Key takeaways:

  • Ambien works by activating GABA neuroreceptors and slowing brain activity and the central nervous system
  • The risk of Ambien overdose is heightened when the drug is abused with other central nervous system depressants such as alcohol, benzodiazepines, opioid painkillers, and long-term use
  • While Ambien possesses the properties that are associated with addiction-forming substances, it does not have severe withdrawal symptoms like benzodiazepines or other CNS depressants

Zolpidem, commonly sold under the brand name Ambien, is a short-term prescription sleeping aid often prescribed to those suffering from insomnia. It is considered less addictive than benzodiazepine alternatives, though the potential for abuse and addiction still exists.

Understanding Ambien (Zolpidem)

Zolpidem, most commonly sold under the brand name Ambien, is a notorious sleeping pill or “Z drug” in the class of prescription drugs known as sedative-hypnotics. It is commonly used as a short-term treatment for insomnia and is marketed as a safer, non-addiction forming alternative to benzodiazepines. 

Ambien is often prescribed in a long-release tablet form, though there are quick-release options to help initiate sleep. Ambien works by activating GABA neuroreceptors and slowing brain activity and the central nervous system. It is a Schedule IV substance under The Controlled Substances Act, meaning the DEA classifies zolpidem as having a lower potential for abuse and addiction. Despite this, people will often abuse Ambien for its hallucinogenic and euphoric properties which are heightened when used alongside other substances such as alcohol.

Zolpidem doses

Zolpidem tablets come in 2 different strengths – 5mg and 10mg. A regular dose is the 10mg tablet, taken 1 hour before you go to bed. If you're older than 65, or if you have kidney or liver problems, you may be prescribed a lower dose of 5mg to start with.

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Effects of Ambien abuse

As with most prescription medications, taking Ambien without a prescription or in higher doses than prescribed is considered abuse. When the drug is abused in high doses or if someone taking this sleep aid resists sleep, it causes euphoric effects as well as potentially causing hallucinations and other sedative effects. It also has a range of negative side effects that can be harmful to physical and mental health, such as:

  • Rapid heartbeat
  • Nausea
  • Diarrhea
  • Loss of appetite
  • Impaired vision
  • Slow breathing rates
  • Stomach cramps/muscle cramps
  • Allergic reactions
  • Memory loss
  • Inability to concentrate
  • Disorientation
  • Depression 
  • Suicidal ideation
  • Anxiety
  • Nightmares
  • Sedation
  • Confusion
  • Dizziness

Ambien overdose

While Ambien is marketed as a safer alternative to benzodiazepine sedatives due to its lower risk of overdose, if abused in high doses it can still cause an overdose. Ambien overdose is often characterized by lowered heart and breathing rate which can be fatal. The risk of Ambien overdose is heightened when the drug is abused with other central nervous system depressants such as alcohol, benzodiazepines, opioid painkillers, and long-term use.

Ambien abuse can also lead to prolonged periods of sedation, which may put the user at risk when working with machinery or in hazardous environments, as well as while driving. This problem is prevalent when interaction occurs between Ambien and alcohol.

Signs of Ambien addiction

Due to Ambien’s popularity and widespread use as a treatment for insomnia, many people who are prescribed the drug will abuse it without realizing the risks. When Ambien is abused in large doses, a tolerance to the drug's effects, including its ability to induce sleep, builds. When tolerance develops it can eventually lead to a physical dependence forming. When a dependence forms, the user will require larger and larger doses to feel the drug's effects. When a physical dependence begins to cause negative consequences to the user's life, a diagnosis of Ambien addiction may be given. [1] Knowing the warning sign of Ambien abuse can mean treatment can be given before addiction takes hold. 

Warning signs of Ambien abuse and addiction:

  • Refilling prescriptions unusually often
  • Repeatedly taking larger doses than prescribed
  • Experiencing cravings for Ambien
  • Wanting to stop abusing Ambien without being able to
  • Engaging in dangerous situations without any memory of them later
  • Spending large amounts of money on the drug
  • Isolating oneself from family and friends

Ambien withdrawal

While Ambien possesses the properties that are associated with addiction-forming substances, it does not have severe withdrawal symptoms like benzodiazepines or other CNS depressants. However, there are still signs of withdrawal when a person stops taking Ambien suddenly and it is recommended that someone with an Ambien substance use disorder attend a medically supervised detox to effectively get the drug out of their system. Withdrawal symptoms from Ambien usually present themselves within 48 hours of last use and can include:

  • Anxiety
  • Mood swings
  • Irritability
  • Sweating
  • Fatigue
  • Nausea or vomiting
  • Abdominal cramps or discomfort
  • Depression
  • Panic attacks
  • Rapid heart rate and breathing
  • Rebound insomnia

Treatment for Ambien addiction

Treating Zolpidem abuse and Ambien addiction starts with the user going through medically-assisted detox, which can usually be completed in both an inpatient and outpatient rehab center. Detox under medical supervision greatly increases the chance of successful recovery and helps manage cravings and withdrawal. 

Once detox is complete, recovering addicts will begin treatment to work through behaviors that lead to abusing Ambien, as well as therapy and counseling to identify and treat any co-occurring disorders. Treatment time for Ambien addiction can vary, with rehab centers offering treatment programs ranging from 30 - 90 days depending on the severity of the addiction. [1]

Once someone has completed a stay in a residential treatment facility or has finished an outpatient treatment program, long-term recovery can begin. Support groups and ongoing counseling are incredibly valuable methods of maintaining sobriety and can give the extra help needed to avoid relapse. If you or someone you know is suffering from Ambien addiction, contact a treatment provider today.