Lunesta Addiction and Withdrawal
Lunesta, one of the brand names of eszopiclone, is commonly prescribed to treat insomnia.1 However, it should be noted that, in general, behavioral therapy is the mainstay of treatment for chronic insomnia and pharmacologic interventions should be considered only if necessary.2
Eszopiclone is one of three non-benzodiazepine prescription sedatives, along with zaleplon (Sonata) and zolpidem (Ambien), collectively referred to as “z-drugs.” Lunesta and the other z- are generally discouraged for older adults (due to risk of injury) and patients with untreated sleep apnea (due to risk of respiratory depression).3
Read on to understand how Lunesta works; its potential side effects and risks, including complex sleep behaviors; its addictive potential; and signs and symptoms of sedative addiction, withdrawal, and overdose. Additionally, learn about the treatment options should you or someone you love struggle with Lunesta, sedative, or other prescription drug misuse.
What is Lunesta?
Lunesta belongs to a class of drugs known as sedative-hypnotics and works as a central nervous system (CNS) depressant.1,4 Similar to other sedative-hypnotics such as benzodiazepines, Lunesta falls under Schedule IV of the Controlled Substances Act, meaning it has a currently accepted medical use in the United States and may lead to limited physiological dependence relative to the drugs or substances in Schedule III.1,4
Risk of misuse and dependence of z-drugs like Lunesta as well as benzodiazepines increases with higher doses, longer duration of treatment, and the concomitant use of other psychoactive drugs.1,5 This risk is also higher in patients with a history of alcohol or drug misuse or a history of other mental disorders.5
Lunesta Side Effects
Lunesta and other z-drugs were originally promoted as being far safer and less addictive than other sedative-hypnotics used to treat insomnia. However, reports of dangerous effects, such as complex sleep behaviors, caused the U.S. Food and Drug Administration (FDA) to put a boxed warning on Lunesta in 2019. It states that all z-drugs can cause complex sleep behaviors and carry a risk—though slight—of serious injury and death. The FDA also added a contraindication for complex sleep behaviors, which means an individual should report these behaviors to their doctor because anyone who has experienced a complex sleep behavior should not take the drug.3
Even prior to the boxed warning (the most prominent warning), the FDA decreased the recommended starting dose of Lunesta and added a warning that Lunesta can cause next-day impairment of driving and other activities that require alertness in 2014.6
The side effects of Lunesta may occur from prescription use and misuse. Side effects range from mild symptoms like dry mouth and drowsiness to more severe effects, including hallucinations and suicidal thoughts.1 An individual who misuses Lunesta may experience side effects in greater severity, particularly if using it at higher doses.
The most common side effects of Lunesta include:1
- Bad taste or dry mouth.
- Cold-like symptoms.
- Lingering drowsiness or impairment the next day.
More serious side effects may include:1
- Behaving or thinking in a strange manner.
- Feeling agitated.
- Being confused.
- Experiencing memory loss.
- Feeling anxious.
- Experiencing hallucinations.
- Worsening depression.
- Having suicidal thoughts.
The most concerning side effects include the risk of performing complex behaviors while sleeping. Individuals report driving, walking, cooking, or taking other medications—and don’t remember these events when they wake—all of which could lead to serious injury or death.3
Lunesta Misuse Statistics
The National Survey on Drug Use and Health gathers data on substance misuse in the United States. While the survey doesn’t compile robust data specifically for Lunesta, the 2020 findings for the use of prescription tranquilizers and sedatives, including eszopiclone (Lunesta) provide the following information:7,8
- An estimated 226,000 individuals aged 12-17 misused prescription tranquilizers or sedatives in the past year.
- The number increases for young adults. About 1.2 million Americans aged 18-25 misused prescription tranquilizers or sedatives in the same period.
- Approximately 4.7 million people aged 26 or older misused prescription tranquilizers or sedatives in 2020.
- An estimated 54,000 individuals misused eszopiclone, specifically, in the past year.
Is Lunesta Addictive?
Treatment admission data suggests that Lunesta alone is not likely to result in addiction requiring treatment. Individuals do not enter substance use treatment as a result of Lunesta misuse.9 But that doesn’t mean Lunesta is not misused, and studies suggest it is generally misused in conjunction with other substances.
For instance, there are reports of those who misuse alcohol co-ingesting eszopiclone to boost feelings of euphoria.10 Additionaly, research strongly associates the misuse of eszopiclone, as well as other z-drugs and benzodiazepines, with misuse of prescription opioids.11 And eszopiclone at doses of 6 and 12 mg have also been reported to produce euphoria effects similar to those of diazepam 20 mg in individuals with a sedative use disorder, the clinical term for a sedative addiction.12 Individuals who use or misuse cocaine or amphetamine may also use Lunesta or other sleep aids to “come down” from the high or to self-manage or relieve withdrawal symptoms.13 Furthermore, using Lunesta and other z-drugs in combination with alcohol, opioids, or other CNS depressants like benzodiazepines increases a person’s risk of adverse effects and a potentially life-threatening overdose.14
Symptoms of Sedative Use Disorder
According to Lunesta’s FDA-approved labeling, Lunesta may not be a good sleep aid option for individuals who have a history of drug misuse or addiction since individuals with a substance use disorder may be at an increased risk of also misusing Lunesta.1 While individuals generally don’t become addicted to Lunesta, misuse of the drug may be part of a polysubstance use problem.
Only a healthcare professional can diagnose a sedative use disorder, but knowing the criteria used to diagnose addiction can be helpful in assessing your own substance use or that of a loved one. These criteria, outlined in the Diagnostic and Statistical Manual of Mental Disorders (5th edition), include:13
- Taking higher doses of a sedative or using it for a longer period than originally intended.
- Wanting or repeatedly trying to cut back or manage your use of a sedative, without success.
- Continuing to take the sedative even after knowing that it has caused or worsened a physical or mental health issue.
- Spending a lot of time getting, taking, or recovering from sedative use.
- Craving the sedative.
- An inability to complete important tasks at home, school, or work due to sedative use.
- Experiencing ongoing relationship or social problems because of sedative use.
- Quitting favorite hobbies or activities due to sedative use.
- Using the sedative in dangerous situations, such as while driving a vehicle.
- Developing a tolerance, meaning a higher dose of the sedative is needed to achieve the same desired effect.
- Experiencing withdrawal symptoms when trying to reduce or stop taking the sedative.
If you recognize any of these signs in yourself or someone you love, it might be time to seek treatment.
Unlike other sedative-hypnotic medications like benzodiazepines and barbiturates, which may produce withdrawal symptoms such as seizures or hallucinations when the substance is abruptly stopped, Lunesta generally does not produce withdrawal symptoms upon discontinuation of the drug when it is taken at therapeutic doses.5
In clinical trials, only 2% (or less) of participants reported experiencing anxiety, abnormal dreams, nausea, and upset stomach within 48 hours of their last dose of Lunesta.1
However, withdrawal symptoms may present themselves if you’ve been using Lunesta in combination with other substances, particularly other CNS depressants.11 Suddenly stopping alcohol or benzodiazepine use, for instance, can produce very unpleasant, even dangerous, withdrawal symptoms.17 Consult your doctor or addiction healthcare professional if you’re ready to get help for polysubstance use or misuse.
While Lunesta overdose is possible, it’s uncommon.1 A Lunesta overdose—without the influence of other medications or drugs—typically presents as oversedation and is not fatal.14 Drug overdose is much more likely and dangerous if Lunesta is combined with other CNS depressants, including alcohol and benzodiazepines.1,14 Symptoms of a CNS depressant overdose can include:1,14,18
- Excessive sleepiness.
- Slowed or stopped breathing.
Lunesta and other z-drugs can also contribute to overdose in people who take opioids therapeutically or who misuse opioids.11
If you or a loved one struggle with polysubstance or substance misuse or addiction, treatment options are available. Health insurance generally covers at least a portion of the cost of treatment. However, coverage specifics vary widely depending on your individual plan, so contact your insurance provider or call AAC before enrolling to better understand your coverage.
Effective treatment should be tailored to meet your unique needs and may include:19-21
Detox. Medically managed detox allows you to clear the substances from your system in a safe and supervised environment, while staff monitors and manages potential symptoms and complications of withdrawal, especially those associated with polysubstance misuse. Detoxification is often a first step in a more comprehensive treatment plan since detox alone is typically not enough to support lasting recovery.
Inpatient treatment. Inpatient or residential programs require you to stay at the facility for the duration of treatment. There, you may participate in individual and group counseling, behavioral therapies, education, and more.
Outpatient services. Outpatient care may look similar—even identical—to inpatient treatment. However, while counseling, therapy sessions, and other appointments take place at specific times at the facility, you return home or to a sober living facility at the end of treatment each day.
Treatment can help you identify the thoughts, emotions, and behaviors that led to substance misuse in the first place and teach you strategies to help you manage stressors and avoid relapse so that you can recover and live a healthy, substance-free life.