Can Ambien Be Abused?
What Is Ambien?
Ambien (zolpidem) is an oral prescription medication used to treat insomnia in people 18 and older.1,2 While Ambien is used by many as a safe, short-term intervention for problems with sleep, the drug is also linked to serious, unwanted side effects and carries some risks for physical dependence, addiction development, and overdose.1,2 Some of these risks occur even when the drug is used as prescribed.
Like other sleep medications, including Sonata (zaleplon) and Lunesta (eszopiclone), Ambien is a sedative-hypnotic drug and central nervous system (CNS) depressant. These drugs affect a chemical messenger in the brain called gamma-aminobutyric acid (GABA) to increase relaxation and improve sleep.1,3,4Over the course of 7 years, ER visits involving Ambien rose by nearly 20,000.
Prescription drugs like Ambien are not immune to abuse. In fact, 1 of every 5 people in the U.S. over age 12 have abused a prescription substance. Consequences of Ambien misuse, in particular, are serious—over the course of 7 years, ER visits involving Ambien rose by nearly 20,000, a 230% increase.5 Due to its known dangers, Ambien is classified as a Schedule IV controlled substance by the Drug Enforcement Administration.2
Is Ambien Dangerous?
In most cases, Ambien is safe and effective when taken as directed by a physician.1 There are some cases, though, where Ambien use can have very serious consequences affecting the well-being of the user and others in their life. When someone uses Ambien, there is a risk of abnormal thinking and behavioral changes, such as:2
- Increased aggressiveness.
- Depersonalization (feeling disconnected or like a different person).
- Auditory and visual hallucinations.
Perhaps the most concerning danger of Ambien use is the possibility of "complex behaviors," or actions taken while an individual is under the influence of Ambien and not fully awake. Someone who's using Ambien and who completes one of these actions will often have no memory of it the next day.2 Examples of complex behaviors commonly associated with Ambien include:
- Sleep-driving (driving a car while partially asleep).
- Preparing and eating food.
- Making phone calls.
- Having sex.
Engaging in these and other behaviors while not fully alert can result in unwanted and sometimes very serious outcomes like:
- Interpersonal conflict/relationship problems.
- Car accidents.
- Bodily injuries.
- Unplanned pregnancy.
- Sexually transmitted diseases.
Ambien can be problematic when used alone, but when mixed with other substances that also depress the CNS, the risks are compounded. Someone using Ambien should avoid:3,5
- Other sedatives.
- Opioids (e.g., heroin and painkillers such as oxycodone).
- Some over-the-counter cough, cold, and allergy medications.
Even taken as prescribed, Ambien can have a long list of side effects, some more serious than others. They include:1,2
- Feeling sedated or "drugged."
- Problems with balance, walking, and coordination.
- Pain in muscles or joints.
- Stomach pain.
- Strange dreams.
These side effects may significantly worsen when the dose is increased.2
For some people, Ambien can exacerbate depression and may lead to thoughts of or attempts at suicide.2 People with preexisting depression should use Ambien with extreme caution and should be closely monitored by their doctors so their symptoms can be tracked.
Can You Get Addicted to It?
Addiction is the strong desire to find and use some substance even when doing so is likely to lead to or is already causing harm.6 Ambien, like many other sedatives, has addictive potential.
It's a common misconception that medications prescribed by a doctor aren't addictive or dangerous, but this is not always the case.6 There are specific guidelines for use for a reason—to minimize the side effects and to lessen the potential for abuse and addiction. When a person starts to take the drug more often or at higher doses than directed, the risks increase significantly.
Ambien, like many other sedatives, has addictive potential. Beyond addiction, Ambien is associated with tolerance, the need to take more of the drug to receive the same benefit, and dependence, the state where the body demands the substance to feel well. Addiction, tolerance, and dependence are separate issues but closely linked.
Ambien addiction is complicated but treatable with professional addiction services.6
What Are the Signs of Abuse and Addiction?
Because you or someone you love may have a prescription for and a real need for Ambien, it can be harder to recognize when a problem with abuse of the substance has begun. However, there are certain signs you can watch out for, including:3
- Taking the medication when it is prescribed for someone else.
- Consuming Ambien to induce effects other than improved sleep.
- Using more of the medication than prescribed by increasing the dose or frequency.
- Changing the route of administration by crushing and snorting or injecting the medication.
- Mixing Ambien with alcohol and other drugs to modify their effects or to create a stronger high.
Someone abusing and/or addicted to Ambien may also often show signs of intoxication that are similar to those of alcohol, such as:7
- Slurred speech.
- A lack of coordination.
- Walking problems.
- Shifting eye movements.
- Impaired memory and attention.
With continued Ambien misuse, a person can develop a sedative use disorder, signs of which include:7
- Using more Ambien than intended or using for longer than you set out to.
- Trying to cut down or stop taking Ambien altogether but not succeeding.
- Having to use more and more Ambien to get the effects you’re used to.
- Feeling strong cravings to use Ambien.
- Going through withdrawal when not using Ambien.
- Continuing to use Ambien despite serious risks to your physical or mental health.
- Problems fulfilling your normal responsibilities (such as those associated with your job, school, or home life).
- Increased conflict with or isolation from friends and family.
- Decreased interest in activities or hobbies.
Long-Term Effects of Using Ambien
There are greater risks associated with Ambien abuse the longer someone uses the drug. For example, someone that regularly displays a lack of coordination from use will likely fall and become injured at some point. While, of course, the complex behavior of sleep driving can cause an accident the first time it happens, if sleep driving continues, an accident is all but guaranteed.
Another risk of Ambien that increases with chronic use is overdose. Ambien overdose can result when the medication is consumed alone or in combination with other CNS depressants.2 Overdose symptoms include:2
- Slowed breathing.
Ambien overdose can lead to death as a result of respiratory suppression (slowed or stopped breathing) that results in a lack of oxygen to the brain.4
If you suspect an Ambien overdose, be sure to call 911 or seek out other emergency medical services immediately. Early treatment can help to reverse symptoms and avoid serious consequences.2
Will I Have Withdrawal Symptoms from Quitting?
The presence and severity of the Ambien withdrawal syndrome depends on many factors, such as:4,8,9
- Your age.
- How often you took Ambien, how long you used it, and your normal dose.
- The route of administration.
- If you used any other substances with Ambien.
- Previous complications in association with withdrawal attempts.
Ambien withdrawal symptoms are a product of Ambien dependence. As use of Ambien continues, the brain adjusts to the presence of the drug and eventually becomes dependent on a certain level of Ambien in the system to feel well and function normally. When Ambien levels drop too low, the body will respond by going through withdrawal.
In the same way that Ambien intoxication mimics that of alcohol, Ambien’s withdrawal symptoms are similar to alcohol, as well. Symptoms include:2,7
- High pulse rate.
- Muscle cramps.
- Shakiness of the hands.
- Nausea and vomiting.
- Possible hallucinations.
- Restlessness and jerky motions.
- Increased anxiety.
- Grand mal seizures marked by stiffness and spastic movements.
Some users may also experience uncontrolled crying, nervousness, and panic attacks.
Withdrawal begins as the body works to process and remove Ambien from the system in a process called detoxification. Ambien detox can be very hazardous; in fact, as many as 30% of people undergoing sedative withdrawal without professional care will have seizures.7 However, with medical supervision and care—such as is found in a medically assisted detox program—the risks are significantly minimized.
Ambien withdrawal symptoms can begin just a few hours after the last dose and last for about a week.7 After the acute withdrawal stage, Ambien users may experience extended withdrawal symptoms, such as poor sleep and mood disturbances, lasting beyond the end of the detox period.7
During withdrawal, former Ambien users may experience strong cravings, a risk factor for relapse. With professional treatment and therapy, you'll learn techniques for managing cravings and avoiding a return to Ambien use. Learn more about how to find the help you need to stay sober below.
How to Get Help
If you are interested in getting help for an Ambien addiction, you can seek out a screening from a physician or addiction treatment expert. Once you have identified the need for treatment, you can shift your goal towards finding the most appropriate setting by:
- Calling your insurance provider to learn what programs are covered under your plan.
- Speaking to others who have been through rehab.
- Completing online searches to read reviews of treatment programs.
- Touring facilities and discussing treatment with staff before committing.
All Ambien addiction programs will focus on ending use of the medication, staying drug-free, and improving your overall health and well-being; however, different programs are likely to vary in terms of treatment setting and the precise combination of therapeutic approaches. Professional addiction treatment programs will vary based on:6,9
- Services offered.
Since there is no single treatment approach that is best for every person, Ambien treatment programs will evaluate your status and needs while assessing:4,6,9
- Which substances, if any, you’ve been taking in combination with Ambien.
- The severity of your addiction.
- Previous experiences with detox and treatment.
- Stressors and supports at home.
- Co-occurring mental and physical health issues.
Once you are assessed, a plan will be tailored to fit your needs. It may include options such as:4,6,9
- Professional detox – Consisting of a set of interventions used to safely and effectively limit withdrawal symptoms and establish abstinence from all drugs. For many heavy users, detox will be the first step in treatment. During this phase, medications may be administered to relieve symptoms. Medications used in Ambien detox include long-acting benzodiazepines, barbiturates, and anticonvulsants.4,9
- Inpatient/residential treatment – Any services that involve leaving home to live at the facility during treatment. Inpatient/residential centers provide relatively intense treatment options for people with significant addictions and/or fewer supports at home. Staff are available around-the-clock to provide ongoing care and support.
- Outpatient treatment – Programs that allow the person to live at home and attend services at the treatment center. The outpatient setting may be recommended for those who have just completed a more intense level of care, have access to a strong network of supportive loved ones at home, or have a lower risk of relapse. Outpatient services encompass a variety of intensities and time commitments, with some offering up to 30 hours of treatment per week (partial hospitalization programs, or PHPs), about 9 hours per week (intensive outpatient programs – IOPs), to as little as one to a few hours per week. Outpatient treatment can be attended for as long as is necessary to maintain sobriety, and it is not uncommon for outpatient efforts to continue for months to years.
Throughout treatment, support groups are a great way to supplement and prolong the benefits of professional services.6
When embarking on addiction treatment, it is helpful to know that people who stay in treatment longer have longer periods of recovery, so being diligent about making and sticking to an aftercare plan can really help you achieve and maintain long-term recovery.6
Ambien addiction affects those taking the medication as well as their loved ones. Understanding and exploring treatment options is an important step towards finding the help that is essential to safely getting off Ambien and starting a new life without substance use.
Getting Better Sleep Without Ambien
Individuals who've been dependent on Ambien and who stop using it will likely face difficulties getting good sleep.7 However, there are ways to alleviate this problem without reaching for another potentially dangerous drug. Sleep hygiene refers to strategies someone can take to better their ability to fall and stay asleep. If you are struggling to sleep without pharmaceutical assistance, your doctor may work with you to improve your sleep hygiene regimen, and urge you to:10
- Get consistent. Your body responds well to routines. By going to bed at the same time each night and waking at the same time each morning, your body can develop a pattern and know what to expect.
- Set the mood. Good sleep is more challenging in an uncomfortable or chaotic place. Make your bedroom a more accommodating, peaceful place by keeping it cool, quiet, and relaxed.
- Remove distractions. Electronics and other forms of stimulation only serve to distract and keep you awake. Remove these items from your space and avoid them well before bedtime.
- Watch your intake. Eating large meals or drinking caffeine before bed will make good sleep difficult or impossible to get. Some might see alcohol as a sleep aid, but it can reduce your quality of sleep and should be avoided.
- Increase your exercise. Engaging in some level of exercise during the day can result in better sleep at night. Experiment with the type of exercise and timing to get your best sleep.
Through experimentation and dedication with sleep hygiene, good rest without Ambien is possible.
- S. National Library of Medicine: MedlinePlus. (2017). Zolpidem.
- S. National Library of Medicine: DailyMed. (2017). Ambien.
- National Institute on Drug Abuse for Teens. (2017). Prescription Depressant Medications.
- Weaver, M. F. (2015). Prescription Sedative Misuse and Abuse. The Yale Journal of Biology and Medicine, 88(3), 247–256.
- National Institute on Drug Abuse. (2016). Misuse of Prescription Drugs.
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- (2016). Withdrawal Syndromes.