Ambien is the brand name for a medication called zolpidem, which is prescribed primarily to treat insomnia, and sometimes other sleep disturbances. If insomnia continues beyond two weeks, there may be an underlying problem that requires an additional diagnosis and treatment. Ambien is not intended for long-term use because it can be intoxicating, abused, and even a source of addiction.

As part of a class of drugs called sedative-hypnotics, Ambien slows down brain processes and induces a sense of relaxation that allows a person to go to sleep. The drug can cause mental and physical impairment, especially lasting daytime drowsiness, so it is important to take Ambien as prescribed, right before going to bed and getting at least eight hours of rest. It may not be safe for a person taking Ambien to drive or operate machinery even the day after use.

As a brand name, Ambien was approved by the Food and Drug Administration (FDA) for prescription use in 1992. There are several other sedative-hypnotics on the market, following Ambien’s success, and they are important medications to temporarily treat insomnia. They were originally designed to be safer than previous insomnia treatments, including barbiturates and benzodiazepines, which were both found to be addictive.

How to Know if Someone Is Abusing Ambien

Although Ambien is not considered addictive when taken as directed, there have been several reports of abuse and dangerous intoxication over the years. Ambien can be habit-forming, meaning that a person who takes it may feel like they rely on the substance to treat insomnia or sleep disturbances, or to manage their life. While they do not seek intoxication, they may become anxious if they have to stop taking the drug.

People who feel like they rely on Ambien may escalate their dose, struggle with tolerance to the substance, and feel anxious or panicked when they cannot take the drug. They may be in denial that they need or crave the substance. They may feel ashamed of their struggle.

Signs that a person struggles with Ambien addiction include:

  • Taking the drug a lot
  • “Losing” the drug and needing constant refills
  • Going to more than one doctor to acquire the drug
  • Frequently talking about the drug
  • Getting in financial trouble by spending money on the drug
  • Spending more time away from work, school, family, or social obligations in order to use the drug
  • Appearing intoxicated or fatigued frequently
  • Being sick more often due to coming down from Ambien intoxication
  • Getting hurt because of drug intoxication
  • Getting anxious or upset when asked about the drug
  • Lying about how much they’ve taken
  • Stealing Ambien
  • Experiencing withdrawal symptoms when trying to stop taking the drug
Dangerous Effects from Ambien Abuse

Ambien may cause side effects even in people who take the medication as directed; however, the physical buildup of the drug in the body when it is abused puts the person at greater risk for experiencing side effects.

Common side effects from Ambien abuse include:

  • Fatigue or tiredness
  • Drowsiness
  • Daytime sleepiness
  • Feeling “drugged” or intoxicated
  • Nausea
  • Diarrhea
  • Headaches
  • Abnormal thoughts or behaviors

Abusing Ambien can also cause serious problems, including:

  • Hallucinations
  • Rebound insomnia
  • Anxiety
  • Nausea and vomiting
  • Addictive euphoria
  • Memory loss
  • Loss of coordination, leading to falls or physical harm
  • Exhaustion or fatigue

Sometimes, Ambien can cause parasomnias, typically walking, eating, talking, driving, and even participating in sexual activity while asleep. These have been reported both in people who take the medication as directed and in people who abuse Ambien recreationally.

Parasomnias put the person in physical danger. If they occur when the person is taking the medication as directed, the prescribing doctor may stop the treatment. When they occur in a person struggling with Ambien addiction, they may not be addressed and can lead to serious harm.

Detox and Rehabilitation

Even people who take Ambien as directed by their doctor may develop physical dependence on this medication. When this happens, their doctor will help them taper off the drug and manage any effects of this process. People who do not take Ambien as prescribed, and who struggle with abuse or addiction to this substance, will need professional help detoxing from the substance. Withdrawal symptoms are not only uncomfortable, but potentially dangerous. They include:

  • Rebound insomnia
  • Agitation and irritability
  • Nervousness
  • Delirium
  • Extreme confusion
  • Cravings
  • Seizures

Treating Co-Occurring Insomnia and Ambien Abuse

Sleepman disorders are a common complaint among many American adults. One survey found that 35.3 percent of respondents obtained fewer than seven hours of sleep in a 24-hour period, which can lead to chronic fatigue and worsen mental health conditions.

Insomnia may indicate an underlying mental or physical condition. Anxiety and depression both have insomnia as an associated symptom. Eating too much, changes in medication, chronic pain, sleep apnea, and restless leg syndrome are all physical conditions that can lead to insomnia. In addition, the person may just struggle with life changes, stress, or short-term impactful issues that cause them to lose sleep. With so many potential causes for insomnia, it is important to work with a physician to diagnose the condition appropriately and develop an appropriate treatment plan.

Going through detox and entering recovery from another addiction can also lead to insomnia. For many substances, recurring insomnia may be a long-term symptom associated with recovering from drug or alcohol abuse. Receiving a prescription for Ambien can put a person in recovery at risk for developing another addiction because of the immediate, euphoric effects associated with it.

People who seek treatment for Ambien addiction can be treated similarly to those being treated for alcohol or benzodiazepine addiction. Medically supervised detox will be managed based on how long the person struggled with the substance and how large their nonmedical dose was. Withdrawal symptoms will be monitored, and serious effects like delirium or seizures can be treated with medication.

However, medicating insomnia is not helpful during this time. If an underlying cause like a mental or physical health issue has not been diagnosed, then treating the sleep disorder is still important. Insomnia and substance abuse are co-occurring disorders, and one will not get better if the other one is not treated appropriately.

Therapy, especially Cognitive Behavioral Therapy, helps many mental, behavioral, and substance abuse conditions, and it has been shown helpful in treating insomnia, too. Other forms of therapy that can ease insomnia and allow a person to go to sleep include:

  • Stimulus control therapy: This involves establishing a consistent sleep/wake pattern by restricting which activities occur in the bedroom.
  • Sleep restriction therapy: This involves limiting how much time is spent in bed to just sleeping, creating an intentional mild sleep deprivation.
  • Relaxation training: This involves various approaches to relaxing the mind, allowing the person to fall asleep.
  • Paradoxical intention: This is purposefully not falling asleep until one cannot stay awake any longer.
  • Biofeedback: This method involves the use of sensors to monitor brain waves and heart rate to understand biological rhythms, and how those change when relaxed versus when stimulated. This allows the person to intentionally relax the mind and body.

Learning various approaches to relaxation can help a person get needed sleep and moderate the impact of insomnia when it occurs in the future. The use of medication to treat insomnia during addiction recovery from other substances is not recommended. It is more beneficial in the long-term to learn to treat this condition without intoxicating drugs.

When a person enters treatment for Ambien abuse, these forms of sleep therapy should be taught alongside addiction counseling. Knowing that there are other, safer ways to manage insomnia will ease psychological symptoms of withdrawal, such as anxiety. This, in turn, can help individuals avoid other intoxicating substances and remain focused on rehabilitation and long-term recovery.