What is zopiclone?
Zopiclone is a drug with very similar effects to benzodiazepines (like diazepam, temazepam). It is pre-
scribed by doctors for the treatment of insomnia (difficulty sleeping), and in the recommended dose brings
on sleep for periods of 6 to 8 hours. However, this leaflet is about the use of zopiclone as a ‘street drug'
and the risks and likely problems this may cause for drug users.
"You can't really worry about your problems
when your brain has been zimmied into neutral"
Zopiclone and Z-drugs
Doctor, I'm having trouble sleeping!
Zopiclone is prescribed in tablet form, either as Doctors are beginning to wise up to the fact that zopiclone or under the brand name Zimovane, zopiclone is being blagged off them and used as a which along with zolpidem (brand name Stilnoct) street drug, so are becoming more cautious about and zaleplon (brand name Sonata), are known as ‘Z prescribing them to known or suspected drug users. drugs' – that is, sleeping pills which begin with the Tablets sold on the street go for about £1 each, letter 'z'. Zopiclone tablets go by the street names although the price comes down if bought in bulk and of ‘zimmers' or ‘zimmies' and in some parts of the goes up when there is a drought on. country ‘zim-zims'. As they have similar ‘benzo-like' effects, it is likely that other z-drugs are also Legal status
sold as ‘zimmers' - the main way of distinguishing Zopiclone is not classified under the Misuse of between street bought Z-drugs is that zaleplon (So- Drugs Act, and so is legal to possess or use without nata) is a capsule and zopiclone leaves a distinctive a prescription. However, zopiclone is a prescription metallic taste in the mouth (see page 5).
only medicine (POM) under the 1968 Medicines Act, and so supply is legally restricted to doctors (pre- Why do drug users use zopiclone?
scribing) and pharmacists (dispensing). Zolpidem Some regular heroin users start out using zopiclone (Stilnoct) is the only ‘Z-drug' covered by the Misuse to get the old ‘monging out' effect when the qual- of Drugs Act - it was made a Class C drug in 2003.
ity of the local heroin is poor. Crack users find zopiclone helps them sleep or takes the ‘edge' off the come-down, while other people use it to get off their face and forget about their problems. Appearance
Zopiclone tablets are produced by at least half a dozen different companies in the UK. Zimovane is the
original UK brand name, but there many other brand names used in other countries. The tablets are usually
film-coated and come in two main doses: 7.5 mg and 3.75 mg. The tablets can be round or oval and although
usually white, but can be blue, orange or various other colours (for imported tablets). They can be marked
with the 7.5mg or 3.75mg dose and can have the letter Z or other letters on them. Some drug users have
bought tablets thought to contain higher doses, which may have been either legally manufactured in another
country or are fakes.
Physical effects and risks
"Trying to sit down can take a zimmer user half an hour – it has to
be seen to be believed, if it wasn't so sad it would be funny"
semi-conscious state. Regular users say the metal ic Not surprisingly, given that it is a sleeping pil , taste becomes less intense over time, although some zopiclone gives you a heavy feeling in the arms and say that strong memories of this taste come back to legs, and makes you want to close your eyes and fall them when they have run out of zopiclone and are asleep. But experienced users often try to resist the urge to ‘fall over and snooze', because once this has passed (after an hour or so) they can experience the Other physical effects
desired effects of sedation and euphoria (‘monged Some long-term heavy users may eventually find out and buzzing'). Being on ‘zimmers' in public places that they experience stimulant-type effects from the increases your vulnerability to street predators (mug- drug too – including constantly talking, fidgeting, gers, rapists, etc) – far more so than the effects of lack of appetite, and sleep disturbances. Vomiting heroin or crack. That's why most users stay at home and constipation/diarrhoea can occur when using, when getting ‘off it' on zopiclone. It causes a loss of while some people report experiencing hangover-like coordination (staggering, swaying, stumbling, etc. ) symptoms (e.g. headaches) when ‘coming down' and very slowed-down behaviour. It can take a great from zopiclone use.
effort to carry out even the simplest actions. Cancer and other physical problems
Metal mouth
Research has shown that, even at recommended Zopiclone causes an unpleasant metal ic after-taste doses, prolonged use of zopiclone may cause cancer in the mouth (dysgeusia), which is experienced by (affecting brain, lung, bowel, breast and bladder). most users within an hour or so of swal owing the Zopiclone can also have an adverse effect on the tablet(s). Although people using the drug to aid sleep immune system (increasing rates of colds and generally do not experience this taste until after infections), and is not recommended for people with they wake up, people who stay awake after using liver or kidney disease, pregnant or breast-feeding zopiclone experience the metal ic taste during this women, or children.
Mental effects and risks
get over-confident, with the worst cases becoming Zopiclone helps you sleep, though users who deluded that they are more-or-less invisible – perhaps manage to stay awake on it can feel drowsy and reflecting their shrunken sense of self-awareness. calm. Zopiclone can ‘turn down' the intensity of your Combined with fuzzy thinking and minimal memory, this emotions, and this makes it desirable to people trying can lead users into unplanned risky activities, believing to escape from unpleasant feelings and memories that they won't get caught – like shoplifting in a store – although zopiclone can also block or lessen good from which they are banned.
feelings as well as bad ones.
"I necked a handful of zimmers, then a few hours later "Eventually, it makes you lose all your feelings, I came round in my flat to find myself surrounded by it makes you feel totally numb" leather jackets – but I had no memory of how they had This can include sexual feelings, which users say are come to be there". almost totally eradicated when under the influence of zopiclone. Aggressive and violent behaviour
Zopiclone misuse may increase aggression and
"A girl could strip naked in front of you, and you would violence - among women as wel as men – and some not want sex with her, you have no strength or energy users become insensitive to pain. Heroin and crack for sex, and no interest in it - or anything at all really".
users who usual y fund their habits by doing crimes like shoplifting and credit card fraud often say that Amnesia and invisibility
periods of zopiclone use led them into carrying out Zopiclone users often say that one of the worst more violent crimes like ‘mugging' – with some things about using the drug is the inability to think admitting to outbursts of random violence. Also, rationally or clearly; along with memory problems when waking up from the deep slumber which ended (e.g. ‘constantly forgetting what you were saying'); zopiclone sessions, users commonly had no memory of and partial or total amnesia. Some people report their violent actions (amnesia).
hiding things (like drugs or money) when ‘wrecked on zimmers' and then having no memory of where "I often forgot about violent behaviour until friends they had hidden them once the drug has worn off. with wounds and bruises reminded me later on what I Like heavy users of temazepam, zopiclone users can had done to them".
Overdose and death
"The risk of overdosing on zopiclone increases when: higher doses
are used; when it is injected and when it is mixed with other drugs"
of tablets generally taken in a session by drug users About 40 to 50 British people die each year due can range from three (about 20 mg) for new users up to poisoning by either zopiclone or zolpidem – to 20 (150 mg) for regular users – with some long- though other drugs are usually involved. The risk term users taking even higher doses. of overdose on zopiclone increases (a) with higher The higher the dose you use, the greater the risk of doses, (b) when it is injected rather than swallowed, overdose and death.
and (c) when it is mixed with depressant drugs like alcohol, sedatives (tranquil isers and sleeping pil s), Injecting zopiclone
or opioids (notably heroin or methadone).
All prescribed users swallow zopiclone tablets, as do most ‘street' users. Sniffing or smoking zopiclone Higher doses
tablets is highly impractical and rarely heard of. The The doses of zopiclone prescribed by doctors for tablets are ‘practically insoluble' – which means the treatment of insomnia usually range from 3.75 that they do not dissolve, even after boiling – and so mg to 7.5 mg a day for adults (zopiclone is not injecting is extremely messy and dangerous. Those recommended for children). By contrast, the number people that do inject the tablets, do so by scraping off the film coating, chopping up the remaining tablet booze as this substantially magnifies the effects very finely then adding water, stirring and heating (and the risk of overdose) of both the alcohol in a spoon or cooker. Although some add dissolving and the zopiclone. Even at prescribed doses it is agents like citric acid or Vitamin-C powder, this advised not to ‘mix' zopiclone with other depressant doesn't really dissolve the powder. The thick chalky drugs, particularly other sleeping pills and alcohol sludge that results is difficult to inject and is much as this greatly increases the risk of overdose and more likely than heroin or crack to cause damage death. But some people will use zopiclone with to the veins, resulting in abscesses, deep vein anything they can get hold of. thrombosis (DVT), aneurysm, ulcers, varicose veins "When I've had zimmers, they make me feel open to taking just about anything, even stuff I wouldn't Injecting zopiclone greatly increases the risk of overdose and death, vein damage and picking up viruses like hepatitis C and HIV. This state of mind is very similar to the disinhibition brought about by heavy alcohol use. Bad reactions Zopiclone mixed with other drugs
have also been reported when zopiclone has been Zopiclone is sometimes crushed and mixed taken at the same time as erythromycin (antibiotic with heroin before it is sold (without the users for people allergic to penicillin), trimipramine knowledge), increasing (you guessed it) the chances (tricyclic anti-depressant), or carbamazepine (anti-of overdose. Those who choose to use zopiclone convulsant and mood stabiliser). sometime use it together with crack, and/or heroin, Mixing zopiclone with other drugs greatly increases to increase their main effects and reduce their the risk of overdose and death.
after-effects. Some people use zopiclone with Dealing with zopiclone overdose
Signs of overdose
Calling an ambulance
Overdose from zopiclone (and other z-drugs) is a The ambulance service do not automatical y cal the result of excessive sedation and depressed respiratory police to overdose situations. Zopiclone overdose can function (fal ing into a sleep so deep your breathing be treated with the benzodiazepine receptor antagonist slows down or stops) which may progress to coma flumazenil, which rapidly reverses the effects of and death. Knowing when a drug user has overdosed zopiclone, so you should tel paramedics if you know or on zopiclone is very difficult, as most of the signs of suspect the person has taken zopiclone.
overdose listed in the medical books - drowsiness, swaying and staggering, clumsiness and slurred speech - are ‘normal' for people using at higher doses. However, if a friend is having difficulty breathing, you notice any strange noises or gurgling sounds, their mouths or lips turn blue or they can't be woken - it is still best to put them in the recovery position (to stop them choking to death on their vomit) and call an ambulance.
The recovery position
"Zimmers are really addictive, and the rattle is
about five times worse than the rattle from gear"
anxiety experienced while waiting for dealers to When they are used in prescribed doses to treat turn up at their homes is too unbearable.
insomnia (one or two tablets per day) - dependence to zopiclone is fairly rare and takes a ‘month or "Much worse than when waiting for rocks or longer'. Drug users often start on a dose of about three tablets a day, which increases to about 10 to 20 tablets a day over a period of one or two weeks before many say they feel ‘hooked on zimmers'.
After cravings, the other withdrawal symptoms most commonly mentioned included fatigue and muscular weakness ("body like jelly"); aching limbs Cravings for zopiclone (an overwhelming compulsive ("dead legs"), sweats, appetite problems (reduced desire to use) are said to be stronger than cravings or increased hunger), and insomnia. Withdrawal for other drugs, even crack or heroin. symptoms listed in medical reports include anxiety, increased heart rate, sweats, flushes, palpitations "I made sure that I always had credit on my phone, and fits. Users often say that coming off zopiclone so that I did not miss any calls from dealers about is far more unbearable than a heroin-related ‘cold new batches of zimmers … but waiting for the turkey'. The duration of the zopiclone withdrawal dealer to turn up with the tabs was agonising – syndrome is comparable to the duration of the you end up pacing the floor, smashing things, and heroin withdrawal syndrome. "You rattle for about three to five days . . after Once a zopiclone habit is well established, users the worst is over, the craving and other stuff - like say they much preferred to travel several miles on thinking about the metal taste - go on for weeks buses or trains to the source of the drugs rather than wait for them to be delivered, because the Coming off
Getting help
As with withdrawals from heroin, one of the Some users have tried reducing the symptoms worst symptoms of zopiclone withdrawals is of withdrawal on their own by using opiates or insomnia (difficulty sleeping), because the lack of other drugs over several months. However, this is sleep magnifies the unpleasantness of the other extremely unpredictable and may well cause more withdrawal symptoms, and reduces your will to deal problems than it solves. If you want to cut down, with them. People addicted to zopiclone prescribed stop or get some advice, contact your local drug to them by their doctor may be advised to switch to service and get some specialist help (see back page an equivalent dose of the longer lasting diazepam for details).
and then slowly reduce over several months. Drug testing
However, doctors and drug clinics do not usually The available body fluid tests for illicit drug prescribe benzo-like sleeping pills to drug users use (including urine, saliva and sweat tests) do recovering from zopiclone dependence (or for not usually include zopiclone. Diazepam and any other reason). This is because of the risk of temazepam are the only hypnosedatives (sleeping overdose and dependence on benzos. The main pills) routinely covered by drug testing devices medication prescribed tends to be Nytol. at present. Drug users attending some criminal justice/drug services as part of a court order are required to be drug free. It has been noticed that even though some people are testing negative they are still turning up heavily intoxicated on zopiclone.
Nytol contains diphenhydramine an (Over The Counter) antihistamine, which is not so habit forming - although a lot of drug users complain it doesn't get them to sleep unless they take, way over the recommended dose.
Summary and reducing risk
.o Zopiclone tablets come in a variety of different shapes and colours, usually
in 3.75mg and 7.5mg doses. Beware of imported tablets as these may be
counterfeit, adulterated, or higher doses.
.o Using bigger doses of zopiclone over time increases the risk of dependence
and overdose, as does regular use of high doses.
.o Regular use for long periods can reduce immunity (more colds and infections),
and even increase the risk of various kinds of cancer.
.o Avoid driving or attempting anything hazardous like cooking or going out
when ‘zimmied'. In fact the safest place to use zopiclone is at home in bed.
.o Looking after children should also be avoided when on zopiclone.
Zopiclone passes into breast milk, so should not be used by nursing mothers.
.o Users who return to taking high doses of zopiclone after a period of abstinence
- when their tolerance has dropped – face a high risk of overdosing.
.o Zopiclone overdose can be treated with the benzodiazepine receptor antagonist
flumazenil, which rapidly reverses its effects. So call an ambulance and tell the
paramedics what has been taken. The police are not routinely called to overdoses.
.o It is a bad idea to inject zopiclone. The tablets are ‘practically insoluble' so
there is a very high risk of vein and tissue damage – along with the usual risk
of picking up and passing on infectious diseases like hepatitis C and HIV.
.o Most deaths from zopiclone involve more than one drug. In particular, using
zopiclone in combination with alcohol, benzodiazepines and opiates – increases
the risk of overdose. Adverse reactions can occur if zopiclone is mixed with any
of three prescription drugs, namely erythromycin, trimipramine, or carbamazepine.
The chemical structure of zopiclone. The full chemical name is chloropyridinoxotriazabicyclononatrienylmethylpiperazinecarboxylate

Source: http://michaellinnell.org.uk/michael_linnell_archive/research_and_reports/pdf/z-drugs_leaf09.pdf

Wales street primary school

Wales Street Primary School First Aid Policy Policy No. 3.2 Definition of first aid (as per DEECD guidelines) First aid involves emergency treatment and support to:  preserve life through: o clearing and maintaining open airways o restoring breathing or circulation o monitoring wellbeing until the person recovers or is transferred into

Stephen v. frye

Stephen V. Frye CURRICULUM VITAE PERSONAL UNC Eshelman School of Pharmacy Office: 919 843-5486 The University of North Carolina at Mobile: 919 260 3118 Chapel Hill Genetic Medicine Building Campus Box 7363 Chapel Hill, NC 27599-7363 Born March 8, 1961 in Greensboro,