Millions of Americans use sleep aids to get to sleep. While both prescription and over-the-counter sleep medications can be useful in the short term for inducing sleep and improving the quality of sleep, some sleep pills are prone to abuse as well by some people. However, contrary to popular belief, researchers from the National Sleep Foundation suggest that most individuals do not abuse their sleep medications. In general, most doctors suggest a maximum of four weeks for prescription medications to prevent long-term dependency and addiction.
Physical Dependency
Addiction is caused when the brain adjusts to the drug's effect and begins to depend on its help, which, in the case of hypnotic sleep aids, is a promotion the neurotransmitter gamma-aminobutyric acid, or GABA. While many prescription sleep medications have the potential for abuse, the newest class of hypnotics, such as zolpidem and zaleplon, are not as addictive as the benzodiazepines and barbiturates they have largely replaced, according to the National Institutes of Health publication MedlinePlus. Benzodiazepines are still prescribed, including Valium or diazepam, but only for short-term relief to prevent physical dependence, according to the National Institute on Drug Abuse. Barbiturates, such as phenobarbital, are seldom prescribed unless all other alternatives have been tried, Dr. Lawrence Park and a team of researchers noted in a 2007 article in the "Journal of Clinical Psychiatry." Ramelteon, on the other hand, is a commonly prescribed sleeping aid with little to no potential for dependence.
Psychological Addiction
Sleeping pills can be psychologically addictive as well. The cause for dependency is simply the reliance on a pill to get to sleep every night. For benzodiazepines, the risk of addiction is declining due to lessening popularity, but psychological addiction is especially a concern for those with a history of drug abuse as well as light-to-moderate alcohol drinkers, according to the Substance Abuse and Mental Health Services Administration. Older adults are also more likely to continue using sleeping pills beyond the recommended time than younger individuals. Despite the accepted insomnia guidelines for short-term use of sleep aids, the National Sleep Foundation suggests many doctors prescribe medications for much longer, depending on individual needs.
Avoiding Withdrawal Symptoms
The National Sleep Foundation suggests that going "cold turkey" can actually promote insomnia, so talk to a medical provider when considering quitting sleep drugs. Slowly tapering off is safer than quitting all at once. According to Park's study in the "Journal of Clinical Psychiatry," 43 percent of subjects who took diazepam reported withdrawal symptoms when the drug was discontinued too quickly. As with other addictive drugs, the avoidance of withdrawal symptoms could also be motivation for continuing dependency.
References
- National Sleep Foundation: Sleep Aids and Insomnia
- MedlinePlus: Sleeping Difficulty
- National Institute on Drug Abuse: Prescription and Over-the-Counter Medications
- "Journal of Clinical Psychiatry"; Evaluation and Treatment of Poor Sleep; Lawrence T. Park et al; 2007
- Substance Abuse and Mental Health Services Administration: Use and Abuse of Psychoactive Prescription Drugs and Over-the-Counter Medications
