Table of Contents
Ambien Addiction, Abuse, and Symptoms

TABLE OF CONTENTS

I. The Basics

This guide explains the effects, trends, and dangers of Ambien use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for Ambien addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general prescription sedative use, which includes Xanax, Valium, Ativan, Luminal, and Nembutal.

Primary Ambien Dangers

  • Addictiveness: In 2007, a study by Nutt et al. set out to rank substances according to their addictiveness. Researchers took into account a variety of factors, including both physical and psychological dependence, as well as the pleasure the user derived from the substance. Benzodiazepines, a type of sedative, were ranked 1.83/3, compared to prescription stimulants at 1.67/3, and alcohol at 1.93/3.
  • Risk of overdose: Because Ambien is a sedative that slows down brain activity and increases drowsiness, taking too much of the medication can cause extreme sleepiness, confusion, irrational thoughts, impaired breathing, coma, and even death. The Substance Abuse and Mental Health Services Administration recorded 19,487 Ambien-related emergency room visits in 2010, marking a 220% increase from the 6,111 ER visits recorded in 2005. The risk of overdose increases when Ambien is used in tandem with other depressants, such as opioids. According to the National Institute on Drug Abuse, there were 11,537 drug overdose deaths in 2017 that involved benzodiazepines and opioids.
  • Unintended side effects: Ambien use can lead to daytime drowsiness, headaches, dizziness, lethargy, loss of coordination/balance issues, dry mouth, nausea, diarrhea or constipation, muscle pain, depression, confusion, insomnia, memory loss, mood swings, agitation, anxiety, sleepwalking, sleep-driving, and other risky sleep-related behaviors.
  • Legal risks: The United States Drug Enforcement Agency categorizes Ambien as a Schedule IV controlled substance, meaning it has a relatively low potential for abuse and dependence. If found guilty, individuals possessing Ambien without a valid prescription face prosecution for misdemeanor drug possession. Numbers differ from state to state, but it’s common to see fines of up to $1,000 and as much as 180 days in jail.

Ambien Background Information

Derived FromAmbien is a laboratory-made compound
Ways UsedIngested orally, crushed, and snorted
Scientific NameZolpidem
Slang/Street Names for AmbienZombie Pills, R2, Roche, Roofinol, No-Go Pills, Date Rape Drug, Rophies, Forget-Me Pill, Mexican Valium, Sleepeasy, Tic-Tacs, A-Minus
How Long in Bodily SystemAmbien acts quickly, taking effect within 20-30 minutes. The average half-life of Ambien is 2.6 hours, but it’s eliminated faster in healthy adults and slower if consumed on a full stomach. It can take up to 11 hours for Ambien to clear the system, although some people feel the effects longer. In higher doses, Ambien may linger even longer.
Punitive Legal Measures: Using/PossessionIt is illegal to possess a Schedule IV drug, such as Ambien, without a prescription. Possession of Ambien without a prescription, or an amount beyond what’s prescribed, is a misdemeanor subject to penalties that commonly amount to a maximum $1,000 fine and 180 days in jail for the first offense, with penalties rising with each subsequent offense.
Punitive Legal Measures: Selling/DistributingPossessing Ambien with the intent to distribute or sell carries stiffer penalties than simple possession. If convicted, first-time offenders face up to five years in federal prison and a $250,000 fine.
DEA Drug RatingSchedule IV

II. Signs of Abuse

Behavioral Symptoms of Ambien Usage and Abuse

How Ambien affects the brain

Ambien induces sleep by activating gamma-aminobutyric acid (GABA), a neurotransmitter that helps control brain activity, and binding it to the brain’s GABA receptors. As GABA activity increases, the user’s brain activity slows, enabling sleep. Ambien may prove to be particularly addictive to users craving the sense of relaxation and calmness that comes with a prescription sedative.

Behavioral signs of Ambien usage and abuse

Given Ambien’s intent as a treatment for insomnia, regular usage often results in side effects, such as daytime sleepiness, lethargy, confusion, and a “drugged up” feeling. Those same symptoms are even more pronounced with Ambien misuse; individuals abusing the medication may be perpetually sleepy, have difficulty concentrating, struggle to stay awake, experience memory loss, and exhibit dangerous sleep behaviors they later can’t recall.

In some cases, users experience rare but serious cognitive side effects linked to dangerous sleep behaviors, ranging from sleepwalking to driving or cooking while asleep, with no memory of those activities afterward. Uncommonly, Ambien use can result in memory loss, hallucinations, confusion, agitation, depression, suicidal thoughts, anxiety, and/or aggression.

An Ambien abuser may start to exhibit negative lifestyle changes, including missing scheduled activities, struggling at work or school, and sleeping more than usual. To keep up with the extra demand, abusers taking excessive amounts of Ambien may attempt to visit multiple doctors to fill duplicate prescriptions or even buy Ambien on the street. In the absence of prescription Ambien, abusers may attempt to get their “fix” by asking a doctor to prescribe other sedatives, such as Xanax or Valium; hypnotics, such as Lunesta; muscle relaxants, such as Soma or Flexeril, or by combining prescription Ambien with alcohol or opioids.

It may be difficult to distinguish between appropriate usage and abuse, as Ambien is known for next-morning impairment, causing even individuals who are properly using the drug to seem tired and/or cognitively impaired.

Physical Symptoms of Ambien Abuse

How Ambien affects the body

Ambien is a sedative that slows brain activity, causing a corresponding relaxation of the central nervous system. Users may experience digestive issues, such as diarrhea or constipation, vision changes, muscle weakness, balance problems, dry mouth, sore throat, and a stuffy or sore nose. Taking too much Ambien may result in breathing difficulty, coma, or death.

Early physical effects of Ambien

Ambien is fast-acting, producing a plethora of short-term physical and psychological effects within 20-30 minutes of ingestion. While some physical effects are desirable, such as falling asleep as intended, other effects could be uncomfortable or even life-threatening.

This table illustrates the possible short-term physical effects associated with Ambien.
Short-term Physical Symptoms
Initial (direct effects of drug, 20 – 30 min.)Drowsiness
Dizziness
Lethargy
Muscle weakness
Vision changes
Lingering (within an hour of taking the drug)Sleep/extreme fatigue
Loss of coordination
Slowed breathing
Headaches
Strange dreams
Post-Use (several hours to days after use)Prolonged sleepiness
Confusion
Memory loss
Nausea
Constipation
Diarrhea
Lack of energy
Dry mouth
Generalized weakness

Severe and long-term physical effects of Ambien

Ambien is intended as a short-term solution for insomnia, to be used while the patient is exploring other ways of coping with sleep disturbances, including behavioral therapy, counseling, and lifestyle changes. Long-term use or any kind of misuse could cause physical and cognitive complications, which increase over time as users become tolerant and need to increase their dosage to experience the same effects.

Long-term effects of Ambien abuse range from chronic drowsiness to depression and suicidal thoughts. When prescription central nervous system depressants, such as Ambien, are used long term, they can cause users to become dependent and lead to withdrawal symptoms when they attempt to decrease the dosage or stop taking the medication altogether. Issues such as headaches, memory problems, coordination problems, low blood pressure, and slow or labored breathing can all put users at risk.

Combining Ambien with other sedatives, such as opioids or alcohol, is even more dangerous. Mixing CNS depressants can cause exponentially severe side effects; for example, combining Ambien and alcohol can make users violent or cause them to do engage in activities they wouldn’t normally do and that they don’t remember later. There is also a risk of losing motor control and lowering the respiration rate until breathing is shallow enough to cause bodily harm.

This table illustrates the possible long-term physical effects associated with Ambien.
Long-term Physical Symptoms
CasualDry mouth
Stuffy nose
Loss of coordination
Sore throat
Nausea
Headache
Diarrhea
Constipation
Chronic

Including all of the above effects for casual use

Muscle weakness
Muscle pain
Balance issues
Visual changes
WithdrawalFatigue
Depression
Anxiety/panic attacks
Rebound insomnia
Abdominal cramping
Sweating and flushing
Mood swings
Rapid heart rate
Hallucinations
Seizures

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of prescription sedative addiction.

III. Ambien Usage

Poor sleep patterns contribute to Ambien's global popularity

Insomnia has become an epidemic. One study of international sleep patterns found a high instance of individuals reporting poor quality sleep in several countries, with numbers higher among females: 31.3% of women in South Africa, 12.7% of women in Tanzania, 10.8% of women in Kenya, 37.6% of women in Vietnam, and 43.9% of women in Bangladesh. In the United States, 35.2% of adults say they sleep less than seven hours, contributing to the nearly 16 million Ambien prescriptions doled out in 2017.

Although overall Ambien usage in the United States has steadily declined since it peaked at 26,740,702 prescriptions in 2011, emergency room visits for adverse reactions to the medication have been on the rise. This trend seems to indicate that while physicians are writing fewer prescriptions, users are increasingly exceeding the recommended dosage or mixing Ambien with other drugs or alcohol in a dangerous manner.

Prescription Sedative Use Throughout the World
HighestSecondThird
Regions with the Highest Number of Prescription Sedative UsersAfricaAsia and AustraliaWestern and Central Europe

Ambien Usage Demographics in the U.S.

Misuse of prescription sedatives like Ambien affects adolescents in the U.S.

According to a SAMHSA survey published in 2016, approximately 497,000 Americans 12 years of age and older — about 0.2% of the population — were currently misusing Ambien or similar prescription sedatives. Of those users, approximately 23,000 were adolescents between the ages of 12 and 17, accounting for about 0.1% of the adolescent population. Around 50,000 adults aged 18 to 25 (0.1% of the overall demographic) misused sedatives, while 425,000 (0.2% of the demographic) adults aged 26 years and older misused prescription sedatives.

Demographics of Prescription Usage
Past Year (2018)Lifetime
8th grade (14-15 yo)2%3.5%
10th grade (15-16 yo)3.9%6%
12th grade (17-18 yo)3.9%6.6%

IV. How to Find Help

Insomnia can be debilitating, with sleepless nights leading into long, weary days plagued by fatigue and struggles with fulfilling personal and professional obligations. For individuals who try prescription sedatives, such as Ambien, in an effort to fall asleep faster and stay asleep longer, developing a long-term Ambien habit could lead to dependency and a need for higher dosages to maintain the same level of relaxation and rest. These higher dosages and long-term use can elicit complications that may be uncomfortable or even dangerous.

Stopping Ambien use could mean coping with withdrawal symptoms, such as tremors, depression, digestive issues, memory lapses, and even hallucinations. It’s important to treat Ambien addiction using a multi-step approach that addresses underlying concerns, such as sleep disturbances, as well as the addiction itself. This method will help prevent relapse and provide users much-needed social and medical support. To learn more about this process, read our Ambien rehabilitation guide, which provides a comprehensive resource for kick-starting recovery.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially individuals who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for finding help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that he or she understands that everyone present will end co-dependence and enabling behaviors.

V. Sources