Importance Score: 65 / 100 🔴
Controversy Surrounds White Lotus Depiction of Anxiety Medication Lorazepam
The HBO series White Lotus has sparked discussions regarding its portrayal of Lorazepam, a potent anti-anxiety medication. Character Victoria Ratliff, played by Parker Posey, heavily relies on this drug, also known as Ativan and classified as a benzodiazepine, to manage her anxieties. While the show acknowledges the medication’s effectiveness, concerns are being raised about its casual depiction and potential for normalization of prescription drug misuse.
Understanding Lorazepam and its Effects
Lorazepam, a benzodiazepine marketed as Ativan, is a powerful sedative prescribed to prevent and alleviate panic attacks and social anxiety. It is recognized for its capacity to aid individuals struggling with debilitating anxiety, intrusive thoughts, panic disorders, and social avoidance. This medication has offered relief to numerous individuals grappling with various anxiety-related conditions.
However, like all prescription drugs, Lorazepam is not without its drawbacks. Improper or excessive use can pose significant risks.
Concerns over Casual Use and Addiction
In a notable scene, Posey’s character dismisses concerns about addiction, stating, ‘They’re not addictive. I just take them when I need it… not a big deal.’ This statement, however, contradicts medical guidance. Lorazepam carries a risk of dependency, particularly with prolonged use or elevated dosages. Medical professionals typically recommend short-term prescriptions, often limited to a month.
Expert Opinions on White Lotus Portrayal
Dr. Holly Schiff’s Perspective
Dr. Holly Schiff, a licensed clinical psychologist, commented on the show’s representation, stating, ‘White Lotus makes constant references to Lorazepam and glorifies the casual use of prescription medication, especially for anxiety and sleep.’ She emphasized that while Lorazepam can be beneficial for acute anxiety under medical supervision, ‘the potential for misuse and dependence is very high.’
Prevalence of Anxiety Disorders
Anxiety disorders are widespread, affecting approximately 50 million adults in the United States. These encompass generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder.
Victoria Ratliff’s character in White Lotus uses Lorazepam specifically for social anxiety, driven by anxieties about her family’s social conduct and her husband’s professional standing. Her frequent, possibly daily, use of the medication raises concerns.
Risks of Misrepresentation
Dr. Schiff further elaborated on the potential harm of the show’s depiction: ‘This is problematic because it doesn’t accurately represent the potential risk associated with a medication like Lorazepam.’ She cautioned that portraying Lorazepam as a glamorous solution or a routine coping mechanism for life’s stresses dangerously normalizes self-medication with prescription drugs.
The show further illustrates casual use when Posey’s character suggests Lorazepam to her stressed and sleepless husband, who subsequently takes a tablet without a prescription or professional consultation. Psychiatrists have expressed alarm over this scenario, highlighting potential dangers.
Lorazepam’s Mechanism and Prescribed Use
Clinical studies have established Lorazepam’s ‘tranquilizing action on the central nervous system,’ as stated on the FDA label. It is indicated for short-term relief of anxiety disorder symptoms or anxiety linked to depressive symptoms. The FDA label explicitly notes that ‘anxiety or tension associated with the stress of everyday life usually does not require treatment with an anti-anxiety drug.’
Alternative Perspectives on Anxiety Treatment
Dr. Carole Lieberman’s Approach
Dr. Carole Lieberman, a board-certified psychiatrist, offers an alternative viewpoint. ‘As a psychiatrist, I never prescribe Lorazepam, because anxiety is better treated with talk therapy that gets to the root of what is making the person anxious.’ She acknowledges limited exceptions for acute episodes like panic attacks but reiterates the addiction risk.
Addiction Potential and Controlled Substance Status
Lorazepam is classified as a Schedule Four controlled substance, indicating a lower addiction potential compared to more strictly controlled drugs, but still necessitating a prescription. It functions by boosting gamma-aminobutyric acid (GABA) in the brain, a neurotransmitter that promotes calm. Insufficient GABA levels can contribute to heightened brain activity and anxiety.
Tolerance, Dependence, and Overdose Risks
Even with prescribed and directed usage, individuals can develop tolerance, requiring increased dosages to achieve the initial effects. Prolonged use can lead to physical dependence, where the drug becomes necessary for feeling normal.
Combining Lorazepam with other depressants, such as alcohol or opioids, significantly amplifies risks. Such combinations can dangerously depress heart rate and breathing, impair coordination, cloud thinking, and elevate the risk of fatal overdose.
Benzodiazepines are implicated in approximately 17 percent of drug overdose fatalities.
Prescription Statistics and Viewer Perception
In 2019, approximately 92 million benzodiazepine prescriptions were dispensed, with Lorazepam accounting for roughly one-fifth of these. Dr. Lieberman notes the duality in White Lotus’s portrayal: showcasing both anxiety reduction and addiction potential. However, she worries viewers may underestimate personal addiction risks.
Importance of Monitoring and Comprehensive Treatment
Dr. Schiff emphasizes the critical importance of self-monitoring, tracking medication effects, and regular consultations with a psychiatrist for safe Lorazepam use. She concludes, ‘It is important for viewers to understand that relying on medications like this without proper oversight is not a healthy or sustainable coping mechanism. It should be used as part of a comprehensive treatment plan that includes therapy, lifestyle changes, and other coping strategies.’