Sleeping Pills & Addiction

Prescription sleeping pills can be addictive, although the way people misuse them is often different than how they might misuse other drugs. 

Sleeping pill misuse can be especially dangerous. Overdosing on sleeping pills has the potential to cause brain damage or even be fatal.

What Are Sleeping Pills?

Sleeping pills are a type of sleep aid, generally best used sparingly and for short periods of time, which can help a person with insomnia and similar sleep issues sleep more soundly. 

When people talk about sleeping pills, they usually specifically mean prescription-grade sleeping pills, not over-the-counter options, which have a weaker effect and fewer risks. Prescription sleeping pills work best as a stop-gap measure, with a patient working with their doctor to adopt healthier sleep habits and improve their ability to sleep without needing these types of aids.  

Key Facts About Sleeping Pills

These are some key facts about sleeping pills and addiction:

• Prescription-grade sleeping pills should only ever be used as prescribed. They can be very dangerous if misused.
• Before trying prescription sleeping pills, it is usually best to try adjusting your sleeping habits while also potentially trying milder sleep aids, such as over-the-counter antihistamines or melatonin.
• Sleeping pills should never be mixed with other types of drugs without first talking to a doctor, especially drugs that suppress breathing, such as alcohol.

Different Types of Sleeping Pills

Commonly used prescription-grade sleeping pills include the following:

Zolpidem (Ambien)

Zolpidem, sold under the brand name Ambien, is one of the most commonly prescribed prescription-grade sleeping aids. It is a “Z-drug,” a type of medication comparable to benzodiazepines but that exhibits fewer side effects. 

While this type of medication definitely has legitimate medical use, it’s important to note that it is also not as fully understood as benzodiazepines. As a result, it may have important health impacts we don’t fully understand.

This medication is used to treat chronic insomnia and short-term, acute insomnia. Evidence suggests it is effective for this purpose.

Doxepin (Silenor)

Doxepin is actually an antidepressant, specifically a tricyclic antidepressant, but it is also approved to treat insomnia and similar sleep difficulties in addition to depression. It works by blocking the effects of histamine, similar to OTC antihistamines sometimes used to treat sleep issues, which reduces a person’s wakefulness and can make it easier to sleep.

Eszopiclone (Lunesta)

Eszopiclone, sold under the name Lunesta, is a hypnotic medication that works by slowing down brain activity, which makes it easier to sleep. 

Like most prescription sleep aids, it is meant to be used shortly before bedtime or if a person has already tried and failed to get to sleep, causing them to quickly become sleepy and remain sleepy for a long time. 

Ramelteon (Rozerem)

This is a newer prescription sleep option of a class of medication called melatonin receptor agonists. It works by binding to melatonin receptors in the brain, mimicking the effect of melatonin. 

It is notably a fairly safe sleep medication while still being effective. It lacks many of the dangers associated with prescription sleeping pills, even if it still has some side effects.

Zaleplon (Sonata)

Zaleplon, sold as Sonata, works very similarly to eszopiclone. While it’s important to always read any materials provided with your specific medication rather than making assumptions based on how other medications operate, most of what is written above about eszopiclone above applies to zaleplon. 

Signs of a Sleeping Pill Addiction or Abuse Issue

There’s some debate about whether sleep pills are “addictive,” as these medications don’t typically cause drug cravings the way other addictive drugs do. 

At the same time, it’s possible for these drugs to cause physical dependence, meaning they can cause negative side effects if you stop taking them. It’s also possible for these drugs to cause psychological dependence, where a person grows to believe they can’t sleep without using sleeping pills even if that isn’t true.

Whatever it’s called, a person may have a problem with sleeping pills if they frequently misuse their medication, even if it’s not for the purpose of “getting high” as misuse of other drugs tends to be. For example, if a person is using their medication to try to sleep, but not using it as prescribed, that’s an issue and can potentially be dangerous.

It’s a problem if a person is using sleeping pills but not following other suggestions their doctor made to improve their sleep patterns. Whenever possible, a person should plan to eventually stop taking sleeping pills and find other long-term paths toward improving their sleep. 

It’s also possible to experience physical withdrawal when one stops taking sleeping pills suddenly, described more below. If you want to stop taking sleeping pills, talk to your doctor about the best way to do so. It’s often recommended that you slowly taper your daily dose rather than stop taking them all at once.

Can You Overdose on Sleeping Pills?

Most prescription sleeping pills have a serious overdose risk if misused, to the point where they have the unfortunate and well-known reputation as being used in suicide attempts. Signs of a sleeping pill overdose include the following:

• Moderate to severe drowsiness
• Confusion
• Problems with coordination
• Floppy or limp muscles
• Slowed, strained, or stopped breathing
• Coma

If a person has collapsed, had seizures, is having trouble breathing, or can’t be awakened, treat it as a medical emergency and call 911 immediately. 

If you are uncertain about the situation but it doesn’t seem like an emergency, call poison control at 1-800-222-1222. They can advise you on how to proceed. If in doubt about the severity of the situation, call 911.

A sleeping pill overdose has the potential to be fatal or cause permanent brain damage. The risk of an overdose, both intentional and accidental, increases significantly if the pills are used in combination with other drugs that also suppress breathing, which is why you should never take sleeping pills with alcohol.

Withdrawal From Sleeping Pills

If a person stops taking sleeping pills suddenly, they can experience withdrawal, essentially rebounding and experiencing the opposite effect their sleeping pills had. They may become more wakeful and restless during bedtime, which is obviously not ideal for individuals who were taking prescription-grade sleeping aids in an effort to try and sleep. 

Withdrawal can be reduced or avoided by tapering a patient’s doses, slowly reducing how much of a sleeping drug they’re taking.

Treatment Options

If a person wants to stop taking sleeping pills, many people can safely and effectively do that by talking to their doctor and tapering their doses as recommended. However, some people may struggle to stop taking sleeping pills, feeling drawn to misuse them for one reason or another.

If you are in this situation, a traditional drug addiction treatment approach can help you recover from your dependence and regain control over your drug use. The focus will likely be on behavioral counseling for your drug problem and treatment of any associated mental health issues through whatever care plan is most appropriate, such as therapy and medication.

References

Medicines for Sleep. (April 2020). National Library of Medicine.

Full List of Prescription Sleeping Pills Names Guide. (October 2020). Hims.

Eszopiclone. (December 2019). National Library of Medicine.

Zaleplon. (December 2019). National Library of Medicine.

By the Way, Doctor: Are Sleeping Pills Addictive? (March 2014). Harvard Health Publishing.

Zolpidem. (November 2019). National Library of Medicine.

Zolpidem Withdrawal Delirium. (December 2011). Indian Journal of Pharmacology. 

Treatment Approaches for Drug Addiction. (January 2019). National Institute on Drug Abuse.