Re-classification of prescribed addictive drugs for insomnia, ADHD or pain

25th July 2014

Re-Classification of Certain Prescribed Drugs

Earlier this month zaleplon and zopiclone were reclassified under the Misuse of Drugs Act as Class C, Schedule IV substances, joining the same classification as the third member of the ‘z-drugs’, zolpidem. The Advisory Council on the Misuse of Drugs issued a statement that “these drugs have a legitimate medical use, but people should be under no illusion, taking them without prescription and medical advice can be dangerous.”

The drug reclassification has occurred to prevent misuse of the drug for recreational purposes and ought not to have implications for legitimate therapeutic users under medical prescription, which are most typically for the treatment of insomnia. 

With the change in legislation there have been fears that legitimate dosages might be reduced by prescribers, or patients will request a reduction or halt. However, withdrawal from z-drugs can lead to serious side effects when associated with high dosages and prolonged use. One study revealed the following symptoms from reduced dosage (Hajak et al., 2003):

• Anxiety

• Tachycardia

• Tremor

• Sweating

• Rebound insomnia

• Flushes and palpitations

• Derealisation and

• Convulsions

The National Institute for Clinical Excellence (NICE) is currently writing guidelines on prescriptions of controlled drugs to be published in December 2015 which will include the protocols for z-drugs. If you are a therapeutic user of one of the ‘z-drugs’ or other controlled drugs, and/or are concerned about this issue, please register as a stakeholder with the institute and submit your opinions: http://www.nice.org.uk/mpc/medicinespracticeguidelines/CDGPG.jsp.

References

https://www.gov.uk/government/news/acmd-advises-the-government-on-the-control-of-prescription-drugs.  

Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: 
a review of case reports and epidemiological data, Hajak et al., 2003 Addiction, 98, 1371–1378

Sleeping pills increase risk of death study finds

Sleeping pills increase risk of death, study suggests - published in the British Medical Journal

 Hypnotics' association with mortality or cancer: a matched cohort study

 In this open access paper by Kripke, Langer and Kilne, a study of electronic medical records of 10,529 patients who received prescriptions for hypnotic drugs were compared with 23,676 matched controls with no hypnotic prescriptions during a period of 2.5 years from 2002 to 2007.

 DRUGS PRESCRIBED included:
 zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates and sedative antihistamines. 

  Conclusions were: Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality. In the UK we are still trying to persuade the government of the long standing problem of involuntary tranquilliser addiction - take a look at the postings from the All Party Parliamentary Group on Involuntary Tranquilliser Addicton www.appgita.com

WARNING - DO NOT STOP TAKING ANY MEDICINE SUDDENLY 

Many medicines, including some pain killers, tranquillisers, sleeping pills antidepressants and other psychotropics can trigger serious withdrawal reactions

•  For withdrawal advice about benzodiazepines,  and z drugs (like zopiclone), see Professor Heather Ashton's Withdrawal Protocol on www.benzo.org.uk
• For Professor David Healy's SSRI withdrawal protocol email APRIL at SSRI at april. org. uk (email address displayed in this way to avoid spam).
• For information about reducing antipsychotic drugs see www.comingoff.com