Millions of people have trouble falling asleep and staying asleep these days. Whether the cause of sleeplessness is related to home, work or something else, or a combination of all, people with insomnia just want to get some rest.

Insomnia is the inability to fall asleep and stay asleep or when someone wakes up too early and cannot get back to sleep. Medical experts say that adults need seven to eight hours of sound sleep per night. Despite that, the U.S. Centers for Disease Control and Prevention (CDC) states there are about 50 to 70 million people age 18 and up who have sleep-related disorders.

At first, doctors prescribed barbiturates for patients who had insomnia. However, drugs in this class are quite addictive, and soon, barbiturates were replaced with benzodiazepines.

Benzos, as they are called in short, are mostly used to treat seizures and spasms, but also treat anxiety. Commonly prescribed benzos include Xanax and Valium for anxiety, and Ambien, Lunesta and Sonata for sleeplessness.

Benzos are a controlled substance and regulated by the U.S. Drug Enforcement Administration (DEA) as Schedule IV drugs. By the DEA’s definition, benzos have a low potential for abuse and a low probability of dependence. However, benzos are misused and abused often. Then, along came “Z-drugs.”

It wasn’t long before benzos were replaced with non-benzos or what is known as “Z-drugs.”

These medicines are Ambien (zolpidem), Lunesta (eszopiclone) and Sonata (zaleplon). In 2016, the U.S. Food and Drug Administration (FDA) ranked Ambien among the 20 most prescribed drugs in the country. Sedatives also made the Top 20 Commonly Abused Drugs by the National Institute on Drug Abuse (NIDA).

It is incorrectly thought that “Z-drugs” are safer than benzos. That thought often leads to the misuse and abuse of these medicines. However, people who take a larger than prescribed dose, or take a few pills from a family member or friend, could find themselves in medical distress.

People who are prescribed these medications can become tolerant in a few days. This means they might want to take more than the prescribed dose to feel the same effects as the regular dose. When this occurs, it usually does not take long before sedative addiction begins. Long-term use of sedatives, including Z-drugs, can be severe.

What Are Sedatives?

Sedatives are central nervous system depressants (CNS), which is a broad term that describes drugs that produce feelings of relaxation, sedation, and sleep.

Z-drugs are an alternative group of sedative medications. They also have addictive potential, and a load of unwanted, dangerous side effects, which include sleepwalking, sleep eating, sleep driving, memory loss, and depression. 

These drugs are also known to stop working and produce effects opposite of what they originally intended, such as intense insomnia. It is not unusual for someone feeling the opposite effects to take more of the Z-drugs to gain the desired effect.

How Do Sedatives Work?

The different classes of sedatives work in a similar fashion. Non-benzo sedatives work as benzos do: they enter the brain and bind to a neurotransmitter called gamma-Aminobutyric acid (GABA).

GABA regulates how the body responds to feeling stress, fear, or anxiety.  It sends nerve signals to the brain and body in response to stressful situations.

Benzos switch on the brain’s GABA receptors, which flood the brain with GABA to produce a much more intense feeling of relaxation. The brain cannot do that on its own. This is how drugs like Valium counteract anxiety. It is also how the drug can be misused so someone can get high.

Z-drugs also affect GABA levels but in a more selective way. Z-drugs target certain GABA receptors explicitly related to inducing sleep and activate them. This very specific effect of the z-drug is less intense than a benzo. It also produces less of what is known as a “sleep hangover.”

Side Effects of Sedatives

The side effects of regular sedative abuse people might experience can start mild and end with a coma or fatality.

The Signs of Sedative Addiction

It can be hard to detect the signs of sedative addiction. The earlier they are determined, though, the better chance the person abusing sedatives has of overcoming that addiction.

As taking the sedative becomes the main drive for the person abusing them, the person will begin to show the signs of substance use addiction in general. 

These signs and behaviors of yourself or someone else are clear indications of sedative addiction. It is imperative to seek professional addiction help and treatment as soon as possible.

The sooner the sedative abuse is addressed and treated, the sooner you or the person with the addiction can prevent further psychological and physical damage, and begin to heal and recover.

What Is Involved in Sedative Addiction Treatment?

Sedative addiction treatment must begin with detox to flush the drugs, harmful toxins, and associated substances out of the body. Detox is first to ensure that the person is fully sober and both physically and mentally fit to start the addiction treatment program.  

A doctor puts the client on a medication tapering schedule; this procedure weans the person off the drug. The client is monitored 24/7 during this process to ensure there is no threat of seizure or other complications.

After detox, a clinician will create and finalize a drug treatment program with you that meets your unique needs. A complete assessment of your overall health and drug use history is performed to develop the best plan for long-term recovery.

The next step is to enter a recovery treatment program. This can be either as an inpatient or outpatient. Whichever type of program is suggested is to ensure progress on the recovery from addiction road.

Residential treatment is best for clients with severe cases of addiction and those who have used and abused two or more substances. Clients reside temporarily at the treatment facility while they obtain a full complement of therapy and care on a full-time basis.

The length of residential programs ranges between 30 and 90 days. However, the National Institute on Drug Abuse (NIDA) suggests a 90-day stay to reach treatment effectiveness.

Outpatient treatment is for mild addiction cases which are determined by your clinician. It still provides the therapy and care needed, but on a more part-time basis. The client can live at home and take care of their everyday responsibilities.

Sedative Withdrawal

Sedative withdrawal symptoms happen when your brain becomes reliant on the brain on the chemicals in the drug you have been taking. Sedatives work to suppress the nervous system.

Over time, your body beings to become tolerant of the drug, and it could even try to counteract the drug to balance brain chemistry. 

It may decrease its natural inhibitory and increasing excitatory chemicals. As your brain adapts to the drug, you may feel like you need it to feel like your usual self. If you stop taking it suddenly, you’ll feel uncomfortable, and you may experience possible life-threatening withdrawal symptoms.

Dangerous symptoms include seizures and delirium tremens. Seizures, when they can come on suddenly, can cause serious injuries or be fatal.

Delirium tremens is a condition that presents with sudden and severe confusion, tremors, terror, chest pains, catatonia, and sometimes death. This is one reason why medical detox is imperative.

How Dangerous Are Sedatives?

These previously mentioned side effects can also become magnified when sedatives are abused, especially when tablets are crushed, and the powder is snorted.

“Rebound insomnia,” is another dangerous sedative side effect. The initial symptoms of insomnia come back but are more intensely felt. This destructive condition can pull someone into a vicious cycle of addiction and withdrawal and possible overdose.

If you experience these symptoms or observe them in someone else, then it is urgent that emergency medical assistance is called as soon as possible. Fatal consequences could occur, more so when someone experiences breathing problems. Without medical intervention, someone can become comatose or even experience organ failure due to a lack of oxygen.

Sedative Abuse Statistics

(Source: The 2017 National Survey on Drug Use and Health)

Sleeping Pill Withdrawal

Sleeping pills like Ambien and Zoloft are prescription medications that are in a category called non-benzodiazepine sedatives because they work similarly to benzos, but they have a distinct chemical structure. They are also sometimes called z-drugs because their chemical names usually include the letter Z and they are usually used to help patients catch some Zs. 

They are generally seen as safer than benzodiazepines and their predecessors, barbiturates. However, they can cause some of the same side effects like dependence, addiction, overdose, and withdrawal. 

Sleeping pills are also in the broader drug category of central nervous system depressants, which can be life-threatening during withdrawal. 

If you or someone you or someone you know has been using or abusing sleeping pills, it’s important to be aware of the withdrawal symptoms and their potential risks. Learn more about sleeping pill withdrawal and how it can be safely treated. 

What Are Sleeping Pill Withdrawal Symptoms?

Sleeping pills are central nervous system depressants, which mean that they affect the nervous system by slowing down nervous system excitability. Over time, your brain chemistry may adapt to its presence, causing tolerance, dependence, and withdrawal when you try to quit. As brain chemistry adapts to the drug, it may increase the release of excitatory chemicals to try to counteract the foreign chemical. When you stop using the drug, the excitatory chemicals cause your nervous system to go into overdrive, which leads to a chemical imbalance that causes overactivity in your brain and body.

This can cause uncomfortable symptoms like anxiety and insomnia. Your mind may become restless, and it will be difficult to rest and relax. If you were taking the drug as a way to treat sleep or anxiety disorders, your symptoms would return because of a phenomenon called rebounding. Rebounding symptoms are often among the first symptoms to appear after you stop using.

Depressants like sleeping pills may also cause potentially dangerous symptoms like seizures and a complication called delirium tremens. Both of these symptoms can cause potentially fatal complications if they aren’t treated medically. However, medical treatment or detox programs greatly decrease your chance of experiencing deadly symptoms.

What Are the Stages of the Sleeping Pill Withdrawal Timeline?

The timeline on which you experience sleeping pill withdrawal will depend on several factors, including your history with the drug. The amount of time you’ve been dependent on the pills, the size of the dose you’re used to, and the size of your most recent dose, can all affect when you experience your first symptoms and how severe your symptoms may be. Quitting cold turkey after being dependent on a high dose of the drug for a long time can mean experiencing more intense symptoms quickly.

However, you might experience withdrawal on the following timeline:

Why Should I Detox?

Sleeping pills like Ambien and other brands are central nervous system depressants. That means they are unique among other drug categories because they can be potentially deadly during withdrawal. Symptoms like delirium tremens and seizures can be life-threatening without medical treatment.

Severe cases of depressant withdrawal can lead to hypertension, arrhythmias, or heart failure. Seizures can also cause dangerous injuries if you go through them alone, especially if they come on suddenly when you are standing or driving.

Medical detox or detox in a hospital setting is the safest way to go through depressant withdrawal. Fatal symptoms because of sleeping pill withdrawal are unlikely, but complications could occur. Detox programs offer 24-hour medically managed care and can help you avoid dangerous symptoms. 

What Is the Next Treatment Step?

After detox, you might need to go through additional levels of care. Detox is an important part of addiction treatment, but it may not be enough to treat a severe substance use disorder effectively. When you first enter a treatment program, you will go through an assessment process that’s designed to determine your needs. There are also clinicians on staff at detox facilities that are able to help you find your next step in treatment.

If you are ready to leave detox, but you still have high-level medical needs, you might need to attend an inpatient or residential treatment program with 24-hour medical monitoring. This can help you avoid medical complications. If you are ready to live independently, you might be able to move on to intensive outpatient treatment or outpatient treatment.

Through these levels of care, you will be able to address underlying issues that contribute to your substance use problems and create a relapse prevention plan.