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To the best of our knowledge, no government or health agency has ever put out a public service announcement warning the public against the dangers of Zopiclone. There aren’t any movies featuring Johnny Depp driving through a desert in a classic car under the influence of Zopiclone, nor are there any scandalous pics of Charlie Sheen or Lindsay Lohan partaking in the drug in the back of a limousine. In fact, for the vast majority of people, Zopiclone is completely unheard of, and for some, it’s a godsend in the treatment of insomnia. For those who’ve developed a Zopiclone dependency; however, the story is very very different.
Zopiclone, a nonbenzodiazepine treatment for insomnia and other sleep issues, hit the market in the early 1980s and was promoted as a safer, more effective, and less addictive alternative to benzodiazepines, which replaced barbiturates in the 1960s for the same reason. Although it poses a smaller risk of causing addiction than the products it replaced, Zopiclone and other “Z-drugs” in the sedative-hypnotic family of drugs still have the potential for abuse. Definitive abuse statistics for this drug are hard to come by, but one addiction centre reported that 5.1% of their patients admitted to Zopiclone addiction (Cimolai).
In the UK, Zopiclone is sold under the brand name Zimovane, although it’s also available as Imovane and Dopareel. When taken as prescribed for a short period of time (1 to 2 weeks), Zopiclone is generally considered safe; however, when taken for extended periods of time, it can become habit-forming (Cimolai).
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Our bodies develop a tolerance to the effects of Zopiclone over extended periods of use. Imagine a patient visiting their doctor to get help with their insomnia. The doctor deems that Zopiclone is a good option for this patient and prescribes it. At first, the patient is incredibly happy with the results. They’re sleeping well, and everything seems to be returning to normal. After about two weeks, they realise that their quality of sleep is dropping again, causing anxiety at the prospect of more sleepless nights.
At this point, our unfortunate patient decides to increase their daily dose of Zopiclone instead of looking at other options or consulting with the doctor again. After all, they’re 100% certain that it works, and they don’t want to waste time, effort, and money trying out alternatives.
Soon, the effects start waning again, leading to another round of self-increasing the dose to get the same effect. Assuming the patient has access to Zopiclone, by legal or other means, this process could repeat until the patient starts taking doses large enough to cause drowsiness, confusion, and lethargy at first; with more dangerous symptoms such as respiratory depression or coma to follow (MedSafe). At this point, the patient has developed a tolerance to the effects of the drug, as well as a dependency that will cause withdrawal symptoms when use is discontinued.
Another point of concern is that patients might take Zopiclone while under the influence of alcohol or other drugs. This can lead to pleasurable effects –a euphoric high– but is considered very dangerous as it further increases the sedative effect of both. The combined effect of drugs and/or alcohol with Zopiclone can lead to extremely deep sleep with difficulty waking up, as well as potentially life-threatening respiratory issues (NHS).
People with a history of addiction or substance abuse, those taking Zopiclone for longer periods at higher doses, or people taking it to cope with stress, anxiety, or depression are at higher risk of Zopiclone addiction.
Zopiclone, along with other “Z-drug” sedative-hypnotics, presents withdrawal symptoms that are clinically indistinguishable from alcohol withdrawal. Co-occurring mental illness, longer periods of abuse, large doses, and old age are all factors that could increase the severity of withdrawal symptoms; however, there is significant variability in the threshold at which a patient might develop withdrawal symptoms or not (Weaver). In other words, Zopiclone rehab patients might experience very different intensities of withdrawal symptoms even if they have similar physiological, general health, and abuse profiles.
Withdrawal symptoms can appear in as little as 4 to 8 hours after the last dose, although 24 to 72 hours is more typical. They usually peak at around 5 days and last for 1 or 2 weeks. Early-onset symptoms include elevated vital signs (heart rate, blood pressure, and temperature), followed by tremors in the hands and tongue, then the extremities. Disorientation, mild auditory (occasionally visual) hallucinations, and profuse sweating may develop as withdrawal progresses. Other reported withdrawal symptoms include severe cravings, insomnia, anxiety, palpitations, and seizures. Left untreated, severe Zopiclone withdrawal can be fatal; however, there are pharmaceutical interventions available that significantly reduce the progression of symptoms (Weaver).
Zopiclone withdrawal symptom treatment comes with a few special considerations when compared to many other drugs. First, we have to acknowledge that Zopiclone withdrawal symptoms can be severe and even fatal, leading to an increased need for medical supervision and pharmaceutical intervention during the detox period. On the other hand, as mentioned in the previous section, Zopiclone withdrawal symptoms present unpredictably and many patients present very mild symptoms, decreasing the need for medical supervision. For these reasons, there isn’t a standardised treatment for Zopiclone withdrawal treatment and each case should be evaluated on its own merit.
In cases where a patient is stable or presents only very mild withdrawal symptoms, they’re often treated in an outpatient setting. In these cases, treatment might include gradually tapering down the Zopiclone doses or substituting Zopiclone with long-acting sedatives. Clonazepam, a long-acting benzodiazepine with less euphoria than other benzodiazepines, might be prescribed during outpatient detox.
In cases where more severe withdrawal symptoms such as hallucinations, seizures, or psychosis present, or if the patient has a history of seizures or delirium tremens, it’s highly recommended to go through detox under the watchful eye of a physician. Depending on the situation, they might prescribe benzodiazepines or barbituates which have both been proven effective in treating Zopiclone withdrawal in clinical trials.
An important note here is that even after all other withdrawal symptoms have dissipated, insomnia and anxiety might continue to present for several months. While neither of these symptoms is life-threatening, they are uncomfortable to live with and might trigger a relapse. Long-acting benzodiazepines that taper down in dosage over a period of 2 to 3 months might help prevent this anxiety and insomnia.
(Weaver)
For more than 20 years, Gladstones Clinic’s team of addiction specialists have been helping people reclaim their lives from addiction using modern, evidence-backed therapies. We take a holistic and integrative approach to addiction, making sure to gain a deep understanding of our patients’ unique situations and causes of addiction before deciding on a suitable course of action and the best combination of therapies.
Zopiclone addiction ruins lives. Gladstones Clinic has the experience, skilled and trained medical professionals, and facilities to help you before the worst-case scenarios play out.
You can visit our pharmaceutical drug addiction rehab page for more information on the signs and risks of pharmaceutical addiction, our page on drug induced psychosis to learn more about where continued drug abuse might lead, or our page on substance abuse where we discuss the mechanisms of addiction in laymens terms.
If you or a loved one are in the grip of Zopiclone, sedative-hypnotics, or other z-drug addiction, please contact us today for obligation-free advice or information on safe and effective methods of stopping the abuse.
Cimolai, Nevio. “Zopiclone: is it a pharmacologic agent for abuse?” Canadian family physician Medecin de famille canadien, vol. 53, no. 12, 2007, pp. 2124-2149. National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231551/. Accessed 08 08 2023.
“Common questions about Zopiclone.” NHS, https://www.nhs.uk/medicines/Zopiclone/common-questions-about-Zopiclone/. Accessed 8 August 2023.
“NEW ZEALAND DATA SHEET 1. PRODUCT NAME 2. QUALITATIVE AND QUANTITATIVE COMPOSITION 3. PHARMACEUTICAL FORM 4. CLINICAL PARTICULAR.” Medsafe, https://www.medsafe.govt.nz/profs/datasheet/z/Zopicloneactavistab.pdf. Accessed 8 August 2023.
Weaver, Michael F. “Prescription Sedative Misuse and Abuse.” The Yale journal of biology and medicine, vol. 88, no. 3, 205, pp. 247-256. National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553644/. Accessed 09 08 2023.
