Temazepam

Main type

Temazepam is a depressant, meaning that it reduces activity in particular parts of the brain. It is also classified as a hypnotic drug, meaning that it induces sleep, and has been available on prescription to combat the effects of sleep disorders such as insomnia for decades.

The drug was first developed in the 1960s and by the ‘80s it had become one of the primary treatments for sleep disorders. It showed particular effectiveness in helping patients suffering from insomnia. It is a synthetic substance, and is manufactured legally in pharmaceutical laboratories.

Temazepam falls into a category of depressants referred to as benzodiazepines, which are primarily used to induce sleep or relieve anxiety. Other well-known benzodiazepines include Diazepam, Alprazelam and Oxazepam.

Benzodiazepines work by slowing down and ‘relaxing’ certain parts of the brain. Usually taken orally, they are absorbed into the body and act upon the chemical balance of the brain. Their primary effect and the reason they produce their calming and sedative properties is that they increase the potency of a specific, naturally occurring neurotransmitter in the brain – Gamma Amino Butyric Acid, commonly referred to by its acronym, GABA.

There are many different neurotransmitters in the body, each with a different function or message to carry between cells. The role of GABA as an inhibitory neurotransmitter is to block messages from being transmitted from one brain cell to another, thus having a calming effect on brain activity. This process usually occurs naturally, and is an essential part of maintaining sleep patterns and everyday functioning. When an imbalance occurs, sleep or anxiety issues may be the result.

Benzodiazepines such as Temazepam may then be prescribed by a doctor to treat these symptoms. Because these drugs enhance the effects of GABA, they create a greater calming effect on the brain, leading to increased relaxation, less anxiety and in the case of hypnotics, sleep.

Temazepam is less popular today as a prescription medication than it once was, due to its high potential for abuse. It is usually only prescribed as a short-term treatment for insomnia, between 2-4 weeks, because tolerance to the drug can rise quickly. Chemical dependency will often develop during long-term use. The withdrawal symptoms experienced by those dependent on Temazepam upon cessation of the drug can be particularly severe and long in duration.

Temazepam is also abused by recreational drug users, who acquire it either by forging prescriptions or by buying it on the black market, on the street and from unlicensed online pharmacies. In many cases it is taken in combination with other drugs, such as alcohol and Heroin.

Other Types

In the UK Temazepam is generally known simply as Temazepam, and is not sold under a particular brand name. In the US, the most common brand name is Restoril, while the drug is known by a variety of different brand names internationally including Normison, Norkotral, Temaze and Nortem.

These legally obtained pharmaceutical supplies may be also be obtained through fraud and deception, stolen or diverted from clinics and distribution centres. They may then be sold and taken orally as tablets or capsules, or even injected after extracting the liquid from the former. Street names for Temazepam include: Rugby Balls, Jellies, Knockouts,Tams, Tems, Mazzies, Beans, Eggs, Norries, No-go’s, Green Devils, Vitamin T and King Kong Pills.

Illegally obtained Temazepam is frequently taken in conjunction with other drugs such as Heroin, and its use may be secondary to these addictions, but an independent Temazepam addiction can build up over time.

Major Effects

Temazepam is primarily used as a prescription drug to induce sleep in patients with short- term insomnia and sleeping problems. The principal effect of the drug therefore is that it reduces brain activity, leading to a calmed state of mind and the rapid onset of sleep. It is also intended to keep the individual asleep for longer during the night.

However, the drug should be taken with care by those who have been prescribed it, particularly the elderly, because it has been associated with an increased risk of falls and accidents. If for example Temazepam, is taken before going to bed, the individual may feel the onset of the drugs sedative effects before reaching their bed, making them shaky on their feet and drowsy.

Temazepam is generally only recommended for short-term medical use (between 2-4 weeks), because after this period of time tolerance to the drug can build, rendering it gradually less effective. It is also highly addictive, and long-term use can lead to a powerful physical dependency. Withdrawal effects of the drug in those with a chemical dependency can be severe.

Long-term use of the drug can also lead to a range of unpleasant side effects, including depression and mood disorders, disruption of natural sleeping patterns, anxiety and memory loss.

When combined with other drugs such as alcohol, these and other side effects of the drug can be worsened, and the risk of overdose may increase. When street users combine the drug with heroin, the risks of both drugs are increased.

A significant risk of illegal use is that many users take the gel found inside capsules, and heat it up to turn it into a liquid for injection with Heroin. However once inside the bloodstream, the gel may resolidify, potentially block veins and leading to severe injuries and fatalities.

Production countries

Temazepam is produced legally in pharmaceutical laboratories around the world, and is made available on prescription under a wide variety of brand names, and as a generic medicine. It is the same drug, regardless of what brand it is.

Temazepam is a controlled substance in many countries, and so can only be prescribed by a suitably qualified doctor or healthcare professional. In the UK for example it is a Class C drug, meaning that it is illegal to possess Temazepam without a proper prescription, or supply it without the necessary license. Both possession and supply can lead to lengthy jail sentences and substantial fines.

In the US, it is a schedule IV controlled drug, also only available on prescription. These and other international restrictions were themselves put into place to combat the ever-increasing numbers of people abusing Temazepam and other Benzodiazepines.

Despite these restrictions however, legally manufactured Temazepam regularly makes its way onto the street. In some cases, addicts may forge prescriptions and acquire as much as they can from different pharmacies. In addition to this, stolen or illegally diverted supplies of the drug are sold to recreational drug users by street dealers. Temazepam may also be smuggled from one country to another.

Frequently, Temazepam is offered on the Internet through online pharmacies, which is also illegal. The risks of buying the drug online, or offline, are further increased by the fact that the buyer has no way of telling what they have been given. A survey by the Royal Pharmaceutical Society in 2008 found that 50% of all the drugs sold illegally on the Internet are fake.

Facts and stats

Facts

  • Temazepam is a hypnotic depressant primarily used in the treatment of sleep disorders including insomnia.
  • It is part of a family of similar depressants referred to as Benzodiazepines. These work by stimulating the GABA neurotransmitter in the brain, which slows down brain activity. Benzodiazepines are mainly used to treat sleep and anxiety disorders.
  • Temazepam can cause a person to fall asleep very quickly once it is absorbed into the bloodstream, therefore care must be taken.
  • It is illegal to possess without a prescription in most countries.
  • In the UK it is a Class C drug, and in the US it is a Schedule IV controlled substance.
  • Temazepam is usually only prescribed for short periods of use due to the risks associated with it in the long-term
  • Continued use can lead to the build-up of tolerance, meaning that a higher dose of the drug is required to achieve the same effects.
  • Temazepam is also highly addictive. Because it changes the chemical balance of the brain, it creates a chemical dependency. When the user eventually discontinues use of the drug, severe withdrawal symptoms can follow.
  • Recreational drug users often take Temazepam to enhance the effects of other drugs, such as alcohol and Heroin.
  • Temazepam capsules containing gel are no longer available legally in the UK, because of the risks associated with abuse. However gel capsules may still be smuggled into the black market from other areas of the world.
  • It is dangerous to mix Temazepam with other drugs, particularly other depressants, such as alcohol.
  • Temazepam is one of the most frequently abused prescription drugs in many countries.

Stats

  • There are more than 30 different types of Benzodiazepine medications. Temazepam is the most abused.
  • 2-4 weeks is the standard length of time that Temazepam is prescribed for in the UK and other countries. This is because long-term use can lead to tolerance, dependence and addiction.
  • 10-30 mg is the standard dose given for treatment of insomnia.
  • 10-20 minutes is the average time taken for the Temazepam to ‘kick in’, though this is dependent on the individual and their tolerance to the drug.
  • The effects of a dose of Temazepam should last between six and eight hours, but this again dependent on the individual and the length of time they have been taking the drug.
  • In Scotland in 1999, a third of drugs-related deaths involved Temazepam, usually injected with Heroin.
  • In England and Wales in 2010 there were 307 deaths in which Benzodiazepines (the class of drugs to which Temazepam belongs) were listed on the death certificate. This was up from 177 in 2006, with significant increases in each intervening year.
  • In 2008/09 the police reported 609 seizures of illegal Temazepam in England, the highest ever recorded.
  • Benzodiazepines were the most commonly seized drug in the Class C drug category in 2008/09, with a total of 4029 seizures – 40% higher than the previous year. The total amount seized was equivalent 1.8 million doses.

Addiction Signs

Benzodiazepines in general, and Temazepam specifically, can be highly addictive. For this reason, care must be taken when using them for medicinal purposes. Particularly in people with a history of substance abuse, Temazepam can lead to a strong physical (chemical) dependency when taken for more than a couple of weeks.

The longer a person takes the medication, the more tolerance they build up, and so it takes a stronger dosage to achieve the same effects. Because the drug alters the chemical balance of the brain, severe withdrawal effects can be experienced upon cessation, accompanied by cravings to continue use. A person who is addicted to Temazepam may feel that they cannot go about their normal life without taking the drug, and if they have been prescribed it they may take higher or more regular doses than have been advised to them by their doctor.

In many cases the drug may cease to produce any noticeable effects, and continued use is instead to prevent the onset of severe and unpleasant side effects, which may include depression, anxiety, mood swings, headaches, spasms, nausea and drowsiness.

Someone who is addicted may display a range of symptoms. Their sleep patterns may be disordered, and they may appear drowsy during the day. Temazepam use can also result in amnesia, in which the individual carries out an everyday activity but then has no recollection of having done so. They may appear distant or moody, and their movements may appear slow or shaky. Treatment for Temazepam addiction should be handled professionally, as it can be severe and drawn out.

Treatments

Temazepam enhances the effects of naturally occurring GABA in the brain, the neurotransmitter responsible for ‘calming down’ brain activity. When the drug is taken over long periods of time – typically a month or more – the body’s own production of GABA will slow down as it tries to rebalance itself.

This has two important consequences; firstly, the drug will become less effective at inducing sleep and a relaxed state, leading to growing tolerance in which larger doses are needed to produce the same effect. Secondly, when the drug is stopped, the body will not be producing enough GABA to maintain equilibrium, triggering potentially severe withdrawal symptoms associated with having too little of the body’s own natural calming remedy.

Withdrawal symptoms experienced by those coming off Temazepam can vary widely depending on the individual, the length of time they have been taking the drug, and strength of dose. Commonly reported withdrawal symptoms include abdominal cramps, mood swings, uncharacteristic aggression, temporary agoraphobia, depression, confusion, hallucinations, suicidal thoughts, sleep disruption, restlessness and changes in blood pressure.

These withdrawal risks are exacerbated by the fact that long-term Temazepam addicts are likely to be taking particularly high and frequent doses of the drug, even though they may be getting little or no benefit from them. In many cases the addict may continue taking the drug simply to avoid the unpleasant side effects of discontinuing it.

As with many addictive substances, the body gets so used to the Temazepam that it ‘believes’ that it is something it needs and is produced naturally.

Going ‘cold turkey’ (sudden and complete cessation) after a long period of Temazepam abuse is seldom advised, and the first step should always be to make contact with a doctor or other appropriate healthcare professional.

Treatment for Temazepam addiction usually involves a very gradual process of tapering off the dosage to minimise any dangerous or unpleasant side effects. Slowly reducing the amount of the drug in the body gives the body time to adapt to the changes in chemical balance, most notably increasing production of GABA to compensate.

Sometimes another Benzodiazepine drug, such as Diazepam, may be prescribed after an initial tapering period to take the place of Temazepam, and this will then be reduced and stopped in time. This slow process is preferred by many medical professionals as the withdrawal effects from sudden cessation can be highly detrimental to health and well-being, and potentially put the patient’s life at risk.

In the case of particularly severe addictions the individual may seek treatment in a specialised rehabilitation clinic. There they can detox under the supervision of qualified medical professionals and also get help to deal with the reasons for their addiction, and develop coping strategies to prevent a relapse.

Because Temazepam is often a secondary addiction to other legal and illegal drugs such as alcohol and Heroin, it may be necessary to undergo a comprehensive and long-term treatment programme that deals with each addiction in turn. This may include not only clinical and medical help, but also psychological and behavioural therapies.