Sleep is one of the most important aspects of your health and well-being. Restful sleep helps you heal, recover from the stresses of your day, and keeps you alert and focused throughout your day.
Not getting enough sleep can cause everything from fatigue to cognitive impairments. In fact, it can even lead to serious diseases and health complications like diabetes, heart disease, obesity, and depression. Unfortunately, the United States has a significant problem with both sleep disorders and anxiety. According to the U.S. Centers for Disease Control and Prevention (CDC), as much as a third of American adults report getting fewer than seven hours of sleep. According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness, affecting more than 18 percent of the population.
Anxiousness and sleeplessness aren’t new problems. Doctors, clinicians, and researchers have been looking for ways to deal with these two disorders for decades, and there have been a more than a few medications used to treat both. Throughout the 20th century, barbiturates were widely used for their anti-anxiety, hypnotic effects. However, benzodiazepines were synthesized and said to be a safer option. They quickly became the most popular prescription drug in the 1970s. Estazolam is one such benzodiazepine that came out that decade, and it’s still used today as an anti-anxiety medication, hypnotic, sedative, and muscle relaxant.
It’s most commonly prescribed for short-term therapeutic treatment for insomnia. However, when overused, Estazolam might not be the safe alternative to barbiturates it was once thought to be.
Estazolam is a benzodiazepine used primarily as a sleep aid but it can also be used for the drugs anti-anxiety effects. It is one of the few benzos that has actually shown success in helping people stay asleep longer through the night, whereas most others only help people fall asleep. Estazolam is typically prescribed for short-term therapeutic use. Taking them consistently for more than four weeks can cause you to start to develop tolerance, weakening the drug’s hypnotic effects. Tolerance grows more quickly in older people and can start in as little as a few days of regular use.
Estazolam has a medium onset of action and a relatively long half-life. While fast-acting benzos are more likely to be abused, benzos with a long half-life stay in your system for longer. This makes them more effective as a sleep aid, keeping you asleep for longer, but also poses a risk for abuse. People may sometimes wake up in the middle of the night and take another dose before the first dose has worn off.
Estazolam is GABAergic, which means that it works by increasing the efficiency of gamma-Aminobutyric acid (GABA), a neurotransmitter that binds to and activates the GABA receptor. This particular receptor is responsible for regulating nervous system excitability. When activated, it causes you to relax, slows down your nervous system, promotes sleep, and gives you a calm feeling. The drug can be used for a short period, to increase the efficacy of GABA before you start to develop a tolerance. As your brain adapts to estazolam, you will start to feel the dwindling effects of the drug. If you start to feel that you are growing dependent, talk to your doctor before quitting completely, because quitting cold turkey can cause potentially dangerous withdrawal symptoms.
Though estazolam has a medium onset of action, it has shown some potential for abuse. When overused, estazolam can cause euphoria and intoxication similar to alcohol. Users may abuse the drug recreationally or as a medication beyond the recommendation of a doctor.
If you’ve been using estazolam as a medication or recreationally and you are worried that you might be developing a chemical dependence or addiction on the drug, there are a few telltale signs. Some signs might also be clear to friends and family if you are worried about a loved one. The first sign that you might be developing a benzodiazepine use disorder is growing tolerance. This will feel like the same dose is less effective than it used to be. After a while, you might have to take heavier or more frequent doses for it to have any noticeable effect. Tolerance occurs when your brain and body get used to a drug and start to produce chemicals to work against the drug and balance brain chemistry.
As tolerance becomes chemical dependence, you may feel the need to use Estazolam to feel normal and avoid uncomfortable symptoms, including:
If you begin to feel withdrawal symptoms, it’s important to consult with a doctor as soon as possible. Benzodiazepine withdrawal can cause a condition called Delirium tremens, which can be deadly.
Because estazolam can be potentially dangerous during the withdrawal phase, it’s important that treatment starts with medical detox. Detox involves 24 hours of care for about a week, depending on your specific needs. During detox, you will be monitored by medical professionals and treated with any necessary medications to ensure your safety. In some cases, you may be weaned off of the drug, or you may be given medications to manage symptoms.
After detox, you can continue your pursuit of recovery in addiction treatment. Clinicians at your detox center will help connect you to your next step in treatment. Through a treatment plan that is tailored to your needs and involves a variety of therapy options, you can get to the root of your addiction. Treatment will be centered on addressing underlying issues, developing your coping skill, creating a relapse prevention plan, and learning life skills that can help you succeed.
After treatment, your center’s aftercare program can help get you connected to additional community services that can help you maintain your sobriety. Programs like Alcoholics Anonymous can help you continually pursue recovery and connect to a community of people with similar goals.
As a benzodiazepine, estazolam carries a risk of overdose, dependence, and addiction. An overdose on estazolam can cause extreme drowsiness, confusion, muscle weakness, slurred speech, tremors, lowered heart rate, shallow breathing, passing out, convulsions, or coma. Overdose can be fatal when slowed breathing leads to oxygen deprivation, coma, and death. In some cases, convulsions and heart rate drops can lead to potentially fatal complications. Estazolam overdose is more likely when a user takes it alongside alcohol. Since both are central nervous system depressants, their effects compound causing overdose to happen more quickly.
Again, benzodiazepines are generally more dangerous for older people and should be avoided, if there are other options. As we age, we lose our ability to process benzos quickly, and it contributes to heightened effects in regular users. Tolerance and dependence can build up more quickly, in as little as a few days. If you have sleep problems or anxiety and you are older than 65, ask your doctor about alternatives.
Anxiety and Depression Association of America. Facts & Statistics. from https://adaa.org/about-adaa/press-room/facts-statistics
CDC. (2018, February 22). Sleep and Sleep Disorders. from https://www.cdc.gov/sleep/index.html
U.S. Food and Drug Administration. Estazolam Medication Guide. from https://www.drugs.com/drug-class/anxiolytics-sedatives-and-hypnotics.html