Ativan & Alcohol: Risks of Mixing Lorazepam and Alcohol

Key Takeaways

• Combining Ativan (lorazepam) with alcohol significantly increases the risk of dangerous side effects, including overdose.
• Both Ativan and alcohol depress the central nervous system, leading to compounded effects like memory problems, blackouts, and impaired coordination.
• Mixing these substances can slow breathing and heart rate, potentially resulting in severe outcomes like respiratory failure, coma, or death.
• It is strongly advised to avoid drinking alcohol while on Ativan, and wait at least 48 hours after taking the medication before consuming alcohol.
• Alcohol should fully leave your system before taking Ativan, as both substances enhance GABA activity, leading to potentially life-threatening interactions.
• Overdose treatment for Ativan and alcohol focuses on stabilizing breathing, heart rate, and oxygen levels, often requiring intensive medical intervention.
• The most effective way to prevent these dangerous interactions is by completely avoiding the combination of alcohol and Ativan.
• Flumazenil may be used to reverse the effects of Ativan in overdose cases, though its use is cautious due to the risk of seizures.

Combining Ativan (lorazepam) with alcohol can lead to dangerous interactions, increasing the risk of harmful side effects, including the potential for overdose.

Ativan is a medication belonging to the same family as Xanax, known as benzodiazepines, and is commonly prescribed for conditions like anxiety. If you’re taking Ativan, you might wonder about drinking alcohol while on this medication. It’s important to fully grasp the potential risks of alcohol consumption when Ativan is part of your medication regimen.

What Is Ativan (Lorazepam)?

Ativan is the brand name for lorazepam, a medication that works by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a natural brain chemical that slows down brain activity. Ativan is prescribed for various medical conditions, including:

• Anxiety
• Epilepsy
• Schizophrenia
• Managing nausea and vomiting caused by chemotherapy
• Treating delirium
• Addressing cardiovascular emergencies

How Ativan and Alcohol Interact

Both Ativan and alcohol are substances that depress the central nervous system. They appear to increase the activity of GABA in the brain. Ativan is believed to influence a complex system involving GABA and benzodiazepine receptors. Meanwhile, alcohol enhances the release of GABA and its activity at GABA receptors. When these two substances are used together, their combined effects can be stronger than using either one alone.

Can You Drink Alcohol While on Ativan?

It’s strongly recommended to avoid drinking alcohol when taking Ativan due to the significantly increased risk of serious side effects, including the risk of overdose.

How Long After Taking Ativan Can You Safely Drink?

To minimize risks, it’s best to refrain from alcohol for at least 48 hours after taking Ativan, even though most studies have focused on the injectable form of the medication. This advice applies similarly when taking Ativan orally.

Healthcare providers can provide more specific recommendations based on Ativan’s half-life, which is the time it takes for a single dose to be completely eliminated from the body. Ativan’s half-life ranges from 10 to 20 hours. Since it generally takes around five half-lives for a drug to be fully removed from the body, you should wait about 48 hours after taking Ativan before considering alcohol consumption.

How Long Should You Wait After Drinking to Take Lorazepam?

It’s essential to ensure that all traces of alcohol have left your system before taking Ativan. It’s never advisable to drink alcohol and take Ativan at the same time. After consuming alcohol, it can remain in your system for hours, peaking in your bloodstream about 60 minutes after consumption and gradually decreasing over time.

The level of alcohol in your system can be measured using tests like a breathalyzer, which indicates your blood alcohol content (BAC). BAC levels can vary based on factors such as the amount of alcohol consumed, your body composition and your gender.

After reaching its peak around 45 minutes post-consumption, BAC typically decreases at a rate of about 0.015 per hour. So, if your BAC reaches the common legal driving limit of 0.08 (as seen in most states), it would take more than five hours for the alcohol to be completely eliminated from your system.

Risks of Mixing Ativan and Alcohol

Combining Ativan and alcohol can lead to a range of serious health risks, including:

Memory Problems and Blackouts

Mixing alcohol and Ativan increases the risk of memory problems, potentially causing blackouts where you may not remember what happened after using these substances.

Higher Risk of Accidents

The combination of alcohol and Ativan raises the risk of accidents. Both substances have sedative effects, which can affect your balance, reaction time, and coordination, increasing the likelihood of falls and motor vehicle accidents.

Slower Breathing and Heart Rate

Using alcohol and Ativan together can slow down your central nervous system, potentially leading to slower heart rate and breathing. In severe cases, this combination can even stop your heart and breathing.

Overdose Risk

The combination of alcohol and Ativan increases the risk of overdose, partly because benzodiazepines like Ativan can make the dangers of alcohol more pronounced. Overall, alcohol is involved in 18.5% of benzodiazepine overdose deaths.

Treating an Alcohol/Ativan Overdose

Signs and symptoms of a combined Ativan (lorazepam) and alcohol overdose include:

• Severe drowsiness or inability to stay awake.
• Slurred speech and impaired coordination.
• Confusion and memory loss.
• Slow or shallow breathing.
• Low blood pressure and weak pulse.
• Dizziness or fainting.
• Nausea and vomiting.
• Blue lips or nails (cyanosis) due to lack of oxygen.
• Loss of consciousness or coma.
• Potential death if untreated.

In a medical setting, the treatment for combined alcohol and Ativan overdose focuses on stabilizing the patient’s vital functions and preventing further damage.

Initially, healthcare providers assess the severity of the overdose by monitoring the patient’s airway, breathing, and circulation. Oxygen therapy may be administered if breathing is slow or shallow, and in severe cases, intubation and mechanical ventilation may be necessary to support respiration. Intravenous fluids are often given to maintain blood pressure, and close monitoring of heart function is essential. If the patient is unconscious, they may be placed in a recovery position to prevent choking on vomit.

In some cases, stomach pumping (gastric lavage) may be performed, or activated charcoal may be administered to limit further absorption of Ativan, although this is typically more effective if given shortly after ingestion.

Flumazenil, a benzodiazepine antagonist, may be used to reverse the effects of Ativan, but its use is cautious due to the risk of triggering seizures, especially in individuals with a history of chronic benzodiazepine or alcohol use.

Continuous monitoring is crucial, as both alcohol and Ativan can cause delayed or prolonged effects. Supportive care, such as maintaining hydration, monitoring for potential complications like respiratory depression, and addressing any co-occurring issues, is key until the drugs are cleared from the patient’s system.

Of course, the most effective way to prevent an alcohol and Ativan overdose is to avoid mixing the two substances, as it can have fatal consequences.