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  • Mixing Ativan and opioids can be dangerous. Benzodiazepines and opioids can cause additive effects inside your body, treating what was once a low dose as a high dose. This can greatly increase your risk of an opioid overdose, which can be fatal.

    Ativan, along with other benzodiazepines, comes with warnings on their labels that warn against mixing them with opioid analgesics. Opioids that can be dangerous when mixed with benzos include commonly prescribed painkillers like hydrocodone, fentanyl, oxycodone, and codeine.

    Physical Effects Of Mixing Ativan & Opioids

    Benzodiazepines and opioids both affect the central nervous system (CNS). They affect different receptors in the brain but can cause additive effects when combined.

    Side effects that may be stronger due to taking Ativan and opioids together include:

    • drowsiness
    • sedation
    • numbness
    • slowed breathing
    • impairment

    Serious versions of these side effects, which include severe respiratory depression and unconsciousness, may be signs of a drug overdose. Overdoses are more likely to happen when taking benzos and opioids together as compared to taking them alone.

    Risk Of Overdose

    Mixing benzodiazepines and opioids can increase your risk of an opioid overdose. Many CNS depressants, such as alcohol, are also dangerous when mixed with opioids. The high frequency at which benzodiazepines are prescribed in the U.S. makes them dangerous.

    From 1999 to 2019, the number of opioid overdose deaths per year has dramatically increased. Several studies during this time show that benzodiazepines were involved in large percentages of these overdose deaths.

    Benzodiazepine prescriptions have increased during this time period, making their availability much higher. As long as benzodiazepines and opioids are commonly prescribed, the dangers posed by mixing them continue to be a serious issue.

    Ativan’s Black Box Warning

    Ativan’s label has a black box warning, which states that the use of opioids and benzodiazepines at the same time can lead to severe respiratory depression, sedation, coma, and death. A black box is the FDA’s strictest warning about prescription drug use.

    In 2020, the FDA required black box warnings to appear on all prescription benzodiazepines. This includes highly prescribed benzodiazepines such as alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), and lorazepam.

    Black box warnings are one way of preventing substance abuse, overdose deaths, and other severe risks of prescription drugs.

    Mental Health Effects Of Mixing Ativan & Opioids

    Ativan and opioids are controlled substances, according to the Drug Enforcement Administration (DEA). They can be habit-forming, especially when taken as targets of substance abuse.

    Mixing Ativan and opioids can impair your thinking. You may find it hard to focus or take longer to process information. Taking these drugs together may also cause dependence on either benzos, opioids, or both.

    Dependence can be both physical and psychological. You may crave these substances or spend a lot of time thinking about when you will use them next. Left untreated, dependence can lead to a number of health effects.

    Polysubstance Abuse

    Health care providers usually know to avoid prescribing opioids and benzodiazepines together. To get around this, people may resort to doctor-shopping, or illegally visiting multiple doctors to get benzodiazepine prescriptions and opioid prescriptions from separate physicians.

    Doctor-shopping for benzos and prescription opioids, or buying them from illicit drug dealers, are both ways of illegally buying drugs. Taking drugs that are bought illegally is a form of drug abuse.

    Drug abuse can put you at increased risk for psychological and physical dependence. Dependence can make it hard to come off these drugs safely, despite the risks caused by mixing them. Managing and treating withdrawal symptoms may be necessary for recovery.

    Why Are Ativan & Opioids Mixed?

    When mixed, benzos and opioids cause a more intense “high” than if they were taken on their own. Feelings of intense euphoria and pain relief are desired effects from mixing these substances.

    Due to the many risks that come with mixing Ativan and opioids, the negatives will likely outweigh the positives.

    Treating Polysubstance Abuse

    Benzodiazepines are often prescribed to treat anxiety disorders, while opioids are prescribed to treat forms of chronic pain and acute pain. If you are taking both of these substances, you may feel like there are no other options to manage your conditions.

    However, mixing opioids and benzodiazepines can do more harm than good, especially in the long term. If you are going through withdrawal after taking these substances for a long time, you will likely need a treatment that helps both your withdrawal and your mental health.

    To find the best treatment options available to you, talk to your healthcare professional or contact us today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Centers For Disease Control And Prevention - Why Guidelines for Primary Care Providers?
    National Institute on Drug Abuse - Benzodiazepines and Opioids
    PubMed Central - Doctor Shopping
    U.S. Food and Drug Administration - Ativan (lorazepam)
    U.S. Food and Drug Administration - FDA Requiring Labeling Changes for Benzodiazepines

    Medically Reviewed by
    Kimberly Langdon M.D.
    on July 18, 2022
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