Halcion and malpractice?

Factual Questions
1

Gots some Major Dental Work (three crowns) going on tomorrow, and I’m extremely dental-phobic with good reason. New dentist (she’s been seeing the kids for 18 months… I haven’t seen a dentist since before that. Bad Mama!!). Last experience with MDW was a crown, followed by a root canal, followed by an extraction, on one of my molars.

I’m not looking forward to the work tomorrow - that last crown was actually not so bad, so (foolishly) I figured I could deal with the root canal w/o happy juice when the crown didn’t resolve the pain. Uh, nope… after the injection of novocaine, when they peeled my hysterical self off the ceiling, they gave me Dalmane (?) which didn’t help much (when the root canal also failed to solve the problem, I had the extraction done under IV sedation which was actually OK).

The new dentist was pretty sympathetic when I told her of my history. I suggested she use a sledgehammer on the side of my head, or at least horse tranquilizers. She gave me, instead, 2 doses of Halcion - one to be taken tonight, one tomorrow morning (and of course I’m not to drive myself).

So I phoned my doc’s office this morning to check in and make sure this was not contraindicated. The person who took the message bollixed it up and I got a callback saying “Sorry, doctor can’t prescribe Halcion due to malpractice insurance!”.

Bwuh??? Is this stuff that dangerous? Anyone hear anything along these lines? What I’ve found googling implies it’s for longer-term use, whereas I’ll have two pills (well, technically I’ve got 4 - I guess for the next time I have work done).

Usual disclaimer: I’ve gotten another message from the doc to confirm that it’s OK me to use this one pair-of-doses (I clarified the situation with the receptionist and got the answer to the question I’d actually asked), I’m just trying to find out whether the stuff is in general that dangerous!

Oh - and on the IMHO side (this might get moved there anyway):
How loopy will this stuff make me? Heaven knows I’m clumsy enough w/o it, but am I gonna fall down the stairs? pee on the carpet? get higher than a kite? Embarass myself in front of the kids? Am I even going to be able to stagger to the car? (no, I’m NOT driving myself!!!Mama is not that stoopid!).

2

IANAD, but it seems odd to give someone sleeping pills for a dental procedure. But, it turns out that Halcion (triazolam) appears to be the drug of choice for oral (as opposed to IV) sedation in the US.

Halcion is in the same “sedative-hypnotic” benzodiazepine drug class as Dalmane, so if one didn’t work, the other might also not work.

3

Yeah - I was freaking out a bit when I heard “malpractice” and “Halcion” in the same sentence and got rather a scary list of hits when I googled that… then I googled “Halcion Dental anxiety” and the hits are less frightening.

I think if I’d had the Dalmane in advance, it might have helped quite a bit. I slept for hours after I got home that time. The problem was, I was already nearly hysterical (the endodontist said he could give me that, if I could get someone to drive me home, and my hands were shaking so badly I couldn’t dial the phone) and that was too much for the happy juice to handle.

Psst - if a mod stumbles across this, it probably really shoulda gone to IMHO and I won’t mind if it’s moved, sorry!

If anyone does have any experiences to share I’d be interested in hearing how well it worked and, well, how messed-up one may get. I’m not much into mind-altering substances and I’m genuinely nervous that I may do something dumb! On the other hand, it’d be nice if my teeth didn’t hurt any more.

4

The receptionist probably thought that you were trying to get the doctor to prescribe Halcion over the phone to deal with your anxiety over the dentist visit. In that case, it probably would have been a malpractice (and possibly legal violation) for the doctor to prescribe these without seeing or at least speaking to you about it.

But I’d be a bit concerned that the receptionist gave such a confused version of the message to the doctor.

5

Eh. My husband had an oral surgery experience with Halcion that I kind of wish I could relate here but aside from this being GQ I really need to act out some of the story. Suffice it to say that halcion is apparently quite safe as its lethal dose is much higher than the effective dose (actual medical doctors will weigh in with more specific terms than “apparently”, “higher” and “quite”).

However, my husband got extremely high from the prescribed dose. Not high enough to actually lay down or listen to me when I told him not to start drinking rum straight from the bottle, but high enough to be a real pain in the rear to handle on the trip to the dentist’s office. He did say it helped with his anxiety during the procedure though.

In my husband’s case it seemed that the oral surgeon wasn’t able for some reason to give actual anesthesia, and compromised with the halcion/novocaine combo.

6

Many years ago, I was prescribed Halcion for insomnia.

Talk about lights out. After I took one and laid down, I could turn on the TV, not feel tired or drugged at all and blink it was morning.

No “hangover.” Nuthin’. 'Course I had 8 hours of blissful sleep before that.

YMMV, or course.

7

I have done “sleep dentistry” twice and my wife has done it once. It is fantastic. You will sit down in your dentist’s chair and you’ll wake up at home. I did regain brief consciousness during one my procedures and although they were working on my mouth, they seemed quite distant. I was able to walk to the car and even ate lunch at Sonic but I don’t remember any of it. I predict that you will be very glad you did it.

8

Thanks guys. I’m a tad less nervous about the meds than I was (and am managing not to think about the procedure at all). I’d be delighted if they’d do IV sedation but that’s a rare thing to find!

Dr Woo, what an image!! Rum (straight from bottle or otherwise) would certainly seem to be a bad idea when using a benzo. Sorry I can’t see you re-enacting the event!

t-bonham@scc.net - you’re probably right about the receptionist - she didn’t sound like the brightest bulb in the pack (“Nitric what?” c’mon, who hasn’t heard of nitrous oxide???). And I agree, it would be rather an imposition for me to expect to be able to call and get Strong Drugs from the doc w/o discussing them beforehand.

9

I’ve had it twice for orthodontia but it was always in combination with nitrous oxide. I’m not very apprehensive when it comes that stuff and tried to refuse it, but the Doc said he didn’t want the aggravation so I tried it. Great stuff – slightly conscious but just barely, everything was just over. When I got home I slept for awhile and that was about it.

Man, that stuff is one hell of a sleeping pill. It’s absolutely impossible to stay awake.

10

Sorry to go OT here but what do you mean your dentist didn’t want the aggravation?

If I had a dentist like that, I’d be out the door in two seconds.

11

A quick update here - had my dental appointment this morning - took one dose of Halcion last night and one this morning. I was actually fairly calm this morning even before I took the morning dose so perhaps the antianxiety part was helping.

Anyway - I took my morning dose 45 minutes before the appointment, showed up, they took me back, got me set up with nitrous etc., and the rest was easy. I didn’t really sleep, nor did it seem like time sped by - I was aware enough of everything they were doing that, when I heard them discussing some newly-uncovered decay in a neighboring tooth, I made writing gestures until they brought me paper and pad and, I’m pretty sure, I wrote “can you fix it today” (though who knows. I wrote while flat on my back, with my eyes closed, the pad on my stomach, and it’s entirely possible it reads “mackdonna shoehorn butterhorse” :D. Evidently whatever I wrote sounded like consent, and they also consulted with Typo Knig by phone, so I spent 5 hours in the chair and came out of it with 3 crowns, 3 fillings in other teeth, and an inlay in a 7th.

I didn’t do anything regrettable. I don’t think so, anyway :eek: And though it feels like my bones are a bit lead-plated (heavier than usual), i don’t think I’ll have any lawsuit-worthy side effects!

My main regret is that they started on the side that had less work done. So I was much less “out of it” while they did the second side… the one where “two crowns” turned into “two crowns, 3 fillings and an inlay”. (I know, that sounds suspicious: “Let’s drug 'er up and then do more work!” but my teeth really are in dreadful shape). Fortunately, even though I was less out of it, the residual Halcion and the nitrous did the job. Also the audiobook I had on the ipod… must have listened to parts of it 5 times!

Oh, one cautionary tale: When they were finishing things up at the end (doing all the cleanup work, cementing in the temporary crowns, etc.) they turned off the oxygen flow to the nitrous mask. But they did not remove the mask. So alluva sudden I couldn’t breathe so good. Oops! I was aware enough that I removed it myself.

12

My daughter was overdosed with 1 mg of halcion/triazolam, and she has never been the same since. She experienced all the effects first reported by van der Kroef - and she has not recovered yet after 3 years.
I have done a great deal of research on the drug and have exposed quite a bit of abuse by dentists and misinformation spread by those promoting this off-label use.

Can read on my blog at www.brainrobber.com

I have done graduate work in epidemiology and have scrutinized studies/papers regarding Halcion/triazolam and its use as a sedative.

Promoters claim of a wide margin of safety is bogus. Their claim of respiratory safety at 2-4 mg is bogus.

They completely fail to properly inform dentists of the risks of this drug, and the public is therefore unaware that this drug is known to cause serious psychiatric effects – rebound effects.

If you take it, be sure you are not given more than .25 mg in one day, and be aware that even that amount can made you do something very crazy. Do NOT add other drugs or alcohol and don’t drink grapefruit juice while it is in your system. It will inhibit metabolism of the drug.

Make sure your dentists KNOWS this drug and knows its history and knows how to deal with over-sedation-- and give you proper information - revealing that its use is experimental.

It is the MOST dangerous benzodiazepine on the market and was banned in the UK and other countries because of its narrow margin of safety and unethical practices of the manufacturer.

13

I am sorry to hear of your daughter’s experience. Was her dosage a single day? or a continuing dosage? It’s definitely higher than recommended even for a single dose here (the normal dose is .125 or .250 mg, rarely .5 mg).

I don’t think this drug is used much in the US, except for single-dose therapy for things like my dental procedures (I also used one tablet for an MRI last winter - all in all I think I’ve had about 6 tablets over 3+ years).

The studies that list psychiatric effects don’t appear to be clear (from the web) as to whether they’re talking about sporadic / single-dose use, or more continuous use over multiple days etc.

14

I was prescribed Halcion once, a few years ago, after the temazepam I’d been taking for insomnia lost its efficacy. It was stronger than temazepam, but otherwise didn’t seem particularly remarkable or different from other benzodiazepines. I only took it for a couple of weeks, though.

15

About 18 years ago, I was taking Halcion daily for a handful of months. Apparently, this was right at the cusp of figuring out its long-term effects.

All I know for sure is that my memory has been messed up ever since. I’ve regained the ability to remember things fairly well, but there’s a couple of years missing.

16

From what I understand, like most benzodiazepines, it’s not that good for long term use, but, unless you have a addiction problem, a couple doses (at the normal amounts) aren’t going to hurt you.

Mama Zappa seems fine, at least, unless there’s some story I don’t know about.

17

Lucky. :frowning: Mine does NOTHING for me.
L-theanine didn’t work, melatonin didn’t work, valerian root didn’t work, Ambien didn’t work and Halcyon didn’t work.