Anxiety is an unfortunately common condition among adults. According to the CDC, 11.7% of American adults over 18 regularly experience feelings associated with anxiety. An estimated 19.1% of U.S. adults had a diagnosed anxiety disorder in the last year, and 31.1% will experience an anxiety disorder during their lives.
There are a number of methods commonly used to treat anxiety. Benzodiazepines, like Ativan, are a popular prescription option. However, plenty of people also turn to cannabis for anxiety relief. A 2022 survey found that 34.2% of medical cannabis patients were using the plant to treat anxiety, with an astounding 43.73% of patients in the West using medical cannabis for anxiety.
With so many people suffering from anxiety–and with both Ativan and cannabis providing relief–many have asked, “Can I use Ativan and cannabis together?”
The answer is complicated, and the research is sparse. Still, there are risks that patients need to be aware of if they’re thinking of using Ativan and cannabis simultaneously.
What is Ativan?
Ativan is a brand name for lorazepam, a medication used to treat anxiety from the benzodiazepine class. Like other drugs in its class, lorazepam works by boosting signals from the GABA neurotransmitter. GABA slows down activity in the brain, sending calming messages to make nerve cells less excitable. For this reason, Ativan is also commonly prescribed to treat insomnia.
Lorazepam has several side effects, ranging from mild to severe. Common mild side effects include:
- Tiredness/drowsiness
- Dizziness
- Feeling weak or lacking energy
- Clumsiness or feeling unsteady
- Nausea
- Diarrhea
- Increased or decreased appetite
- Blurriness or unclear vision
- Constipation
- Changes in sex drive
- Changes in sexual ability
- Unexplained excitement, irritability, or restlessness
Lorazepam also has side effects that are more intense or could indicate a severe underlying reaction. Those include:
- Uncoordinated or shuffling pace
- Tremors that persist over time or an inability to sit still
- Difficulty talking
- Hives, rash, or itching of the mouth, eyes, or face
- Difficulty breathing
- Yellow discoloration in the eyes or skin
- Racing, fast, or irregular heartbeat
Like other benzodiazepines, Ativan has a high risk for dependence. Most doctors will not prescribe it for long-term use for just this reason. Once dependence occurs, withdrawal symptoms are expected.
In addition to Ativan, lorazepam is also known under Lorazepam Intensol and Loreev XR.
Ativan and Weed Interaction
Both cannabis and Ativan are used to relieve symptoms of anxiety, leading people to question whether it’s safe or effective to take them together. It might seem like a natural match at first, but there may be potential for dangerous interactions, leading medical professionals to caution against mixing cannabis and benzodiazepines.
Cannabis and Ativan have sedating effects. Taken together, they may cause excessive drowsiness in ways that might be difficult to predict, making it dangerous to drive, operate machinery, or even perform simple daily tasks. Experts warn that even CBD paired with Ativan may cause excessive drowsiness.
There is also evidence that cannabis may affect how the body metabolizes benzodiazepines like Ativan. According to the most recent research, cannabinoids like CBD inhibit the CYP3A4 enzyme, which the body uses to break down medications, including lorazepam.1 A spreadsheet released by Penn State’s College of Medicine corroborates the idea that cannabis impacts the metabolism of lorazepam, increasing its effects.
There’s also evidence that cannabis may directly affect the way the body’s GABA receptors work. Ativan, as a benzodiazepine, works by influencing the body’s GABA receptors so that any additional interference could have unexpected consequences.
According to a 2011 study, prolonged cannabis use has the potential to decrease GABA receptors in the brain while also increasing GABA production. When cannabis use is stopped, nerves become overly excitable, which may lead to increased anxiety. However, the study was only conducted on cultured cells, but the results indicate serious implications for mixing cannabis and benzodiazepines.2
Is there a Benefit to Taking Ativan with Weed?
Even though the research is limited, medical experts are reasonably certain that using cannabis and benzodiazepines together is risky. So, while it may be possible that using cannabis and Ativan together will provide more significant anxiety relief, the risks that the combination poses far outweigh the benefits.
If you’re using Ativan or another benzodiazepine, it’s important to speak to your doctor before using cannabis. At the same time, if you already use cannabis and are prescribed Ativan, let your doctor know about the cannabis use before taking Ativan.
What are the Risks of Using Ativan and Marijuana?
There isn’t much research into the interactions between cannabis and other medications, including Ativan. That said, based on their effects and what is known about how they interact with the body, experts warn against using them together.
Because both cannabis and Ativan cause drowsiness, there’s concern that the combination can cause excessive or unpredictable drowsiness. The effects would make driving or operating machinery dangerous and could be severe enough to impede your daily activities.
There’s also a very real risk that cannabis can inhibit the breakdown of Ativan in the body, extending and amplifying its effects. The amplified effects would increase the risk of any of Ativan’s side effects, including the more severe ones. It could also potentially increase the risk of an overdose.
Using cannabis and Ativan together is not recommended, and if you’re considering using the combination, speak to your doctor.
What About CBD and Ativan?
Some people prefer CBD to alleviate anxiety because it doesn’t cause the same “high” as THC products. It might seem like combining CBD with Ativan would be safer than using high-THC cannabis, but current research suggests the same risks apply.
CBD may also cause drowsiness, and it’s commonly used by consumers who are struggling to get to sleep3. So, even though CBD doesn’t cause the same “high” feeling as THC, it still has the potential to cause drowsiness and enhance Ativan’s effects.
CBD is a known CYP3A4 inhibitor, meaning that, just like high-THC cannabis, CBD has the potential to slow the body’s breakdown of Ativan. This means that the medication will stay in the body longer, which could lead to more severe effects than usual.1
Just like with high-THC cannabis, mixing CBD and Ativan may lead to distressing or unsafe side effects, and the combination isn’t recommended. Speak with your doctor if you’re considering using Ativan with CBD.
Precautions When Taking Ativan and THC
While Ativan is widely considered to be an effective medication for anxiety, less research exists on THC as a treatment for anxiety. Even though some research indicates the promise of using THC for anxiety, using Ativan and cannabis together can present avoidable risks, and combining the two is not recommended.
Simultaneously taking the two medications may increase drowsiness, making driving, operating machinery, or performing daily activities dangerous.
If you’re considering consuming cannabis while on Ativan, speak with your doctor about the potential risks and alternatives that can allow you to find safe, effective relief.
References
- Balachandran P, Elsohly M, Hill KP. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. J Gen Intern Med. 2021;36(7):2074-2084. doi:10.1007/s11606-020-06504-8. ↩︎
- Deshpande LS, Blair RE, DeLorenzo RJ. Prolonged cannabinoid exposure alters GABAA receptor mediated synaptic function in cultured hippocampal neurons. Experimental Neurology. 2011;229(2):264-273. doi:https://doi.org/10.1016/j.expneurol.2011.02.007 ↩︎
- Moltke J, Hindocha C. Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems. Journal of Cannabis Research. 2021;3(1). doi:https://doi.org/10.1186/s42238-021-00061-5 ↩︎
The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.
