Abstract Hypnotics (sleeping pills) are prescribed widely, but the economic costs of the harm they have caused have been largely unrecognized. Randomized clinical trials have observed that hypnotics increase the incidence of infections. Likewise, hypnotics increase the incidence of major depression and cause emergency admissions for overdoses and deaths. Epidemiologically, hypnotic use is associated with cancer, falls, automobile accidents, and markedly increased overall mortality. This article considers the costs to hospitals and healthcare payers of hypnotic-induced infections and other severe consequences of hypnotic use. These are a probable cause of excessive hospital admissions, prolonged lengths of stay at increased costs, and increased readmissions. Accurate information is scanty, for in-hospital hypnotic benefits and risks have scarcely been studied — certainly not the economic costs of inpatient adverse effects. Healthcare costs of outpatient adverse effects likewise need evaluation. In one example, use of hypnotics among depressed patients was strongly associated with higher healthcare costs and more short-term disability. A best estimate is that U.S. costs of hypnotic harms to healthcare systems are on the order of $55 billion, but conceivably might be as low as $10 billion or as high as $100 billion. More research is needed to more accurately assess unnecessary and excessive hypnotics costs to providers and insurers, as well as financial and health damages to the patients themselves.
Daniel F. Kripke, M.D. is a licensed physician certified by the American Board of Psychiatry and Neurology and an Emeritus Professor of Psychiatry at the University of California, San Diego. He also has done research with the Scripps Clinic Viterbi Family Sleep Center. Dr. Kripke was elected a Fellow of the American Psychiatric Association, co-authored hundreds of medical articles and has given invited lectures in 18 countries. In 1973, Dr. Kripke established one of the first sleep clinics in the United States. He treated patients with sleep disorders until retirement from his clinical practice at age 70. Dr. Kripke continues to be active as a researcher and as an advocate for raising awareness of the dangers associated with sleeping pills, particularly hypnotic drugs.
Dr. Kripke’s research has shown that hypnotic drugs, especially certain benzodiazepines and Z drugs with similar actions on the brain, have the potential to cause infection, depression, and are associated with increased risk of death and cancer. Dr. Kripke’s desire in joining Benzodiazepine Information Coalition is to inform the public about the grave risks of these drugs.