In 2021, an estimated 3.9 million people abused benzodiazepines and approximately 12,500 people died from an overdose involving them.[1] Benzodiazepines, also called “benzos,” are a class of drugs used to treat anxiety and seizure disorders, however, they can be addictive and dangerous when abused.
Two of the most commonly prescribed and misused benzodiazepines are Ativan (lorazepam) and Xanax (alprazolam).
In this article, you will learn:
- What Ativan is
- What Xanax is
- How the medications are similar
- The differences between Xanax and Ativan
- About benzodiazepine abuse and addiction
If you or a loved one are struggling with benzodiazepine addiction, please reach out to First Step Behavioral Health today to discuss your treatment options.
What is Ativan (Lorazepam)?
Ativan is the brand name for lorazepam, a benzodiazepine medication used primarily for its anxiolytic (anti-anxiety), sedative, and anticonvulsant properties. It was approved by the U.S. Food and Drug Administration (FDA) in 1977.[2]
Ativan is commonly prescribed to treat anxiety disorders, including generalized anxiety disorder and panic disorder. It is also used as a short-term treatment for insomnia due to its sedative effects. Additionally, Ativan is employed in the management of certain seizure disorders, such as status epilepticus, due to its anticonvulsant properties.
Ativan is prescribed in pill form and is available in three different doses, including:
- 0.5 mg
- 1 mg
- 2 mg
In medical settings, Ativan is available as an oral liquid or an injection that can be administered by a medical professional.
What is Xanax (Alprazolam)?
Xanax is a brand name for alprazolam, a benzodiazepine that is the most commonly prescribed psychotropic drug in the United States. It was originally approved by the FDA in 1981, just a few years after Ativan.
Xanax is commonly prescribed for the treatment of anxiety disorders, including generalized anxiety disorder and panic disorder. It is also used to manage symptoms of anxiety associated with depression and other mental health conditions. Additionally, Xanax may be used in the short-term treatment of insomnia due to its sedative effects.[3]
Xanax comes in immediate-release (IR) and extended-release (XR) tablets. Immediate-release tablets come in 0.25, 0.5, 1, and 2 mg doses. Xanax extended-release tablets come in 0.5, 1, and 2 mg doses.
Due to its rapid onset of action and effectiveness in relieving acute symptoms of anxiety, Xanax is often favored in situations where immediate relief is necessary.
Understanding Benzodiazepines
Benzodiazepines like Ativan and Xanax are used as a second-line short-term treatment for generalized anxiety disorders. Doctors may prescribe them for panic attacks and symptoms of anxiety if antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) don’t work. They are also used to treat certain types of seizure disorders.
Benzodiazepines work by enhancing the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits or reduces the activity of nerve cells in the brain. This mechanism of action leads to the anxiolytic (anti-anxiety), sedative, muscle-relaxant, anticonvulsant, and calming effects of benzodiazepines.
Due to their potential for tolerance, dependence, and withdrawal symptoms, benzodiazepines are generally prescribed for short-term use or intermittent use to manage acute symptoms. Long-term use requires careful monitoring and consideration of alternative treatments due to the risks associated with dependence and withdrawal. The risk of abuse and addiction is increased when mixing benzos with other drugs like alcohol or opioids.
Like other benzodiazepine drugs, Ativan (lorazepam) and Xanax (alprazolam) share many similar side effects, including:[4]
- Drowsiness
- Dizziness
- Depression
- Confusion
- Difficulty speaking
- Constipation
- Poor coordination
- Weakness
- Appetite changes
Side effects can be more severe in older adults. People aged 65 and older who take benzodiazepines are at an increased risk of confusion, difficulty thinking clearly, falls, and motor vehicle accidents.
Key Differences Between Xanax and Ativan
There are many similarities between Ativan and Xanax, including their common side effects, uses, and drug interactions. However, there are some key differences between the two.
The primary difference between Ativan and Xanax is that Ativan has a longer half-life. It acts more slowly in the body and is metabolized at a slower rate. While it takes longer to kick in, the effects last longer than those of Xanax do. As a result, people have to take Xanax more frequently than they do Ativan.
When taken orally, Xanax reaches its highest concentration after 1-2 hours, but Ativan doesn’t reach peak concentration until two hours. The half-life of Xanax is 11.2 while the half-life of Ativan is between 12-18 hours.[2,3]
Since Ativan has a longer half-life, it also stays in the human body longer. A single dose of Ativan can take about 2-4 days to leave the body while a single dose of Xanax can be out of your system within two days.
Is Xanax or Ativan More Addictive?
Both Xanax (alprazolam) and Ativan (lorazepam) belong to the benzodiazepine class of medications, which are known for their potential to cause dependence and addiction when used improperly or for prolonged periods. However, Xanax has a faster onset of action and a shorter duration compared to Ativan. This rapid onset can contribute to a higher risk of addiction because users may experience more immediate relief and therefore be more likely to seek repeated use.
Long-term benzodiazepine use, even when used as prescribed, can lead to the development of physical dependence.[5] People who are physically dependent will experience withdrawal symptoms if they suddenly stop taking benzodiazepines. Benzodiazepine withdrawal can be potentially life-threatening, so you should never stop taking Xanax or Ativan cold turkey. Always seek guidance from your doctor or a medical detox center.
Find Help for Benzodiazepine Abuse
At First Step Behavioral Health, our benzodiazepine addiction treatment program begins with a medically-supported detox. Since benzodiazepine withdrawal can be serious and life-threatening, it is important to detox under close medical supervision. Our state-of-the-art detox facility is committed to ensuring the safety and comfort of clients as they begin their recovery journey.
After detox, clients transition to our inpatient or outpatient treatment programs where they receive comprehensive, evidence-based treatment tailored to their individual needs. Those who participate in our South Florida mental health and substance abuse treatment programs will have access to full amenities provided through our center, including excellent care, a wellness center, emotional support, and dual diagnosis treatment services.
To learn more about our benzodiazepine addiction treatment programs in Pompano Beach or get started with a confidential, risk-free assessment, please contact us today.
References:
- National Institute on Drug Abuse (NIDA): What is the scope of prescription drug misuse in the United States?
- U.S. Food and Drug Administration (FDA): Ativan Injection (lorazepam injection)
- National Institute of Health (NIH): Alprazolam
- United States Drug Enforcement Administration (DEA): Benzodiazepines
- Psychiatry Online: Benzodiazepine Use and Misuse Among Adults in the United States
