Ativan is the brand name for the drug lorazepam, a benzodiazepine. It is mostly prescribed to treat severe clinical anxiety but can also be used as a pre-anesthetic or an anesthetic. Ativan is also used for treating insomnia, seizures and substance withdrawal symptoms of other benzodiazepines or alcohol.
What Are Benzodiazepines?
As one of the most prescribed groups of drugs in the United States, benzodiazepines are responsible for a greater threat than opioids. In addition to Ativan, they include drugs such as Klonopin, Xanax, and Valium.
Benzodiazepines were created as alternatives to the highly addictive barbiturates that were popularly prescribed in the past for the treatment of seizures and anxiety. The excessive prescription of barbiturates resulted in various substance abuse concerns and well-publicized overdoses.
The highly esteemed and famous actress and singer Judy Garland overdosed on barbiturates and died from the episode. Health researchers hoped that benzodiazepines would have a smaller risk for abuse, but it is not the case; they are still highly addictive and accessible.
Ativan is a Controlled Substance
All benzodiazepines, including Ativan, are designated as controlled substances by the DEA (Drug Enforcement Administration), listed under the Schedule IV category. This translates to these drugs being highly addictive with a great potential for misuse. It is a problem that can result in physical dependence if they are frequently abused.
Benzodiazepines For Short-Term Use
Benzodiazepines are meant to be used temporarily to help the person deal with anxiety or sleep disturbances while they find other long-lasting solutions, such as learning to modify behavior to control their outcomes.
This drug class is not meant to be used for common issues with daily frustration or stress. When used this way, it is very easy for the person taking it to become addicted quickly.
Medical professionals should not prescribe benzodiazepines to treat issues with anxiety unless the patient has a major neurological condition or specific mental health disorder that causes clinically significant anxiety.
Physicians should avoid prescribing benzodiazepines for sleep disorders and find other ways to help the patient. When a person uses benzodiazepines continually to alleviate the symptoms of insomnia and other sleep disturbances, they can rapidly develop a tolerance and may require a higher dose to produce the desired effects. This is another way these drugs can easily be misused and become addictive.
Benzodiazepines Are Sedative Drugs
All drugs in the benzodiazepines category are known as central nervous system depressant drugs or minor tranquilizers. They can cause dangerous sedative effects that only trained anesthesiologists and other physicians can monitor.
All benzodiazepines have a chemical structure that is similar and affects the neurotransmitter gamma-aminobutyric acid (GABA). Neurotransmitters are chemical messengers used by neurons, nerve cells in the brain, to communicate with one another and spark the body’s functions.
When GABA is released, it slows down the function of other neurons in the brain. This is what causes the body to experience the calm and relaxation desired when a person experiences seizures, anxiety, or sleeplessness.
Risks Associated With Long-Term Use of Benzodiazepines
The long-term use of benzodiazepines has the potential to lead to the development of physical dependence. Prolonged exposure to this class of drugs can create memory loss and dementia in elderly patients.
Ativan and other benzodiazepines can even be fatal when combined with alcohol and other substances that depress the central nervous system such as opiate drugs and other benzodiazepines.
How Long Does Ativan Remain in the Body?
For most people, Ativan is considered to produce an intermediate action of onset of somewhere between 15 and 30 minutes in comparison with other benzodiazepines. When taken orally, Ativan will produce its peak effects within two hours for most people.
The Half-Life of Ativan
When referring to the half-life of a drug, it is the amount of time it takes the body to eliminate half of a single dose from the body. It takes a single dose of Ativan approximately 12 hours to cycle through the body and be eliminated.
Since it takes about five half-lives for a drug to be completely removed from the body, it can take nearly 60 hours for the body to clear a single dose of Ativan.
Ativan is broken down by the liver into a metabolite. It is a breakdown product that has a half-life of 18 hours, which means that it stays in the system for approximately 90 hours.
When Ativan combines with other drugs, the half-life changes. For instance, taking Theophylline for asthma in a combination with Ativan shortens the half-life. In contrast, taking the gout medication Probenecid increases Ativan’s half-life.
Factors That Influence Ativan’s Half-Life
Various factors can influence how long Ativan stays in the body:
- Route of administration: The normal administration of Ativan is through the oral route in the form of liquid or tablets. There is also an injectable form of the drug. Ativan has similar effects regardless of whether it is administered orally or intravenously. The half-life will change depending on which form it is used.
- Frequency of use: The more frequently Ativan is used, the longer it will take for the body to eliminate it; thus, the half-life may increase in those people who habitually use the drug.
- Amount taken: The larger the dose, the longer it will take for Ativan to be eliminated from the body. This is due to the liver requiring a longer time to clear the larger dose.
Patient’s Age: The older population usually clears Ativan out of their bodies 20% slower than those who are younger.
Ativan and Drug Testing
Various types of drug tests are used to detect the presence of lorazepam. Ativan will be detected in the system for different lengths of time, according to which drug test is administered.
The following shows the various drug tests that can detect the drug:
- Blood tests: Tests that analyze the blood chemistry will detect Ativan levels at their peak in one to six hours after administration and may continue to show up in the blood for several days.
- Urine tests: Urine samples show the use of Ativan only after two hours after administration and can continue to be detected for three to six days. These types of tests are the most common method for testing for the drug.
- Saliva tests: Saliva tests can show Ativan levels after about 15 minutes after administration and can continue to be detected for approximately eight hours.
- Hair tests: This type of test doesn’t allow for Ativan to be detected at times. When Ativan does show up in hair tests, it is present in very minute concentrations and, therefore, makes this type of test unreliable.
When testing for Ativan, false positives can occur with other prescription drugs. These are known to give false-positives on benzodiazepine and Ativan drug tests. They include
- Efavirenz used for HIV treatment
- Sertraline used for mood regulation
- Oxaprozin used for treating pain
Circumstances That Can Alter How Long Ativan Stays in Your System
There are several considerations to keep in mind that influence the amount of time Ativan and other drugs can be detected.
- A person’s metabolic condition such as their kidney function and general state of health can influence how Ativan or any drug is metabolized and eliminated. Patients who have kidney dysfunction would metabolize and eliminate the drug slower.
- Age affects the metabolic rate at which drugs are eliminated. The younger you are, the more efficient and faster your metabolic response.
- Body weight also affects the rate at which the body eliminates lorazepam. Heavy people seem to eliminate the drug faster than thinner individuals.
- The amount and frequency of the doses affect how long it is detected in your system. Habitual users who frequently take the medication will build a tolerance and are more likely to take high doses. They will eliminate the drug slower than individuals that do not use the drug with frequency and have not developed a tolerance.
- Drug interactions while taking lorazepam can influence the rate of elimination. For instance, alcohol is metabolized by the liver before other drugs in the body; therefore, lorazepam will stay longer in your system when combined with it.
- Proper hydration also influences how quick or slow Ativan is metabolized and eliminated from the body. Well-hydrated bodies can eliminate the drug much quicker than those who are dehydrated.
- Some foods may also affect the rate of metabolization and elimination of Ativan and any drug. For example, consuming fatty foods prior or during taking the drug is known to slow down the metabolization and elimination from the body.
How Can You Get Ativan Out of Your System?
Compared to other drugs in its class, Ativan’s half-life is relatively long. Similar to other benzodiazepines, a physical dependence can occur from its frequent use. This leads to undesired withdrawal symptoms when you abruptly stop taking this medication.
It is a wise idea to speak to your physician first before drastically changing your habitual dose. Lorazepam must be discontinued only under the direct supervision of a medical professional because the sudden withdrawal can lead to severe adverse effects that may become serious.
When you safely stop using Ativan, there are several steps you can take to increase the speed at which the drug clears from your body completely. Ativan is eliminated through urine; thus, excellent hydration is a key factor to a complete and faster detox program. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.
What Are Symptoms of an Ativan Overdose?
Most of the overdoses seen in clinical settings for Ativan involve combining opiates such as Vicodin or OxyContin as well as alcohol. It is a lethal combination that requires emergency medical care.
It is important to know the symptoms of an Ativan overdose so that you or those around you can call 911 immediately.
These are the signs of an Ativan overdose:
- Sudden and unusual dizzy spells
- Drowsiness or extreme sleepiness
- Slowed or shallow breathing
- Unresponsiveness, fainting, or blackout
What Precautions Can You Take With Ativan?
To prevent any medical complication or an accidental overdose, there are precautions one can take when using Ativan.
- The use of Ativan must be discussed with your physician if you are pregnant or planning to become pregnant.
- Your baby may be affected by the drug if you are pregnant or breastfeeding.
- Avoid using alcohol while using Ativan.
- Do not use street drugs as they can have compounds that depress your breathing.
- Do not take Ativan if you have suicidal thoughts or suffer from depression.
- Older patients may experience more potent effects while taking Ativan including drowsiness.
- Discuss Ativan use with your physician if you are taking or plan to take opioid medications. Those include medications such as Demerol, morphine, tramadol, oxycodone, and methadone. The combination of these with Ativan can cause life-threatening conditions.
- Avoid tobacco products as these can reduce Ativan’s effects.
Your doctor must be aware of all the medications, vitamins, herbal products, and other substances you are taking. Your Ativan dosage might have to be modified if any other drugs are present in your system. Remember to always notify your doctor when you have stopped using a medication or have started a new one.
Overcoming Ativan Misuse and Getting Help
The first step to take if you’re looking to discontinue using Ativan is to speak to your physician. Even if you are taking Ativan exactly as prescribed, you have the potential to develop a physical dependence. Discontinuing Ativan abruptly can cause life-threatening emergencies and can increase the risk of experiencing seizures while you’re on the withdrawal transition.
As you stop using Ativan, you should be carefully monitored by medical professionals as the drug is slowly and gradually detoxed from the body until it is completely tapered off. If you need help, you can find it through our outpatient treatment program at Granite Recovery Centers.