Ambien is among the most popular prescription sleep aids in the United States. Ambien is a brand name for the generic drug zolpidem, which belongs to a class of drugs known as “z-drugs.” Other z-drugs include zaleplon (Sonata) and eszopiclone (Lunesta). Z-drugs are central nervous system depressants that increase signaling of an inhibitory neurotransmitter in the brain called GABA, leading to reduced brain activity. This is why z-drugs are so good at helping people fall and stay asleep.
Ambien misuse can have dangerous consequences, including respiratory depression (slow, irregular breathing), coma and even death. Ambien is also associated with some risk for dependence and misuse. Lethal Ambien overdoses typically occur with co-use of other drugs or alcohol.
Ambien and other z-drugs were initially marketed as risk-free insomnia treatments. However, research shows z-drugs are associated with significant adverse effects when taken regularly, even as prescribed. Ambien has been linked to dependence, addiction, and cases of “complex sleep behaviors” like sleepwalking. Some people have woken up in Florida jails after being arrested for driving while under Ambien’s influence.
Can You Overdose on Ambien?
When used as prescribed and without alcohol or other drugs, Ambien has a low risk of overdose. Regular Ambien use is associated with the development of tolerance and dependence, which can increase the risk of someone misusing Ambien.
Most Ambien overdoses are associated with co-use of other central nervous system depressants, such as alcohol, opioids or benzodiazepines. Combining Ambien with these substances or even over-the-counter drugs like diphenhydramine (Benadryl) or valerian root substantially increases the risk of overdose. When Ambien is co-used with other drugs, the dangers of an overdose are substantially increased, and death can occur.
How Many Ambien Would It Take to Overdose?
When taken alone, lethal overdoses of Ambien are rare. However, adverse effects become apparent at 400–600 mg (a standard prescribed dose is generally between 5–10 mg). Without other drugs, a lethal dose of Ambien is estimated to be around 4,000 mg.
Many people take Ambien in order to get high, which puts them at risk for an overdose. In addition, Ambien is frequently co-used with alcohol in order to have a more intense experience. When Ambien is combined with other drugs or alcohol, the lethal dose is estimated to be around 1,100 mg.
Ambien Abuse in Florida
Although Ambien is not a controlled substance in Florida, it is listed as a Schedule IV drug. This means that it has a low potential for misuse and has accepted medical use in the United States. However, some medical professionals are concerned that Ambien should be more carefully regulated. This is in light of an ever-increasing number of injuries and arrests caused by people behaving erratically or dangerously while under the influence of Ambien.
Ambien prescriptions are carefully monitored in Florida. Ambien was the fifth most prescribed scheduled drug in Florida in 2017, with over 600,000 prescriptions being written. It is worth noting that eight of the remaining nine drugs on the list were either benzodiazepines or opioids, which should never be combined with Ambien.
Although Florida-specific data on Ambien overdoses is not readily available, the U.S. Substance Abuse and Mental Health Services Administration released some information in 2014. Their report indicated that the number of nationwide emergency department visits related to Ambien overdoses doubled between 2005 and 2010.
Ambien Overdose Symptoms
It is important to understand that signs and symptoms of an Ambien overdose may be affected by the presence of other drugs. The most dangerous sign of an Ambien overdose is respiratory depression, which is characterized by slow, shallow and irregular breathing.
The likelihood of Ambien-related respiratory depression is substantially increased when alcohol, opioids or benzodiazepines (including Xanax, Valium, and Ativan) are co-used. Many people may not intend to mix these drugs together. However, someone who has a few alcoholic drinks and then takes Ambien at bedtime is putting themselves at risk for an overdose.
Psychological symptoms that are commonly associated with Ambien overdoses of 400–600 mg may include:
- Psychological Symptoms of Ambien Overdose
Physical symptoms of Ambien overdose may include:
- Physical Symptoms of Ambien Overdose
Respiratory depression (shallow or irregular breathing)
Cardiovascular toxicity (weak or irregular heartbeat)
Ambien Overdose Treatment
Ambien overdoses are medical emergencies. If you suspect an overdose, call 911.
In most cases, Ambien overdose treatment is limited to supportive care and monitoring in a hospital setting. In extreme cases, a drug called flumazenil may be administered to limit Ambien’s ability to create its sedating effects. Flumazenil can make the situation worse in the case of polydrug overdose, however, which is why it is not given in all cases. In addition, people with seizure disorders should not be administered flumazenil.
If you or a loved one is concerned with Ambien misuse, The Recovery Village Palm Beach at Baptist Health can help. Our experts can provide you with treatment options that can help you overcome Ambien dependence and allow you to develop effective drug-free sleep habits. Contact us today to learn about our comprehensive treatment plans.
Gunja, Naren. “The Clinical and Forensic Toxicology of Z-drugs.” Journal of Medical Toxicology, June 2013. Accessed October 27, 2019.
Young, Kelly. “Insomnia Drugs Get Boxed Warning for Complex Sleep Behaviors.” New England Journal of Medicine – Journal Watch, May 2019. Accessed October 27, 2019.
The Ledger. “Polk Sheriff’s Office: Kingsford Elementary teacher Tasha Fisher accused of driving under the influence after wrong-way stop in Lakeland.” January 2, 2019. Accessed October 27, 2019.
Proctor, Ashley; Bianchi, Matt. “Clinical Pharmacology in Sleep Medicine.” ISRN Pharmacology, November 2012. Accessed October 27, 2019.
Florida Department of Health. “Committee Substitute for House Bill No. 21.” March 19, 2018. Accessed October 27, 2019.
Florida’s Prescription Drug Monitoring Program. “E-FORCSE Quarterly Dashboard.” March 2017. Accessed October 27, 2019.
The Substance Abuse and Mental Health Services Administration. “Emergency Department Visits Attributed to Overmedication That Involved the Insomnia Medication Zolpidem.” The DAWN Report, August 2014. Accessed October 27, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.