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Sleeping Pill Withdrawal | Timeline, Symptoms, Detox

Sleeping pill is the common name for a class of drug called hypnotics that have the primary function of inducing sleep. Those pills can be used as an anesthetic during the surgery or to treat sleep disorders, including insomnia. Sleep disorders are pervasive and affect more than 40 million Americans on any given night. Healthy and quality sleep can have a significant effect on overall health since our bodies do most of the healing during sleep. Because of the importance of achieving restful sleep and the pervasiveness of sleep problems, sleeping pills are widely prescribed and potentially abused.

Since the 1950s, barbiturates were used to treat sleep disorders in the United States. However, those medications possess a high risk of dependence and can be fatal in case of overdose. In general, barbiturates have been replaced with benzodiazepines, a drug with slightly lower dependence probability. Nevertheless, benzodiazepines have a fair share of potential side effects.

Today, benzos are the most frequently used hypnotic when it comes to treating sleep disorders and are the most commonly prescribed drug overall. However, because they also have a high potential for dependence if taken longer than recommended, many clinicians are moving toward non-benzodiazepine options. Nonetheless, substance abuse disorders involving benzodiazepines are still a significant problem and, like other central nervous system suppressants, it has the potential for dangerous withdrawals.

Sleeping Pill Addiction

Sleeping pills, like benzodiazepines, are central nervous system suppressants. They increase the activity of neurotransmitter gamma-aminobutyric acid (GABA) at the GABA receptors resulting in sedative, hypnotic, anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant effects.

Over a prolonged period, the brain chemical balance changes, and a higher dose of benzodiazepines is needed to achieve the same effect. If used as prescribed, the medications help to fall asleep faster by reducing wakefulness; however, they worsen sleep quality by effective sleep architecture – the light sleep increases, and the deep, quality sleep decreases accordingly. Moreover, benzodiazepines cause rebound insomnia (re-emergence of symptoms of insomnia).Sleeping pills have several possible side effects that are related to their sedating effects. Doctors typically discourage benzodiazepine use in elderly patients because of these adverse effects.

Common side effects include:

  • Drowsiness
  • Dizziness
  • Decreased coordination
  • Lack of concentration
  • Depression 
  • Hypotension

Drowsiness, dizziness, and a decrease in coordination may lead to accidents and falls, which can be especially dangerous in the older population. Still, long-term benzodiazepine use is most common in the 65 to 80-year-old age bracket. Benzos can also impair driving ability, so it’s not recommended to use them while driving or operating heavy machinery. Non-benzodiazepines have some of the same side effects and may also be dangerous for older people.

Some less common side effects of benzos, including loss of appetite, blurred vision, confusion, euphoria, and depersonalization, can occur as well. Social phobias, anxiety, depression, loss of interest in recreational activities, and other mental issues can be caused by long-term benzodiazepines use. Paradoxical reactions, including violent outbursts, aggression, and irritability, can occur as well.

Common Sleeping Pills

There are a wide variety of benzodiazepines, but there is growing popularity of Z-drugs or benzodiazepines-like that can be used as sedatives. They offer sedating and anxiolytic benefits without affecting sleep architecture, and there may be a lower chance of rebounding insomnia and anxiety. 

There is limited evidence to suggest that they are less addictive than benzos. Still, they are commonly prescribed to people with insomnia who don’t have any co-occurring issues that would require benzos. Here are some of the most common non-benzodiazepine sleep aids:

Ambien: Ambien (zolpidem) has similar therapeutic and possible side effects to benzodiazepines. Its short half-life causes it to wear off after just three hours, which should be enough to help people who have trouble getting asleep, but it won’t prevent waking in the middle of the night. Like benzodiazepines, zolpidem can be used as an anticonvulsant and muscle relaxant.

Lunesta: Lunesta (eszopiclone) is chemically similar to Zolpidem and produced a reasonably substantial clinical response during clinical trials. Due to moderate improvement in sleep onset and maintenance, Lunesta is popular in the elderly population. However, dizziness, impaired coordination, daytime drowsiness, or aggressive behavior can occur.

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What Are Sleeping Pill Withdrawal Symptoms?

Withdrawal symptoms from sleeping pills vary based on multiple factors. Those using sleeping pills for extended periods can experience more severe possible adverse effects. Individuals who consume high doses of the medication more likely will deal with stronger unfavorable effects. One of the most common symptoms after stopping taking sleeping you with pills is craving for the drug, irritability, increased anxiety, or agitation.

Other withdrawal symptoms that are likely may include:

  • Sweating
  • Anxiety
  • Tremors
  • Rebound insomnia
  • Nausea
  • Mood swings
  • Panic
  • Depression
  • Muscle spasms
  • Inability to concentrate
  • Irritability

If you have experienced sleeping pill withdrawal in the past, you are likely to face worse symptoms. A phenomenon that can occur as a result of sleeping pill abuse is something known as kindling, which means you will experience more severe withdrawal symptoms in subsequent periods because of the lasting changes made to your brain. While sleeping pills will most likely not cause severe withdrawal symptoms such as seizures or delirium, they can still cause kindling.

Why Should I Detox?

Quitting drugs cold turkey may sound like a good idea, but it can be difficult, painful, and dangerous. In some cases, it can be critical.

Given the difficult physical symptoms, withdrawing on your own without professional medical help can be very challenging. It’s important to find a professional, medically assisted detox program to support you during the process of Sleeping pills withdrawal.

Doing this will ensure that you are carefully monitored in a safe environment while your body goes through the difficult detoxification process. Participating in an addiction treatment program also gives you a better chance at lasting recovery as a result of the structured medical and emotional support you will receive.

Seizures, while not likely, can occur and be extremely dangerous. For this reason, an individual must not play around with their lives and consider medical detox. It involved 24-hour medically managed care that will keep someone for three to seven days. You may be treated with medications that alleviate symptoms and take medicines to taper off the drug.

What Is the Next Treatment Step?

A full continuum of treatment ensures the best opportunity for a successful recovery. Following a full continuum of treatment means starting with the medical detox process and then progressing gradually from an inpatient status to outpatient treatment. You will then have the opportunity to participate in an alumni program after the formal treatment program is completed. The stages of addiction treatment include:

The primary goal is medical stabilization during the first stage of withdrawal treatment, which is known as detox. Expect the detox stage to last from a few days up to a week. When you arrive, your medical team, which will include doctors, nurses, and support staff will complete your comprehensive medical assessment, which will help determine your level of addiction and additional medical needs you may have. The assessment includes a medical exam plus a urine screening for drugs.

Your medical team will monitor you 24/7 to help manage uncomfortable withdrawal symptoms and prevent dangerous Sleeping pills withdrawal symptoms.

Many people also experience anxiety, depression, and other emotional and psychological challenges during the detox period. Your treatment plan will also include comprehensive support to help you with these symptoms. A longer-term treatment plan will be put into place for you once you are medically stabilized.

If you and the treatment team determine that you need further medical treatment, you may continue the next stage of treatment on an inpatient basis, which might be because of co-occurring medical conditions or post-acute withdrawal symptoms. Inpatient treatment is intensive and includes 24/7 clinical monitoring. At this stage, you will start seeing a therapist regularly to help you process the emotional and psychological aspects of addiction and recovery.

Partial hospitalization (PHP) is in-between outpatient treatment and inpatient care. The goal of PHP is to stabilize your mental status and better prepare you for success once you return to independent living after you leave the treatment center. During this stage, you’ll live at a transitional living facility while undergoing a supportive and rigorous treatment program. This program will be five days a week for six hours each day. You will be able to participate in individual, group, and family therapy programs to help you address emotional and mental health needs.

Learning positive life skills, coping mechanisms, and techniques to help prevent relapse so that you will be prepared for long-term recovery will be the primary focus during PHP.

The next stage is the intensive outpatient program (IOP). An IOP allows you to live at home while also attending counseling and programs to help support your recovery. Depending on your treatment plan, you will participate in about nine or more hours of clinical therapy several times each week.

Intensive outpatient therapy will help you to continue learning new ways to manage cravings, stress, and other challenging issues that may arise once you live on your own again. After you complete the IOP stage, you will transition into the Outpatient and Alumni programs, which is also known as aftercare.

Sources

National Institute on Drug Abuse. (n.d.). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

Olfson, M., King, M., & Schoenbaum, M. (2015, February). Benzodiazepine use in the United States. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25517224

Wagner, J., & Wagner, M. L. (2000, December). Non-benzodiazepines for the treatment of insomnia. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12531036

Huedo-Medina, T. B., Kirsch, I., Middlemass, J., Klonizakis, M., & Siriwardena, A. N. (2012, December 17). Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544552/

Delirium tremens: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from https://medlineplus.gov/ency/article/000766.htm

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