Evolution of the Addictovigilance Signal of Zopiclone: A 2014–2020 National Follow-up Study

Abstract

Zopiclone, like zolpidem, is under surveillance in France due to its potential for dependence, abuse and misuse. However, part of the narcotics regulation was implemented in 2017 in France for zolpidem only, which has led to an increase in the number of zopiclone consumers. The objective of this article is to present French addictovigilance data regarding the evolution of the abuse, dependence and misuse profiles of zopiclone. We used the following 3 data sources over two periods: the 3-year period before the regulatory measure regarding zolpidem (2014–2016) and the 3-year period after the regulatory measure (2018–2020): (i) Medic'AM, a public database which provides a good overview of the number of boxes of zopiclone reimbursed in France; (ii) all French cases of drug dependence or abuse reported by health professionals to the French Addictovigilance Network (FAN); and (iii) a national epidemiological tool based on the surveillance of falsified prescriptions. Between the first and the second study periods (i) despite an increase in the exposure of the population to zopiclone, the proportion of reports to the FAN remained stable; (ii) the proportion of misusers increased significantly (p < 0.01), from 27% (n = 31) to 48.3% (n = 72); (iii) the profile of problematic users remained comparable with persistence of markers of problematic use; and (iv) there was a significant increase (p = 0.01) in zopiclone fraud for obtention, from 26.1% (n = 30) to 40.9% (n = 61), which mainly concerned nomadism. Prescribers should remain cautious in providing zopiclone prescriptions.