Zolpidem is a widely prescribed non-benzodiazepine hypnotic with established efficacy for insomnia. Despite prescription monitoring systems, zolpidem continues to appear in forensic cases with serious social consequences. This study evaluated the forensic and societal impact of prescription hypnotic misuse and explored implications for medication safety beyond regulatory approaches. Zolpidem-positive cases referred to the National Forensic Service (NFS) were reviewed across three forensic settings: (1) postmortem examinations, (2) drug facilitated sexual assault (DFSA), and (3) driving under the influence of drugs (DUID). Among more than 9,000 such cases handled by the NFS in 2025, poisoning accounted for 5.6% of all deaths, and drug poisoning represented 44.2% of poisoning-related fatalities. Zolpidem was the most frequently identified drug in fatal poisoning and the most frequently detected drug in DFSA and DUID cases, reflecting its consistent presence across forensic contexts. These findings suggest monitoring alone may not fully prevent harm from hypnotic misuse. Overall, zolpidem illustrates how a therapeutically valuable medication may cause unintended societal consequences depending on how it is prescribed, accessed, and used. Forensic toxicology offers unique insight into consequences of drug misuse beyond clinical settings. Comprehensive approaches integrating pharmacovigilance, prescribing, and public awareness are needed for medication safety.