Understanding the Z-Drug Category – The Non-Benzos

Benzodiazepines – often called “benzos” – are a class of psychoactive drugs including Valium, that are commonly prescribed for conditions such as anxiety, muscle spasms, seizures, or insomnia. Non-benzodiazepines are a class of psychoactive drugs that react similarly to benzos, and are often prescribed for the same reasons. While both offer similar effects in terms of treating particular conditions, the two differ in the way they are chemically composed. Being two completely different chemical structures, benzos and non-benzos are completely unrelated on a molecular level.

What are Non-benzodiazepines?

Probably the most common in this class of prescription drugs is the sleep aid, Zolpidem, which is better known as Ambien. Additional non-benzos commonly prescribed in the United States are eszopiclone (Lunesta), zaleplon (Sonata) and variations on Zolpidem like Zolpidem Tartrate (Intermezzo sublingual).

While often found in pill form, some non-benzos – or Z-Drugs – are administered via oral spray, as is the case with some prescription Zolpidem cases.

The Side Effects of Z-Drugs

While typically thought of as safe, non-benzos typically carry the same risk of side effects as benzodiazepines. Commonly, side-effects are quite mild such as abdominal or stomach pain, skin rash or irritation, dizziness, lightheadedness or fainting, and sometimes even confusion or clumsiness.

Occasionally present side effects, although rare, are changes in appetite, bloody or cloudy urine, blurred vision, daytime drowsiness, constipation, nausea, swollen joints, trouble focusing, vision changes, memory problems or mood swings. The latter of these two sets of side effects are said to affect less than 8-percent of all users.

Health Risks Associated With Long-Term Use

While health risks vary depending on dosage, frequency, and metabolism of the user, there are certain long-term effects of non-benzodiazepine use that have proven to be rather consistent. For example, those with liver disease or the elderly commonly experience a problem known as drug accumulation where the active ingredients of drugs such as Ambien build up in their system over time. This leads to problems metabolizing the drug which can cause additional kidney or liver conditions.

Additionally, non-benzodiazepines have been shown to increase the risk of depression by more than double. Studies show that long-term users of sedative-hypnotics, such as z-drugs, have a decidedly higher rate of suicide, and increased mortality risk overall.

It is important to also note the risk of dependence and the effects of withdrawal. Non-benzos, just like benzodiazepines aren’t intended for long-term usage in most cases. As such, if you are prescribed non-benzos for periods exceeding 90 days, it’s important to both take the drug as prescribed (to lower the risk of addiction) and avoid abrupt discontinuations in usage. Doctors and healthcare professionals typically site acute withdrawal reactions (which are remarkably similar to benzo withdrawals) and rebound withdrawal effects which simply mean the rapid return of the condition the drug was used to treat in the first place. Ceasing use of non-benzos often bring about the re-emergence of symptoms that were absent or reduced by using the drug if there isn’t a period of stepped down usage – or weaning.

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Mike McInnes                   Zach Lindley