To The Editor: We would like to thank Dr. Zeigler for her insightful response to our case presentation. Dr. Zeigler appropriately points out some of the risks involved in prescribing benzodiazepines to individuals with substance use disorders. Unfortunately, insomnia is a common problem in individuals who are in early recovery from substance use disorders, and there is little empirical evidence to guide treatment of this problem. There are promising cognitive behavior strategies that have demonstrated efficacy in sleep disorders, but these strategies have not yet been tested in individuals who are in early recovery from substance use disorders. Additionally, there is a new class of pharmacotherapeutic agents for sleep disorders that target the melatonin system. These agents have little or no abuse potential, but, to our knowledge, they have not been tested systematically in individuals who are in recovery from substance use disorders. Both cognitive behavior strategies and new pharmacotherapeutic agents hold promise in treating the difficult problem of sleep disorders in individuals in recovery.
The author’s disclosures accompany the original article.
This letter (doi: 10.1176/appi.ajp.2007.07020291r) was accepted for publication in March 2007.
Reprints are not available; however, Letters to the Editor can be downloaded at http://ajp.psychiatryonline.org.