Weed and Ativan: Can You Mix the Two?

Weed (cannabis) and Ativan are both central nervous system depressants, and it is not recommended that you mix the two before speaking with your doctor.

Mixing the two substances may cause drug interactions such as feelings of severe drowsiness, confusion, hindered motor function, or difficulty concentrating. Cannabis users may experience Ativan differently depending on the dose, their metabolism, or personal tolerance for the drug.

While there is no long-term research on the effects of cannabis use and Ativan, experts generally recommend avoiding tasks requiring mental alertness or coordinated motor skills if both are being taken simultaneously. In rare cases, individuals who combine the two substances may experience slow or shallow breathing.

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What Is Ativan?

Ativan (also known as lorazepam) is an anti-anxiety benzodiazepine that is often used to treat symptoms associated with insomnia, anxiety disorders, and epilepsy. It’s sometimes also prescribed for off-label treatments such as alcohol use disorder. Ativan is a long-acting, potent prescription medication. The drug usually begins working within 20-30 minutes, and its full sedating effects last six to eight hours.

Doctors often prescribe Ativan for short-term treatments, such as over a four-week period, as it can become addictive. Individuals who use Ativan may sometimes notice side effects such as daytime drowsiness, trouble controlling movement or coordination, or muscle weakness.

According to the U.S. Drug Enforcement Administration (DEA), Ativan is among the top five most prescribed benzodiazepines in the United States. In 2019, approximately 18.4 million prescriptions were filed for the drug.

How It Works

Ativan belongs to a class of prescription drugs called benzodiazepines. Benzodiazepines are central nervous system (CNS) depressants, which means they calm the over-excited nervous system by producing feelings of drowsiness, sedation, and relaxation.

Ativan works by acting on gamma-aminobutyric acid receptors (GABA) in the brain. GABA receptors play a role in regulating sleep and feelings of relaxation and anxiety. Ativan slows down the central nervous system (CNS) by temporarily modulating how these receptors function.  As a result, the individual feels calm, relaxed, and sedated. Its fast-acting effects render it a temporary solution to the onset of severe anxiety attacks.

Potential Benefits and Risks of Mixing Cannabis and Ativan

Since marijuana and Ativan depress the central nervous system, the combination of the two tends to have an additive effect. This means that cannabis use combined with Ativan may lead to a drug interaction, such as heightened dizziness, confusion, and drowsiness.

Cannabis products containing THC may interact differently than cannabis products without THC. For example, CBD products that contain 0.3% THC or less are less likely to have an adverse effect than products with higher concentrations of THC. However, care should be taken when mixing Ativan with any cannabis product. CBD can desensitize liver enzymes that metabolize drugs like Ativan and other benzodiazepines, so it is wise to talk to a physician before using both at the same time in order to reduce the chances of an adverse reaction and to taper benzodiazepine use where recommended.

Potential Benefits

The potential benefits of combining Ativan and weed haven’t been researched, and no clear benefits have been documented. However, observational studies note a reduction in benzodiazepine use in patients recommended medical cannabis.

Potential Risks

A number of risks may arise from mixing Ativan and weed. The effects may vary from individual to individual, as factors such as personal tolerance, metabolism, and dosage can influence the likelihood of adverse effects. Common side effects include dizziness, extreme drowsiness, a lack of coordination, or compromised motor function. The onset of these symptoms can occur quickly, so experts suggest avoiding tasks requiring concentration, motor skills, or coordination, such as driving.

Another less common risk of mixing Ativan and marijuana is respiratory system depression. In the same way that the combination of these substances can slow the function of the central nervous system, they can also depress the respiratory system, leading to slow or very shallow breathing. This risk may be higher among individuals in a frail state of health.

Currently, no rigorous studies clearly outline the short- or long-term effects of mixing marijuana and Ativan. Much of what we know is based on observational data. As such, until there is more robust research, it’s a good idea to be cautious when combining these two substances.

What to Do If You Need to Use Both Ativan and Marijuana

In general, experts recommend that people avoid mixing cannabis and Ativan if possible. If you need to use medical marijuana and Ativan simultaneously, however, starting with low doses is advisable, particularly when you’re beginning your treatment. Monitor how the combination of the substances affects your body, then speak to a medical professional about adjusting to higher doses or scaling back if necessary.

Avoid undertaking activities requiring alertness, concentration, and motor coordination until you are familiar with the combined effects of the two substances. You may need to lower your doses if you experience excessive or prolonged effects that interfere with your day-to-day activities. Pay attention to your breathing too. If you notice your breathing slowing or becoming shallower, seek medical assistance immediately.

The Bottom Line

If you need to use both Ativan and medical cannabis, consult with a healthcare provider. The combined effects of marijuana use and Ativan may lead to adverse effects in some individuals. It’s important to be aware of the potential risks. Monitor how your body responds to the combination of Ativan and weed, and seek medical advice if you notice any adverse effects affecting your day-to-day functioning.

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