Benzodiazepines are central nervous system depressant medications that result in a slowing of the actions of the neurons in the brain and spinal cord. Benzodiazepines were developed as an alternative to barbiturates, which at one time were the primary medications used to control anxiety but were found to be extremely addictive. Most benzodiazepines, such as Xanax and Valium, are typically used in the management of anxiety, the treatment of seizures, as sleep inducers, and as muscle relaxants.
What Is Halcion?
Halcion (triazolam) is a benzodiazepine that is typically prescribed as a sleep aid. It was patented in 1970 and marketed in the 1980s. Because Halcion has a very short half-life, it is best suited to help individuals get to sleep. The half-life of the drug refers to the time that it takes a person’s metabolism to reduce the original concentration of the drug by half under normal conditions; the half-life of Halcion is about 1.5-2 hours in most cases. The drug has less efficacy regarding its ability to control issues with anxiety, although it may induce very quick and short-acting muscle relaxant effects. Thus, in some cases, it can be used as an aid to reduce anxiety in individuals who are undergoing surgery before they receive a full anesthetic or for individuals who have issues with claustrophobia and need to be placed in an MRI scanner. In these cases, the drug can relieve very brief periods of anxiety quickly, and it then wears off rather quickly.
Sleep aids like Halcion are intended to only be used as short-term solutions to initial insomnia (difficulty falling asleep), and they are not designed to be used for lengthy periods of time. Tolerance to Halcion develops very quickly, and individuals find that they quickly need more Halcion to induce the same sedation and relaxation that they initially got from much lower doses. Thus, Halcion is not designed to be prescribed for long-term use. Instead, individuals with chronic initial insomnia can use it while they develop skills that can be taught in therapy to initiate relaxation and sleep. The drug can also be effective in dealing with issues regarding jet lag and other short-term issues with difficulty sleeping relaxing, or anxiety; for anxiety, it is limited to very short-term use, and the drug is not considered to be a useful anti-anxiety medication in most cases.
The drug is a controlled substance and cannot be purchased with a prescription from a physician. The United States Drug Enforcement Administration classifies Halcion as a Schedule IV controlled substance, indicating that it has a moderate potential for abuse and for the development of physical dependence. Even though benzodiazepines were developed as a less addictive alternative to barbiturates, all benzodiazepines, including Halcion, carry a moderate to significant risk for the development of physical dependence (tolerance and withdrawal).
Effects of Taking Halcion
Chronic use of the drug can result in the development of tolerance and withdrawal symptoms when one attempts to quit using the drug. Other issues may also occur with chronic use and abuse of the drug, such as more severe issues with attention and memory, depression, and rebound effects when one attempts to stop using the drug. Rebound effects occur when an individual experiences symptoms that the drug is originally designed to control once they stop using the drug. Rebound effects associated with Halcion discontinuation include initial insomnia and feelings of anxiety that may be moderate to severe. In some cases, these symptoms may resemble panic attacks in some individuals.
Who Abuses Halcion?
Research indicates that the majority of people who use benzodiazepine drugs like Halcion under the supervision of a physician and for their prescribed uses do not, as a group, significantly abuse the drug. Even though individuals who use Halcion for extended periods of time are at risk to develop physical dependence on the drug, they would not be considered to be abusing the drug if they use it under the supervision of a physician and according to its prescribed parameters. This is because the definition of a substance use disorder (substance abuse or formal addiction) requires that an individual uses the drug for nonmedicinal reasons and that its use results in a number of negative ramifications that cause significant distress for the person or result in issues with the individual’s functioning at work, in school, in their personal relationships, or other important areas of life. Using a drug for medicinal reasons, under the supervision of a physician and according to its prescribed instructions, does not fit the definition of a substance use disorder even if the individual develops physical dependence on the drug.
Individuals who typically abuse Halcion take it for its psychoactive effects and/or use it in conjunction with other substances, such as alcohol or other drugs. Some individuals who are initially prescribed Halcion may eventually go on to abuse the drug. In addition, individuals with other mental health disorders who take Halcion for any number of reasons are more prone to developing issues with abuse.
Thus, even though the individuals who develop tolerance and/or withdrawal symptoms to the drug may be expressing symptoms that are associated with substance use disorders, unless the individual is using the drug outside its prescribed uses and experiencing negative ramifications as a result of use, the presence of symptoms of physical dependence alone may not indicate that the person has a substance use disorder. There may be a fine line between a person engaging in medicinal use and misusing or abusing a drug like Halcion.
When there is some question regarding whether or not a person is abusing a drug, it is best seek professional advice. The actual diagnosis of a formal substance use disorder, in this case an anxiolytic use disorder, needs to be made by a licensed mental health clinician.
Signs of Abuse
The development of tolerance and withdrawal symptoms in conjunction with two or more of the above symptoms signify that the individual may have a substance use disorder. Withdrawal symptoms occur when the individual has not used the drug for a day or two. The symptoms are often easily controlled by taking Halcion again.
Signs of withdrawal include:
- Flulike symptoms when the person has not used the drug for a few days, including issues with nausea, vomiting, headache, insomnia, fever, chills, etc.
- Increased anxiety when the person is not using the drug
- An inability to sleep when the person stops using the drug
- Increased pain, stiffness, or the occurrence of muscle cramps when the person has stopped using the drug
- A significant loss of appetite when not using the drug
- Confusion, issues with memory, and psychotic symptoms, in some cases, such as hallucinations and delusions
- Seizures, in rare cases (Seizures are severe symptoms that have the potential to be fatal; immediate medical attention is required.)
Treating Halcion Abuse
Anyone with a suspected Halcion abuse issue should consult with a physician before discontinuing the drug. Withdrawal from benzodiazepines has potentially serious effects, and in some cases, it may be fatal for individuals who develop severe seizures. Individuals withdrawing from combinations of Halcion and alcohol may also develop seizures. Physicians can put protective protocols in place for individuals who are at risk to develop severe issues with withdrawal.
The American Society of Addiction Medicine has outlined a formal withdrawal management protocol for recovery from benzodiazepine abuse. The formal protocol begins with an individual becoming involved in a physician-assisted withdrawal management program. The withdrawal management process can be done on an inpatient or outpatient basis depending on the case. Physicians typically administer some other benzodiazepine, such as Valium, on a tapering basis. The dosage is decreased at specific intervals, and physicians monitor the individual over time to make sure that withdrawal symptoms are reduced significantly and safely. Any other co-occurring symptoms due to the withdrawal process from Halcion or other drugs, and any issues with other co-occurring mental health disorders, can also be managed during this process.
The withdrawal management portion of treatment is time-limited, and individuals in recovery should continue to participate in therapy, support groups, and other needed interventions long after the withdrawal management process has been completed. Individuals who just go through withdrawal management and do not seek any long-term treatment have a relapse rate of nearly 100 percent.
There is no specific time duration regarding the length of long-term aftercare treatment programs. In general, most sources now suggest that a minimum of five years of abstinence is required before an individual can be considered to be safely in recovery. Many individuals find that they need to maintain attention to recovery on a much longer basis, and the recovery process continues for many years following the discontinuation of substance abuse.