For someone who shifts from one side of the bed to the other, tries dozens of hacks for getting a good quality sleep at night that all go in vain will find a sleeping pill no less than a magic pill. Although sleeping pills are a temporary solution to insomnia, for a sleep-deprived person the effect of a sleeping pill is life-changing and there is a greater chance that he might continue taking the drug for longer than the prescribed time and in increased doses which leads to dependency and addiction.

More than one-third of the people in the UK struggle with bouts of insomnia and it is worrisome because this reflects the rate of sleeping pills consumption among the masses, since most of these people turn to medication for treating their insomnia. It is news to no one that these sleeping pills have the potential for abuse if they are misused and not taken as prescribed by the doctor.

Sleeping pills are classed as ‘sedative hypnotics’ and include benzodiazepines, non-benzodiazepines (Z-drugs), and Melatonin (Circadin) among others. In an analysis done by Public Health England (PHE) in 2017-18, the Z-drugs which include Zopiclone and Zolpidem had a prescription rate of 2% with 1 million medicines dispensed. Due to the potential for addiction witnessed with the use of Z-drugs the sales of these prescription-only sleeping pills are strictly regulated. Unfortunately, these medications are available illegally on the streets, sourced through the black market and an upsetting trend of their misuse is on the rise.

Zopiclone is a non-benzodiazepine sleeping pill also known as a Z-drug. Zopiclone is available in the market with the brand name Zimovane and Imovane among others. It is used for short-term treatment of insomnia and helps in improving the quality of sleep such that the person would not have breaks in their sleep which is a frequent complaint of people dealing with insomnia.

Read Also: Flucloxacillin and Alcohol

Zopiclone maintains a deep sleep, owing to its sedative property and tranquilizing effect. However, due to the increased use of Zopiclone as a recreational drug and the risk of addiction and abuse, this drug is labeled as a class C control drug which means it will be available only after a doctor’s prescription and not as an over-the-counter medicine.

Zopiclone is similar to a benzodiazepine in its function but the two are not related structurally. Zopiclone interferes with the signaling in the brain by acting through the GABA neurotransmitter which is known for its inhibitory effect on the brain’s activity. Zopiclone is known to increase the activity of GABA thus producing a calming effect and enabling the person to sleep. In addition, Zopiclone is also known to produce a feeling of euphoria and tranquility by acting on the dopamine and serotonin receptors similar to benzodiazepine which are involved in the brain’s reward system. The latter effect is the reason people abuse Zopiclone- to achieve a high and to enter a state of tranquility.

Dosage and use of Zopiclone (Zimovane)

Zopiclone is a white to light yellow crystalline solid available as a tablet in the market. For some people who have difficulty swallowing a tablet, an oral preparation of the drug can be ordered.

Zimovane comes in two strengths that are 3.75mg and 7.5mg tablets. You are required to take a tablet of 7.5mg strength once a day. Zimovane should be taken one hour before going to bed and you should not indulge in any other activity after taking the drug. The reason being that, people are reported to be sleep-walking, talking, and cooking after taking Zimovane and they do not remember any of it once the effect of the drug is over. So there is a risk of causing harm to oneself and others, unintentionally under sedation caused by Zopiclone and hence care should be taken that you should have an uninterrupted sleep of 7 to 8 hours after taking the drug.

A lower dose of 3.75mg is administered in the geriatric population and those who have kidney or liver problems. Taking a lower dose tends to reduce drowsiness and the risk of side effects attributed to Zopiclone.

You should take the tablet as a whole with water and do not crush or chew the medicine. You are advised to not take Zopiclone regularly rather you should take it every alternate day to mitigate the risk of dependence. Also, note that this drug can be used only for 2 to 4 weeks as a short-term treatment of insomnia and long-term use should be avoided as it increases the risk of Zopiclone addiction.

After oral administration, Zopiclone goes into the gut and has 80% bioavailability. It distributes throughout the body and also goes to the brain. It takes an hour for Zopiclone to work in the brain as it boosts the effect of GABA and helps a person attain a night of deep sleep. The drug is metabolized in the liver and half of it is removed through the lungs and the remaining one-third is removed through the kidneys. 

Pregabalin(Lyrica) Addiction and Side Effects in the UK

According to WHO, Zopiclone is more suitable for maintaining a complete night’s sleep rather than sleep induction. Therefore, you should not do activities that might interfere with the action of Zopiclone such as drinking alcohol or taking other central nervous system depressants as this will exacerbate the sedative effect of Zopiclone.

Zopiclone has the following side effects:

  • Metallic taste- people often complain about a bitter, metallic taste in the mouth after consuming zopiclone. It is suggested that you drink plenty of water and use mouthwash or sugar-free gums to mitigate this effect
  • Feeling sleepy or drowsy- since Zimovane is a sedative, it acts by making a person feel sleepy even after 8 hours of sleep. It is advised not to drive or use heavy machinery even 12 hours after you have taken the drug to reduce the risk of accidents
  • Amnesia- Loss of memory is a frequent complaint in people who use Zimovane due to clouding of the brain and inability to grasp new information
  • Hallucination- people start seeing things that are not there. This is because the drug interferes with the signaling in the brain creating a bizarre effect on the thought process
  • Delusion- although less frequent but people start having false beliefs 
  • Falls- if you are elderly there is a higher chance that you may receive fractures due to falling over since this drug makes you drowsy and results in loss of balance and coordination thus increasing the incidence of tripping over
  • Loss of coordination- you may sway and stagger and have an unstable gait due to loss of balance and coordination

If any of these side effects worsen such that they negatively affect your normal routine, consult a doctor and he may prescribe you another sleeping pill that has less potential of side effects.

Initially, zopiclone was considered as a non-addictive hypnotic with minimal potential for abuse, however, over the past couple of decades, there has been a rise in the cases of Zopiclone misuse and addiction that has led to a change in medical opinion. Consequently, Zopiclone is labeled as a class C controlled substance by the authorities in the UK making it available only on prescription. Nevertheless, recreational use of Zopiclone has been observed as people use illicit means to obtain the drug. 

Related: Dual Diagnosis Treatment and Luxury Rehab UK

Researches have concluded that Zopiclone is not addictive when used in the recommended doses to treat insomnia for a short duration of time, as prescribed by the doctor. However, if people prolong the use of Zopiclone, which is taking longer than 2 to 4 weeks and more than once a day it will slowly lead to the development of tolerance and then dependence. Tolerance means that you will have to take a greater dose of the drug to maintain the required therapeutic or recreational effect. Once tolerance has developed, dependence follows where the body fails to function normally and the person experience withdrawal effects if he does not take the drug. 

Soon the person becomes addicted to Zopiclone owing to its sedative effect and euphoric property some people use it to get high as it interferes with the reward system in the brain. As a result, people who become addicted to Zopiclone may use all possible means to obtain Zopiclone which may include going to a pharmacy for getting drug supplies or using the street form of the drug which has even more deleterious consequences.

However, the potential for addiction is based on certain factors. Firstly, if a person has a prior history of drug abuse then the chances of abuse with Zimovane are higher since the person will be tolerant to the drug and will take increased doses. Secondly, a person being treated for a psychological ailment will have a greater risk of developing dependency, resulting in addiction.

If any signs of addiction or dependence develop it is suggested to talk to your doctor and stop using the medication after discussing with your healthcare provider.

Zopiclone addiction has been on the rise in the UK. According to the Prescribed Medicines Review conducted by Public Health England, 100,000 patients were found to be receiving a continuous repeat prescription for a Z-drug from 2015 to 2018 in England. Addiction to any drug, may it be Zopiclone has the potential for overdose and death and Statistica reveals that deaths due to intoxication and overdose of Zopiclone have increased from 1994 to 2019 with 140 death reported in 2019 in England and Wales.

One of the reasons for addiction is the continued use of medicine in the elderly mostly, to treat insomnia but in the younger age group, the reason for increased use is mainly for recreational purposes. People often combine Zopiclone with alcohol and other street drugs to exacerbate the euphoric effect and for a greater punch of ecstasy not realizing that this combination can be fatal. Zimovane is available through the black web and sold under the street name of ‘zimmies’ or ‘zimmers’ and is consumed for illicit means. 

Certain signs act as ‘red flags’ for addiction and abuse of Zimovane. If you or your loved one has any of these findings then chances are that you are at a stage of drug addiction and need care and an effective withdrawal program. The signs and symptoms of Zimovane abuse are as follows:

  • Taking more doses of Zopiclone than recommended by the doctor and more frequently
  • Borrowing Zimovane tablets from someone else
  • Buying Zimovane from pharmacies and street dealers
  • Hiding the drug so that none of the family members can catch them abusing it
  • Using Zimovane long after the condition has subsided
  • Poor relationships since they are always under the ‘high’ caused by the drug and are unable to meet the requirement of relations
  • Having hampered memory and judgment since Zimovane acts by depressing the brain and they will face difficulty in remembering day to day events
  • Studies/ Work affected as the person will be too drowsy to function normally and will lag behind in all spheres of life
  • Becoming isolated and withdrawn from people
  • Losing interest in activities that earlier used to excite them
  • Experiencing withdrawal symptoms while attempting to leave the drug or when they run out of their drug supplies
  • Undertaking risky, dangerous, and illegal activity under the effect of Zimovane
  • Experiencing rebound insomnia. Although ironic, but excessive use of Zimovane results in a condition called rebound insomnia which is much more extreme than the insomnia they first took the drug for, and consequently, they continue taking the drug and this vicious cycle goes on.

You need not ignore any of these red flags you should talk to your doctor or contact the nearest detox center for a chance at a drug-free life and to improve your condition with help of medicated professionals that are ready to serve you.

Since Zopiclone is a central nervous system depressant, its overdose result in slowing down the brain’s functioning, and the manifestation of an overdose may range from drowsiness to coma based on the quantity of Zopiclone ingested.

In overdosage of Zimovane, the mild effects are those of:

  • confusion
  • drowsiness
  • lethargy and weakness

Some Signs of Zimovane overdose include:

  • Ataxia
  • Hypotonia
  • Hypotension
  • A-V block
  • Methameoglobinaemia
  • Respiratory depression
  • Coma

Management of an overdose

Activated charcoal and gastric lavage can be done within one hour of potentially life-threatening overdose. Moreover, central nervous system depression can be treated with flumazenil as it has a short half-life. Do not use flumazenil in the case of mixed overdose when Zopiclone is combined with alcohol or any other CNS depressant.

So far the fatal dose of Zopiclone is not known. However, an overdose of Zopiclone is life-threatening when combined with alcohol and other central nervous system depressants. The concomitant use of the two depressants results in potentiation of their adverse effects resulting in detrimental consequences such that it can be fatal. Since Zopiclone is known to cause respiratory distress and so is alcohol and other CNS depressants, combining the two will result in decreased oxygenation which will result in coma and death. Moreover, taking alcohol and Zopiclone before sleeping makes a person go into a deep sleep and it is difficult for them to wake up from it. 

In addition, the presence of any illness or a debilitated state of the person overdosing on Zopiclone puts them at a greater risk of developing severe consequences.

If a person attempts to stop taking Zopiclone, they will experience a plethora of symptoms during the withdrawal episode. Since their body has developed a dependency on the drug it is hard for the brain to function without it. Zopiclone increases GABA in the brain which creates a calm effect but after Zopiclone is withdrawn the GABA levels reduce and alters the brain’s functioning by increasing the rapid firing of impulses disrupting the balance and this may even present as seizures. The brain tries to adapt and function without the drug and a set of signs and symptoms ensues. 

During Zopiclone withdrawal, physical as well as psychological symptoms have to be dealt with and so professional support is best recommended as it promises optimum care and provides wonderful strategies to combat the withdrawal symptoms that can be challenging to get rid of when fighting alone.

Withdrawal symptoms of Zimovane

Usually, withdrawal symptoms present between 6 to 24 hours after your last dose and may reach a peak 2 to 7 days after that. Most cases of withdrawal symptoms subside in a couple of weeks whereas, some develop post-acute withdrawal symptoms (PAWS) that last months or years.

 Withdrawal symptoms of Zimovane may vary from person to person. These include:

  • muscle pain
  • anxiety
  • depression
  • shakes and tremors
  • rebound Insomnia
  • sweating and hot flashes
  • agitation
  • confusion
  • headache
  • palpitations
  • tachycardia
  • delirium
  • nightmares
  • hallucinations
  • panic attacks
  • nausea 
  • vomiting
  • irritability 

In extreme cases, the following symptoms are present:

  • derealisation
  • depersonalization 
  • hyperacusis (when everyday sounds seem louder than usual)
  • numbness and tingling of extremities
  • Hypersensitivity to light, noise, and physical contact
  • Seizures (in rare cases)

There are certain conditions in which you should not take Zimovane. These include:

  • myasthenia gravis
  • respiratory failure
  • severe sleep apnoea
  • severe hepatic insufficiency 
  • pediatric population
  • people with hypersensitivity to Zopiclone or any other Z-drug 

FAQS