Medical cannabis emerges as a safe alternative to zolpidem amid national alert

Amid the doubts of those struggling for a peaceful night's sleep, the words of rheumatologist and clinician Tiago Campanholi come as a relief: medical cannabis, when properly monitored, can be a safer alternative to traditional hypnotics. 

While the country watches with concern the irregular use of zolpidem, the discussion about gentler and more effective therapeutic pathways gains momentum and reignites the search for care that truly embraces.

“Medical cannabis is part of the therapeutic arsenal for sleep disorders,” says Campanholi. He explains that phytocannabinoids, terpenes, and flavonoids act on important stages of the sleep-wake cycle, promoting sedation, sleep induction, increasing REM phase, and reducing traumatic nightmares, neuronal excitability, and symptoms of restless legs syndrome.

For the doctor, prioritizing cannabis over hypnotics like zolpidem may represent a lower risk of adverse effects, dependence, and other complications, as long as the treatment is closely monitored and dose adjustments are made according to each patient's response.

The specialist's statement comes at a time when zolpidem, widely used for insomnia in Brazil, is becoming a public health concern. According to a publication by Folha de SP, the irregular use of the medication has prompted the creation of a new national guideline proposing stricter prescription rules and reinforcing the risks of prolonged use. This decision follows the increase in cases of dependence, self-medication, and severe side effects.

Alert grows over zolpidem risks

The document, prepared by neurologists and published in the Archives of Neuro-Psychiatry, points out that zolpidem, initially introduced as a safer alternative to benzodiazepines, has been used for much longer periods than recommended. As reported by Folha de SP, the rise in dependence and adverse reactions has led specialists to suggest stricter protocols, with usage limitations, continuous medical monitoring, and clearer guidance for health professionals.

Additionally, there are increasingly frequent reports of amnesia, mental confusion, sleepwalking, and complex behaviors during sleep such as driving, cooking, or shopping without remembering upon waking.

Cannabis emerges as an integrative alternative

In light of this scenario, medical cannabis comes into focus as a safer strategy, especially for patients seeking alternatives with less cognitive impact and reduced risk of dependence. 

According to Dr. Campanholi, compounds such as THC, CBN, CBD, myrcene, alpha-pinene, phytol, and limonene can be combined in the treatment of sleep, provided there is caution regarding drug interactions and gradual adjustments.

“When well managed, cannabis tends to present a lower risk and can replace the prolonged use of these medications. The goal is to offer an effective, safe treatment with minimal adverse effects,” concludes Campanholi.