Ambien is a brand name drug that has the generic zolpidem as its active ingredient. This prescription medication is indicated for the treatment of sleep disorders, including insomnia. Per the Centers for Disease Control and Prevention, an estimated 50-70 million Americans have problems getting a healthy amount of regular sleep. In view of the fact that America has a strong pill culture, it should come as no surprise that Ambien is one of the most commonly prescribed prescription drugs – and not just in the sleeping pill category, but across all prescription medications. In 2011 alone, US residents filled 39 million prescriptions for zolpidem.
Ambien is classified as a sedative-hypnotic. This class of drugs has a proven therapeutic effect but is also addiction-forming. It is well observed in the medical community that individuals will not typically become addicted to Ambien if they follow the prescribing doctor’s orders for use. However, for a host of different reasons, a prescribed user can lapse into addiction. Individuals who use Ambien recreationally (without having a legitimate prescription or need for this medication) face an acute risk of addiction. To understand how Ambien can be both therapeutic and addiction-forming, it is helpful to consider how it works in the brain.
Ambien in the Brain
The brain is composed, in part, of a signaling system. Speaking in broad strokes, a neurotransmitter (a chemical messenger) binds to a receptor site and activates it. The activation leads to a release of messages in the brain. When Zolpidem is in the brain, it acts like a benzodiazepine, although this drug is not classified as a benzodiazepine (a sedative). Zolpidem binds with benzodiazepine receptors in the brain and triggers its sedative properties without causing other side effects to emerge. More specifically, research has found that zolpidem docks in a neurotransmitter that is a subtype of a GABA receptor. GABA activation typically slows down the activity of neurons in the brain, which is why zolpidem has a hypnotic and sedative effect. In fact, the brain can slow down to the point where a person falls asleep and stay asleep.
It is critical to understand that patients under the care of a doctor are advised to take a dosage of Ambien that will safely induce the desired effects. When a person takes too much Ambien, the drug has different effects on the brain. According to firsthand reports, a person may experience any of the following psychoactive effects when high on Ambien:
- An intense feeling of relaxation
- A buzz that arrives in a way similar to the rush associated with ketamine or DXM
- A feeling of being wobbly
- A sense of being free from anxiety
- Distorted sense of motion
Ambien abuse exposes a person to the risk of an overdose, which can be fatal. The likelihood of a fatal overdose increases if a person mixes Ambien with alcohol or another drug, especially one with a sedative effect. For this reason, it is critical to be aware of the signs of overdose that include, but are not limited to, confusion, a lightheaded feeling, shallow breathing, fainting, sleepiness, or coma.
Ambien Addiction: A Personal Account
Ambien addiction may not start with an abuse intention, but a person can become physically and psychologically reliant on this drug nonetheless. Writer Laurie Sandell has shared her story of Ambien addiction with Glamour, and it provides valuable insights into how Ambien abuse can begin and the many dangerous side effects associated with its abuse. Sandell experienced debilitating insomnia for years. First, in her 20s, when she had a job that started earlier and she would worry about not waking up in time. But after three years, Sandell left that job to be a freelance writer, which catapulted into a sleep routine under her control, though this freedom kept her in an unhealthy sleep pattern. Eventually, Sandell joined Glamour as an articles editor, and the busy work and after-work scene kept her sleep-deprived.
But the first time Sandell took Ambien, after her mother (an insomniac) gave her a few pills, she was astounded at how well she slept. Sandell, sleep-deprived for years, says she was primed to become addicted to Ambien, and her abuse started nearly right away. Sandell would call doctors for multiple prescriptions (a practice called doctor shopping) and mixed Ambien with alcohol. Sandell was so happy to be getting sleep, she blinded herself to the many red flags that were flying around her. The following are some of the dangerous side effects Sandell experienced during her addiction to Ambien:
- Overtaking the drug soon after getting a prescription: She felt the need to take a pill every night, though the initial prescribing doctor instructed her to only take Ambien for occasional sleeplessness.
- A preoccupation with the drug: Sandell would make sure that she had enough pills to get through the month, which led to doctor shopping (as mentioned earlier) because she would run through her 30-day Ambien prescription too quickly.
- Secretiveness: Sandell did not tell her friends about her Ambien abuse, even though she would normally share important details about her life with people close to her.
- Keeping the use away from a mental health professional: Sandell did not tell her therapist, though she’d been in counseling for a year and was accustomed to sharing important information about her life in sessions.
- Sleep-eating: Sandell would wake up and find herself or her sleeping area covered with food. She did not recall the sleep-eating, which tipped her off that Ambien was having a blackout effect on her. One morning, Sandell found a pot of soup over a lit flame on her stove.
- Wanted to stop using Ambien but being unable to do so: Sandell could not stop using Ambien, although she wanted to do so.
- Taking Ambien at inappropriate times: Sandell would take Ambien to sleep on flights. On one occasion, she was in such a deep sleep that the flight attendant thought she had stopped breathing. Sandell had missed all the cues to wake up, such as the pilot’s announcement and the commotion in the cabin as passengers collected their things to get ready to disembark.
- Memory failure/blackouts: Sandell would have long conversations on the phone with her boyfriend, and the next day she would not remember what she said.
- Exposure to dangerous situations: Sandell, on at least one occasion, slept overnight in a full bathtub, which could have caused her to drown.
- Weight loss: Sandell, who is 5’8” went down to 98 pounds.
- Physical symptoms: She experienced panic attacks, sweats, increased heart rate and palpitations, and anxiety.
Afraid of the many symptoms she was experiencing, and unable to be in denial any longer, Sandell reached out and told a friend what was happening. She soon entered a rehab center for treatment. Sandell achieved abstinence and made significant changes to her lifestyle after completing rehab. She cites yoga and her efforts to maintain a regular sleep schedule as being instrumental to her improved sleeping pattern and ability to keep her free from Ambien abuse. Since Sandell had an underlying sleep condition, and Ambien did not cure it (as it does not purport to do so), it should come as no surprise that she still has a sleeping disorder, but changes in her lifestyle are improving the condition.
Treatment for Ambien Addiction
As the National Institute on Drug abuse explains, medical detox is supervised detoxification. For some drugs, such as opioids and opiates (e.g., prescription pain relievers and heroin, respectively), the US Food and Drug Administration (FDA) has approved medications to treat the addiction during the withdrawal and abstinence maintenance phases of recovery. At present, there are no FDA-approved medications that target Ambien addiction treatment. However, medical detox has numerous safeguards in place that can effectively support a person during Ambien withdrawal.
When a person regularly takes an addiction-forming drug, the body will habituate to the use of this drug and become physically dependent on it. Tolerance and withdrawal are the two main features of physical dependence. Due to tolerance, a person will need to take more of a drug in order to experience the desired side effects. For instance, a person will need to take more and more Ambien (hence, doctor shopping) to achieve the desired high.
When a person stops using a drug, or reduces the familiar amount to a significantly lower than familiar level, the body will go into withdrawal. Symptoms will manifest. These symptoms can be mild, moderate, or severe. The following is a list of some known Ambien withdrawal symptoms and signs:
- Panic attacks
- Vivid dreams
- Panic attacks
- Mood swings
During medical detox, the attending doctor and addiction specialist staff can optimize the process for comfort and safety. Doing so many include providing the client with prescription medications to ease the withdrawal symptoms (such as muscle relaxers), over-the-counter medications (such as headache relievers), proper hydration and nutrition, suitable accommodations, and psychological support. In addition, if a person has a dual diagnosis (co-occurring mental health conditions, such as a depressive disorder and substance use disorder), the treating medical team can ensure that the correct and safe dosages of the needed psychiatric medication are provided without presenting any dangers to the withdrawal process. Another critical key to medical detox is that it can help to prevent the onset of severe symptoms, such as seizures. Typically, the severity of the symptoms depends on the length and volume of Ambien abuse. Another key benefit is that medical supervision can prevent a person from relapsing, especially because drug cravings are common withdrawal symptom.
- Contingency Management
- Motivational Interviewing
- Cognitive Behavioral Therapy
- Dialectical Behavior Therapy
- Talk therapy
In addition, a person recovering from Ambien abuse in a rehab program will also participate in peer support meetings, such as those within the Narcotics Anonymous (faith-based) and SMART Recovery (non-faith-based) lineage. Recovery groups are not technically considered to be therapy, though they are therapeutic. Unlike in group therapy sessions, a therapist is not present. Rather, these groups are member-led and work off the principle of mutual aid. A key benefit of recovery meetings is that they can form the backbone of a person’s aftercare process after completion of a rehab program. Depending on a person’s location, there could be one to several local groups that host meetings one or more times a week. If there is no local group, a person could start one, keeping with the member-directed and member-led spirit of these fellowship groups.
After this review of how Ambien addiction can start, what being addicted to Ambien can be like, and the treatment approaches currently in use, one thing is hopefully clear: Anyone can experience Ambien addiction, and anyone can effectively recover from it. As Sandell’s story reveals, a key to achieving recovery is seeking help. Secretiveness about drug abuse is a main behavioral sign of addiction. For many, the day simply arrives when the secret can no longer be maintained because the abuse is getting out of control. Rehab is an effective way for individuals to take back control of their lives from Ambien or any other drugs.