Sleeplessness is a heavy burden. It doesn’t just mean going through the next morning in a groggy fog, it can have a serious impact on your health. Sleep is when you physically and mentally recharge. From a scientific standpoint, we don’t actually fully understand why we need sleep so much. In fact, we don’t even understand why we dream. But we do know that a good night sleep allows us to heal from the mental, emotional, and physical stresses of the day.
However, sleep problems affect millions of people every year, and it’s one of the United States most common disorders. That fact could explain why we have worked so hard to develop medications that are useful for treating sleep disorders like insomnia for over a century.
Sleep aids have existed since the late 1800s when barbituric acid was introduced as a sleep-inducing chemical substance. The class of drugs that encourages sleep is called hypnotics or sedatives. However, the most popular drugs we’ve developed for this purpose have involved a specific class of drug called central nervous system (CNS) depressants. These drugs have become famous (and infamous) in American culture. The Rolling Stones parodied advertisements marketing sleep aid and anxiety medications to otherwise healthy women in their song “Mother’s Little Helper.”
Because they are known to cause dangerous side effects like dependence, overdose, and withdrawal, barbiturates have been replaced by benzodiazepines (benzos), which have shown to be effective in helping people get to sleep. However, benzos have shown to cause some of the same negative side effects as barbiturates. A relatively new drug has been introduced in the last few decades known as “Z-drugs” like zolpidem, more commonly known as Ambien.
However, Ambien works in the brain in a similar way as benzodiazepines and barbiturates. As CNS depressants, all three chemicals are in a class of drug that is known in the addiction treatment world for their potentially deadly withdrawal side effects. Learn more about what makes them so dangerous and how withdrawal symptoms can be safely treated.
Could Ambien withdrawal be as deadly as its chemical cousins?
Though Ambien is widely used as a legitimate sleep aid, it’s central nervous system depressing effects can mimic the effects of alcohol when abused. This gives it a significant risk of abuse as a recreational substance. Unfortunately, adolescents are often at high risk for experimenting with an abusing Ambien and other sleep aids to get high. Because it’s harder to get more traditional drugs of abuse as an underaged teen, would-be recreational users often look for household substances. And with 50 to 60 million people suffering from sleep problems in the U.S., Ambien is common in medicine cabinets all over the country. A 2012 study of more than 17,000 adolescents in the U.S. found that 1.4 percent had abused Ambien at some point during their lifetime.
Recreational drug abuse isn’t the only way an Ambien addiction can form. It can be caused by overuse of a prescription and mixing a prescription with other CNS depressants like alcohol.
However, if a loved one is struggling with Ambien dependence or if they’ve started abusing sleep aids, there may be some telltale signs, including:
If you have been abusing or misusing Ambien, chemical dependence might be around the corner. However, some early symptoms can let you know that a substance use disorder is beginning. One of the most common early signs of chemical addictions is tolerance. This signal refers to a phenomenon in which Ambien’s hypnotic effects are no longer working like they used to. It may feel like you need to take more substantial or more frequent doses to achieve that same effects as when you first started.
Ambien is designed for therapeutic use, and it shouldn’t lose potency with normal use. Tolerance is a sign that your brain is starting to adapt to the presence of Ambien and it’s working to rebalance brain chemistry.
The next step is physical dependence. Intense Ambien cravings are a telltale sign of this phase. In your nervous system, dependence means that the way your brain communicates has been chemically altered and your messaging system has come to rely on Ambien to function normally. To you, this may seem like the need to use Ambien to feel normal. Without it, uncomfortable symptoms may start to develop.
Withdrawal symptoms will start when you cut back on your use of Ambien, skip a dose, or stop using altogether after developing a chemical dependence. Some of the first effects of withdrawal to emerge will be caused by a phenomenon called rebounding, which refers to a return of the symptoms you initially took the drug to remedy. For Ambien, this means returning symptoms of sleeplessness or insomnia.
Other common symptoms of Ambien withdrawal can include:
Some of the more dangerous symptoms of withdrawal will occur if you stop using Ambien abruptly or quit “cold turkey.” Ambien withdrawal, like other CNS depressants, can cause intense nervous system shock when you dramatically decrease your dose, stop using, or take an antagonist drug like flumazenil. However, early symptoms tend to be milder. If you start to experience these early Ambien withdrawal symptoms, it’s important to seek medical assistance immediately.
Like most CNS depressants, Ambien is a GABAergic chemical. This means that it enhances the activity of a chemical called gamma-aminobutyric acid (GABA), which is a naturally occurring chemical that the brain uses to communicate in the nervous system. This chemical’s role is to relax you by slowing down your nervous system so that you can rest and sleep. It also eases anxieties and allows your brain to come down from periods of high energy, stress, and activity.
Different chemicals achieve this GABA-exciting effect in different ways, but they all ultimately cause you to feel calm and drowsy. However, it can have some severe consequences if you take Ambien for longer than prescribed, if you take high doses, if you use it without a prescription, or if you mix it with other drugs. As you abuse Ambien, your brain will start to adapt to the abundance of the chemical in your system by taking measures to counteract the resulting chemical imbalance. In other words, your brain will try to add more nervous system stimulating chemicals to the mix to counter the depressing effects of the drug.
Quitting cold turkey is like releasing the floodgates. The excitatory effects that were building up and being held back by the drug will be unleashed and your nervous system will go into overdrive.
This nervous system overactivity can cause serious symptoms, including:
CNS depressant withdrawal has been known to cause a medical condition called Delirium tremens (DT). The condition is characterized by a sudden onset of confusion, strange behavior, and serious symptoms. DT often occurs with shaking, convulsions, irregular heartbeat, shivering or shaking. People who experience DT also report hallucinations and a sense of panic. Many people report the feeling or perception that snakes, insects, or rats are crawling on them. It has also been observed causing bizarre symptoms of catatonia like being awake but unresponsive, agitation for no reason, repetitive movements, waxy flexibility (allowing other people/ examiners to move them into new body positions which they maintain), and others.
Delirium tremens becomes extremely dangerous in the case of seizures, fever, and coma. While these symptoms are rare, they are more likely when a person is dependent on a very high dose of a CNS depressant, which they stop suddenly. Without medical help, these symptoms can be deadly. However, the prognosis is significantly improved by medical intervention, with fatality dropping to less than two percent of cases.
Since Ambien was approved for use in sleep disorder treatment, the U.S. Food and Drug Administration (FDA) has altered the recommended dosage of the drug, especially for women. They have required that manufacturers put updated dosage recommendation on the label because Ambien can potentially cause serious impairment the morning after it’s used if the dose is high enough. In some cases, Ambien impairment can be present even if you feel wide awake.
Side effects like slower reaction time and poor judgment can persist after you wake up. This poses a threat to people who might be driving to work or other obligations early in the morning. This is especially relevant to women. Studies show that women tend to process Ambien slower than men, causing more prolonged effects and side effects.
Ambien isn’t appropriate for everyone and it can exasperate certain mental or physical disorders. In some cases, mental disorders can be at the root of a sleep disorder and the use of Ambien would be ineffective. In these cases, Ambien can actually worsen symptoms of insomnia.
Sedatives also have the potential to make insomnia and anxiety worse when abused. Ambien is intended for the therapeutic treatment of sleep disorders, and it shouldn’t typically be used for long, continuous periods. According to the FDA, if insomnia worsens, or if it doesn’t improve after a few weeks of Ambien use, you should consult your doctor and learn more about alternative options.
Since Ambien addiction comes with some serious consequences, it’s important to address any potential substance use disorder, even though withdrawal can be dangerous. If you or someone you know is struggling with Ambien addiction, there are treatments available that can help you overcome dependence safely.
Because Ambien withdrawal is potentially dangerous, treatment usually begins with medical detox. According to the continuum of care model of addiction treatment, medical detox (otherwise known as medically managed intensive inpatient services) is the highest level of care in addiction treatment. It involves 24/7 medical treatment from medical professionals. The goal is first to ensure safety during detox and then to ease any uncomfortable symptoms that might occur.
Detox for CNS depressants like Ambien might involve a slow reduction of your dosage until you get to the smallest dose. After you are weaned down to a low dose, Ambien use is stopped. There is an alternative approach called the pulse method, in which you are given a dose every other week, but there is no evidence to suggest that would be effective.
After you get through Ambien withdrawal and you are no longer dependent on the drug, you may still feel intense cravings. Addiction is a complex disease that can last for a long time or lead to relapse if it is not addressed. If you have become addicted, your detox clinicians should connect you with continued care.
Though addiction and chemical dependence are serious consequences of drug use and abuse, there is help available if you need assistance in overcoming a substance use disorder. If you find yourself experiencing some of the symptoms of Ambien withdrawal, it’s important to speak to a doctor or seek medical assistance immediately. Learn more about Ambien withdrawal treatment by speaking to an addiction specialist at Delphi Behavioral Health Group. Call 844-899-5777 to hear more about your options. If you are looking to overcome dependence or addiction to any CNS depressant, medical detox may be your safest option. Don’t hesitate to call.
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