Sleep medication

Main type

Sleep medication like Ambien, Stilnox and Imovane (also known as Zimovane) are medications given for insomnia or sleeplessness and they are all categorised as depressant drugs. Ambien is the commercial name for the chemical zolpidem tartrate, Imovane is the chemical zopiclone and both are sometimes referred to as ‘z-drugs’. Sleep medications like Ambien and Imovane are referred to as sedatives or hypnotics and they affect the chemistry of the brain to induce drowsiness and cause the person taking the drugs to fall asleep. Sleep medication like Ambien comes in the form of pills or tablets that are swallowed. With Ambien, the pills are designed so that they have two active layers; the first is dissolved quickly and helps induce a state of sleep, while the second layer is designed to maintain a sleep and prevent the person waking up during the night.

Ambien and Imovane are not an ‘over the counter’ medication and can only be prescribed by a doctor who has identified the genuine symptoms of insomnia in a patient.

Zolpidem tartrate was first synthesised as a medication for insomnia in 1988 and was subject to five years of clinical trials before being approved and trademarked as Ambien in 1993.

Zopiclone was introduced in 1986 and like Zolpidem was hailed as an improvement on benzodiazepine drugs, with fewer side effects. Zopliclone is marketed in the USA under the brand name Lunesta and is known by many different names all over the world including Imovane. Although widely prescribed for insomnia, these drugs carry with them the high risk of addiction, especially if used for long periods of time.

Addiction to sleep medications can cause major problems, both physical and mental. Side effects of taking the drug can be to cause anxiety, nervousness and make addicts experience suicidal feelings. When Ambien is taken in doses that exceed the prescribed amount it has been associated with episodes of sleepwalking and extreme drowsiness the day after taking it.

Ambien is designed as a short-term solution to sleeplessness. Those who have been prescribed the drug to treat insomnia are directed not to take the drug for longer than ten consecutive days. Although the drug aids sleep, there is evidence that the quality of sleep induced by Ambien is not as effectively restorative as natural sleep and can cause fatigue in someone who has taken it for extended periods.

Mixing with alcohol enhances the potency of these drugs, with potentially disastrous physical consequences.

Someone taking sleep medication long-term will develop a tolerance to it, meaning they must take more and more in order to sleep, leading to a risk of overdose.

Other Types

Ambien is the commercial name for the drug zolpidem tartrate. This drug may also be marketed under the name Stilnox. Zopiclone is marketed under a variety of different brand names worldwide. In South America, the medication is called Zalepla or Zetix, in the UK it is sold as Zimovane, in Ireland in might be known as Zileze, Zimoclone or Zorclone. In Australasia and some European countries it is marketed as Imovane or Imrest, in Germany Ximovan, in Egypt Hypnor and in Spain Limovan.

Recreational users might refer to Ambien as ‘A-minus’, ‘zombie pills’ or ‘no-go pills’.

The drug Zoplicone may be referred to on the streets as ‘zimmers’, ‘zimmies, ‘zim-zims’ or ‘zoppies’.

As a depressant drug, sleep medications may also be generically referred to as ‘downers’ because of the way the combat the effects of stimulant drugs like cocaine and amphetamine (known as ‘uppers’).

Major Effects

When prescribed for insomnia, sleeping medications like Ambien and Imovane have the effect of combating the causes of this condition and making the person taking it feel drowsy and fall asleep. In some cases, however, the drug can cause serious side effects. In the short term these might include weakness, feeling unsteady of the feet, a slowed heart rate, shallow breathing, nausea, vomiting, short-term memory loss and severe headache. These medications can also make someone feel ‘foggy’ as if they have been heavily drugged as well as causing twitching or shaking. In some cases taking Ambien can cause someone to sleepwalk, potentially putting them in harmful situations.

In most cases these side effects only occur if the drug is being abused and taken in doses that exceed the normal prescribed amount.

Because Ambien is meant for short-term use only, there are serious harmful effects that can arise if the drug is taken for longer periods.

Someone taking Ambien long-term may suffer from delusions, including thoughts of suicide. The drug may also impair the general judgement and reasoning abilities of the user. Long-term use of Ambien can lead to the body developing an ever increasing tolerance to the drug, which may lead to dependence as more and more is needed to induce sleep. This also increases the likelihood of overdose. A decrease in libido is another effect of long-term use of Ambien.

Ambien can have the effect of impairing the motor functions of the user, making them unable to complete tasks that require a degree of coordination such as operating machinery or driving. Many of those who abuse sleep medication have difficulty talking properly, and will tend to slur their words and stagger around.

Sleeping medications based on Zopiclone like Imovane (aka Zimovane) may cause the side effects of indigestion, constipation, nausea and vomiting, diarrhoea, increased appetite and heart palpitations. Rashes on the skin may also form and, in rare cases, someone taking zopiclone will have a tingling sensation all over their body. In men, zopiclone may cause impotence or delayed ejaculation. Blurred vision and increased urination may also occur.

Production countries

Sleep medication like Ambien, Stilnox and Imovane (or Zimovane) are legal prescription drugs that are manufactured under license in a wide variety of industrialised nations. The chemical zolpidem that is marketed as Ambien and Stilnox and is widely prescribed across the world, with the Netherlands being one of the countries where Stilnox is consumed the most. The patent for Ambien is held by the French pharmaceutical company Sanofi-Aventis, one of the largest companies of its kind. Sanofi-Aventis makes a variety of prescription and non-prescription drugs and vaccines and are represented throughout the world.

The drug zolpidem is also generically available in the USA and UK and is sold as a generic drug called Sandoz in South Africa, Ratiopharm in Germany and Teva in Israel.

Sanofi-Aventis is also the main manufacturer of the drug Zopiclone.

Sleeping medication like Ambien is produced exclusively by legitimate means and there are no cases of it being manufactured ‘on the streets’. As such all sleeping medications used for illicit purposes are those that are diverted from legitimate sources, i.e. from those who have been prescribed the drug to treat insomnia.

In countries with private health care like the USA, those addicted to sleeping medication often engage in ‘shopping around’ different doctors in order to increase their supply.

In the USA Ambien is the most widely prescribed sleep medication.

Facts and stats

Sleeping medications are legally produced drugs that are intended for short term use in order to specifically treat the symptoms of insomnia. They are also abused by some who either take the drug in greater quantities or for a longer term than they have been prescribed. Here are some more essential facts about sleeping medications.

  • Ambien became available as a treatment for insomnia in 1988.
  • Zolpidem tartrate is the chemical name for the drug Ambien and it also marketed in some cases as Stilnox.
  • Ambien has the potential to extend a sleep period to that of 35 hours.
  • Ambien is intended specifically for short-term use because long-term use can lead to tolerance and dependency.
  • Sleep medications like Ambian and Imovane are depressant drugs and as such, taking them with other depressants like alcohol greatly increases their potency with potentially life-threatening consequences.
  • Zopiclone and Zolpidem are sometimes referred to as the ‘z-drugs’
  • Sleeping medications of all kind are also called sedatives.
  • The medications prescribed for sleeping disorders come in pill form.
  • In some cases sleeping medications like Ambien can cause side effects which range in seriousness from fatigue and headache to convulsion and hallucinations.
  • Addicts of Ambien may slur their words, have difficulty walking and seem ‘drugged up’.
  • Illicit users may take sleeping medications orally or else crush the tablets and mix them with alcohol to ingest.
  • Zopiclone is marketed under various names all over the world including Zimovane and Imovane.
  • Sleeping medications are almost never prescribed to anyone under the age of 18 and illicit users under this age are exposing themselves to severe physical harm.
  • In the clinical trials for Ambien, the most commonly observed side effects were drowsiness, which was observed in 2% of cases, diarrhoea, which was observed in 1% of cases and dizziness, which was also observed in 1% of cases.
  • Ambien can increase a single sleep period to as long as 35 hours.
  • According to research data in the USA, there are over half a million people using Ambien and other prescription sleeping medications in greater doses or for longer periods than prescribed.
  • In the USA in 2010, there were in excess of 17,000 hospital emergency department admissions that were attributed to the misuse of Ambien, including those who had overdosed on the drug.
  • Around one fifth of people in the USA have admitted to using sleeping medication like Ambien when they did not medically require it.
  • Statistical evidence suggests that use of Ambien may be contributing significantly to rates of road traffic accidents in the USA. In 2006, laboratories who test drivers’ blood samples after accidents put Ambien in the top ten of drugs found in the blood of impaired drivers. In the American state of Washington use of the drug was judged to be a contributing factor in 78 driver arrests. In 2005 it was a factor in 56 arrests.

Addiction Signs

Addiction to sleep medications can be gradual and difficult to detect. In many cases someone may have been prescribed Ambien for legitimate treatment of insomnia, but continuing to take the drug after the maximum recommended period can lead to dependency. This is because the body becomes tolerant of sleep medications, meaning that after a short while more and more is needed in order to get to sleep. Very soon a person regularly taking sleep medications can become addicted.

Someone dependent on medications like Ambien may show signs of constant fatigue or drowsiness and seem confused or ‘cloudy’ in their thinking. They may start slurring their words or show signs of a loss of control in their muscles. They may lose their balance often or develop a twitch. Someone addicted to Ambien may also display reduced or shallow breathing and their heart rate might be reduced as well. Addiction to sleep medication like Ambien can also stunt someone’s sexual urges.

Ambien medication is not cheaply obtained, so someone with a dependency on the drug may show signs of financial difficulty and have trouble meeting their payments for other things. An Ambien addict who has difficulty obtaining the drug will often not be able to sleep at all for those periods they are without Ambien, so signs of sleeplessness like tired, bloodshot eyes, skin pallor and increased sweating might be observed.

In order to hide their sleep medication addiction, some will withdraw and detach themselves from friends, colleagues or family members. They may display signs of severe depression including suicidal thoughts which they may talk about.

Ambien abuse affects short term memory so addicts will often have difficulty remembering things, missing appointments and so on.

Another sign of Ambien addiction may be frequent episodes of sleepwalking as the drug decreases the latency of ordinary sleep, despite lengthening its duration.

Treatments

Once someone has become addicted to sleeping medication like Ambien, it is essential they seek professional help in order to manage their detoxification and rehabilitation. As soon as someone who has built a dependency towards Ambien stops taking the drug they will begin to experience unpleasant and painful withdrawal symptoms that, for their own welfare, should be managed under clinical observation and with medical support. Suddenly stopping taking sleep medication can result in seizure and, in some cases, death.

Without such medical support there is a risk that the person suffering withdrawal may turn to other drugs to alleviate their symptoms, which may include nausea, vomiting, dizziness, stomach cramps, sweating and convulsions. Attempting to treat these symptoms without advice can have potentially disastrous consequences.

Medically supervised detoxification programmes will safely taper off the dose of Ambien to aid the comfort of the addict. During this time appropriate medication may be prescribed to relieve symptoms of withdrawal, including anti-depressants. A full medical examination of the addict is carried out in order to discover if there is any medical cause for the insomnia that the addict may have been attempting to treat with Ambien, that had not been previously identified. Throughout the initial detox phase, the addict’s nutritional intake is also strictly monitored and some foods or drinks may be banned, particularly those containing stimulants like caffeine.

In some cases a different sleep medication drug to the kind an addict has developed a dependency to may be substituted, for example a benzodiazepine in the case of non-benzodiazepine drug like Ambien. The detoxification stage of a rehabilitation programme will be tailored to an addict’s individual needs based on the severity of their addiction.

The initial detoxification phase of an addict’s rehabilitation is normally carried out in a residential centre and may last between one and two weeks. After detox, rehabilitation may continue with the addict either as an inpatient or an outpatient.

The benefit of inpatient treatment for sleeping medication addiction is the structure that a clinical facility can provide for every aspect of an addict’s rehabilitation. Private and group therapy sessions may be carried out intensively without distraction or temptation from the outside world. In this way there is a greater chance of complete recovery.

An outpatient programme can allow the addict to resume their daily life responsibilities including employment, whilst still engaging in support therapy. It is important to note, however, that rehabilitation is only effective in the long term when an addict fully admits to having a problem with the drug.

Therapy sessions are designed to resolve the underlying issues that created the conditions for the abuse of Ambien or other sleeping medications and to develop coping strategies of dealing with life without recourse to abusing such drugs. Behavioural therapy will show the addict how to replace negative behaviours with positive ones.

Group therapy sessions, which are offered by a number of organisations may also be helpful long term. These are where ex-addicts can share their experiences and encourage others to remain drug-free.