Zolpidem: a masked hero. A reply to ZORRO study
Abstract
The use of zolpidem has been driven by the still-widespread false belief
among doctors that, since zolpidem is chemically not a benzodiazepine,
it cannot lead to addiction and tolerance. We would like to contribute
to better highlight certain characteristics of zolpidem and its
potential as a substance of abuse due to the fact that our operating
unit, which is entirely dedicated to medication abuse, has described
among the most numerous cases of addiction to high doses of
benzodiazepines and related hypnotics. - Zolpidem was in fourth place
among the 29 molecules present on the Italian market; - We believe it’s
now time to drop the term “Z-drugs”: zolpidem, zopiclone e zaneplon
all have different chemical structures, they bind to different receptors
and have completely different abuse potentials3. In our case history,
both zopiclon and zaneplon were virtually absent, albeit being commonly
used in Italy; - Istvan & colleagues highlight the fact that addiciton
and abuse are prevalent in samples suffering from mental illness. In our
case history this hasn’t been confirmed: about half of our patients had
no history of psychiatric illnesses, nor a history of addiction to
illicit substances or alcohol; - Lastly, regarding zolpidem’s
hazardousness, we would like to report the fact that the drug was
significantly preferred by addicts with a positive ADHD test result. In
conclusion, the 2000s saw solid confirmation of the effectiveness of
partial agonists in the treatment of some common addictions, such as
buprenorphine, varenicline, cytisine. This didn’t happen for BZs