Ambien and Alcohol

In 2021, 2.2 million U.S. residents met the criteria for a prescription sedative use disorder, while 29.5 million residents were diagnosed with an alcohol use disorder. Both substances show prevalence here in the U.S., also highlighting the need for polysubstance use disorder treatment.

Alta Mira is a leading provider of substance use disorder treatment, with our blog serving as a resource to educate our communities. In this article, we are discussing Ambien and alcohol, how they interact, and the dangers to look out for.

The concurrent use of Ambien (zolpidem) and alcohol can result in significant physiological and psychological interactions, primarily due to the collaborative effects of both substances on the central nervous system (CNS). Ambien is a non-benzodiazepine sedative-hypnotic prescribed to treat insomnia by enhancing the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that induces sedation and relaxation. Alcohol similarly acts on GABA receptors, amplifying its depressive effects on the CNS. When combined, these substances can profoundly increase sedation, impair motor coordination, and suppress cognitive functioning.

On a physiological level, both substances pose the risk of respiratory depression, specifically when Ambien is taken illicitly and alcohol consumption is high. These compounding effects on the respiratory system reduce oxygen intake to critical levels, particularly during sleep. This increases the risk of experiencing an overdose. Furthermore, the combined depressive effects on the cardiovascular system lower heart rate and blood pressure, which may lead to hypotension or cardiac arrhythmias in severe cases.

Psychologically, the interaction of these substances may exacerbate mood disturbances, including depression and anxiety. Ambien is effective in initiating sleep, however, when mixed with alcohol, the risk of amnesiac events. Studies have shown that when Ambien was taken in high doses and/or mixed with alcohol, individuals lost 3-5 hours of time. However, they were seen to be interactive with the environment they were in with no recollection. The study highlighted that sleep-driving and other complex behaviors were noticed.

The simultaneous use of alcohol and Ambien is associated with a range of adverse effects that can significantly impair an individual’s physical and mental well-being. One of the most notable side effects is excessive sedation, which renders the person incapable of performing basic tasks or responding to emergencies. This state of deep sedation leaves the person susceptible to accidents, such as falls or vehicle collisions, especially if the individual operates machinery or drives while under the influence.

Cognitive impairments are another prevalent adverse effect. Both substances impair executive functions, including judgment, decision-making, and memory. Partaking in risky behaviors, such as unsafe sexual practices or engaging in potentially dangerous activities, without full awareness of the consequences are a possible side effect. Furthermore, individuals who consume alcohol and Ambien together experience heightened levels of confusion and disorientation, which could exacerbate pre-existing cognitive deficits in vulnerable populations, such as the elderly.

Gastrointestinal distress, including nausea and vomiting, is also reported. These symptoms, although seemingly minor, eventually lead to severe complications such as dehydration or aspiration pneumonia if vomiting occurs during unconsciousness. Chronic use of alcohol and Ambien together also add strain to the liver, as both substances are metabolized through hepatic pathways. This increases the risk of liver damage or failure over time, particularly in individuals with pre-existing liver conditions or those consuming high doses of alcohol.

The health risks associated with combining Ambien and alcohol are multifaceted and often severe. Acute risks include the development of tolerance and dependence on one or both substances. Regular concurrent use may desensitize GABA receptors, diminishing the efficacy of Ambien and prompting higher doses to achieve the desired sedative effect. This escalation accelerates the development of a substance use disorder or polysubstance use disorder, where alcohol and/or Ambien become a need for the brain to feel normal.

Chronic health complications include damage to the liver and kidneys, as these organs are responsible for metabolizing both substances. Prolonged use will cause conditions such as alcoholic hepatitis, cirrhosis, or renal insufficiency. Additionally, the combination may exacerbate pre-existing conditions such as hypertension and diabetes, furthering physical health demise.

Mental health also deteriorates from chronic alcohol and Ambien use. Those living with depression or other mental health conditions will experience worsening symptoms, and increasing negative thoughts such as self-harm or suicide.

The risk of overdose is markedly elevated when Ambien and alcohol are consumed together, primarily due to their combined depressive effects on the CNS. Overdose can result even with doses of Ambien that would be considered therapeutic in isolation, as alcohol amplifies its effects. Symptoms of an overdose include:

• Extreme drowsiness
• Confusion
• Difficulty breathing
• Unresponsiveness
• In severe cases, coma or death

Respiratory depression is the most critical concern in overdose scenarios involving more than one substance. Both Ambien and alcohol suppress the brainstem’s respiratory centers, leading to hypoventilation or complete cessation of breathing. This condition is life-threatening without immediate medical intervention. When an overdose is suspected, it is imperative to seek medical attention immediately.

A study found that of those being admitted to the emergency room, 67% were taken for full evaluation. Of these, only 17% were discharged – the rest were moved to the intensive care unit (44%), the medical floor admission (17%), or the psychiatric unit (16%). This further highlights the importance of seeking medical treatment for Ambien and alcohol overdoses.

Withdrawal from alcohol and Ambien requires clinical expertise in the treatment process. Though both substances are depressants, each causes its own set of symptoms, furthering the risk of complications during the withdrawal phase.

Alcohol withdrawal begins 6-24 hours after the last drink and peaks within 48 to 72 hours. Symptoms range from mild to severe depending on the amount of alcohol being consumed, the length of time, and if other substances were being taken. The most severe form of alcohol withdrawal – delirium tremens (DTs) – is a serious complication that results in hallucinations, seizures, and delusions. DTs are life-threatening when left untreated, indicating a need for a medical detox.

Though Ambien has been marketed as safe as it does not have the same dependence risks as benzodiazepines, there have been recent studies noting Ambien withdrawal symptoms in those taking it long-term. A study highlighted a case where Ambien was stopped abruptly and resulted in intractable nausea requiring hospitalization. Despite being the only reported case, others have been cited where abruptly stopping Ambien caused withdrawal-like phenomena. More research is necessary to provide proper warnings for new prescriptions.

Effective management of withdrawal requires a comprehensive, multidisciplinary approach, beginning with a medically supervised detoxification. Pharmacological interventions will require variation among each person’s history, as certain medications will be more effective for some but not all. Supportive therapies, such as hydration, nutritional supplementation, and psychological counseling, are also integral to the recovery process.

Taking multiple substances such as Ambien and alcohol can cause serious physical and mental health complications, but that doesn’t mean all hope is lost. Both alcoholism treatment and Ambien use disorder treatment are available to get you back to feeling your best again. Therapies, healthy coping skill development, and medications will give you all the tools necessary for a successful and lasting recovery. There is no need to wait any longer – your compassionate care team is ready to help you begin healing today.

Managing a polysubstance use disorder may have you feeling lost, but there are solutions available. Alta Mira offers an expert team of addiction specialists, ready to guide you through the process of recovery. Our professionals combine holistic practices that promote physical health while also providing evidence-based therapies for your mental health. Call us today at 866-922-1350 to learn more about our program offerings.

Alta Mira: Science-backed treatment, world-class care

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