Sleeping Pills: Suicide Attempt Requires Many

Sleeping pills are commonly used to treat insomnia and anxiety. They are available over the counter (OTC) as natural supplements or by prescription. Prescription sleeping pills are stronger than over-the-counter ones and are only meant for short-term or occasional use. Sleeping pills can be addictive and have been linked to increased mortality and suicide rates. Mixing sleeping pills with alcohol or other medications can cause breathing to stop and may result in death. While it is difficult to overdose on melatonin alone, it is possible to overdose on sleeping pills, and it can be fatal. If you or someone you know is experiencing suicidal thoughts, please seek help from a professional or call the National Suicide Prevention Hotline at 1-800-273-8255.

Suicide risk factors: insomnia, depression, addiction, and mental illness

Suicide is a complex issue that rarely stems from a single cause. Instead, it often arises from a convergence of stressors and health issues that create feelings of hopelessness and despair. While suicide has multiple risk factors, this response will focus on insomnia, depression, addiction, and mental illness.

Insomnia, or chronic sleep disruption, is strongly correlated with suicidal ideation and behaviours. Even short-term sleep disturbances can increase suicide risk. Lack of sleep can negatively impact mood and impair one's ability to think clearly and act rationally, making it harder to cope with life's stressors. Treatment of insomnia with cognitive behavioural therapy (CBT-I) has been shown to reduce suicidal thoughts.

Depression is the most common condition associated with suicide, often going undiagnosed or untreated. Substance abuse, including alcohol and drug misuse, can exacerbate depression and increase the likelihood of suicidal thoughts and actions. This is partly due to the damaging effects of addiction on relationships, which can leave individuals feeling isolated and hopeless. Additionally, substances impair cognition, further increasing suicide risk.

Addiction is itself a significant risk factor for suicide, with all categories of substance use disorders (SUDs) linked to higher suicide mortality rates. The combination of alcohol, drug, and tobacco use disorders poses the greatest risk, followed by dual alcohol and drug use disorders. The presence of a mental health disorder alongside addiction further increases suicide risk.

Mental illness is a critical risk factor for suicide. Conditions such as bipolar disorder, anorexia, schizophrenia, and opioid misuse are highly associated with suicide. Untreated mental illness can lead to self-medication with drugs or alcohol, increasing the risk of overdose and suicide.

While this response addresses specific risk factors, it is important to recognise that suicide is multifaceted and influenced by individual, relational, community, and societal factors. Connecting with others and seeking professional help are crucial protective factors against suicide.

Over-the-counter sleeping pills: antihistamines, anti-allergens, and hypnotics

While it is possible to overdose on sleeping pills, the pills currently on the market contain milder compounds that are less potent and safer. As such, an overdose on sleeping pills alone may not be fatal. However, mixing sleeping pills with other drugs or alcohol can cause one to stop breathing and may result in death.

Over-the-counter (OTC) sleeping pills include antihistamines, which are typically used to treat allergies, and hypnotics. Antihistamines can cause drowsiness by blocking histamines, the substances in the body that cause alertness. Some common ingredients in OTC antihistamines include diphenhydramine and doxylamine. While antihistamines are not addictive, the body can get used to them quickly, and they can become less effective over time. It is possible to overdose on antihistamines, so it is important to follow the product instructions or consult a doctor to determine a safe dosage.

Hypnotics are another type of sedating medication available over the counter. A 2018 overview of sedatives and hypnotics states that these medications can be effective for short-term use but may worsen insomnia if used long-term. The American Academy of Sleep Medicine advises that these medications can cause drowsiness the following day and may affect one's ability to drive or engage in activities requiring alertness. Additionally, they may cause individuals to perform actions such as driving, walking, eating, or making phone calls while asleep, a phenomenon known as sleepwalking.

While melatonin is often mentioned as a supplement to aid sleep, it is important to note that it is not a drug and is not regulated as such. Melatonin is a hormone naturally produced by the body that promotes sleep. Studies have found no evidence of a melatonin overdose, even at extremely high doses over extended periods. However, taking too much melatonin may cause side effects, and the dangers of misusing sleeping pills can begin long before an overdose occurs.

Prescription sleeping pills: Ambien, Lunesta, Sonata, and benzodiazepines

It is important to note that overdose toxicity with Z-drugs like Ambien, Lunesta, and Sonata is possible, and that fatal overdose may be more likely when combined with other substances that slow a person's breathing, such as opioids or other central nervous system (CNS) depressants. These CNS depressants include alcohol and benzodiazepines.

Ambien (also known as Zolpidem, Edluar, Zolpimist, and Intermezzos) is typically taken at a 10mg dose. At 600 mg, a user is entering overdose territory, and serious damage is likely. Death is reported at doses higher than 2,000 mg, but a lethal dose may still occur at lower amounts. Ambien is considered a controlled substance, which means it has a potential risk for dependence and misuse.

Lunesta (Eszopiclone) overdose can happen at approximately 90 times the intended dose, requiring upwards of 270 mg of the drug. Fatal overdoses typically only occur when mixed with depressants like benzodiazepines or alcohol. Lunesta has been found to last longer than Ambien or Sonata, and it is recommended that users get at least 7 to 8 hours of sleep before taking it.

Sonata (Zaleplon) generally requires around 200 mg for an overdose. It has an onset of within 30 minutes and lasts for four hours. Sonata is also a controlled substance with a potential risk for dependence and misuse.

Benzodiazepines are prescription medications sometimes used to treat sleep issues and can act quickly. While a benzodiazepine overdose is rarely fatal on its own, it can be deadly when mixed with other substances like opioids.

If you or someone you know is experiencing suicidal thoughts or tendencies, please seek help immediately. You can call the National Suicide Prevention Hotline at 1-800-273-8255.

Side effects of overdose: lethargy, drunk-like behaviour, and breathing issues

While it is possible to overdose on sleeping pills, modern formulas are milder, safer, and less potent, making them a less effective method for suicide. However, they are not entirely safe, and high doses can still be fatal.

The side effects of overdose include lethargy, drunk-like behaviour, and breathing issues. People who regularly take sleeping pills should be able to differentiate typical sleepiness from excessive lethargy, which may indicate an overdose. Drunk-like behaviour, such as clumsiness, is another potential sign of overdose. Additionally, slow or dysfunctional breathing may indicate an overdose, and medical attention should be sought immediately if the victim appears to be gasping for air or loses consciousness.

Mixing sleeping pills with other substances, such as alcohol or opioids, can be particularly dangerous and increase the risk of overdose. Alcohol and opioids suppress areas of the brain that control vital functions like breathing, heart rate, and temperature control. Combining sleeping pills with these substances can intensify their individual effects, leading to a potentially fatal overdose.

It is important to seek help if you or someone you know is experiencing suicidal thoughts or tendencies. Resources such as the National Suicide Prevention Hotline are available to provide support and assistance.

Seeking help: suicide hotlines, rehab centres, and outpatient treatment

It is important to recognise that suicide is a complex issue influenced by various factors and mental health conditions. If you or someone you know is experiencing suicidal thoughts, it is crucial to seek professional help immediately.

Suicide Hotlines

Suicide hotlines, also known as crisis lines, provide immediate support, crisis counselling, and emotional assistance free of charge. These services are typically available 24/7 via phone, text, or online chat, ensuring accessibility and confidentiality. Hotlines offer a judgement-free space to discuss difficult emotions and experiences, providing a sense of connection and support. They can also help individuals navigate additional resources for ongoing assistance. Research indicates that individuals feel less distressed after reaching out to helplines, highlighting their effectiveness in mitigating emotional distress.

In the United States, individuals can access the National Suicide Prevention Hotline by calling 1-800-273-8255 or 988 for the Suicide & Crisis Lifeline.

Rehab Centres

Rehab centres, also known as treatment centres, offer specialised care for individuals struggling with suicidal ideation. These facilities provide a range of treatment options, including inpatient and outpatient programmes. Inpatient programmes typically involve a short-term stay at the facility, allowing for intensive therapy, crisis stabilisation, and safety-focused care plans. Outpatient programmes offer more flexibility, with individuals attending sessions 1-5 times per week while residing at home. Rehab centres often utilise evidence-based therapies, such as CBT and DBT, to address underlying mental health conditions and provide individuals with tools for managing their symptoms.

Some notable rehab centres in the United States include Harmony Hills in Florida and Harmony Ridge Recovery Center in West Virginia. These centres offer holistic, evidence-based approaches to suicide prevention, addressing issues such as trauma, PTSD, and co-occurring mental health disorders.

Outpatient Treatment

Outpatient treatment is a form of ongoing care that individuals typically engage in after completing a residential programme at a rehab centre. This form of treatment allows individuals to continue their recovery journey while reintegrating into their daily lives. Outpatient programmes may involve individual therapy sessions, group therapy, and educational workshops. They also often provide personalised aftercare plans to ensure ongoing support and relapse prevention. Outpatient treatment can be tailored to specific age groups, such as teens aged 12-18, addressing underlying causes like trauma, depression, and anxiety.

It is important to note that rehab centres and outpatient treatment programmes typically accept insurance to help cover the cost of treatment.

If you or someone you know is struggling with suicidal thoughts or tendencies, it is vital to seek help immediately. In addition to the hotlines mentioned above, individuals can reach out to health centres, behavioural health treatment facilities, or their personal doctor to discuss treatment options and begin the journey towards healing.

Frequently asked questions