the Risks of Long-Term Sleep Aid Abuse and Misuse

Concerns about medication safety?

Hello, I would like to ask about a situation.
I have been taking 5-6 sleeping pills daily, experiencing hallucinations, yet I feel as if I am not.
The key point is that this has been the same every day for a year, totaling around 1,825 sleeping pills consumed in a year.
I have been taking various brands.
When I run out, I switch to another clinic to obtain more; if I can't get any, I buy them from the pharmacy.
This cycle has been ongoing for 6-7 years.
I do not seek medical attention, believing I know my symptoms best, and I rely on sleeping pills to get by.
I have a relationship with the clinic doctor, so I continue to receive prescriptions until I can no longer obtain them, at which point I switch to another clinic.
Is this situation considered drug abuse? Can clinic doctors (general practitioners, family medicine doctors, or neurologists) prescribe medications in this manner? Is this also a misuse of medical resources? Can sleeping pills be purchased at a pharmacy? How should this situation be addressed to resolve the issue? Thank you.

D.L., 30~39 year old female. Ask Date: 2013/01/03

Dr. Gu Zhenting reply Pharmacology

Sedative-hypnotic medications should ideally not be used long-term.
From a medical perspective, they are intended for "symptomatic treatment," meaning they address the symptoms rather than the underlying causes.
Except for a few cases of primary insomnia, most insomnia has other underlying reasons.
Therefore, sedative-hypnotics assist in alleviating the symptoms of insomnia patients, reducing the impact of insomnia on their quality of life.
It is important to be aware of "tolerance," which means that the effectiveness diminishes with continued use, and "withdrawal," which refers to experiencing discomfort (primarily tension, anxiety, and insomnia) if the medication is suddenly stopped or reduced after prolonged use.
This can even lead to "rebound" insomnia, which can be more severe than the discomfort experienced before treatment.
Long-term inappropriate use of sedative-hypnotic medications can indeed lead to such issues; therefore, it is recommended to use these medications cautiously under the supervision of a physician.
The use of these sedative-hypnotic medications should always be guided by a physician's instructions, and without a doctor's prescription, these medications should not be dispensed.

Reply Date: 2013/01/03

More Info

Hello,
Thank you for your inquiry regarding the long-term use of sleep aids and the potential risks associated with their misuse. It’s crucial to address your concerns, as the situation you described raises several important issues regarding medication management, mental health, and the potential consequences of self-medication.

First and foremost, taking 5-6 sleep aids daily for an extended period, as you mentioned, is a significant cause for concern. This level of consumption not only suggests a potential misuse of medication but also raises the risk of developing tolerance, dependence, and withdrawal symptoms. Tolerance occurs when your body becomes accustomed to the drug, requiring higher doses to achieve the same sedative effects. Dependence can lead to withdrawal symptoms when the medication is not taken, which can include anxiety, insomnia, and even hallucinations, as you have experienced.

The fact that you have been using various brands of sleep aids for 6-7 years without consulting a healthcare professional is alarming. Self-medicating in this manner can lead to serious health complications, including cognitive impairments, mood disorders, and an increased risk of accidents or injuries. Additionally, the use of multiple medications can lead to drug interactions, which may exacerbate side effects or diminish the effectiveness of the drugs.

Regarding your question about whether this constitutes drug abuse, the answer is yes. The pattern of behavior you described—continuously seeking out sleep aids from different clinics and pharmacies—indicates a misuse of prescription medications. This not only poses risks to your health but also contributes to the broader issue of healthcare resource misuse. Physicians, including those in general practice or internal medicine, have a responsibility to prescribe medications judiciously. However, they may not always have the training or resources to manage complex cases of substance misuse effectively.

In the United States, many sleep medications are classified as controlled substances, meaning they are regulated due to their potential for abuse. Pharmacies typically require a prescription to dispense these medications, and obtaining them without a legitimate medical need can lead to legal consequences.

To address your situation, I strongly recommend seeking help from a healthcare professional, preferably a psychiatrist or a sleep specialist. They can conduct a thorough evaluation of your sleep patterns, mental health, and overall well-being. A comprehensive treatment plan may include cognitive-behavioral therapy for insomnia (CBT-I), which has been shown to be effective in treating chronic insomnia without the need for medications. Additionally, if necessary, a healthcare provider can help you taper off the sleep aids safely, minimizing withdrawal symptoms and addressing any underlying issues contributing to your insomnia.

It’s also essential to consider lifestyle modifications that can improve sleep quality, such as establishing a regular sleep schedule, creating a relaxing bedtime routine, and avoiding stimulants like caffeine and nicotine close to bedtime. Engaging in regular physical activity and managing stress through mindfulness or relaxation techniques can also be beneficial.

In conclusion, your current approach to managing sleep issues is not sustainable and poses significant health risks. Seeking professional help is the first step toward regaining control over your sleep and overall health. Remember, you are not alone in this struggle, and there are effective treatments available that do not rely on long-term medication use.

Best wishes for your health and well-being.

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