It usually starts out as someone just wanting to get a good night’s sleep. Innocently enough, they start out trying warm milk or tea before heading to bed. Nothing works. So, they’re left with a choice: continue not getting rest, which can affect daily activities, or taking a pill that guarantees a night of quiet comfort and bliss. Yes, they go for the pill. The drug in question here is none other than Ambien.
Ambien or Zolpidem is a drug that can be obtained without prescription and is to be used at most, for two weeks, though a few days is recommended by doctors. The effects of the drug are immediate, putting one to sleep in approximately 15 minutes. So, what is considered abuse? Usually, using more than the recommended dose (over 10 mg), for a few weeks builds up the user’s tolerance, causing one to need to use more in order to get the same outcome. Like most drugs, when mixed with other substances, like alcohol, there is an intensified effect. When ambien abuse occurs, people may take it orally, crush and snort it, or cook it for an intravenous injection.
How do you get high off of something that supposed to put you to sleep?
The Ambien brand specifically has become very popular among recreational drug users. Users often report that they get high by fighting the effects of the drug. This is done by not allowing the body to sleep which can cause visual effects and an overall high. For some people though, resisting the sedative effects helps them to feel the side-effect of euphoria more than sedation. Some people report decreased anxiety as well as perceptual changes, auditory/visual distortions and even hallucinations.
The company that produced Ambien, has put a protective covering on the drug which is supposed to prevent the possibility of snorting, however, to a serious drug user this is not an obstacle.
What are the side-effects of Ambien?
Regardless of what dosage one is taking of the drug, there are possible side-effects. Some of them include the following:
- Hallucinations, through all physical senses, of varying intensity
- Delusions- A false belief strongly held in spite of invalidating evidence, especially as a symptom of mental illness
- Euphoria and/or Dysphoria (the opposite of euphoria)
- Impaired judgment and reasoning
- Uninhibited extroversion in social or interpersonal settings
- Increased impulsivity
- When stopped rebound insomnia may occur
- Ataxia or poor motor coordination, difficulty maintaining balance
- Decreased libido
- Increased appetite
- Anterograde amnesia- loss of memory for events immediately following a trauma; sometimes in effect for events during and for a long time following the trauma
Some people take this drug for the side-effects; however, it may be less common than use of benzodiazepine (Any of a group of chemical compounds with a common molecular structure and similar pharmacological effects, used as antianxiety agents, muscle relaxants, sedatives, hypnotics, and sometimes as anticonvulsants). Because of the cost associated with the drug, use of it may be lower in the United States than in other parts of the world where there are generic brands available. No studies have been conducted as of yet to tell whether cost and availability of the drug is correlated with increased abuse.
Like any drug, if taken for extended periods of time, Ambien dependence can occur. Under the influence of Ambien, it is common for people to take more than is actually necessary because they have forgotten prior usage. In this particular, the elderly population is at particular risk. There is of course, also the percentage of the population that takes more than the necessary dose. It is recommended that users, who have a tendency for abuse, give additional tablets to a friend for safe keeping. Another suggestion is placing the medication in a cupboard locked with a combination lock since the side-effects listed above may prevent an individual from operating such a lock while under the drugs influence.
It is possible that before a user becomes fully acclimated to these effects, their symptoms may be strong enough to be labeled as a drug induced psychosis. Incidentally it is possible that antipsychotics, like Seroquel, may be prescribed in order to combat side effects and to aid in sleep. However, due to the hypnotic effects of both of these medications, it is probably better to combine Ambien with an anti-depressant which also has sedative effects. This is more likely to cancel out the side-effects of either drug, producing the desired result – relief from insomnia.
Users have reported sleepwalking and in some cases binge eating, driving, sleep talking, and performing other daily tasks have been reported during sleep. The user can sometimes perform these tasks as though they were fully awake. Conversations may be carried on and users may be able to respond as though they were fully awake. This is similar to the average sleep talker, the difference being that sleep talking is usually incoherent and has no relevance to the current situation. In the case of an Ambien user, speech can sound similar to that of an individual suffering from schizophrenia. A common symptom of schizophrenia is word salad, which is a jumble of incoherent speech.
An individual under the influence of Ambien may seem totally in control which can bring about concerns of their safety of the sleepwalker and others. Driving while under the drug's influence is generally considered several orders of magnitude more dangerous than the average drunk driver, due to the diminished motor controls and delusions that may affect the user. For all these reasons, proper treatment of Ambien abuse is necessary. Ambien abuse should be treated like any other type of substance abuse. The proper counseling needs to be obtained in order to stop a problem from becoming life threatening.
Rachel Hayon, BSN, MPH
- Ambien.com (2004). AMBIEN® Prescribing Information. Information About a Short-term Treatment for Insomnia - Ambien.com Home Page for Health-care Professionals. Sanofi-Synthelabo Inc. New York, NY 10016. Retrieved on 2007-06-9.
- Depoortere H., Zivkovic B., Lloyd K.G., Sanger D.J., Perrault G., Langer S.Z., Bartholini G. (1986). Zolpidem, a novel nonbenzodiazepine hypnotic. I. Neuropharmacological and behavioral effects. Journal of Pharmacology and Experimental Therapeutics 237:649-58.
- Kang, Peter. "Ambien Patent Extension Seen Positive For Pfizer, Neurocrine", Forbes.com, 2006-04-10. Retrieved on 2007-9-06
- S. Afr. Med. J. (January 2000). Extraordinary arousal from semi-comatose state on zolpidem. A case report. National Center for Biotechnology Information (NCBI). Retrieved on
- Schlich D., L'Heritier C., Coquelin J.P., Attali P., Kryrein H.J. (1991) Long-term treatment of insomnia with zolpidem: a multicentre general practitioner study of 107 patients. J. Int. Med. Res. 19:271-9.
- Maarek L., Cramer P., Attali P., Coquelin J.P., Morselli P.L. (1992). The safety and efficacy of zolpidem in insomniac patients: a long-term open study in general practice. J. Int. Med. Res. 20:162-70.
- Kummer J., Guendel L., Linden J., Eich F.X., Attali P., Coquelin J.P., Kyrein H.J. (1993). Long-term polysomnographic study of the efficacy and safety of zolpidem in elderly psychiatric in-patients with insomnia. J. Int. Med. Res. 21:171-84.
- Caldwell J.A., Caldwell J.L. (2005). Fatigue in military aviation: an overview of US military-approved pharmacological countermeasures. Aviation, Space, and Environmental Medicine 76:C39-51.
- Evidente, Virgilio Gerald H., Caviness, John N., and Adler, Charles H. (2003). Case Studies in Movement Disorders. Seminars in Neurology 23:277-284. Thieme Medical Publishers. 26 Jan 2004.
- Pritchett DB, Seeburg PH. "Gamma-aminobutyric acidA receptor alpha 5-subunit creates novel type II benzodiazepine receptor pharmacology." Journal of Neurochemistry. 1990 May;54(5):1802-4.
- Wafford KA, Thompson SA, Thomas D, Sikela J, Wilcox AS, Whiting PJ. "Functional Characterization of Human Gamma-aminobutyric AcidA Receptors Containing the alpha4 Subunit." Molecular Pharmacology. 1996 50:670-678.
- Perrais D, Ropert N. "Effect of zolpidem on miniature IPSCs and occupancy of postsynaptic GABAA receptors in central synapses." Journal of Neuroscience. 1999 Jan 15;19(2):