Zolpidem Abuse Symptoms, Side Effects, and Treatment Programs

What Is Zolpidem?

Zolpidem tartrate is a sedative-hypnotic agent found in many prescription sleep aid drugs used to treat insomnia.¹ The most widely known brand name formulation of zolpidem in the U.S. is Ambien.

The pharmacological effects of zolpidem often lead the user to feel extreme relaxation and drowsiness. While these effects are intended to help manage disruptive sleep disorders, they can be rewarding and pleasurable for some users—leading the individual into a dangerous pattern of abuse, which may eventually develop into a sleeping pill addiction. Fortunately, there is help for those suffering with zolpidem addiction.

Zolpidem Abuse

Similar to benzodiazepines, zolpidem works by increasing the activity of the inhibitory neurotransmitter GABA at specialized receptors, resulting in sedation. In fact, it binds to a particular subtype of these GABA receptors that is related mainly to sedation. When taken as prescribed,² zolpidem brings on less anti-anxiety, muscle relaxant, and anti-seizure activity than benzos and fewer issues with side effects like rebound insomnia and withdrawal.

While it is safe for appropriate prescription use, zolpidem can certainly be risky when abused. In 2010 alone, more than 64,000 emergency department visits involved zolpidem use, 30% of which were due to adverse reactions to the drug.³ Even at the prescribed dose, regular zolpidem use can result in the development of physiologic dependence and may lead to the onset of a withdrawal syndrome in the absence of the drug.¹

Zolpidem is prescribed in a number of forms, under various trade names, including:

• Tablet (Ambien).
• Extended-release tablet (Ambien CR).
• Sublingual tabs (Edluar, Intermezzo).
• Oral spray (ZolpiMist).

Those abusing zolpidem may abuse each form above in different ways, but abuse often entails using the drug in excess of prescription parameters: taking a higher dose, taking it more frequently than prescribed, or taking it recreationally.

Zolpidem abuse can also include combining it with other substances—like alcohol—to alter or enhance its effects.

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Signs and Symptoms of Zolpidem Abuse

Zolpidem exerts its effects by dampening signals in the brain. Many of the side effects of zolpidem abuse are related to this slowing of neuronal activity and can be troublesome for the user.

Some signs of zolpidem abuse include:^1,4

• Fatigue.
• Headaches.
• Dizziness.
• Struggle to maintain balance.
• Nausea.
• Gastrointestinal issues.
• Changes in appetite.
• Body shakes.
• Redness of the eyes.

Someone who is abusing zolpidem may act strangely, sometimes exhibiting confused, anxious, or upset behavior.⁴ In some cases, users may “sleepwalk” or otherwise engage in activities, such as driving, eating, or having sex, during their sleep. This can be extremely dangerous, as some of these activities (e.g. driving) require extreme attention for someone who’s awake. These users may experience a period of amnesia afterward, not remembering what they said or did while asleep.⁴

A small percentage of zolpidem users experience effects that run counter to the sedative-hypnotic stereotype. One study found that some users do not feel the sedative effects, even at high doses. Instead, their zolpidem high involves a rush of euphoria and a stimulant-like high.⁵

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Side Effects of Zolpidem Abuse

Zolpidem’s negative health effects can take their toll on the user, especially in cases of abuse. When a person begins abusing it, they may become tolerant to and dependent on the medication.^6,7 Tolerance means that the initial dose fails to provide the desired effects and increasing doses are needed over time. Dependence refers to the state when the body is accustomed to the drug and essentially functions abnormally without it.

While both tolerance and dependence can occur in those who use the drug as prescribed, it is especially common in those who abuse it, and they often lead users to escalate their zolpidem use.

As use increases, the user may find that they start to crave and use the drug despite negative consequences associated with use. This is a pattern of behavior known as addiction, and zolpidem users may find themselves addicted after long-term use/misuse of the drug.^6,7 Those with a history of drug and alcohol abuse are particularly susceptible.

Abuse of and addiction to zolpidem can bring about a host of unpleasant effects. Beyond the physical symptoms users can incur, those who misuse zolpidem can experience a range of symptoms of psychological fallout from their abuse. Taking zolpidem in any fashion, especially outside of individual prescription guidelines, can lead to:¹

• Aggressive and/or strange behavior.
• Hallucinations.
• Feelings of dissociation from the body.
• Anxiety.
• Confusion.
• Mood changes.
• Depression.
• Suicidal thoughts.

Ambien effects can last beyond the intended therapeutic range into the following day, leaving users sleepy, uncoordinated, and out-of-it despite overnight abstinence.¹ In cases where they’ve been active in their sleep, they may have no memory of their actions.

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Zolpidem Statistics

The 2014 National Survey on Drug Use and Health found that:

• Nearly 330,000 people reported non-medical use of sedatives like zolpidem in 2014.⁸
• Rates of use for sedatives like zolpidem remained relatively stable between 2002 and 2014.⁸

Those abusing zolpidem—especially older individuals—face an increased risk of medical complications and accidents requiring emergency care when they take this substance. In fact:³

• While rates of zolpidem use have remained relatively stable, emergency department visits connected to this drug increased by almost 220% between 2005 and 2010.
• Almost 70% of zolpidem-related emergency department visits in 2010 involved women.
• 74% of emergency department visitors who had taken zolpidem were patients aged 45 and older.

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Teen Zolpidem Abuse

Fortunately, teen zolpidem abuse rates are not high. Only 0.2% of adolescents aged 12 to 17 reported current non-medical use of sedatives like zolpidem in 2014. However, young people who do abuse zolpidem are at high risk of incurring harmful outcomes.⁸

As the brain matures through adolescence, substance abuse can potentially cause serious developmental disruptions. Prevention is vital as a person approaches adulthood.

Zolpidem is only available by prescription, but many younger people acquire the drug through prescription diversion from friends and family. One of the best ways to prevent teen substance abuse is to make sure all prescription medications in the house are secure. In addition, educating teens about the risks associated with drug and alcohol abuse can help them make informed decisions when it comes to using substances.

Find Ambien Addiction Treatment Programs

Professional treatment can start anyone battling addiction on the path to a happier and healthier life. Rehab programs are located throughout the U.S., and a variety of treatment types is available. You can use SAMHSA’s Find Treatment tool to search for facilities. Many state government websites will also provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’

If you or someone you love is suffering with zolpidem (Ambien) addiction, American Addiction Centers (AAC) is here to help. Please call us today free at to learn about how to get into an addiction treatment program. There are also free prescription drug helpline numbers you can contact.

Resources, Articles, and More Information

For more information, check out the following articles:

• “The Ambien Effect”
• Effects of Ambien Use
• How to Help an Ambien Addict

To join the conversation around substance abuse, visit our Forum today.

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