Lorazepam Half-Life Considerations

Lorazepam undergoes glucuronidation in the liver and is eliminated primarily through the kidneys.[17] Several factors can affect the time it takes for your body to eliminate half of this medication. However, because of its potential for misuse and abuse, individuals who are dependent on lorazepam may take larger doses than prescribed, which can result in an extended clearance rate. Here, you will learn about the factors contributing to lorazepam’s half-life, how long it stays detectable in the body, and what elements can extend its duration.

What is Lorazepam (Ativan)? 

Lorazepam is a benzodiazepine commonly prescribed for short-term relief of anxiety symptoms and insomnia. It is available in tablet, extended-release capsule, and liquid forms. Lorazepam tablets and liquid are taken with or without food two to three times daily, and extended-release capsules are taken once a day.[2] This medication is available by prescription only under its generic name or the following brand names:

• Ativan
• Loreev
• Loreev XR

How Lorazepam works

Lorazepam works by binding to benzodiazepine sites on GABA A receptors in the central nervous system (CNS).[5][1] This slows brain activity and induces tranquility. It also produces an anti-emetic effect, reducing nausea and vomiting.

Lorazepam Uses

Lorazepam is FDA-approved to treat status epilepticus, anxiety symptoms related to anxiety disorders, and anxiety-induced insomnia.[3] It might be prescribed to treat conditions other than these. This is called off-label use.[4] Conditions treated off-label include:

• tranquilization of agitated patients
• panic disorder
• alcohol withdrawal delirium
• alcohol withdrawal syndrome
• chemotherapy-associated nausea and vomiting
• vertigo
• psychogenic catatonia

Lorazepam is a helpful medication in inpatient settings due to its rapid action when administered intravenously. Most patients who receive intravenous lorazepam feel its peak effects within one to three minutes.[5]

What is the Elimination Half-life of Lorazepam?

The body absorbs Lorazepam well. Its peak plasma bioavailability reaches 90% in approximately two hours.[5] Between 10 and 20 hours, this amount decreases by half.[6] The exact half-life of lorazepam depends on the dosage amount and frequency. However, the mean half-life is approximately 12 hours, according to the FDA.[7]

Can Taking Too Much Lorazepam Affect its Elimination Half-life?

The elimination half-life of Lorazepam remains constant regardless of the dose, so taking too much will not affect it. However, taking doses too closely together can elevate the amount of the drug in your bloodstream, increasing the risk of overdose.[16] Furthermore, when Lorazepam is combined with other benzodiazepines, its central nervous system depressant effects can be amplified, further heightening the risk of severe sedation and overdose.[16]

How Long Does Ativan Stay in Your System?

According to the National Library of Medicine, when a drug such as Lorazepam is taken at regular intervals, it can take four to five half-lives for it to leave the system.[8] However, this number is based on the metabolism of a healthy individual. People with underlying medical conditions, such as kidney disease, liver disease, and diabetes, may have difficulty processing the medication, leading to an increased elimination half-life.

Can Long-Term Use Cause Lorazepam (Ativan)Addiction?

Lorazepam is listed as a Schedule IV Controlled Substance by the US Department of Justice.[9] Drugs in this schedule have a higher-than-normal risk for misuse and dependency. Therefore, long-term use can lead to Ativan addiction. Someone who misuses lorazepam may do so by:[10]

• using more than the prescribed amount
• taking lorazepam to get high
• combining lorazepam with another substance to enhance their high
• using someone else’s lorazepam prescription
• using lorazepam for reasons other than prescribed
• using lorazepam in a manner other than prescribed

Individuals who misuse lorazepam may develop a tolerance to the medication.[11] This means that the prescribed dose will no longer be effective for them. As a result, they may start using more than the prescribed amount to feel any effects. Unfortunately, this can lead to a physical dependence on the medication.

Lorazepam Dependency and Withdrawal

People who are dependent on lorazepam may experience adverse side effects when trying to stop it. This is called withdrawal. Lorazepam withdrawal symptoms vary in severity from mild to severe and usually include:[12]

• disturbances
• irritability
• anxiety
• mood swings
• difficulty concentrating
• tremors
• sweating
• nausea
• headaches
• heart palpitations
• muscle pain
• panic attacks

Withdrawal symptoms can occur in individuals using lorazepam as prescribed, particularly at higher doses or after long-term use. They may require taper doses of 0.5 mg every three days to avoid withdrawal symptoms.[5]

Can You Overdose on Lorazepam?

When a person takes lorazepam in amounts greater than prescribed, it can extend the drug’s elimination half-life. As a result, their system may struggle to eliminate the medication effectively, increasing the risk of toxicity.[5] Since lorazepam depresses the central nervous system, its toxicity can lead to adverse effects. Symptoms of lorazepam toxicity include:

• difficulty talking
• cognitive impairment
• balance issues
• loss of coordination
• tiredness
• confusion
• respiratory depression
• slowed heart rate
• loss of consciousness

In some cases, individuals who overdose on lorazepam may experience a seizure or coma.

Does Ativan’s Half-life Affect Withdrawal?

When someone is dependent on lorazepam, they may experience withdrawal symptoms if medication levels drop.[5] This can happen during the drug’s elimination half-life. To ease these symptoms, the physician might reintroduce lorazepam at a lower dose and gradually decrease it. They may also prescribe a less addictive alternative. Some individuals may need drug detox to withdraw safely, especially if they have an addiction to lorazepam. During a drug detox, individuals receive supportive care, and off-label medications such as beta-blockers or antidepressants may be used to manage withdrawal symptoms, though no FDA-approved medication specifically targets benzodiazepine withdrawal.

How Long Does Lorazepam Show on a Drug Test?

Drug tests detect metabolites or waste products left behind from substances such as opioids and benzodiazepines. Even after total elimination, metabolites from Lorazepam are detectable on blood, saliva, and urine tests. Lorazepam is detectable in the urine for up to seven days in therapeutic use and up to 30 days with chronic use.[13] Lorazepam may be detectable on hair tests, saliva tests, and blood tests for several hours or days after last use.

Signs of a Lorazepam Addiction

Individuals addicted to lorazepam may frequently show signs of being under its influence. This can include side effects like slurred speech, impaired coordination, and episodes of drowsiness.[14] However, these signs alone are not sufficient to diagnose someone with lorazepam addiction. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines specific criteria for diagnosing a substance use disorder, including lorazepam addiction. A person who meets two or more of these criteria in 12 months can be diagnosed with an active addiction.[15] They include:[15]

• experiencing intense cravings for lorazepam
• using more lorazepam than prescribed or for longer than prescribed
• missing school or work due to using lorazepam
• continually using Lorazepam despite the negative consequences
• requiring higher doses of lorazepam to feel the effects
• experiencing withdrawal symptoms when stopping
• having problems with family or friends due to lorazepam use
• prioritizing lorazepam use over important obligations
• relapsing after discontinuing use

Treating an addiction to lorazepam can be challenging and often requires professional help. Stopping the medication abruptly can cause withdrawal symptoms, which may lead a person to start using it again.[14] Due to the serious risks associated with withdrawal and the possibility of increasing doses, individuals with a lorazepam addiction may need to undergo detoxification in a medical setting.

Treatment Options for  Lorazepam Addiction

Addictions frequently arise from past drug use or underlying mental health issues. Because of this, it is vital to seek treatment to help prevent relapse and reduce the risk of overdose. Rehab for lorazepam addiction provides various levels of care to meet individual needs. When selecting the right level of care, consider factors such as:

• the location of the treatment center
• available detox services
• options for treating polysubstance use
• programs for dual diagnosis
• the overall cost of treatment

By assessing these factors, people with lorazepam addiction can find the most suitable care for their recovery.

Medical Detox

The primary approach to treating lorazepam addiction is medical detoxification. This process involves close monitoring by licensed medical professionals as individuals follow a safe tapering schedule to reduce their reliance on the medication gradually. To ease withdrawal symptoms and discomfort during this time, healthcare providers may also prescribe FDA-approved medications, such as Paxil. This combined approach helps ensure a safer and more manageable recovery experience.

Inpatient Rehab

Inpatient rehabilitation is ideal for individuals who have a severe addiction to lorazepam. This setting offers a controlled and safe environment where patients can participate in various treatment programs. The primary goal is to eliminate the influences of lorazepam addiction while allowing patients to engage in their recovery fully. The process typically starts with a medical detoxification, after which additional evidence-based programs can be introduced, such as cognitive behavioral therapy (CBT), adventure therapy, or yoga. People in an inpatient program live at the facility in a homestyle unit alone or with a roommate. Some programs allow family and friends to visit on specific dates; many have communal areas dedicated to recreational activities.

Outpatient Treatment

In an outpatient treatment program, patients with lorazepam addiction receive care while living at home. They can participate in activities like 12-step groups and art therapy, attending only a few hours each week. This less intensive approach is ideal for those who have made progress in recovery or cannot attend inpatient programs due to logistical or insurance issues. There are several types of outpatient programs, including:

• Partial Hospitalization Program (PHP)
• Intensive outpatient program (IOP)
• Alcoholics Anonymous
• Narcotics Anonymous

Getting Help for Lorazepam Addiction 

Misuse can lead to an extended half-life, increasing the risk of overdose and its harmful effects. To withdraw safely and prevent relapse, it’s essential to seek help. With the right approach to care, recovery is achievable. Contact Southeast Addiction Center TN today to discuss a personalized treatment program and take the first step toward recovery.