Last reviewed by Miljan Krcobic on August 27th, 2018.
What is Lorazepam?
Lorazepam is a generic name for a short-acting benzodiazepine drug. This drug works by affecting chemicals in the brain known as neurotransmitters that may be unbalanced in patients with different types of anxiety disorders. Lorazepam is used to treat all types of anxiety disorders, insomnia and status epilepticus.
Lorazepam is most usually prescribed for no longer than 4 months because of the risk of causing addiction. A typical course of lorazepam treatment, last about 2-4 weeks. The most common brand name for lorazepam is Ativan.
This medicine is available in the form of immediate-release and sublingual tablets in doses of: 0.5 mg, 1 mg and 2 mg and in the form of solution for intramuscular or intravenous injection in concentrations of 2 mg/ml and 4 mg/ml. FDA approved lorazepam in 1977. Ativan is originally manufactured by Valeant Pharmaceuticals.
What is Lorazepam used for?
Lorazepam is mostly used as anti-anxiety drug, but it can be also used as hypnotic, anticonvulsant, sedative and preanesthetic agent. Lorazepam is most commonly prescribed to treat anxiety disorders and to relieve anxiety linked with depression. Lorazepam injection is used to treat prolonged epileptic seizures in emergency situations.
Lorazepam can be also used before surgery to produce sedation, relieve anxiety, and reduce recall of surgery in patients who are anxious about them. Lorazepam is also used to treat epilepsy, insomnia, irritable bowel syndrome (IBS), agitation caused by alcohol withdrawal, and anticipatory vomiting from cancer treatments. FDA approved indications for lorazepam are:
- Anxiety Disorder
- Status Epilepticus
How lorazepam works in the body?
Lorazepam works by binding to the sites of GABA-A receptors of benzodiazepine receptor in the brain. By binding to this receptor sites it potentiates the inhibitory effects of GABA neurotransmitter, which then opens the chloride channel in the receptor, allowing chloride influx and causing hyperpolarization of the neuron cell.
Can lorazepam makes you ‘’high’’?
Most people don’t get high on lorazepam when they use lorazepam according to prescription as recommended by their doctor. However, if it is taken for non-medical reasons and in higher doses than recommended, lorazepam can make you high, especially if it is known that it can produce semi-euphoria effects. So, because lorazepam binds to the receptors in the brain responsible for rewarding effects it does can make you feel high.
Except euphoria, lorazepam can also cause sedation, dizziness and drowsiness. The calming effect of this frug makes it particularly attractive given the daily stresses of life. Because lorazepam causes feelings of sedation and relaxation, it can become addictive to those taking it.
Lorazepam can cause addiction also in patients who are legitimately taking it. Lorazepam can also be the trigger of physiologic and psychological dependence which is based on drug’s dosage, potency, duration of therapy and frequency of use. This is why lorazepam should be prescribed for only 2-4 weeks.
Drug such as lorazepam may artificially produce euphoria in certain patients by manipulating the chemistry of the brain to make it seem that something exciting is going on. To get this feeling again, potential abusers will choose to use the drugs again-and again. Over time, the brain needs more and more of the drug in order to get the same feelings of pleasure.
This is because the drug as a chemical molecule causes surges or waves, of the neurotransmitter dopamine in the brain which initially produce the euphoria. When the action is repeating, the brain adjusts to the higher amounts of dopamine by producing it less of it and after some period also by reducing the number of receptors which are responsible for transmitting and receiving the signals.
After that, the drug abuser will continue drug intake to bring the dopamine levels back up to normal and in order to avoid the craving that compels them to seek more of the drug even when their lives and health are falling apart. That is really the essence of addiction.
Can you get more intensive high experience if you snort lorazepam?
Lorazepam gets into the bloodstream faster when it is snorted, but it may expose you to much higher doses than your body will absorb when the recommended dose is used. This raises the risk of side effects and some of them can be life-threatening such as difficulty breathing or irregular heartbeat and even coma or death.
Lorazepam effects generally last for 6-8 hours for single doses. Taking lorazepam orally is always safer option and has fewer complications, since it has been produced for such use. Snorting lorazepam will certainly cause faster and more intense effects, but this quick fix has its serious risks. Severe side effects that may be caused after lorazepam use via snorting may be following:
- Difficulty breathing or swallowing
- Extreme drowsiness
- Fainting or coma
- Irregular heartbeat
- Muscle weakness
- Tremors, inability to sit still
- Severe skin rash
- yellowing of eyes or skin
Who abuses lorazepam the most?
The use of benzodiazepines such as lorazepam without a prescription is one of the major concern public health. Thos who abuse benzodiazepines also abuse other drugs as well. SAMHSA study found that 95 % of benzodiazepine addicts also abuse another drugs at the same time.
The same researchers also found that non-medical use of benzodiazepines such as lorazepam continues to increase in teenagers and individuals between the ages of 18-25. So, teenagers are also abusing benzodiazepines and the biggest problem is that they may become addicted very quickly.
This can cause very serious consequences for a still-developing brain, since neurological development continues into the mid-20s and drug abuse and can permanently alter this development. The incidence of combined alcohol and benzodiazepine use is also become very troubling.
Lorazepam ‘’high’’ experience
Here is some lorazepam ‘’high’’ experience described on Erowid website (https://erowid.org/):
Case 1: “Feeling Good”
“…Lorazepam is the best drug I have ever tried, hands down. I have tried pot, acid, shrooms, speed, etc. Nothing comes close. If I feel I’ve had a bad day, or badly need sleep, I put 4 .5 mg pills under my tongue (2mg total) and soon I go sleepy-bye. I have done Lorazepam many times just for fun, as have many of my friends who constantly ask me for it when they’re stressed out. Recently, a friend and I took 2mg together after smoking some pot. He drank two beers and was so high, he just wandered around the house saying ‘Oh god, I’m so wasted.’ This is a guy who smokes pot and drinks every day, and does a lot of Valium. He said he didn’t like the Lorazepam as much as the Valium, ‘It makes me feel too low.’ He said. Some people have said Lorazepam is weaker than Valium, although if you took 2mg of Valium, you probably wouldn’t feel much of anything. I’ve never taken it, so I don’t know. Lorazepam make me feel emotionally numb (a blessing at times), very comfortable, sleepy, slightly happy, and I hear music in my head. When I lived with my sister, she’d hear me singing, see my glassy eyes and say, ‘Oh, you took your pills again, huh?’ Another thing I’d like to say is that this stuff is very addictive. Getting unhooked can be absolutely horrible. I know, I’ve done that about 3 times. It’s not easy. I vowed never to take this stuff more than 1 time a week. Sometimes I go a month or two without thinking about it. I wouldn’t recommend this to people who have a history of drug problems, but if you’re suffering from panic attacks, depression, stuff like that – it’s the BEST. It also has a habit of blocking my memory. If I’m really high on this stuff and fall asleep, I wake up wondering, ‘when did I go to sleep?’ ‘Wow, it’s morning already?’ It’s funny stuff. Don’t drive on this stuff EVER. Don’t take it every day unless a doctor has told you to. Don’t stay hooked on it, because if you’re on it every single day, you’re a zombie. Fabulous drug though..”
If lorazepam is used during a long-term period (more than a month) there is an increased chance of withdrawal syndrome to be caused. Withdrawal from lorazepam can be very dangerous and in some cases even fatal because of the potential of develping seizures during the withdrawal process. Lorazepam withdrawal usually happens in two stages: an acute stage and a long-term stage.
Ativan has an elimination half-life time of about 10-12 hours on average, so initial withdrawal symptoms can begin relatively fast sometimes within 24 hours after the administration of last dose. However the average withdrawal onset is 3-4 days. Acute withdrawal starts usually with a rebound effects such as anxiety, increased heart rate, increased blood pressure and insomnia. The first, acute withdrawal phase symptoms may include:
- Headache, sweating, tremors, difficulty concentrating, and/or confusion
- Heart palpitations, tachycardia and increased blood pressure,
- Nausea, vomiting, abdominal cramps, weight loss
- Irritability, anxiety, panic attacks and mood swings
- Seizures in rare cases
A withdrawal syndrome occurs after the acute phase and usually lasts about 10-14 days; however, in those who administrate very high doses during a long-term period, it could last even longer. In this stage, patients will remain to experience withdrawal symptoms of anxiety, cravings for the drug, headache, nausea, vomiting, general malaise, and may even to begin to develop depression.
In some patients, third phase of withdrawal may also be exhibited where return of anxiety symptoms will continue to be present. Certain patients may continue to have symptoms such as mood swings, general malaise, depression and lack of motivation for months to years following discontinuation of lorazepam. According to some sources this is known as post-acute withdrawal syndrome.
How long does lorazepam stay in your system?
According to some relevant sources the average elimination half-life for lorazepam is an approximately 12 hours, which means that after taking your last dose, it could take up to 2.75 days for the drug to be fully eliminated from your system. According to some others sources elimination half-life for the lorazepam may be slightly lengthier at 15.7 hours. So, if the elimination half-life time is 15.7 hours, it will take nearly 3.59 days to fully eliminate the drug from your system.
It is also important to take in consideration lorazepam metabolite called lorazepam glucuronide which has a longer elimination half-life of about 18 hours. To fully eliminate this metabolite from your system it will take longer time than the drug itself. Lorazepam glucuronide will remain in the body and can be detected in your urine for up to 4.13 days after post-ingestion.
Different factors may influence how long lorazepam will stay in your system. These factors include: age, body mass, genetics, metabolic rate, liver function, co-administration of food or drugs, urinary pH, dosage and frequency of use.
Is lorazepam a controlled substance?
Lorazepam is categorized in a Schedule IV drug under the Controlled Substances Act in the U.S. and internationally under the United Nations Convention on Psychotropic Substances which means that it is considered as substance with a low potential for abuse. It is an also categorized in Schedule IV drug under the Controlled Drugs and Substances Act in Canada.
Does lorazepam show up on drug test?
There are several different types of tests that could detect the presence of lorazepam. Traditional drug tests like the SAMHSA-5 are able to detect only drugs like marijuana, amphetamines, cocaine, opioids, and PCP. Thus, with such standard tests you will not probably be tested for lorazepam or any other benzodiazepines. However, an extensive drug test could certainly detect the presence of lorazepam.
Urine tests: It has been shown that lorazepam can be detected in urine for over 144 hours (6 days) after ingestion of latest dose. Although in frequent users, the detection range from a urine sample may exceed a period for more than a week. Since lorazepam-glucuronide has a longer elimination half-life time than lorazepam, thus it may be detected for up to 9 days after administration.
Blood tests: Lorazepam can be detected in the blood samples within 6 hours of administration and up to 3 days thereafter. According to this you would likely need to stay clan from lorazepam during these days in order to avoid blood positive results.
Although in frequent users, the detection range from a urine sample may exceed a period of 3 days. Blood tests are highly-invasive and less convenient when compared to urine tests, so they are rarely used to determine whether someone had ingested Ativan.
Hair tests: If the detection time has passed both for urine or blood test, lorazepam can be still detected in hair. In the samples of hair (that is between 3 cm and 6 cm in length) lorazepam can be detected for up to 4 weeks (1 month) after exposure.
Saliva tests: Detection time of lorazepam in saliva is approximately 8 hours. Though saliva tests may be very convenient for detecting recent lorazepam, other modalities of testing, mostly urine are preferred.
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