Ambien®, formally known as zolpidem, is in a class of medications known as sedative-hypnotics, otherwise known as sleeping pills. This sleeping pill is generally prescribed for individuals who are diagnosed with insomnia, but it is only intended for short-term use. Ambien was initially designed to have similar effects as benzodiazepines without the harmful side effects.
Ambien Use Disorder
However, Ambien, like Xanax® and Valium®, has a very high use disorder profile and a physical dependence can form in as little as two weeks. Individuals who take Ambien for longer than two weeks will most likely need a higher dosage to produce the same effects. This tolerance quickly builds up over time until the individual becomes physically dependent on Ambien.
Classifying Sleeping Pills
Sleeping pills fall into the sedative-hypnotics category, which includes benzodiazepines and barbiturates. There are also non-benzodiazepine hypnotics that are commonly referred to as z-drugs because they induce sleep. These include zolpidem (Ambien), zaleplon (Sonata®), and eszopiclone (Lunesta®). Over-the-counter sleep aids include diphenhydramine (Benadryl®) and acetaminophen/diphenhydramine (Tylenol® PM). These are also commonly abused because they are easily accessible compared to prescription sleep aids.
Maintaining a healthy sleep schedule can be extremely difficult during this day in age, where we are always plugged in. According to studies, about 80%of the population in the United States struggles with transient insomnia, and an estimated 15% of adults in the U.S. have chronic insomnia. Approximately 37% of individuals rely on sleep aids to fall asleep and stay asleep during the night.
Ambien Abuse Statistics
- There are more than 80 different sleep disorders; a dependence on Ambien is the result of an individual having unresolved issues related to the sleep disorder.
Signs and Symptoms of Ambien Intoxication
- Short-term memory loss
- Feeling “drugged”
- Altered judgment and reasoning
- Poor coordination
- Delusions or hallucinations
- Intense drowsiness
- Slowed breathing
- Sleep disturbances and nightmares
- Abnormal limb and muscle movements
- Ambien blackouts (parasomnias such as sleep-eating, sleepwalking and sleep-driving)
Ambien has a high potential for physical dependence, and therefore when you discontinue Ambien, you will most likely experience withdrawal symptoms. Similar to benzodiazepines and alcohol, Ambien should not be stopped “cold turkey,” especially if you have been taking Ambien for longer than two weeks. Ambien withdrawal can be similar to benzodiazepine withdrawal and can induce seizures if you have been taking high doses of Ambien for an extended time. Withdrawal symptoms can start within 3 hours after the last dose and usually peak around 3-5 days and can last up to two weeks.
Signs and Symptoms of Ambien Withdrawal
- Stomach cramps
- Mood swings
- Panic attacks
- Nausea and vomiting
Ambien is most commonly prescribed to individuals who struggle with insomnia. If an individual who is addicted to Ambien, stops taking this medication, he/she is at risk of rebound insomnia. Rebound insomnia is the inability to fall asleep or stay asleep and is often much worse than before the individual began taking Ambien. Rebound insomnia can last up to several weeks.
Seeking Help for Ambien Use Disorder
If you or someone you know demonstrates two or more of the following behaviors, we recommend you see a substance use disorder professional:
- Refilling prescriptions more often than needed
- Repeatedly taking larger doses of Ambien than prescribed
- Experiencing cravings for Ambien
- Forging prescriptions for Ambien
- Loss of memory after waking up from an Ambien induced sleep
- Spending large amounts of money on Ambien
- Purchasing Ambien off the street
- Isolating yourself from family and friends
- Stashing Ambien in hidden places
- Physical withdrawal symptoms
- Unable to stop taking Ambien despite the urge to cut down
- Mixing Ambien with alcohol or other drugs
- Driving under the influence of Ambien
It is highly recommended that you do not stop taking Ambien “cold turkey.” Instead, you can start a slow taper by decreasing the dose slowly over time. Because Ambien withdrawal can be dangerous, you should seek professional help from a treatment center. Treatment professionals can help safely taper your dosage and also provide you with medications and psychotherapy to ease the withdrawal symptoms and prevent future cravings.
Depending on the severity of your Ambien use disorder, you may be advised to enroll in an intensive treatment level of care, such as residential treatment. Regardless of the level of care, you will need to undergo detoxification as the initial step. Detoxification is the first step in treatment for Ambien use disorder. During this phase, medications may be administered to relieve withdrawal symptoms and prevent seizures. Medicines used in Ambien detoxification include long-acting benzodiazepines, barbiturates, and anticonvulsants. Cognitive behavioral therapy (CBT), family therapy and dialectal behavior therapy (DBT) are well-known psychotherapy approaches that are successful in treating Ambien use disorder. These therapies help you develop healthy coping skills to prevent future relapses.
Treating the Underlying Sleep Disorder
Treating just the Ambien use disorder is incomplete until the co-occurring sleep disorder is also resolved. Addressing and treating your insomnia is an integral part of managing your Ambien use disorder. Sleep training techniques and practicing sleep hygiene are two essential treatment approaches to addressing insomnia or other sleep disorders. Sleep hygiene refers to strategies you can take to better your ability to fall and stay asleep. These include:
- Avoiding stimulation before bed (this includes electronics)
- Avoiding caffeine in the afternoon
- Exercising in the morning
- Keeping strict bedtimes and morning wake times
- Relaxation techniques and meditation before bed
- Aromatherapy before bed
- Avoiding large meals before bed
- Having a comfortable and relaxing bedroom