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Dependence on Ambien

Are you concerned that you might be developing a dependence on Ambien (zolpidem)? Are you worried about Ambien addiction? In this article, we’ll explore the difference between dependence and addiction. We’ll also look at the different strategies used to treat both. And we invite your questions about dependence on Ambien at the end.

What is drug dependence?

Our bodies are designed to seek homeostasis. When you take any kind of drug over time, the body will adapt to that drug by either “slowing down” or “speeding up” certain processes to accommodate for the physical reactions the drug provokes in the brain and body. So in its most basic sense, Ambien dependence is a physical reaction to the drug zolpidem.

Dependence on Ambien occurs when you either take Ambien in high doses or for extended periods of time. Ambien dependence simply means you won’t be able to stop taking Ambien abruptly without withdrawal symptoms. Your body has adapted to the presence of zolpidem in the brain, and will experience specific symptoms when you cut down your dosage or stop taking Ambien.  Because Ambien is so effective as a sleep aid and because of how fast does Ambien work, Ambien dependence can occur quickly, in the first weeks of taking the drug.

Ambien dependence time: How long to be dependent on Ambien?

Because Ambien is highly addictive, zolpidem is typically only prescribed for very short-term use. Ambien may be prescribed for as little as 7 days, but usually not longer than 4 weeks.You can become dependent on Ambien after only a couple of weeks taking the drug. The longer you take Ambien and the higher the dose, the more likely you are to develop a dependence.

Dependence on Ambien symptoms

Ambien dependence has a few main symptoms. These symptoms don’t necessarily indicate an addiction to Ambien. They’re simply signs that your body is used to functioning with Ambien in your system. Dependence on Ambien symptoms include:

  • feeling that you need to take Ambien every day
  • experiencing withdrawals when you haven’t taken Ambien
  • if you’ve developed a tolerance, needing to take higher doses than prescribed to ease your insomnia

Ambien dependence vs addiction

Dependence on Ambien is different from a Ambien addiction, which includes psychological symptoms (see below). Although dependence is frequently present during clinical cases of drug addiction, it is not necessary for an addiction diagnosis. Ambien addiction is more likely if you’re not taking zolpidem as directed, by taking large amounts or when you snort or smoke Ambien.

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How long does Ambien stay in hair and urine samples for possible addiction detection? A single dose of Ambien can be detected in hair up to five weeks after exposure and specialized tests for Ambien can detect zolpidem in urine samples up to 60 hours after ingestion.

Physical dependence on Ambien

As we’ve been discussing above, physical dependence on Ambien can happen to anyone. But how can you treat dependence? Generally, you must go through symptoms of withdrawal until Ambien is totally out of your system. For example, a physical dependence on Ambien can be unpleasant if you’re no longer experiencing trouble sleeping and don’t need to take the medication. Withdrawal symptoms can be treated by gradually lowering your Ambien dose over a period of days or weeks, so that your body can slowly adjust to the lower levels of the drug.

Psychological dependence on Ambien

Ambien dependence crosses the line into addiction when you start experiencing intense psychological dependence. A psychological dependence on Ambien requires completely different treatment from a simple physical dependence. Therapy and support groups may be recommended by your doctor to help you deal with the mental and emotional Ambien dependence you’ve developed.

So how do you get addicted to Ambien?  And how do you know if you’ve developed psychological dependence on Ambien, or not? If you’re psychologically dependent on Ambien, you will:

  1. feel the need to take Ambien to cope with everyday stress
  2. feel a compulsive need to use Ambien
  3. experience strong Ambien cravings
  4. continue to use Ambien even if it has negative consequences

Ambien dependence withdrawal

The only way to treat Ambien withdrawal is to gradually decrease the dose of zolpidem under the medical supervision of your prescribing doctor. Generally, you continue to taper Ambien dosage until you can safely go off Ambien totally. If this is not an option and you stop Ambien cold turkey, you will eventually feel better, but it can take days or weeks to stop having symptom. Ambien withdrawal is pretty unpleasant and can cause:

  • extreme nausea
  • dizziness and vertigo
  • headache
  • impaired coordination and balance

Sleeping Pills Withdrawal Treatment Programs specialize to assist all those who attempt to quit Ambien but find it difficult to stay away from a relapse for a longer period of time. In addition to pharmacological help, trained staff at detox clinics or treatment facilities can make the process of withdrawal far more manageable by offering motivation and psychological support.

Ambien dependence questions

Do you still have questions about Ambien dependence and addiction? We welcome all questions in the comments below.

Reference Sources: DailyMed: Ambien
NCBI: Intractable nausea caused by zolpidem withdrawal
FDA Medication Guide: Ambien Tablets 

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16 Responses to “Dependence on Ambien
Katie
8:57 pm April 7th, 2013

I have been taking 10mg of generic ambien every night for a few years. My prescription ran out and wasn’t refilled due to the weekend. My doctor hasn’t said anything about me needing to stop taking it. I will have been without it for 4 nights when the doctor’s office reopens. I haven’t had any withdrawal type symptoms. But have had to use melatonin and otc sleep meds to get any kind of sleep. (I guess not sleeping would count as a withdrawal symptom?) I’m wondering how much longer it would take for my body to kick it. If I’m almost, there I’d like to know it. I’m pretty sure it’s probably different for everyone. Is there a ballpark range?

11:16 am April 8th, 2013

Hello Katie. Generally, Ambien withdrawal starts about 6 hours after your last dose and symptoms tend to peak about 48 to 72 hours later. Ambien withdrawal can last for several weeks after peak symptoms have resolved. Check with your doctor for a tapering regime if you want to get off Ambien completely.

nikki
1:24 am December 18th, 2013

I have been using ambien for over 10 years and just recently started seeing a new Dr who swears she gave me a script but did not. Now I have nothing and I’m freaking out. Having very bad withdrawals and little sleep. Does anyone know how long this will last?

4:06 am December 23rd, 2013

Hello Nikki. Withdrawal from Ambien can provoke problems with sleeping and re-bound insomnia can last for days to weeks after cessation of use. How are you doing now?

Micheal
7:56 pm June 16th, 2014

I have been on 10mg of Ambien for about 2 years, is this dangerous?

1:58 pm June 17th, 2014

Hello Micheal. You’ll need to consult with your prescribing MD to assess risk of long term use of Ambien. You can also speak with your local pharmacist about finding more information about the long term negative side effects to this Rx sleep aid.

Mike
1:02 am August 19th, 2014

I have always suffered from sleep problems and was prescribed ambien over 10 years ago. I take it only for bed but I’ve since grown a tolerance to it and don’t feel it is healthy to keep upping dosage. I’d like to ween off of it but fear my lifetime sleep issues will require a substitute. Any recommendations?

angelica
3:48 am August 20th, 2014

Can ambien be diagnosed by the dsm5?

Stephen
3:59 am August 20th, 2014

Hi, I was dependant on Valium for a period of about two years, but no longer take them, for about two years. Once a week I wake in the early hours, and cannot get back to sleep. I bite a small piece, a third or a quarter, from the end of a 10mg Zolpidem tablet, which is sufficient until morning. This has been going on for about a year, I do not feel any dependency, but wary about the possibility. I am 70 years old, and about 75kg. What is your opinion? Thanks

jim
12:10 pm March 26th, 2016

When does the tolerance wear off ? It took a year of nightly 10 mgs to get to where like it does not exist any more. I am saving some in reserve but don’t know when I should try to make it work it again. I certainly don’t want to drink myself to sleep anymore. Ambien was easy, soft and kinda fast, even though it wore off after 3-4 hours.

Lydia @ Addiction Blog
11:03 am March 29th, 2016

Hi Jim. Tolerance starts to wean off when the intake is discontinued. It happens gradually, but with a different pace in different individuals.

Chris
5:24 pm March 31st, 2016

I have been taking Zolipidem for two years or more. Recently I’ve forced myself to sleep with only half my presrcibed dose…but it doesn’t work very well…I am currently down to 2.5 mg, nightly, and intend to go down to 1.25 nightly as soon as I have time off work to deal with the withdrawal…I was prescribed it to treat delayed somnolence where it typically takes me three hours or more to fall asleep…

Renae
2:23 pm August 8th, 2016

Your physician doesn’t tell you that this sleeping aid is a dependency until you are actually in that predicament.

Bruce
2:31 pm December 15th, 2016

I often have difficulty getting to sleep (mind won’t shut down). I also typically wake up during the night several times. Usually I can get back to sleep, but not always. I’ve been tracking the hours of sleep, times restless/awake (using Fitbit data) , whether or not I took zolopidim and if I drank alcohol for about the last 60 days to look for trends etc.

In early 2014 while working in another city I was given a prescription for zolopidim. Turns out it was for 6 months, 30 pills each month, that had to be refilled monthly (couldn’t refill after 180 days). I ended up getting 5 months (150 pills) of 10 mg each. I never intended to take a pill every night and in fact have been cutting these in half and as of today still have maybe 10 or so left.

My “need” ebs and flows based on circumstances such as travel, ambient noise (wife snoring), maybe stress etc. I do what I can NOT to take a pill. But I’ve noticed that the amount of time the 5mg works for me has diminished to maybe 3-4 hours. In other words, if I take it at 11:00 I will wake up at 2:30 or 3. Can usually get back to sleep – not always.

So can safely say I’m not addicted but think I would fall in the dependent category. Have recently discussed with my new doctor and she has already agreed to refill when needed, but at 5mg instead of 10. Question is should the 5mg be keeping me asleep for more that 3-4 hours? In the end I find this drug very effective for my needs and have never experienced any of the reported side effects. I would hate to lobby for 10 mg doses as that would indicate an increasing dependence. Comments? She has given me a referral to a sleep specialist but I have postponed until I understand my own activities a bit better.

Thanks for any help.

Lydia @ Addiction Blog
1:50 pm December 26th, 2016

Hi Bruce. I suggest that you speak with your doctor about your concerns.

Linna
8:26 pm March 19th, 2017

I have been taking Zolpidem 10 mg for 15 years. I have a bedtime routine, wash face, brush teeth, get PJs on, turn down the bed, turn off TV, computer, take the pill with my bottled H2O, get into bed with a good book. 15 minutes and I know it’s time to pull the chain on my headboard reading light. This has worked for me every night for over a decade and I never became ‘tolerant’. I wake once around 4A to use bathroom but am able to go back to sleep for another 3-4 hours with total sleep 7-8 hours and wake refreshed. I have no memory loss, create quilts, play piano, walk a mile daily and eat healthy diet. If I get really involved in putting together quilt blocks, it may be 1 AM before I realize I’m still WIDE AWAKE. Recently, my PCP retired and the new, much younger doctor has decided she won’t prescribe it and suggested weaning me off beginning next month with 5 mg. I’ve already tried cutting the pills in half and 5 mg does absolutely nothing. I weigh 172 lbs and am 72 years old with a ‘sturdy’ build. My parents lived into their 90’s. I have been placed in a category: female in her 70’s, therefore, Zolpidem will harm me. I have absolutely no symptoms of this, function well mentally and emotionally – until now. This new, young physician has decided to do what’s best for HER and not for ME. I am distraught. I have had kidney cancer twice. A nephrectomy in 2000 for renal cell. Follow up discontinued after 5 years. 12 years later a NEW tumor was incidentally found in remaining kidney, same renal cell, and was re-sected. Surgeon had told me it would never come back, but it did. While it is possible to function during the day, the very realistic fear that this will recur once again is ALWAYS on my mind, especially at night. The surgeon told me that WHEN it comes back, it will do so rapidly. He didn’t say IF. He also stated my kidneys just seemed to be a ‘garden for cancer’. I do not smoke and only drink 1/2 C coffee in the morning. I was just fine until this new doctor decided to treat me like a category instead of an individual. I am borderline frantic and feel that, unless there are actual physical symptoms illustrating adverse effect to ME there is no good reason for me to discontinue taking it other than her personal judgment. I am dependent on it, yes, but have never abused it. My insurance company wouldn’t let me, anyway. She clearly wanted to be rid of me (kept checking her wristwatch) with my continued questions (which she failed to answer) and referred me to a study (which I found I am not eligible for) a sleep doctor (less than stellar reviews) and a psychiatrist. WHAT? The new PCP is passing the buck and literally throwing me to the wolves. She suggested Trazedone, which I took many, many years ago and which left me feeling drugged and hungover in the morning. SSRIs are not the answer, either. After first kidney cancer, antidepressant = huge weight gain and irresponsible spending. It took me years to regain control of weight and finances. 172# may sound like a lot, but certainly not compared to 236# at the height of my antidepressant-induced weight gain. Rozerem was tried 2 years ago and did nothing other than nauseate me and leave me sleepless after an entire week. I wasn’t depressed – until seeing this new PCP and fearing not being able to sleep. She even suggested a sleep apnea study but I have absolutely no indication this is an issue, whatsoever. Again, she just wanted me out of her exam room because she is unable to see me as an individual rather than a category. Thank you for any suggestions you might have.

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