Mixing Ambien and Alcohol
Ambien — the brand name for the hypnosedative drug zolpidem — is a short-acting non-benzodiazepine sedative. It is FDA-approved for short-term treatment of insomnia due to difficulty with sleep initiation.
Ambien is used as a safer alternative sedative to benzodiazepines. Ambien has a rapid onset of action (within 30 minutes) and has a short half-life of only two hours. Therefore it causes very little residual sedation the next day compared to benzodiazepines. It also has low abuse potential and is classified as a Schedule IV controlled substance. However, Ambien still has potentially harmful side effects and withdrawal symptoms, and these can be greatly worsened by concurrent use of alcohol.
How Ambien and Alcohol Interact
Ambien works by binding to neurotransmitter receptors in the brain known as GABA receptors. When it does so, the result is a slowing in brain activity, which produces the sedating effect. Alcohol also binds to the same GABA receptors, resulting in a significant magnification of the effects of Ambien.
Detailed physiological studies on the effects of Ambien and alcohol on the GABA receptor system have demonstrated that Ambien reduces the amount of the neurotransmitter GABA while alcohol down-regulates the number of GABA receptors, causing a synergistic effect whereby Ambien and alcohol suppress this important regulatory system of the brain by separate mechanisms.
The net effect is that mixing Ambien and alcohol results in a boost of the effects of both, including side effects and withdrawal symptoms.
Side Effects of Mixing Ambien and Alcohol
Ambien and alcohol side effects are similar, due to their similar effects on the brain.
Besides the sedating effects, mixing Ambien and alcohol also potentiates the other effects of Ambien, including:
- Memory impairment
- Slowed muscle movements and diminished muscle control
- Disinhibition, especially concerning extroverted or aggressive behavior
- Abnormal thinking and behavior
- Parasomnia behaviors, such as driving, walking, talking or sexual behavior while asleep
These same synergistic effects apply to the long-acting controlled release formulation of Ambien, Ambien CR. However, mixing Ambien CR and alcohol may result in prolonged side effects.
Risks of Mixing Ambien and Alcohol
The risks of mixing Ambien and alcohol are similar to the risks of each drug, but these risks are elevated due to their additive effects. These include:
- Injury from confusion, sedation, impaired cognition and impaired motor coordination
- Disinhibition and high-risk behavior, including suicidal behaviors
- Increased risk of injury or harm from parasomnia behaviors
- Withdrawal seizures
Can You Overdose on Ambien and Alcohol?
Yes. When Ambien is combined with other CNS depressants — especially alcohol or opioids — these overdose effects are magnified, and the lethal dose of Ambien or alcohol is greatly lowered.
Ambien overdose is characterized by:
- Excessive sedation
- Cardiovascular compromise
- Respiratory suppression
Alcohol and Ambien overdose are much more likely to cause respiratory suppression and death when the drugs are taken together than when either drug is taken alone.
The lethal dose of Ambien and alcohol is unpredictable and depends on a number of individual factors, such as:
- General health
- Liver and kidney function
- Tolerance to Ambien and alcohol
- Presence of other CNS depressants, especially opioids
Ambien and Alcohol Withdrawal
Ambien produces a withdrawal syndrome similar to that of benzodiazepines, but with some additional features, including:
- Anxiety and panic attacks
- Abdominal pain
- Heart palpitations
Most of the withdrawal symptoms of Ambien are a result of the rebound effects on the GABA system of the brain from the reduction or discontinuation of the drug. Since the most serious withdrawal effects of alcohol are likewise due to the effects on the GABA system, the risk of serious withdrawal symptoms is greatly elevated when withdrawing from both drugs simultaneously.
The most concerning withdrawal effect that can be caused by either drug alone are withdrawal seizures. Of course, this risk is elevated when withdrawing from both drugs simultaneously. Withdrawal seizures are a medical emergency and can occasionally be fatal.
Besides the usual withdrawal effects of Ambien, withdrawing from Ambien and alcohol simultaneously puts people at risk for Ambien withdrawal delirium, a condition characterized by agitation, confusion, psychosis, loss of bowel and bladder function and increased potential for self-harm.
Getting Help for Ambien and Alcohol Addiction
The importance of proper treatment for substance abuse cannot be overstated. Recovery from addiction is not simply the absence of using Ambien or alcohol or other drugs. The underlying causes of the addiction and the damaging effects of substance use and related behaviors on physical and mental health should be identified and addressed. Likewise, any underlying mental health disorders should be diagnosed and properly treated.
Because of the serious withdrawal syndromes associated with Ambien and alcohol, people who abuse these drugs should seriously consider starting their Ambien addiction treatment with a safe and supportive medical detox program.
The Recovery Village Ridgefield offers the best in comprehensive, professional drug detox and addiction treatment programs. If you have concerns about Ambien, alcohol or other substance use in yourself or a loved one, please feel free to contact us for a confidential discussion with one of our staff.
Chung, Shiu, et al. “Zolpidem use and the risk of injury: A population-based follow-up study.” PLoS ONE, June 27, 2013. Accessed August 20, 2019.
Drug Enforcement Administration (DEA). “Drug scheduling.” Undated. Accessed August 20, 2019.
Dudyala, Swathi, et al. “A case report on zolpidem abuse: Dependence and withdrawal syndrome.” Journal of Basic and Clinical Pharmacology, March 28, 2018. Accessed August 20, 2019.
Food and Drug Administration (FDA). “Highlights of prescribing information – Ambien.” February 2008. Accessed August 20, 2019.
Food and Drug Administration (FDA). “Highlights of prescribing information – Ambien CR.” December 2016. Accessed August 20, 2019.
Kumar, Sandeep. et al. “Ethanol reduces GABAA alpha1 subunit receptor surface expression by a protein kinase C-gamma-dependent mechanism in cultured cerebral cortical neurons.” Molecular Pharmacology, May 2010. Accessed August 20, 2019.
Licata, Stephanie, et al. “A therapeutic dose of zolpidem reduces thalamic GABA in healthy volunteers: A proton MRS study at 4 Tesla.” Psychopharmacology, May 2009. Accessed August 20, 2019.
Mattoo, Surendra, et al. “Zolpidem withdrawal delirium.” Indian Journal of Pharmacology, November-December 2011. Accessed August 20, 2019.
National Institutes on Drug Abuse. “How effective is drug addiction treatment?” January 17, 2018. Accessed August 20, 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.