Injecting Ativan (Lorazepam) | Intravenous (IV) Ativan Use
The benzodiazepine lorazepam is available as an intramuscular or intravenous injection. Under the brand name Ativan, this formulation is an emergency treatment for status epilepticus or prolonged seizures. It may also be given to patients waiting for surgery, to reduce their anxiety.
Lorazepam injections are only approved for medical settings, such as the emergency room. Recreational injection of lorazepam can put you at risk for many adverse side effects.
How Lorazepam Can Be Injected Recreationally
An Ativan prescription usually comes in tablets or pills. These pills can be crushed into powder, dissolved into liquid, and then injected. Injecting lorazepam will cause it to reach GABA receptors in your body faster than swallowing it, causing faster and more intense effects.
Crushing and shooting Ativan pills is a form of drug abuse. Many forms of drug abuse may put you at higher risk for side effects, physical and psychological dependence, and eventual withdrawal symptoms.
Dangers Of Injecting Lorazepam
There are many risks that come with injecting lorazepam, especially if it is being abused. Some risks are unique to injection. Others are caused by lorazepam’s status as a powerful central nervous system (CNS) depressant.
Illicit use of lorazepam may increase your risk of exposure to other CNS depressants, such as scopolamine, haloperidol, and clozapine. Taking lorazepam with other CNS depressants can create potentially harmful drug interactions.
Risk Of Overdose
In a medical setting, lorazepam is properly diluted before it is injected. If Ativan is bought off the street, or from an illicit drug dealer, there may be a chance it is not diluted properly. Injecting high amounts of benzodiazepines into your blood can increase the risk of overdose.
Illicit benzodiazepines may also be mixed with other substances. Benzos are especially dangerous when mixed with opioids like fentanyl or heroin. Concomitant use of these substances can make a seemingly lower dose of lorazepam life-threatening.
A concentrated lorazepam solution, or one that is mixed with opioids, can cause severe respiratory depression, coma, unconsciousness, and death.
Risks Specific To Injection
Injecting Ativan usually involves puncturing the vein (intravenous) or muscles (intramuscular). These methods come with their own risks, including:
- increased risk of blood-borne diseases (HIV, hepatitis, etc.)
- collapsed veins
- muscle pain
- infection at or around the injection site
Improper injection can also increase the risk of harm to your health.
Other Effects Of Injecting Lorazepam
In a medical setting, lorazepam injections can be short-term anticonvulsants. Ativan can also act as a preanesthetic, causing sedation in patients waiting for surgery. Even in this setting, where dosings are monitored, injecting lorazepam has risks.
Lorazepam shares side effects with many other benzodiazepines and CNS depressants. Common side effects include impairment, unsteadiness, and headache.
Some patients may be at higher risk for adverse reactions, especially those with preexisting health problems (like sleep apnea or hypersensitivity to benzodiazepines), neonates, and children (pediatric use). Ativan injections are usually contraindicated (not recommended) in these cases.
A paradoxical reaction is an effect that is the opposite of a drug’s intended effect. Benzodiazepines usually cause drowsiness, sleepiness, and other sedative effects.
Paradoxical reactions that may occur after injecting lorazepam include:
- tachycardia (increased heart rate)
Ativan’s Other Ingredients
Concurrent use of lorazepam and opioids is known to be dangerous. Ativan’s other ingredients can also be harmful in some cases, especially in patients with renal (kidney) and hepatic (liver) problems.
One additive to Ativan is polyethylene glycol. There are some incidences of this substance causing toxicity in some patients, especially in the kidneys. In patients with renal problems, injecting lorazepam may lead to kidney failure.
Another ingredient, propylene glycol, can be toxic in high doses. This can cause a number of metabolic and cardiovascular effects, such as a buildup of lactic acid and hypotension (low blood pressure).
Treating Benzodiazepine Abuse
Ativan is a Schedule IV controlled substance, according to the United States Drug Enforcement Administration (DEA). Schedule IV substances include Ativan along with other benzodiazepines, such as Valium (diazepam) and Xanax (alprazolam).
Whether prescribed as anticonvulsants or anxiolytics (treatments for anxiety disorders), benzodiazepines are usually not prescribed for long-term use. Both short- and long-term use can cause lasting effects to your health, especially in cases of abuse.
Treating a benzodiazepine use problem will often help your health long-term. To find a benzodiazepine abuse treatment program that works best for you, talk to your healthcare professional or contact us today.
The Journal of Pediatrics - Pharmacokinetics of Intravenous Lorazepam in Pediatric Patients with and without Status Epilepticus
National Institute on Drug Abuse - Benzodiazepines and Opioids
PubMed - Recognition, treatment, and prevention of propylene glycol toxicity
U.S. Drug Enforcement Administration - Controlled Substance Schedules
U.S. Food and Drug Administration - ATIVAN (lorazepam) Injection
World Health Organization - Global HIV, Hepatitis and STIs Programmes
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