Between 50 and 70 million people in the United States are believed to suffer from a sleep or wakefulness disorder, the Centers for Disease Control and Prevention (CDC) reports. Poor sleep quality can impact many facets of a person’s life, from physical health to mental capabilities. Insomnia, or difficulties falling and staying asleep, can make it hard for a person to function normally in everyday life, as lack of sleep can impede the completion of even mundane and everyday tasks.
The US Food and Drug Administration (FDA) reports that in 2013, there were 3 million prescriptions dispensed for the sedative-hypnotic sleep aid Lunesta. The active ingredient in Lunesta, eszopiclone, works similarly to benzodiazepine drugs, although technically it is chemically different in nature. Eszopiclone is often termed a nonbenzodiazepine “z-drug” for its similar method of action. Benzodiazepines, and z-drugs, increase levels of the natural sedative GABA (gamma-aminobutyric acid) in the brain. This helps to reduce functions of the central nervous system, such as blood pressure, body temperature, heart rate, and respiration, as well as minimize muscle tension and alleviate anxiety and hyperactive nerve firings that may prevent the onset of sleep.
The journal Neuropsychiatric Disease and Treatment reports that eszopiclone can also induce euphoria much the same way that diazepam (Valium) can when taken in high doses. While generally considered to have a lower incidence of abuse and often thought to have fewer side effects than benzodiazepines, z-drugs like Lunesta may still be a target for abuse, leading to negative consequences that may include addiction.
At the time of the National Survey on Drug Use and Health (NSDUH) in 2014, approximately 330,000 people were currently misusing prescription sedative drugs, the largest percentage of which were between the ages of 18 and 25. Prescription drugs may seem safer than illicit drugs, making them a target of abuse. Lunesta may be abused by recreational drug users for the euphoric “high” it may produce, or by individuals looking for a way to self-medicate insomnia symptoms. Lunesta may be combined with other drugs or alcohol to amplify the effects of both substances. It may be used in higher than the recommended doses or in ways it is not designed to be taken.
Lunesta may be habit-forming with long-term use, and individuals may keep taking the drug after a prescription for it has run out. Using Lunesta without genuine medical necessity and without a licit prescription is a form of drug abuse.
Health Concerns regarding Lunesta Abuse
Lunesta and other z-drugs like Ambien have been in the spotlight for the potential to cause next-day impairment and for reports of people engaging in sexual intercourse, driving, eating, talking on the phone, or other behaviors while apparently sleepwalking. The person will then have no memory of performing these actions the next day. These alarming incidents caused the FDA to change the recommended dosage of Lunesta from 3 milligrams down to 1 milligram in 2013.
While eszopiclone has a half-life of around five hours, the Australian Prescriber reports, impairment of next-day memory, motor coordination, and driving skills may continue for up to 11 hours after taking Lunesta, the FDA warns. For this reason, the makers of Lunesta, Sunovion Pharmaceuticals, recommends that individuals be able to get at least 7-8 hours of sleep after taking the drug. Individuals are cautioned that Lunesta can decrease a person’s mental alertness and ability to function without impairment the next day.
Lunesta abuse may result in overdose, especially if mixed with other central nervous system depressants. Drug overdose death is the number one cause of injury death in the United States, according to the 2015 National Drug Threat Assessment (NDTA) as published by the Drug Enforcement Administration (DEA). Additionally, nearly a half-million Americans needed emergency medical treatment from an emergency department (ED) in 2011 for an adverse reaction after misusing a sedative, hypnotic, or anxiolytic prescription medication, the Drug Abuse Warning Network (DAWN) reports.
Lunesta Addiction and Misuse
Abusing a drug like Lunesta for an extended period of time can have lasting effects. The British Medical Journal (BMJ) cites an increased risk for cancer and excess mortality from the use of a hypnotic drug like eszopiclone, for instance. Long-term Lunesta use can also alter brain chemistry and cause dependency on the drug. Once dependence is formed, withdrawal side effects, like upset stomach, abnormal dreams, anxiety, and nausea, may occur when the drug wears off. Individuals may experience cravings and psychological symptoms similar to benzodiazepine withdrawal.
Dependence, cravings, and withdrawal symptoms are often signifiers of addiction. Addiction goes beyond just physical drug dependence, however. The American Association of Addiction Medicine (ASAM) calls addiction a brain disease that impacts specific parts of the brain that helps a person to think clearly, make sound decisions, and control impulses. When someone battles drug addiction, they are unable to control how much and how often they take drugs. Abusing a drug like Lunesta unchecked can lead to many behavioral, social, financial, personal, emotional, and physical consequences. Early intervention is key in helping to minimize the damage.
Signs of problematic Lunesta abuse and addiction include:
- Taking Lunesta for longer periods and in higher amounts than intended
- Multiple attempts to stop taking Lunesta that are unsuccessful
- Going to more than one doctor, or “doctor shopping,” to get Lunesta prescriptions
- Exaggerating symptoms to obtain Lunesta prescriptions
- Altering Lunesta in any way or taking it beyond the means of a prescription
- Use of Lunesta in situations that may be hazardous
- Continuing to use Lunesta even with full awareness of negative consequences that will likely occur from doing so
- More risk-taking behaviors than usual
- Mood swings and erratic behaviors
- Regularly not being able to remember activities performed the night before
- Questionable decision-making skills
- Drop in grades and/or work output and production
- Alterations in social circles and relationship issues
- Decreased interest in recreational and social activities that were priorities before
- Marked change in sleep patterns
- Presence of pills and pill bottles in easy-to-reach locations
- Withdrawal from family and friends
- Episodes of aggression or self-harming behaviors that are out of character
- Difficulties feeling pleasure without Lunesta
- Decline in physical appearance, health issues, and possible weight fluctuations
Lunesta Abuse and Addiction Treatment Options
Lunesta addiction often includes physical dependence and withdrawal symptoms that are best treated through a medical detox program. Medical detox can provide around-the-clock medical supervision and mental health support while the drug processes out of the body. Medications may be beneficial in controlling withdrawal symptoms and cravings during medical detox.
There are many factors that influence the detox timeline, and withdrawal is highly individual in nature. Detox is followed with either a residential or outpatient treatment program, depending on the person’s individual circumstances. A thorough assessment upon admission can be useful for treatment providers as they decide on what level and type of treatment program may be best suited for the individual.
Addiction and insomnia may both complicate and feed into each other. During an integrated treatment program, individuals can see improvement in both areas. When people feel well-rested, they are better able to think clearly, make sound decisions, and have fewer health concerns. Insomnia may have many root causes, from stress to an underlying mental illness or medical issue. Therapy and counseling sessions can help individuals to discover what may be triggering sleep difficulties and also why they may be abusing Lunesta. New coping mechanisms and skills are taught and behavioral therapies can aid in the modification of potentially self-destructive thoughts.
Holistic methods, like healthy and balanced meal planning, fitness programs, structured sleeping and waking times, yoga, massage therapy, and mindfulness meditation, can also be beneficial in helping to improve insomnia symptoms and therefore minimize the potential for relapse to substance abuse. Encouragement, supportive care, complementary therapies, and pharmaceutical methods are all tools used during addiction treatment to aid in a sustained recovery.