Sleeping Pill Withdrawal

Sleeping pills are commonly prescribed and even when used as directed, they can lead to dependency that is associated with potentially debilitating withdrawal symptoms.

An estimated 4% of US adults (approximately nine million people) have a prescription for sleeping pills. Many of these individuals may be unaware of the potential dangers associated with regular use, even when used as directed. Notably, the Food and Drug Administration (FDA) recently mandated that “black box warnings” be included in prescribing information for three of the most popular sleeping pills – eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien), which are collectively referred to as “z-drugs”. Z-drugs are sedative-hypnotics, which reduce brain activity, leading to drowsiness/sedation and reduced levels of anxiety. Sedative-hypnotics are often associated with dependency and withdrawal issues.

Although less commonly prescribed for sleep disorders, benzodiazepines (e.g. Xanax, Valium, Ativan) and barbiturates (e.g. Fiorinal, Fioricet) may also be prescribed for insomnia. Both of these drug classes also pose a high risk for dependency and withdrawal and should be taken with caution.

Related Topic: Fioricet withdrawal

What Causes Sleeping Pill Withdrawal?

Z-drugs work by enhancing the effects of a neurotransmitter called GABA. Increased GABA signaling causes reduced brain excitability, which causes the sedation associated with z-drugs. Even short-term regular use of z-drugs leads to tolerance, which means that larger and larger doses are required in order to achieve the same effect.

The development of tolerance precipitates dependency and reflects chemical changes that occur in the brain. When drugs are not taken to maintain this change, withdrawal symptoms frequently manifest in the form of insomnia, restlessness, and anxiety. Benzodiazepines are generally associated with similar symptoms that are more intense and last longer.

Some people try to flush sleeping pills out of their systems in an attempt to cure withdrawal effects (or pass a drug test). Because z-drugs have short half-lives (between 1 and 7 hours), they are generally completely metabolized within a day or so. However, the withdrawal symptoms that result from z-drug use are caused by chemical changes in the brain that persist even after the drug is completely eliminated.

Sleeping Pill Withdrawal Side Effects

Z-drug withdrawal symptoms are common among users who try to reduce or eliminate their use, and include both physical and psychological effects. It is important to understand that even after the drugs are completely out of your system, withdrawal symptoms frequently persist for weeks, months, or even years after cessation.

How Long Do Sleeping Pills Stay in Your System?

Sleeping pills tend to have relatively short half-lives (1-7 hours for z-drugs, up to 12 hours for short-acting benzodiazepines), so they are rapidly metabolized and are generally not detectable in urine, blood, or saliva tests for more than a day or two. However, sleeping pill addiction withdrawal can persist for weeks, months, even years after the drugs have been completely eliminated from the system.

Sleeping Pill Detox for Treatment of Withdrawal

It is not uncommon for users to question how to make sleeping pills wear off. Unfortunately, there is no safe way to speed up the metabolism of sleeping pills.

For people who are seeking treatment for a sleeping pill addiction, medically supervised detox is frequently recommended. Medical detox involves an evaluation with a medical professional who can evaluate the degree of dependency and prescribe a taper for the drug. In extreme cases, benzodiazepines with moderate to long half-lives may be prescribed to attenuate withdrawal symptoms.

Outpatient Detox

It is important to undergo an evaluation with a medical professional before detoxing in order to ensure a safe, successful experience. Outpatient detox is only recommended for people who have mild dependency issues. Z-drugs (including commonly prescribed brand names Lunesta, Sonata and Ambien) often respond well to outpatient detox. Chronic users of sleeping pills, especially benzodiazepines, may find that a short residential stay prior to outpatient care can maximize successful outcomes.

Additional benefits of outpatient detox include access to medical healthcare professionals who can address questions/concerns that arise during the detox period. Furthermore, clinicians can prescribe a tapered sleeping pill prescription that will minimize withdrawal symptoms.

Detoxing at Home

For those with mild dependency issues, home detox can be a viable option although consultation with a doctor or rehab facility before attempting to detox is recommended.

• Risks of Abrupt Discontinuation: For people who have used sleeping pills daily for long periods of time, abrupt discontinuation of the drugs can be dangerous. Because these drugs change brain chemistry, getting off sleeping pills cold turkey could potentially cause seizure-inducing chemical imbalances. Benzodiazepines have a higher risk associated with quitting cold turkey than z-drugs.
• Controlled Taper: The most effective way to recover from dependency is to wean off of sleeping pills. Gradually reducing the amount of the drug taken is the best way to prevent potentially debilitating withdrawal side effects, and is safer than abruptly quitting. Talk to your doctor or a rehab facility to create a personalized tapering schedule.

Finding a Detox Center

There are several factors to consider when choosing a detox center: