Here’s a question for any PoT readers who are physicians or who otherwise have experience prescribing sedative-hypnotics (aka, “sleeping pills”):
I’ve been working through D.F. Kripke’s paper “Mortality Risk of Hypnotics: Strengths and Limits of Evidence,” which claims that “hypnotics cause huge risks of” premature death in those who use them. In many ways, the paper strikes me as a methodological disaster area (here’s a cogent critique), but I’m curious what any physicians/prescribers out there think about two of the anecdotal claims Kripke makes about physicians who prescribe sedative-hypnotics.
Here’s the first one:
(1) There may be no authoritative documentation, but young hospital physicians are sometimes instructed to prescribe hypnotics so that they will not be awakened at night for such as-needed prescriptions. In such cases, the hypnotic prescriptions are to allow the physicians to sleep, not the patients. Allow me to document that this was my training at prestigious hospitals.
And here’s the second:
(2) There may be no published documentation, but physicians have repeatedly told me that they prescribe hypnotics in fear that unsatisfied patients will depart for new physicians. Physicians are fond of their patients, but it is difficult to exclude any financial motivation to retain patients. Unstated is the tendency for patients prescribed addicting drugs to return for refills to avoid withdrawal symptoms.
I’m curious whether Kripke’s claims ring true to physicians in practice, or whether he’s just over-generalizing and cherry-picking from his own experiences. Hard for a non-clinician to tell.