Insomnia is one of the more common complaints among people in the US. This disorder is characterized by a difficulty in falling and/or staying asleep. The resulting lack of sleep, over a few nights or more, is diagnosed with a concurrent daytime impairment, such as fatigue, malaise, memory impairment, loss of attention or concentration, loss of motivation, decrease in social and/or work functioning, tension headaches, stomach problems, and worries about falling asleep at night. For people who struggle with insomnia, getting a good night’s rest is step one in starting to feel better.
Benzodiazepines as Prescription Sleep Aids
Over the past several decades, doctors and psychiatrists have worked hard to find insomnia remedies, and now, there are many potential prescription and over-the-counter medications that can help people get to sleep. Some of those fall into the benzodiazepine category, which includes insomnia relief medications like Halcion ( the brand name for triazolam) and ProSom (the brand name for estazolam). These potent prescription benzodiazepines modulate the release and uptake of the neurotransmitter, gamma-aminobutyric acid (GABA). By controlling GABA receptors, benzodiazepines like Halcion and ProSom slow neurons’ firing, which helps the individual feel relaxed or sleepy. In some individuals, this relaxation can also trigger the brain’s reward system and flood the brain with dopamine, one of the neurotransmitters associated with happiness and pleasure.
There are many benzodiazepine medications with radically different half-lives, five of which are approved in the US to treat insomnia: Halcion, ProSom, Restoril, Doral, and Dalmane. Halcion has a short half-life of 3-8 hours, while ProSom has an intermediate half-life of 11-20 hours. All benzodiazepines are listed by the Drug Enforcement Administration (DEA) as Schedule IV substances, because they have an important medical use but also a potential for addiction and abuse.
For some people, the relaxation and pleasure become addictive. Benzodiazepines also easily lead to physical dependence, so the brain has difficulty functioning without the medication. Since they first began to enter the market in the 1960s to treat anxiety disorders, benzodiazepines have been documented as potential substances of abuse, and doctors now rarely prescribe these medications to treat any disorder for more than two weeks. When a person takes a sleep aid like Halcion or ProSom for longer than a month, there can be serious consequences, including dependence, tolerance, and addiction.
Risks of Halcion, ProSom, and Benzodiazepines for Insomnia
General side effects from abusing benzodiazepines like Halcion or ProSom include:
- Drowsiness or fatigue
- Dizziness or low blood pressure
- Vision problems
- Loss of coordination
- Depression, irritability, and mood changes
- Shaking or trembling
Addiction to or abuse of Halcion, ProSom, or other benzodiazepine insomnia treatments can lead to various short-term issues, such as:
- Impaired cognition and motor function: All kinds of sleep aids lead to impairment the next day. With benzodiazepines like Halcion and ProSom, this is sometimes referred to as the “hangover.” Even when taking the medication as prescribed, the individual can wake up feeling drowsy. Prescription warnings include instructions not to drive or operate heavy machinery while taking these medications, because the person will have reduced physical and mental reflexes, which could put them in danger.
- Parasomnia: These are behaviors performed while asleep. The most common parasomnias are walking, eating, driving, engaging in sexual activity, and having conversations while asleep. Many sleep medications can induce parasomnias, but benzodiazepines like Halcion and ProSom have been linked to a high risk of these behaviors due to their amnesiac potential.
- Amnesia: Halcion, ProSom, and other benzodiazepines are linked to temporary forms of amnesia, especially in large quantities. People who abuse these medications are at risk for short-term memory loss, blacking out, or being unable to form memories for a short period of time. Long-term abuse can lead to cognitive impairments.
- Tolerance: For many addictive substances, tolerance takes time; however, for benzodiazepines, tolerance develops in a month or less. The body becomes accustomed to the presence of the medication, which can reduce the effects of the substance. For people who take Halcion or ProSom as prescribed, tolerance is an indication that it is time to switch to another medicine, or to try another approach to treat insomnia. For people who abuse benzodiazepines for recreational purposes, they may begin to take larger quantities of these medications, increasing their risk for dependence and overdose.
- Dependence: Physical dependence, like tolerance, can form in as little as two weeks of taking Halcion, ProSom, or other benzodiazepine insomnia prescriptions. Dependence essentially means that the brain relies on the medication to control neurotransmitters. This can lead to withdrawal symptoms if the person stops taking the medication, because their brain chemistry is attempting to reach equilibrium on its own.
- Overdose: People who abuse Halcion, ProSom, or other benzodiazepines are at risk of overdosing as they take higher doses of these substances. It is dangerous to mix these medications too, since they can enhance each other’s effects. Other central nervous system (CNS) depressants, like alcohol or opioid drugs, are also dangerous to mix with benzodiazepines, and doing so can increase the risk of overdose symptoms. These symptoms include an inability to wake up, stupor, darting eye movements, reduced or slowed breathing, low blood pressure, and irregular or slow heartbeat.
When a person struggles with addiction to benzodiazepines, such as Halcion or ProSom, for a long period of time, they put themselves at risk of developing chronic conditions, including:
- Withdrawal symptoms: Even if a person takes Halcion or ProSom as directed, the body can still develop a dependence on these medications, which can lead to withdrawal symptoms when the person stops taking the prescription. However, a person is more likely to experience withdrawal after long-term use, or abuse, of benzodiazepines. Symptoms include abdominal cramps, muscle aches and weakness, vomiting, tremors, sweating, rebound anxiety, insomnia, or panic attacks. If a person has taken large doses of strong benzodiazepines for a long period of time, they are at risk of benzodiazepine withdrawal syndrome, which is a protracted and more physically dangerous set of symptoms, including cravings, depression, suicidal thoughts, and seizures.
- Alzheimer’s disease: A team of researchers from France and Canada studied long-term effects of benzodiazepine prescriptions and found that people who took medications like Halcion and ProSom for 3-6 months had a 32 percent greater chance of developing Alzheimer’s disease, while people who took these prescriptions or abused these substances for longer than six months had an 84 percent greater risk of developing this age-related condition. Following a doctor’s orders to take Halcion or ProSom for less than one month did not increase the risk of Alzheimer’s. Long-acting benzodiazepines showed more correlation to increased risk than short-acting ones, like ProSom and Halcion.
- Cancer: Long-term prescriptions and abuse of benzodiazepines like ProSom and Halcion have been linked to an increased risk of developing some types of cancer.
- Insomnia: Although Halcion and ProSom are prescribed to treat insomnia, when abused in large doses for a long time, benzodiazepines like these can cause the conditions that they are designed to treat. People who struggle with benzodiazepine addiction can suffer rebound effects like insomnia, anxiety, panic attacks, and even seizures.
For people who struggle with addiction to, or abuse of, Halcion, ProSom, or other benzodiazepines, it is very important to get help as soon as possible. These medications can be harmful with long-term, high-dose use. A doctor will be able to help individuals taper off the drug in a safe way, which reduces withdrawal symptoms. Then, the doctor can help with finding a rehabilitation program to address the addiction or substance abuse problem. In many instances, withdrawal can take place in a comprehensive treatment program. Working with an overseeing medical professional, and therapists in both individual and group therapy, can help people overcome their addiction and sustain a long-term, robust recovery.