Understanding Lorazepam and Alcohol: Why This Combination Is Dangerous

What you will learn

• Lorazepam (Ativan) and alcohol are both central nervous system depressants that should never be combined due to life-threatening risks.
• Mixing lorazepam with alcohol can lead to severe drowsiness, respiratory depression, memory blackouts, and even death.
• You should wait at least 48 hours after your last lorazepam dose before consuming any alcohol.
• Both substances carry high potential for dependence, and using them together increases tolerance and withdrawal complications.
• Ascendant NY offers comprehensive, holistic treatment for individuals struggling with benzodiazepine and alcohol co-dependence.

If you’ve been prescribed lorazepam for anxiety or another condition, you may be wondering whether it’s safe to have an alcoholic drink. The short answer is this: drinking alcohol while taking lorazepam is strongly discouraged. The combination of these two substances can lead to serious, potentially life-threatening complications ranging from severe drowsiness and confusion to respiratory depression (shallow breathing that leads to a buildup of carbon dioxide and a lack of oxygen) and death. Both lorazepam and alcohol are central nervous system depressants, which slow down activity in the brain and spinal cord, and when used together, their effects can become overwhelming and dangerous [1].

What Is Lorazepam?

Lorazepam, commonly known by its brand name Ativan, belongs to a class of medications called benzodiazepines [2]. These medications work by slowing brain activity through enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter (chemical messenger) that promotes calmness and relaxation.

Healthcare providers prescribe lorazepam for several purposes. It’s commonly used to manage anxiety disorders and panic attacks, providing rapid relief when symptoms become disruptive. Lorazepam is also prescribed for seizure control, particularly in emergency situations, and as a pre-surgical sedative. According to the United Kingdom’s National Health Service (NHS), lorazepam typically begins working within 20 to 30 minutes of taking it, with effects lasting approximately 6 to 8 hours [3].

While lorazepam, which is available in oral tablets, extended release tablets, and liquid forms, can be highly effective for short-term symptom management, long-term use can lead to physical dependence. When someone who has been taking lorazepam regularly tries to stop, they may experience uncomfortable and sometimes dangerous withdrawal symptoms. This is why doctors typically prescribe lorazepam for short-term situations rather than as a long-term solution.

Common side effects include drowsiness, dizziness, weakness, and nausea. More serious effects, such as confusion, difficulty concentrating, or fainting, can also occur. Misusing lorazepam or taking it in ways not prescribed by your doctor can lead to addiction.

How Alcohol Affects the Body

Alcohol is also classified as a central nervous system depressant, which means it slows down brain function and nerve activity. When you drink alcohol, it slows your reaction time, impairs coordination and balance, clouds judgment, and can significantly alter how your body metabolizes other medications. These effects occur because alcohol interacts with various receptor systems in your brain [4], including the same GABA-A receptors that lorazepam targets.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has extensively studied how alcohol interacts with[1] benzodiazepines. Their research consistently shows that combining alcohol with sedative medications significantly increases the risk of adverse events. The depressant effects of alcohol can suppress breathing controls in the brain, and when combined with benzodiazepines, this suppression becomes even greater and more dangerous.

Why Mixing Lorazepam and Alcohol Is Dangerous

When you combine lorazepam and alcohol, you’re increasing central nervous system depression [4]. The sedative and hypnotic effects of each substance don’t just add together; they can amplify each other in ways that can rapidly become dangerous. The combination is dangerous because alcohol and benzodiazepines both suppress the breathing centers in your brain through different but complementary mechanisms.

Comparison of Effects: Lorazepam Alone vs. Combined With Alcohol

The combination significantly impairs your balance, reaction time, and decision-making abilities, dramatically increasing your risk of falls, motor vehicle accidents, and other injuries. Both lorazepam and alcohol can independently cause memory problems, but when combined, they can produce  amnesia, often referred to as “blackouts.” During these blackout periods, you may appear awake and functioning, but have no memory of your actions.

Potential Long-Term Risks and Interactions

Both substances carry a high potential for dependence, and using them together can accelerate the development of addiction. Lorazepam’s sedative effects aren’t only amplified by alcohol; other central nervous system depressants can have similar dangerous interactions. These include antihistamines, opioid pain medications, muscle relaxants, and sleep aids. The Mayo Clinic warns that mixing any of these substances with alcohol compounds the danger of adverse effects significantly [5].

Guidelines for Individuals Prescribed Lorazepam

. The NHS explicitly states that you should not drink alcohol while taking lorazepam due to the serious risks involved [3].

Open communication with your healthcare provider is essential. If you regularly consume alcohol, discuss this honestly with your doctor. They can help you understand the specific risks, adjust your medication schedule if needed, or recommend alternative treatments such as certain antidepressants or cognitive-behavioral therapy (CBT, a form of talk therapy that focuses on identifying and changing unhelpful thoughts and behaviors).

Reading labels carefully is an important protective measure. Many over-the-counter medications contain ingredients that can interact with lorazepam. Some liquid medications even contain alcohol.

If you’ve been taking lorazepam for an extended period, never stop taking it abruptly without medical supervision. The Mayo Clinic emphasizes that tapering off lorazepam  [5] under a doctor’s guidance is essential for your safety, as sudden discontinuation can lead to severe withdrawal symptoms, including seizures.

Balancing Medication Needs With Responsible Alcohol Use

Abstaining from alcohol while taking lorazepam might feel challenging. However, your health and safety must come first. If you anticipate situations where you might want to drink occasionally, have an open conversation with your doctor about whether lorazepam is the right medication for you.

At Ascendant NY, we believe in comprehensive treatment approaches that address the whole person, including evidence-based therapies, mindfulness practices, relaxation exercises, and holistic wellness strategies that can reduce anxiety without relying solely on medication.

Prioritizing your health means recognizing that managing anxiety or other conditions should take precedence over drinking alcohol. A holistic wellness plan that includes proper nutrition, regular exercise, therapy, social support, and stress management techniques is more beneficial than alcohol for coping with anxiety and other health conditions.

Recognizing Signs of Dangerous Interaction

Dangerous interactions between lorazepam and alcohol can lead to adverse side effects, health problems, or death. The earlier a person can identify these interactions, the greater the chance they will have of stopping them from causing further harm.

Warning signs of impending harm might be excessive sleepiness, confusion, slurred speech, pronounced dizziness, difficulty breathing, and uncoordinated movements.

If you see any of these signs or have these symptoms, you must get emergency medical assistance. The signs may indicate drug overdose (failure to wake/alertness, slowed/irregular breathing, lack of responsiveness, and/or blue-tinted fingernails and/or lips), as well as the possibility of memory blackout due to excessive central nervous system depression.

Steps to Take if You Have Mixed Lorazepam and Alcohol

Get immediate medical attention if you or someone you know has taken lorazepam, mixed it with alcohol, and is showing symptoms that give you concern. Do not wait to see if symptoms improve, and don’t assume that someone will be able to sleep it off. A central nervous system depressant overdose is a medical emergency.

Do not try to make the individual vomit or give the person more medication while waiting for emergency responders. Stay with the person and monitor their breathing. If the individual is unconscious yet still breathing, place the individual in the recovery position (on their side, with their head tilted back and a bent leg to support them).

After emergency responders arrive, provide them with any information you have about the medications taken, the amount consumed, and when they were consumed. After recovery, the person of concern should talk to a physician to re-evaluate any prescription medications and consider whether the individual may require assistance with any drug problem(s).

Addiction and Treatment Considerations

There is a great deal of risk for developing dependence on both alcohol and benzodiazepine medications. When a person consistently uses both substances, the body builds up tolerance quickly. A user will need to consume an increased quantity of the substance in order to attain the desired result, leading them to develop a greater physical dependence upon the substances consumed. This makes the process of withdrawal a more difficult and potentially hazardous experience.

Supervised detox programs, where medical professionals may provide medications to alleviate withdrawal symptoms, are the safest way to detox from alcohol, benzodiazepines, or both simultaneously. At Ascendant NY, we have inpatient and outpatient detox programs and offer the option of medication-assisted treatment to ease withdrawal symptoms and reduce cravings.

We take a comprehensive approach, looking at the whole person and focusing on your mental, spiritual, and emotional well-being as well as your physical health while you are in recovery. The majority of individuals who have problems with drug and/or alcohol use also have underlying mental health issues like anxiety, depression, trauma, or other conditions. We work with each person experiencing a substance use disorder to give them both relief from withdrawal symptoms and help them manage any ongoing mental health issues.

The treatment process consists of individual therapy to identify the underlying causes of substance abuse and to learn more appropriate ways of coping, group therapy and peer support, family therapy to assist in repairing family relationships, and various forms of holistic therapy (yoga, mindfulness meditation, art-based therapies) and medications when appropriate to safely treat co-occurring mental health and substance misuse problems.

Ongoing support and aftercare are an integral component of successful long-term recovery. Recovery is a lifelong process and benefits from an ongoing commitment to regularly scheduled support group sessions, routine therapist contact, the establishment and expansion of healthy support networks, as well as healthy lifestyle changes.

Conclusion

Lorazepam can treat anxiety by providing relief from the symptoms associated with this disorder. However, when taken with alcoholic beverages, the combination can have adverse effects on the user, which can lead to death.

For those who currently take Lorazepam and wish to consume alcoholic beverages, the safest option is to remain alcohol-free for at least 48 hours after taking the last dose of Lorazepam. Most importantly, maintain open communication with your healthcare provider about your alcohol use.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more