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A benzodiazepine drug, Lorazepam, whose brand name is Ativan, is a common prescription for treating anxiety and it was out in the market back in 1977. Even though Lorazepam is greatly effective for treating anxiety when it is used for a shorter period of time, it can get problematic if taken for a longer duration of time. Using Lorazepam for a longer term is linked it memory impairment, dementia and dependence. Moreover, it is also linked to rapid tolerance onset, addiction and abuse. Benzodiazepine is one of the most addictive drugs in the market. However, if taken under the guidance of a medical supervisor, it can help minimize the risk of addiction and abuse. Many users have shown significant increase in psychological and physical relaxation after taking benzodiazepines and Ativan.
Lorazepam’s relaxant effect is formed due to the enhancing of GABAergic neurotransmission, at the GABAA receptor to be precise. This happens through the chloride ion channels’ openings. CNS activation is depressed by enhancing GABA, leading to a facilitative sedative and/or a hypnotic response, along with reduced anxiety. However, due to the numerous stemming effects caused by long term lorazepam usage, a lot of users have begun to discontinue it and are understandably curious to know as to how long it will stay in their body’s system and when will they be completely detoxified.
If you have completely stopped the intake of Ativan, you would want to know as to how long will it be in your system. Now it is important to note that many users have experience withdrawal effects of Ativan once they stopped taking it. These should be monitored and checked by a doctor. Moreover, if it is discontinued abruptly, it could lead to seizures or even death. This can happen with any agent that could elicit some potent effect of any GABAergic processes.
How Long Does Ativan Stay In Your System ?
Many sources suggest that Ativan’s half life is approximately 12 hours, which means that once you have taken your last dosage of Atican, it would take about 2.75 days for Ativan to be full out of your body. Some other sources, however, suggest that the accurate half life of Ativan is a bit longer than 15.7 hours. If that is correct, then it would take about 3.59 days for complete elimination of the drug from your body. Now, you also need to know that lorazepam glucuronide’s active metabolite has a half life of 18 hours, which is much longer. Hence, to completely eliminate lorazepam glucuronide, it will take more time than the drug. Lorazepam glucuronide can remain in your system and can also be detected from your urine for as long as 4.13 days, once it is ingested.
Factors influencing the stay of Ativan in the system
You should know that there are many factors, apart from the half life of Ativan which will impact its stay in your body. These impacts are mostly subtle, but they do play an important role. Based on them, some people are able to get the drug out from the system quicker as compared to some others. Scroll down to keep reading about these factors in detail.
The amount of dosage: Ativan’s dosage is one of the factors which can have an impact as to how long it will stay in the system. Commonly, the prescription of Ativan is about 1 mg to 6 per day. In rarest of rare case, especially for the people who have built up a tolerance, a dosage of 10 mg per day can be prescribed. The dosage of Ativan has an impact as to how quickly or slowly the body can metabolize and then excrete it out. For example, for someone who has taken, let’s say, 0.5 mg of Ativan, it will be out of their system much quickly as compared to someone who has taken a 6 mg dose. Larger doses for Ativan can cause long lasting effects as compared to the smaller doses. The reason this happens is because your body’s ability to metabolize any drug efficiently will decrease, directly proportional to the increase of the dose. In continuation of the example of two different amounts of dosage, the difference between the elimination times of both the users will remain unclear. It could take hours or even days, depending on the amount of difference between the two doses.
Simultaneous intake of other drugs or supplements along with Ativan: If you’re taking Ativan, you need to understand that if you’re simultaneously taking any other supplements or drugs; they could have an impact on its metabolism, absorption and the speed at which it will be out of your system. If you consume alcohol while taking Ativan, it can impair Ativan’s glucuronide conjugation. Further, it can also reduce the elimination rate up to 18%. Similarly, taking other supplements or drugs could either inhibit or prolong the metabolism of Ativan and its clearance.
Some other substances can also expedite Ativan’s breakdown as well as its elimination rate. However, the level to which these exogenous substances when co-ingested will influence elimination rate of Ativan is yet to be well understood. It is still a concept which can very well be considered. For most of the users of Ativan, if they take other supplements or drugs, it will not affect the elimination rates.
Frequency of the dosage: The frequency of the dosage of Ativan can also impact its stay in the body. For example, if someone takes the drug thrice a day, the elimination time of Ativan will obviously be much longer than for someone who takes it just once a day. The reason why this happens is because for the former, the last dose will be most likely in the evening or later afternoon. So, their body would have just begun the metabolism of the last does. For the person who has taken just one dose will have come far through the metabolism process. However, for the frequent users, Ativan is not accumulated in the tissues of the body. It is only obvious that there would be tolerance. They tend to build a tolerance to the effects of the drug, thereby getting used to taking multiple dosages. For this very reason, it should take a longer while for the frequent users to get detoxified from Ativan.
Some individual factors: Consider a hypothetical situation where two people are taking the same dose of Ativan at the same time. How can it be determined as to whose elimination rate is faster and whose is slower? In such a case, the individuals’ personal factors come into the picture. These include – height, weight, age, genetics, metabolic rate and kidney function.
- Metabolic rate: For people with greater BMR (Basal Metabolic Rate), metabolism of drugs is quicker as compared to the ones with a lower BMR. The reason why that is for the people with higher BMR, Ativan’s breakdown is faster. However, this not proven and could be possibly inaccurate.
- Age: Age is known to affect the elimination rate of Ativan from the system. Older people can show up to 22% slower elimination rate as compared to younger people. The reason why people over the age of 65 are able to eliminate Ativan out slowly is not yet known. However, there are many theories to explain this assumption – blood flow, health condition, organ functionality, metabolic rate, etc.
- Genetics: The differences in ability for metabolism of Ativan can also arise from genetics. Some individuals could metabolize quickly because of the presence of genes responsible for regulation of kidney function or liver function. Some other people might be poor at metabolism of Ativan and thus may take a bit longer time for its complete elimination along with the metabolites.
- Body weight and height: there are theories which indicate that a person’s weight and height could have a minor influence of the elimination time of Ativan. To be precise, the person’s height and weight in relationship with Ativan’s dosage can influence the excretion. For example, for a light weighted, short person as compared to a heavy weighted, tall person, it would comparatively take more time to excrete out Ativan. This means that for heavier people, it speeds up the process of excretion of Ativan.
- Kidney function: Liver impairment is not known to have much influence of the excretion of Ativan out from the body. However, the functionality of kidney could alter the rate at which it is removed. If you have any renal abnormalities, you will take a bit longer time for the removal of Ativan along with its metabolites.
Metabolism and Excretion of Ativan explained
Once Ativan is orally ingested, it gets absorbed slowly due to its weak lipid solubility. Almost 90% of it then gets bounded to proteins, reaches, in direct proportion of the administered dose, plasma levels. Here’s the thing – as great the dose it, as great is the plasma level. If you intake 2 mg Ativan, it would yield a serum concentration, peak, of 20 mg/ml. This should happen after about 2 hours of ingestion. This serum concentration consists of 50% lorazepam, active ingredient, and 50% metabolite lorazepam-glucuronide, biologically inactive. Lorazepam-glucuronide’s formation occurs when metabolism of lorazepam occurs in the liver through glucuronic acid’s conjugation. UGT2B15 enzymes facilitate Glucuronidation, which means that only a few pharmacological substances could interfere with its elimination.
After the serum concentrations peak post 2 hours ingestion, lorazepam levels keep falling with a half life of 12 hours. Within this time frame, 50% of Ativan will be out. Since lorazepam-glucuronide is fairly soluble in water, it gets distributed throughout your body. It has a greater elimination half life as compared to lorazepam – almost 18 hours. It has been estimated that almost 74.5% lorazepam dose gets excreted by the kidneys as lorazepam-glucuronide. It is discarded through urine. About 13.5% lorazepam is excreted in the form of various small metabolites. Within 5 days of taking the drug, about 95% of lorazepam gets eliminated in the form of feces and urine. Lorazepam-glucuronide gets completely eliminated from a person’s body in about a week.
Tips for aiding clearance of Ativan from your body
Even though for most people, the absorbtion, metabolism and excretion of Ativan from their bodies works at the same pace, there might be a few ways to speed up the process. Here are some ways you could use it:
- Hydration or diet: Even thought drinking lots of water isn’t proven to expedite the process of excretion of drugs, keeping yourself hydrated along with having a diet full of antioxidants could help the elimination of drugs at a quicker rate. If you are dehydrated, or are not eating a nutritious diet, on the other hand, the drug elimination process could take longer than usual.
- Supplements: There are certain supplements available which can enhance Ativan’s metabolism. If you happen to have thought of taking some supplements to detoxify your body, you could talk to a doctor and make sure there are no contradictions. Inducers are the supplements that can ensure that Ativan will be removed from your body in the most efficient way.
- Stop its intake: Discontinue taking it, if you want to remove Ativan out from your system at the earliest; preferably, sooner rather than later. However, the process of discontinuing it should be discussed with a doctor. Understand that for the longer time that you take it, it will increase the elimination time that much.
- Exercise: Since exercise can boost the metabolic rate which influences the drug elimination speed, it could help in taking it out at a faster rate. Moreover, working out also helps detoxification of the body, increase circulation and also helps the nervous system to adjust the functioning without taking the drug. Going for jogs once a day can surely help you take out the drug from your system quickly.
- Change in urinary pH: for a lot of drugs, urine’s pH impacts the rates of their elimination. For the people with a higher acidic pH, drugs get excreted faster as compared to the ones with an alkaline pH. Alkaline urine slows down the excretion process and induces reabsorption of both the drug as well as the metabolite.
Drugs tests for Ativan
There are a lot of drug tests which can be used to determine Ativan’s presence in the system. SAMHSA-5, one of the common drug tests, can be used only to detect drugs like cocaine, marijuana, opioids, PCP and amphetamines. Hence, you probably will not be able to find Ativan if you go for this test. However, if the test is extensive, you can definitely find the presence of Ativan and benzodiazepines. Here are some of the tests which can be done:
- Hair test: for drug ingestion for a longer period of time, hair tests could be done. For this test, the person needs to give their hair sample, usually between 3 to 6 cm – the longer, the better. If the hair test is done properly, it can be determined if someone has taken Ativan till a month post exposure.
- Urine test: It has been known that lorazepam can be found in the urine of a person even after 6 days of ingestion. For the users who are frequent, it can be found for more than we week. Moreover, for urine analysis directed towards detection of lorazepam-glucuronide, it can be found even 9 days after it is ingested.
- Saliva test: it has been found that lorazepam can be found in the saliva for up to 8 hours after ingestion. This test is not so commonly used. Even though it is more convenient, it is better to rely on tests like the urine test.
- Blood test: Ativan is present in the bloodstream in 6 hours after ingestion and till 3 days later. Hence, to be found clean on the test, you would want it out from your system quickly. For the people who take frequent high doses, it stays even longer than 3 days. But, blood tests are not so convenient and are highly invasive, so urine tests are preferred over them.
Who all can be subjected for testing of Ativan?
A lot of people can, actually, since a lot of people take this drug. It is important to note that getting positively tested for Ativan could make you get rejected for a prospective job, it can get you fired and if you are into sports, it can get you permanently banned. Here are the people who can be tested:
Employees: Employers can test their employees any time in case of a doubt for the presence of Ativan. If an employee is working on some heavy machinery, they need to remain alert, as Ativan many decrease their alertness and make them drowsy, which could lead to some fatalities.
Military personnel: It goes unsaid how important it is to remain drug free in the military. They are often tested for drugs to make sure they are not working on any heavy machinery to avoid fatalities. If caught using Ativan, the person can get de-listed
Athletes: Even though taking benzodiazepines can cause negative effects on their performance, many athletes could be used to taking drugs. To make sure that they are not, they are often tested. If caught, they can get suspended or banned for life.
Drug rehab clientele: If someone is in a rehab to fight the usage of drugs, they are often tested for drugs to make sure they have indeed stopped taking them. If Ativan is found, they would be required to stay for a longer time at the rehab.