Investigation of preference for nightly triazolam versus placebo in moderate social alcohol drinkers

This study was designed to examine whether the widely prescribed benzodiaze pine hypnotic triazolam has reinforcing effects in moderate social alcohol drinkers, without histories of drug abuse or insomnia, in the context of it s use as a hypnotic. Eleven healthy adult volunteers who met criteria for ' good sleepers' participated in a 60-session double-blind choice study which was conducted on an outpatient basis with participants sleeping at home. T wenty three-session sampling/choice tests were conducted sequentially to pr ovide 20 evaluations of the reinforcing effects of 0.25 mg/70 kg triazolam versus placebo, ingested orally 30 min before bedtime. Each three-session t est consisted of two sampling sessions, in which participants received expo sure to each of the two drug conditions in different colored capsules, foll owed by one choice session, in which participants were asked to choose one of the two colour-coded capsules for self-administration. Four participants exhibited a significant choice of triazolam, three, a significant choice o f placebo (i.e. triazolam avoidance), and four, a random (i.e. non-signific ant) choice between triazolam and placebo. The reasons provided by particip ants were consistent with their choices and with the expected effects of tr iazolam versus placebo. Analyses of post-sleep questionnaires indicated tha t triazolam did not produce a clinically meaningful improvement in sleep. T he finding that triazolam functioned as a reinforcer in participants withou t insomnia suggests that triazolam has reinforcing effects in some individu als for which hypnotic treatment is not clinically indicated, and that heal th care professionals must continue to assess the risk/benefit ratio of ben zodiazepine hypnotic prescription.