Alcohol is one of the most commonly consumed intoxicating substances in the United States. While most people drink socially, some people drink to excess. Heavy drinking, binge drinking, and alcohol use disorder (AUD) disrupt and end lives. The Centers for Disease Control and Prevention (CDC) reports that, on average, 88,000 people die annually from alcohol-related causes, ranging from car accidents to liver disease. Alcohol is involved in one out of every 10 deaths among working-age adults, 20-64 years old.
Because so many people in the country drink at least casually, there is a high risk of mixing medications and alcohol. Sometimes, this occurs unintentionally; for example, a person may take a prescription medication for anxiety, like Ativan, then go out for a drink or two with friends. In other instances, the person may struggle with substance use disorder, mixing multiple drugs to become more intoxicated. Mixing alcohol with a benzodiazepine like Ativan greatly increases the intoxication the individual will experience, but this can be deadly.
What Is Ativan?
Ativan is the brand name for an anti-anxiety medication called lorazepam. This drug is in the family of benzodiazepines, so it is chemically similar to Valium, Xanax, and Klonopin. It is typically prescribed to treat general anxiety, depression-related anxiety, epilepsy, insomnia, irritable bowel syndrome (IBS), alcohol withdrawal, and some nausea associated with cancer treatment.
Ativan is a rapid onset drug and, like other benzodiazepines, designed for short-term use. If taken for longer than two weeks, even a person who is taking this medication as prescribed risks developing a physical dependence on the substance.
Warning labels on Ativan state that drinking alcohol while taking this medication can be dangerous. Unfortunately, lorazepam is statistically one of the most abused prescription drugs in the United States, so many people are at risk of abusing both alcohol and Ativan.
Why Are These Substances Harmful When Mixed?
Both alcohol and Ativan are central nervous system (CNS) depressants, and mixing drugs in this group is generally dangerous; however, benzodiazepines and alcohol affect similar areas of the brain, involved in the production of the neurotransmitter gamma-aminobutyric acid (GABA). This neurotransmitter plays a key role in helping neurons communicate; when there is not enough of it, neurons fire rapidly, which increases the risk of convulsions in people with seizure disorders, increases the likelihood of panic attacks associated with anxiety or post-traumatic stress disorder, and reduces a person’s ability to sleep if they struggle with insomnia. However, with more GABA present in the brain, a person will feel relaxed, happy, and even sleepy. As prescribed, drugs like Ativan play an important role in helping a person begin to relax; however, as substances of abuse, benzodiazepines can lead to depressed breathing, intoxication, increased risk of interacting with other drugs, physical dependence and tolerance, addiction, and overdose.
The National Institute on Drug Abuse (NIDA) reports that benzodiazepines, including Ativan, are rarely the primary substances of abuse; these drugs are typically abused to enhance the effects of other CNS depressants, especially opioids or alcohol. The Drug Abuse Warning Network (DAWN) reported that, between 2005 and 2011, nearly 1 million emergency department admissions involved benzodiazepines, but they were most common in combination with opioids, alcohol, or both. It was rare for overdoses to be caused solely by benzodiazepines like Ativan. The DAWN report found that opioids or alcohol alongside benzodiazepines increased the risk of more serious outcomes, like longer stays in intensive care, by 24-55 percent.
Benzodiazepines, including Ativan, are being referred to as a “shadow epidemic,” because they are found in so many poisoning and overdose reports and deaths. While opioids were involved in around 70 percent of overdose deaths in 2013, benzodiazepines were found in about 30 percent of overdose deaths. However, they are rarely considered as risky as alcohol or opioids because they are more often found in combination with these drugs, which are considered the primary drugs of abuse.
Dangers of Mixing Alcohol with Other Benzodiazepines
Serious Physical Risks from Mixing Ativan and Alcohol
- Extreme drowsiness
- Dizziness due to low blood pressure
- Slowed, irregular, shallow, or difficult breathing
- Impaired cognition
- Impaired balance and physical control
- Memory problems
- Unusual behaviors
- Passing out
If a person overdoses on a combination of alcohol and Ativan, it is extremely important to call 911 immediately. They will only survive with emergency medical attention.
Other very serious risks associated with combining these two drugs include:
- Increased intoxication and side effects due to the substances enhancing each other’s effects
- Increased risk of overdose from similar side effects, including respiratory depression
- Unpredictable side effects, like blackouts
- Increased risk of brain damage over time due to changes in brain structures
- Increased risk of triggering a mental illness, especially a mood disorder
- Much higher risk of physical dependence and tolerance, which may lead to addiction
- Struggles associated with addiction, like strained relationships with loved ones, job loss, financial and legal problems, and damage to health
Long-term, increasing alcohol’s bioavailability intensifies damage to the stomach, liver, heart, and brain. Benzodiazepines like Ativan do not lead to liver damage; however, alcohol is more likely to damage the liver when these drugs are combined because they increase how effectively alcohol can cause intoxication.
Chronic drowsiness is also a side effect, and there is an increased risk of oxygen deprivation from depressed breathing, causing damage to the brain and body.
When Ativan Is Prescribed for a Purpose, Is It Okay to Drink Alcohol?
If a person has a prescription for Ativan, it is unlikely they will take it for a long time; benzodiazepines are usually prescribed for two weeks or less of consistent use, or to be used as needed. The only exception, currently, involves seizure disorders like epilepsy. However, for anxiety, insomnia, or even alcohol withdrawal, it is unlikely that a person will take Ativan for longer than two weeks.
Taking Ativan regularly means that one should not consume alcohol. If the prescription is to be taken as needed, then it is important to avoid alcohol for several hours after taking the benzodiazepine. Combining these two substances, even accidentally, amplifies one’s level of intoxication, so the risk of memory lapses, accidents, legal problems from a DUI, and blackouts increases greatly.
Mixing these two medications is never recommended.