💊 Why Sleeping Pills Without a Prescription Are a Silent Epidemic in India

Across India, medications like Zolpidem (Ambien, Zolfresh) and benzodiazepines such as Alprazolam, Clonazepam, and Diazepam are still commonly purchased without valid prescriptions. While these drugs are effective for short-term relief of insomnia and anxiety, unsupervised use poses serious risks—including:

• Dependence

• Memory problems

• Withdrawal symptoms

• Accidental overdose

• Sleepwalking and other complex sleep behaviors

🧾 The Legal Status of Zolpidem and Benzodiazepines in India

India has a robust framework of laws meant to control and monitor the sale of habit-forming psychotropic medications, such as:

📋 Schedule H and H1 – Drugs and Cosmetics Act, 1940

• Zolpidem, Alprazolam, Clonazepam, and Nitrazepam are Schedule H1 drugs.

• Strict rules apply:

  • Valid prescription required

  • Pharmacies must retain prescriptions for 3 years

  • Red warning box and “Rx” label required

  • Monthly reporting to regulatory authorities

🧠 NDPS Act (1985)

• Several benzodiazepines and zolpidem are also listed as psychotropic substances under the Narcotic Drugs and Psychotropic Substances Act.

• Unlawful possession or sale can result in imprisonment and fines.

Despite these regulations, enforcement is inconsistent, leading to widespread OTC misuse, especially in smaller towns and rural areas.

⚠️ Risks of Unsupervised Long-Term Use

Most users of over-the-counter sleeping pills aren’t aware of the clinical dangers, especially with long-term, unmonitored use.

🚨 Dangers Include:

• Rebound insomnia when stopping suddenly

• Memory loss, drowsiness, and confusion

• Falls and fractures (especially in elderly patients)

• Drug interactions with alcohol, painkillers, or antidepressants

• Complex sleep behaviors like sleepwalking, driving, and eating with no memory of events

✅ Chennai: Leading the Fight Against Unsafe Use

Chennai has emerged as a model for strict regulation of prescription medications:

• Pharmacies sealed for illegal sale of benzodiazepines and zolpidem

• Audit checks and enforcement by the Directorate of Drugs Control

• Active implementation of Schedule H1 and NDPS guidelines

• A part of Tamil Nadu’s “Comprehensive Anti-Drug Campaign”

📈 Tamil Nadu reported a three-fold increase in pharmaceutical drug seizures—rising from ~40,000 tablets in 2023 to over 1.42 lakh in 2024.

This shows both:

• Rising misuse, and

• Stronger enforcement and accountability

🩺 A Safe, Modern Approach to Sleep Recovery

As a psychiatrist in Chennai, I follow a safer, proven framework:

• Only short-term prescriptions when necessary

• Personalized taper plans for those already dependent

• Offer non-pharmacological sleep treatments, including:

  • CBT-I (Cognitive Behavioural Therapy for Insomnia)

  • Sleep hygiene coaching

  • Melatonin (when appropriate)

👨‍⚕️ About Dr. Srinivas Rajkumar T

Dr. Srinivas Rajkumar T, MD (AIIMS, New Delhi), DNB, MBA (BITS Pilani)
Consultant Psychiatrist – Chennai

I specialize in:

• Safe tapering of benzodiazepines and zolpidem

• Insomnia management without long-term pills

• CBT-I and behavioral sleep therapy

• Stress and anxiety care

📍 Clinics:

• Apollo Clinic, Velachery (Opp. Phoenix Marketcity)

• Kumar’s Healthcare, Chromepet (Near Tambaram, Pallavaram)

📞 Appointments: 8595155808

“You deserve good sleep—without depending on pills for life. Let’s taper safely and restore natural sleep.”

📚 References

1. Pharmacy sealed for illegal sale of psychotropic drugs in Chennai
   https://timesofindia.indiatimes.com/city/chennai/store-sealed-for-selling-drugs-illegally/articleshow/96980039.cms

2. Tamil Nadu sees 3X rise in seizure of pharmaceutical tablets diverted for misuse (2024)
   https://www.newindianexpress.com/states/tamil-nadu/2025/Feb/17/tamil-nadu-sees-three-fold-rise-in-seizure-of-pharmaceutical-tablets-diverted-for-narcotic-use

3. Comprehensive Anti-Drug Campaign in Tamil Nadu becomes national model
   https://timesofindia.indiatimes.com/city/chennai/tamil-nadus-comprehensive-anti-drug-campaign-a-model-for-india/articleshow/123147863.cms