in the UK as Almazine and Ativan. While the medicine is effective in treating alcohol withdrawal, sleep disorders, anxiety, seizures, and status epilepticus, it has gained a bad reputation for causing physical dependence and withdrawal symptoms that can sometimes last years in recovering addicts.

Lorazepam is very powerful. One milligram is equivalent to 30-40 mg of Valium. It binds strongly to benzo receptors in the brain and takes a few days to disassociate from the receptors. The problem is further compounded by the strength of the tablets. Some doctors prescribe 2.5 mg pills be taken three times daily, a dose that increases the risk of dependence. According to the Royal College of Psychiatrists, four in ten people who take benzos for up to six weeks become addicted, and short-acting benzos like lorazepam are harder to stay off.

Lorazepam is one of the most prescribed medicines because of its range of application. The exposure also means that there is a higher potential for abuse. Lorazepam is a Schedule IV controlled substance in the United States.

Types/Brands of Lorazepam

Like other benzos, lorazepam works on the GABA receptors, to induce feelings of relaxation and calmness. It is mostly used to treat anxiety disorders but is also prescribed for irritable bowel syndrome (IBS), stomach upset from chemotherapy, dysautonomia, Borderline Personality Disorder, Cervical Dystonia, insomnia, and epilepsy. It produces a similar effect to Diazepam and Xanax but is more potent in its pill strength than most benzos.

Medication containing lorazepam include:

  • Lorazepam Intensol
  • Ativan
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Recognising the Common Warning Signs of Lorazepam Abuse

There are some warning signs you can look out for in someone who is abusing lorazepam. It is a powerful drug that has a higher potential for dependence and addiction than others. When someone is physically dependent on it, their body craves the drug and develops tolerance to their normal dose. They will need lorazepam just to feel like themselves or to perform normal functions.

Outward signs are usually the first to appear:

  • Loss of appetite
  • Headache
  • Nausea
  • Dizziness
  • Sweating
  • Confusion
  • Vomiting
  • Tremors
  • Hallucinations
  • Blurred vision
  • Low sex drive
  • Constipation
  • Changes in appetite
  • Mood swings
  • Memory and cognition problems
  • Difficulty maintaining balance
  • Irritability
  • Stomach pain

If they have a prescription, you’ll notice they take larger doses at an increased frequency and become preoccupied with how to get more drugs and take them. “Doctor shopping” is one of the first signs of abuse. Someone who is dependent on lorazepam visits multiple doctors and pharmacies, to get as many prescriptions as they can to maintain their drug habit. This is while they still care to get prescriptions for their medication.

Abuse can happen within only six weeks of continued use. If they take the drug for longer than four weeks, it might be a sign that they have developed a tolerance for the drug. Psychological symptoms include cravings when they go a short while without taking the drug, and the manifestation of withdrawal symptoms when they attempt to quit their lorazepam abuse.

The Dangers of Lorazepam Abuse

A report from SAMHSA found that 32% of hospital visits involving benzos, like lorazepam, result in outcomes such as hospitalization and death. Most of the visits involve recreational users, who combine Ativan/lorazepam with alcohol, opioids, and other benzos. Combining lorazepam with alcohol enhances the effects of both substances, and increases the potency of the high.

Another danger is in snorting lorazepam – as this method increases the effect of the drug. When you snort lorazepam, it is transported directly to your bloodstream, exposing you to more side effects, which could have been avoided by taking the pill orally.

The substance stresses the liver as it tries to metabolize it alongside other substances, especially alcohol, at once. Subsequently, older adults whose livers are not as effective are at higher risk of liver damage.

You shock your body and brain when you snort a high dose of lorazepam, and the usual side effects are intensified. They include nausea and vomiting, extreme drowsiness, muscle weakness, irregular heartbeat, fainting or coma, difficulty swallowing, yellowing of the skin, severe skin rashes, confusion, and inability to stay still.

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Recognising a Lorazepam Addiction

As with many prescription-only drugs, there is a risk of developing physical dependence, and addiction, when you take lorazepam in any way not prescribed by your doctor.

Lack of control over lorazepam use: The first sign of addiction is that you have no control over your lorazepam use. It’s the first thing you do in the morning and the last thing you do at night. You keep it in your car, your pockets, and in easy-to-reach spots. Your brain depends on high levels of dopamine to function, which forces you to take the drug at frequent intervals.

  • You know the negative consequences but can’t stop abusing lorazepam
  • Your health is taking a turn for the worse but you continue using lorazepam anyway
  • You’re engaging in more fights and arguments with your loved ones over your lorazepam use
  • You experience withdrawal symptoms when you attempt to quit lorazepam
  • You exhibit risky behaviour, such as buying drugs online or driving under the influence
  • Cravings for lorazepam
  • Ignoring work and home responsibilities to use lorazepam
  • Drop in performance at school or work because of lorazepam abuse
  • You develop a tolerance and need higher doses to feel the original effects
  • You’ve tried to quit but failed

Lorazepam Addiction and the Brain

According to the National Survey on Drug Use and Health, there were over 1.7 million Americans abusing benzos, like lorazepam, in 2013. Lorazepam is a CNS depressant that slows down imbalanced electrical activity in the brain. This is how lorazepam relieves the symptoms of restlessness, irrational fear, tension, and anxiety.

The human brain and body were not designed to process large combinations of Central Nervous System (CNS) depressants, or process a flooding of dopamine and serotonin neurotransmitters on a high level. Your brain might shut down as a result of low blood pressure, respiratory depression when the brain doesn’t receive sufficient oxygen and overdose. These substances trigger GABA receptors in the brain, obstructing normal brain reactions to common stimuli.

What are the Immediate Side Effects of Lorazepam Abuse?

The immediate effects occur right after you’ve taken the drug. It peaks two hours after you took the pill, and induces positive feelings of:

  • Sedation
  • Relaxation
  • Calmness

When you take higher doses, you might experience the following:

  • Accidents or falls
  • Extreme drowsiness
  • Weakness
  • Poor judgment
  • Impaired cognition
  • Respiratory suppression
  • Tremors
  • High fever
  • Irregular heartbeat
  • Diarrhoea
  • Constipation
  • Difficulty swallowing
  • Dry mouth
  • Distorted vision

What Are the Long-Term Effects of Lorazepam Abuse?

Tolerance: If you use lorazepam for longer than it was prescribed, you could develop tolerance. Within two weeks, your brain adapts to changes in dopamine and serotonin levels, reinforcing the need to take larger doses to feel the original effects.

Dependency: When your brain has adjusted to higher levels of neurotransmitters, you will experience withdrawal symptoms when you stop taking lorazepam. The brain responds to this abrupt change by sending rebound anxiety symptoms, depression, flu-like symptoms, nausea, and tremors.

Overdose: The risk of overdose is high when you continuously abuse lorazepam or combine it with other CNS depressants. Symptoms include delayed respiratory response, unconsciousness, impaired liver function, suicidal ideation, slurred speech, migraines, and coma.

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Intervention for a Lorazepam Addiction

When your loved one is abusing drugs, it’s a frightening experience for everyone who loves them. You worry about the effect on their lives, and you don’t know how to convince them to seek treatment for their addiction. If you notice that drugs have affected their physical or mental health, finances, job, family relationships, and/or physical appearance, it’s time to intervene.

The best way to hold an intervention is to seek the help of a professional interventionist, who can increase the chances of a positive outcome from the intervention. When conducted correctly, interventions have a 93% success rate, as an interventionist knows how to encourage an addict to get help when they are in denial.

A few tips to help include:

  • Do your own research on lorazepam addiction. Learn about the symptoms, side effects, risk factors, and dangers of addiction.
  • Gather together the interventionist team. It should include close friends and family. Members should be able to state their case without prejudice or judgment.
  • Establish goals
  • Rehearse the intervention before the day
  • Hold the intervention
  • Stick to the plan

Detox and Withdrawal from Lorazepam

When you quit lorazepam, you will experience withdrawal symptoms. Your body is learning to function without the presence of lorazepam and fights back with physical and psychological withdrawal symptoms. The duration of detox and the length of withdrawal depends on the severity of your addiction, combination of drugs, and history of substance use disorder.

Addiction experts advise that you do not withdraw “cold turkey”, or you could well experience the symptoms of lorazepam abuse in a more intense way.

Physical and psychological symptoms include:

  • Panic attacks
  • Rebound anxiety
  • Tremors
  • Cravings for lorazepam
  • Changes in blood pressure
  • Irritability
  • Aggressive behaviour
  • Depression
  • Muscle pain
  • Headaches
  • Sleep disturbances
  • Seizures (mostly for long-term recreational users who regularly took high doses)

Doctors use tapering to reduce the severity of withdrawal symptoms. They gradually reduce your dose until all traces of lorazepam have left your system. You’ll be provided with longer-acting benzodiazepines, and antidepressants, to ease symptoms, and anti-seizure medication to reduce severe symptoms of benzodiazepine withdrawal.

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Treatment and the Next Steps for Lorazepam Addiction

The most comprehensive treatment for lorazepam abuse is to enroll in an inpatient rehab center. Treatment includes medication-assisted treatment, behavioral therapies, skill building, education classes, relapse prevention planning, 12-step programmes, and aftercare.

Inpatient rehabilitation centers provide a therapeutic community, devoid of distractions and triggers, to ensure your only focus is on making a full recovery from lorazepam abuse and addiction. You are surrounded by a community of recovering addicts and care specialists, whose only goal is to help you reach your recovery goals. Options for inpatient treatment include standard rehabilitation centers, state-run programmes, executive rehab, and luxury rehab.

If your job or school prevents you from attending rehab full-time, or you can’t afford the cost of inpatient treatment, you can enroll as an outpatient. You still receive medication and therapies at the rehab center, but you don’t live in the facility. This benefits individuals who are short-term users, without any mental disorders or medical conditions.

If you need help or feel overwhelmed, call a free drug counseling helpline, and a counselor will help you find the right treatment option for lorazepam addiction.

Questions about Treatment

How long does lorazepam stay in your system?

Lorazepam has a half-life of 12 hours, which means it takes roughly three days for the drug to leave your system. The active metabolite, lorazepam glucuronide, can be detected in a urine test four days after your last dose, and it takes five days for 95% of the drug to be fully eliminated from your system.

What are the warning signs of lorazepam abuse?

Behavioral warning signs of lorazepam abuse include failed attempts to quit lorazepam abuse, continued use when you know the negative consequences, and preoccupation with buying and using lorazepam. Physical signs include tremors, headaches, loss of appetite, shallow breathing, memory loss, drowsiness, seizures, and bleeding in the digestive tract.

Can I overdose on lorazepam?

Yes. Lorazepam is a powerful benzodiazepine with high potential for abuse and addiction. An overdose usually happens when you take larger doses than prescribed, or combine lorazepam with substances that depress the central nervous system.

What are the treatment options for lorazepam addiction?

Treatment options include detox to remove all harmful toxins from your system, inpatient rehab to help you understand your addiction and learn to cope with triggers or outpatient treatment for those who can’t attend rehab full-time, and aftercare to help you maintain abstinence after rehab.

Will insurance cover the cost of treatment?

All medications under the classification of benzodiazepines are recognized in the DSM-V as substance use disorder. Hence, insurance will cover the full, or partial, cost of treatment depending on your level of coverage. Contact your insurer for more details.

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