How Long Does Ativan (Lorazepam) Stay in Your System?

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Ativan (lorazepam) is a benzodiazepine sedative used to treat anxiety and seizures. It may also be prescribed for people who are undergoing alcohol withdrawal, for nausea from chemotherapy, and for irritable bowel syndrome. It depresses the central nervous system and has risks when combined with other depressants or alcohol, including the possibility of fatal respiratory depression.

Be aware that Ativan can be habit-forming. For this reason, it is usually prescribed only for short periods. With long use, you become tolerant and larger doses are needed. Stopping Ativan after using it for a long period can result in withdrawal symptoms of anxiety, sleeplessness, and irritability.

While you have Ativan in your system, it is important to understand how it might interact with other medications and substances. You need to be alert for the symptoms of an overdose or severe side effects and work closely with your doctor to avoid these situations.

How Long Does Ativan Stay in Your System?

Urine: Up to six days

Blood: Up to three days

Saliva: Up to 8 hours

Hair: 30 days or longer

How Long Does It Take to Feel Effects?

Ativan belongs to a class of drugs called benzodiazepines that have sedative and hypnotic effects. The drug works by enhancing the effects of a natural chemical called GABA, which depresses the central nervous system (CNS) leading to a calming or relaxing effect. 

Ativan will make your drowsy while it is in your system. You should not drive or operate machinery while you are drowsy.

Ativan can be given as tablets, liquid concentrate, or by injection. The different routes have different timetables for when they take effect.

Tablets vs. Liquid vs. Injection

With tablets or liquids, the peak effects are seen in 2 hours. An injection begins to have effects in 15 to 30 minutes, and its effects last for 12 to 24 hours.

How Long Does Ativan Last?

While lorazepam is a fast-acting drug, it has a relatively long half-life. The half-life of lorazepam is 12 hours, meaning that it decreases in concentration in the body by half every 12 hours.

The drug is metabolized primarily by the liver and then eliminated from the body by the kidneys through urine. Its metabolite has a longer half-life of 18 hours. It takes five to six half-lives for drugs to be mostly eliminated from your system.

If you are going to be taking a urine drug screen for employment or other purposes, be aware that it will test positive if you are taking Ativan. Disclose your prescription to the testing lab so they can accurately interpret the test results.

Blood

Ativan can first be detected by blood tests six hours after ingestion. Blood tests can also detect the substance for three days after the last use. However, this detection window may be longer in cases where people have been taking Ativan at higher doses for three days or longer. 

Urine

Ativan is eliminated in the urine for 1 to 6 weeks, depending on how much is administered and for how long. Urine screening tests can detect Ativan in samples up to six days after the last use.

In those who have been taking the drug regularly or at higher doses, this detection window may be somewhat longer. If testing looks for the metabolite lorazepam-glucuronide, which is produced as the drug is broken down by the body, detection may take place up to nine days after the last use.

Hair

As with other drugs, Ativan can be detected in hair samples for much longer than with other methods. It can be detected with a hair test for up to 30 days after use. 

Saliva

Saliva tests have found that Ativan could be detected in samples for up to eight hours after use. However, saliva tests are rarely used to screen for benzodiazepines such as Ativan. 

Factors That Affect Detection Time

There are a number of things that can influence just how long Ativan remains in a person's system. While rates usually follow a fairly consistent timeline, some people will metabolize and clear the drug more quickly than others.

Some of these factors that can influence how long Ativan remains in your body include:

Individual Factors

  • Age: Older people tend to clear the drug more slowly than younger people. This is likely because older individuals have slower metabolisms, decreased organ function, lower blood flow, and other health issues that can affect how quickly the drug is processed and excreted.
  • Kidney Function: Research has found that liver impairment does not have much of an impact on Ativan clearance rates; however, kidney problems are associated with prolonged drug half-life.
  • Height and Weight: Taller, heavier people typically clear the drug more quickly than shorter, lighter individuals.

Dosage and Frequency of Use

Higher doses of Ativan take longer to metabolize. The drug is detectable for longer periods in individuals who have been taking the drug for a longer period of time.

Use of Other Substances

The concurrent use of other substances can have an impact on how quickly each substance is processed and excreted from the body.

For example, research has found that consuming alcohol while using Ativan reduces clearance rates by 18%. Researchers believe that short-term alcohol consumption impairs the coupling of the drug or its metabolites with other molecules, which slows the metabolism process.

How to Get Ativan Out of Your System

Ativan has a relatively long half-life and, like other benzodiazepines, its use can lead to physical dependence.

If you do decide to stop taking Ativan, always talk to your doctor first. You should only stop using lorazepam under the supervision of a medical professional due to the potential risk of severe withdrawal side effects.

Once you have safely stopped taking Ativan, there may be a few things that you can do to speed up how quickly the drug completely clears your system. Because Ativan is excreted through urine, staying well-hydrated by drinking plenty of fluids may slightly increase how quickly the drug is removed from your system.

Symptoms of Overdose

An overdose with Ativan is most commonly seen if you take it with alcohol or opiate medications. This can be life-threatening, and it is important that your family or household members know what symptoms to look for so they can get emergency help quickly.

The signs of an Ativan overdose include:

  • Unusual dizziness
  • Lightheadedness
  • Extreme sleepiness
  • Slowed or difficulty breathing
  • Unresponsiveness

If you suspect that someone has overdosed on Ativan, call 911 immediately. 

Precautions

You risk serious breathing problems, sedation, or coma when you take Ativan with alcohol or other medications that can depress breathing. Some things that you can do to prevent accidental overdose or other complications:

  • Do not use alcohol while taking Ativan. Do not take any street drugs as they may contain substances that can depress your breathing.
  • If you are breastfeeding, be aware that this drug passes through into your milk and may affect your baby.
  • If you are pregnant or plan to become pregnant, discuss this with your doctor.
  • If you are depressed or have suicidal thoughts, Ativan should be avoided.
  • Older people may experience more effects of Ativan and often are given lower dosages. They may be more affected by drowsiness and need to take precautions.
  • Cigarette smoking or using tobacco products can reduce the effects of Ativan.
  • If you take or plan to take any opiate or opioid medications, discuss them with your doctor as they can result in a life-threatening reaction with Ativan. These include medications with codeine or hydrocodone (such as for a cough or pain), fentanyl, hydromorphone, Demerol, methadone, morphine, oxycodone, and tramadol.

Discuss all medications, supplements, vitamins, and herbal products you take with your doctor as you may need dosages changed when you have Ativan in your system.

Always tell your doctor whenever you plan to start a new medication or stop using one. These include muscle relaxants, oral contraceptives, sedatives, sleeping pills, and medications for depression, seizures, Parkinson's disease, asthma, colds, or allergies.

Getting Help

If you need help stopping Ativan use, start by talking to your doctor. Physical dependence can occur even if you take your drug exactly as prescribed. Quitting Ativan suddenly can be dangerous or even life-threatening due to the increased risk of seizures during the withdrawal process. You must be monitored by a medical professional as you go through the detox and withdrawal process.

In most cases, you can detox from the drug on an outpatient basis. There are no medications approved to treat Ativan dependence, but the standard approach is to slowly reduce the amount of the drug used over a period of time to prevent severe withdrawal symptoms. Your doctor will monitor your progress as you slowly taper off of the drug.

Your doctor may also recommend other treatments such as psychotherapy. Types of psychotherapy that may be used during drug recovery include cognitive-behavioral therapy and dialectical behavioral therapy. If you need help with your treatment, ask your doctor to refer you to a psychiatrist or another mental health professional who specializes in addiction recovery.

You can also call the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357 or use their online treatment locator to find providers and treatment services in your area.

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