Ativan (lorazepam), a short-acting benzodiazepine, is an anti-anxiety medication that produces heightened effects on the central nervous system when taken with other depressants, including alcohol.
Drinking alcohol and taking Ativan together can contribute to severe drowsiness, respiratory issues, coma and death. In fact, most cases of Ativan overdose occur in combination with alcohol or other substances.
Ativan, or lorazepam, is a potent, immediate-duration benzodiazepine.
It belongs to the same family as other anti-anxiety prescription medications, such as Klonopin, Valium and Xanax. Although it may not be as well-known as some of its cousins, it is still a federally controlled substance with a high risk for abuse and addiction.
Benzodiazepine overdose by itself — when not taken in combination with other substances — is usually not fatal. People who overdose on lorazepam are likely to experience depression but with normal vital signs like breathing and heart rate.
As a CNS depressant, Ativan works by slowing brain activity, creating a more relaxed environment for those struggling with anxiety. It is also commonly used for epilepsy and seizure disorders due to its depressant properties.
However, Ativan and other depressants put people at risk for abuse and addiction due to the euphoria it can cause. Lorazepam and other benzos are rarely misused by themselves, and are usually taken with other substances like alcohol to increase its effects.
Both substances work on the same gamma-aminobutyric acid (GABA) receptors in the spinal cord and brain. Since they work on the same cellular targets, the risk of overdose is greatly increased. Overdose on these substances has a high risk for respiratory depression (slowed or stopped breathing).
No, you should not drink alcohol while taking Ativan or other benzodiazepines. Your doctor will warn you against combining these two substances. No amount of alcohol is safe to drink while using lorazepam.
Every substance has a half-life, which is the amount of time it takes for the body to eliminate half of the substance. The half-life for lorazepam is 12 hours. Drugs are completely eliminated in five half-lives, so lorazepam will not be removed until 60 hours after the last dose. Therefore, you should wait at least three days after your last dose of lorazepam to drink alcohol.
The metabolism of alcohol is well understood, but it is also complicated. It takes approximately one hour to metabolize one standard drink of alcohol for most people, but metabolism varies greatly based on weight, total body water, gender, genetics and other factors. Therefore, it would be safest to wait at least 1–2 days after drinking alcohol to take Ativan.
Since alcohol and Ativan work on the same GABA receptors in the CNS, combining them will cause the effects of each individual substance to multiply. GABA is the primary neurotransmitter in the central nervous system. Brain cells use a mixture of “go” and “stop” signals to regulate messages, and GABA is the “stop” signal.
Normally, levels of GABA are kept well-controlled. However, when there is not enough, people can suffer from conditions like anxiety and epilepsy (seizure) disorders. Because of this, benzodiazepines have accepted medical use, and it’s the same reason why alcohol withdrawal can cause seizures and death.
Both substances can cause “blackouts” or long periods where you have no memory. Combining these substances can cause minutes or hours where you “black out’ and have no memory of events. You are at a very high risk of accidental injury and death during this time.
When combining these two substances, your body is faced with several environmental threats. While alcohol is prone to make you tired, light-headed and drowsy, you are also confronted with Ativan’s effects: concentration issues, movement and coordination difficulty, and delayed physical reactions. The side effects of this combination can put you at risk for accidents and loss of consciousness.
A study in 2005 found that levels of alcohol and benzodiazepines were significantly higher in patients who received treatment for violent accidents versus other types of accidents.
When these two substances are mixed, your brain receives signals to shut down certain body functions, including breathing. So, when taking Ativan with alcohol, your body’s oxygen can decrease, which is a primary risk factor for overdose death. Another potential cause of death is inhaling vomit into the airway while unconscious, causing suffocation.
Having healthy blood pressure is crucial to your heart’s functionalities. However, when mixing Ativan and alcohol, your body can experience hypotension or bradycardia. Hypotension is when there is not enough pressure in your blood vessels to provide oxygen to the body, while bradycardia is when the heart is not beating fast enough, putting organs at risk of decreased oxygen.
Even if an overdose doesn’t occur, mixing Ativan and alcohol can cause long-term health issues, including development of a substance use disorder and liver damage, among other conditions. An increased likelihood of self-harm is also possible.
Psychological, emotional and behavioral effects include damage to your finances, relationships and other areas of your life. Broken relationships and damage to career or school performance are two possible consequences of Ativan use disorder.
Long-term Ativan and alcohol misuse can put your liver at risk. Alcohol is toxic to the liver, especially in high doses. Ativan is not likely to be toxic to the liver on its own, but it is metabolized by the liver. This means that damage from alcohol can increase blood levels of lorazepam.
When misused over long periods of time, the risk of overdose increases due to liver damage and higher tolerance to the substances, meaning people need more and more of the same drug to produce the same effect. This can contribute to overdose.
Not only does polysubstance abuse of alcohol and Ativan come with the risk of addiction, but polysubstance abuse can also increase the likelihood of dangerous or severe withdrawal symptoms during detox. A recent study by The Recovery Village found that people who were detoxing from multiple substances were:
You can assess your alcohol use by taking one of our free and confidential self-assessments:
If you take Ativan with alcohol, you are at a heightened risk of overdose. Don’t be afraid to reach out for professional help. Confronting a substance use disorder on your own is challenging, but the beginning of your recovery journey is only a phone call away.
The Recovery Village at Palmer Lake has a proven track record of providing caring and successful substance use treatment at our Palmer Lake, Colorado facility. The facility is staffed by trained addiction professionals with years of experience treating addiction disorders.
We offer a full continuum of care that encompasses outpatient, intensive outpatient (IOP), and inpatient/residential treatment options. Contact us today to speak with one of our helpful representatives.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.