Ambien is the most widely known brand name of a sedative-hypnotic drug called zolpidem, which was one of the first Z-class drugs on the market. These medications were developed to treat insomnia, although, like the medications that preceded them, they are intended only for short-term insomnia treatment. Ambien and related Z-class drugs were believed to be less addictive than benzodiazepines and barbiturates, the previous medications that triggered substance abuse in many people. Unfortunately, many people also abuse Ambien for nonmedical reasons or develop a dependence on the drug and continue taking it after they should have stopped.
Abusing Ambien is highly risky because this drug is still a potent, controlled substance that can lead to overdose. Like other central nervous system (CNS) depressants, Ambien can suppress some body functions like breathing and heart rate to dangerous lows, and this can lead to death.
Typically, zolpidem is prescribed in doses from 1.75 mg to 12.5 mg. A doctor will start the patient at the lowest possible dose, which is usually considered to be 3.5 mg for men and 1.75 mg for women. There are differences between the doses because of the physiological differences between genders.
It is in rare cases that a dose would exceed 5 mg because more of the drug would put the person taking it at much greater risk of dependence and abuse. However, some people need very strong sedative treatment for sleep conditions, so it is important to have access to larger doses for extreme, rare cases. It is also important for physicians to monitor patients taking larger doses for any signs of abuse. Physicians will also make sure that on a physiological level, the person can safely metabolize that large a dose of Ambien.
When taken as prescribed, Ambien still carries several risks. There are common side effects from taking this drug, which can be serious. They include:
Although these side effects are all common, the most dangerous effects are memory loss, parasomnias, and euphoria.
If you take Ambien and do not fall asleep, you may struggle with memory loss, and this can affect how much Ambien you take. For example, you may take a second dose because you do not remember that you took the first dose. This puts you at risk of overdosing on this sedative drug.
Parasomnias like sleepwalking, sleep-eating, sleep-driving, and having sex while asleep are all very serious and carry a lot of dangers, from falling to having a car accident to contracting a sexually transmitted infection (STI). With sleep-eating behaviors, you may accidentally take more Ambien if it is not properly and safely stored, and this can also lead to an overdose.
Euphoria is one of the biggest risks. If you enjoy the feeling of taking Ambien, especially taking it and not falling asleep so you can experience its full sedative effects, this is a form of prescription drug misuse. If you start taking more of the drug to keep getting high, this is drug abuse. If you develop compulsive behaviors around taking Ambien and cannot control how much you take, you may have developed an addiction to the sedative-hypnotic. Taking larger and larger doses of Ambien to get high puts you at risk of overdose, especially if you combine Ambien with other intoxicating substances like alcohol.
If someone shows any overdose symptoms, regardless of the drug they are overdosing on, call 911 immediately. They need emergency medical attention to survive.
Signs of an Ambien overdose to look for include:
An Ambien overdose can be fatal. Oxygen deprivation from suppressed breathing or sudden heart failure are the most common reasons for death from an overdose involving Ambien. Typically, more than 15 mg will cause an Ambien overdose because the person will experience too much sedation; however, even a prescribed dose of Ambien may lead to overdose symptoms if the drug is combined with other CNS depressants, like opioids, alcohol, benzodiazepines, or muscle relaxants. A 2011 study found that people who were admitted to the emergency room because of taking too much Ambien were twice as likely to end up in intensive care for a longer hospital stay if they mixed the drug with alcohol.
Laboratory tests on rats have found that a fatal dose of Ambien alone is around 600 mg, which is far more than most people take, even accidentally or nonmedically; however, fatal outcomes can occur at much lower doses because of the drug’s sedative properties.
Other overdose symptoms that are not common include:
There is no such thing as “sleeping off” or “walking off” a drug overdose, including an overdose on Ambien. Always call 911 or the Poison Control Hotline to get help. Once you have done that, stay with the person until medical help arrives. If the person is conscious, do not let them wander off, and do not let the individual take any more Ambien or consume any other intoxicating substances. If the person isn’t throwing up, then they may be able to take small sips of water. If they are unconscious, and you are concerned they may throw up, you can put them in the recovery position.
Once the emergency medical professionals arrive, they will make sure the person can breathe; if there are any breathing issues, these will be addressed. Once at the hospital, doctors will make sure the person’s heart and breathing rates are stable. Then, they will introduce IV fluids, and they may pump the individual’s stomach so that no more Ambien is metabolized.
Fortunately, Ambien’s effects can be reversed by flumazenil. This drug binds to the GABA receptors in the brain, which drugs in both the benzodiazepine and sedative-hypnotic classes bind to.”
While this will temporarily stop an overdose, it will not completely stop it or reverse any damage, so flumazenil is currently only given in emergency situations by medical professionals who can continue to monitor the person for overdose signs.
Do not wait until after an overdose to get treatment for drug addiction. Even a newer prescription medication like Ambien can lead to serious addictive behaviors and overdose. If you notice that you have a hard time stopping the drug, that you take more of it without a doctor’s permission, that you abuse the drug to get high, or that you mix Ambien with other drugs to increase your overall euphoria, you likely struggle with addiction and need help to avoid an overdose.
Addiction is a chronic disease, which means that evidence-based treatment can help you end your physical dependence on substances, change your behaviors toward them, and reduce your risk of relapse. In addiction treatment, you will be able to:
There are currently no medications that can be used to ease withdrawal symptoms when ending the body’s dependence on Ambien. However, working with medical professionals can help you manage any uncomfortable symptoms such as nausea or muscle aches. You also will have access to social support while overcoming these symptoms.
Once you have safely detoxed, you will enter a rehabilitation program—either inpatient (residential) or outpatient—that will help you learn to recognize the compulsive behaviors around consuming drugs that are associated with addiction. Counselors will help you develop better coping mechanisms and stress management tools, so you can avoid relapsing when you are confronted with life, work, family, or personal stress. Since Ambien is prescribed to treat insomnia, part of your rehabilitation may involve cognitive behavioral therapy to manage sleeplessness, including ways to relax enough to get rest without taking drugs.
After completing rehabilitation, you will work with a counselor to develop an aftercare plan. This should include ongoing care, like exercise, diet changes, substance avoidance, and stress management tools to help you get enough sleep every night.
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