Mixing Ambien and Alcohol: Dangers, Effects, Overdose & More

Last Updated: December 1, 2023

Editorial Policy | Research Policy

Difficulty sleeping is a common concern affecting many individuals. Studies conducted worldwide have reported a range of results, showing insomnia may affect anywhere from 10% to 50% of the population. In 2020, a survey found that 8.4% of adults in the United States had used sleep medications either daily or on most days within the last month to help address this problem. 

Ambien is commonly prescribed to treat insomnia. Products like Ambien were initially marketed as safer alternatives to benzodiazepines like triazolam. Over time, however, there is increasing evidence on the misuse and potential for dependence associated with these medications. It is particularly important to know possible interactions between Ambien and other substances. When combined with other central nervous system depressants like alcohol, the results can be dangerous. 

What Is Ambien?

Ambien is a non-benzodiazepine sedative-hypnotic medication used primarily for patients with insomnia. In some instances, a controlled-release version of Ambien is prescribed for individuals experiencing difficulty staying asleep throughout the night. The term non-benzodiazepine means Ambien is not a benzodiazepine, but it does interact with benzodiazepine receptors in the brain. Additionally, Ambien is a scheduled substance due to its potential for abuse and the development of physical dependence. 

Ambien is often supplied in its generic form, zolpidem. It is a strong central nervous system (CNS) depressant that may cause: 

  • Complex sleep behaviors: There are patient reports of not only sleepwalking but also driving, making phone calls, preparing and eating food, or having sex while asleep—all with no memory of these events. 
  • Next-day impairment: Taking Ambien with less than seven or eight hours of time to sleep or combining it with other CNS depressants increases the risks of impairment the following day. The effects are increased risks of drowsiness, longer reaction times, blurry vision and impaired driving. 
  • Increased risk of falls and bone fractures.
  • Suicide attempts. 

Taking higher-than-prescribed doses or combining Ambien with other CNS depressants like alcohol increases the risk of dangerous side effects. 

Side Effects of Mixing Ambien with Alcohol

When alcohol is mixed with Ambien, the additive CNS depressant effects of each substance increase the risk of side effects: 

  • Slower, more shallow and labored breathing
  • Memory impairment
  • Loss of control or unusual behavior
  • Motor control impairment
  • Drowsiness
  • Difficulty staying awake

This increase in CNS depression has the potential to be dangerous. Over the past two decades, overdose deaths involving sedative-hypnotics medications like Ambien have risen significantly. In many of the cases, multiple substances were used, and alcohol was involved in about one-sixth of these fatal overdoses. Respiratory depression caused by multiple CNS depressants is the primary danger. Mixing alcohol and Ambien increases the likelihood of breathing slowing down or stopping completely. 

Recognizing Signs of Ambien Overdose

Ambien overdoses can be very dangerous and even life-threatening. The signs of an overdose include: 

  • Disorientation, lack of responsiveness or loss of consciousness
  • Coma
  • Seizure
  • Labored, slow breathing or slow heartbeat

These symptoms are an extension of Ambien’s sedative properties but with far greater than intended effects. 

Treating Ambien Overdose

An Ambien overdose is a medical emergency. If someone is displaying any of these symptoms, call 911 immediately. As you wait for help to arrive, you can:

  • Monitor breathing: Make sure the individual’s airway is clear of any obstructions, and remove anything around the neck, such as necklaces or ties.
  • Monitor pulse. 
  • Administer CPR: If breathing has stopped or you can no longer detect a pulse, 
  • Do not attempt to make the individual vomit: Ensuring the individual can breathe is most important, and vomiting has the potential to block the airway. 

When paramedics arrive, it is crucial to provide an accurate account of any other substances that have been ingested. Ambien becomes much more dangerous when mixed with other CNS depressants. Because Ambien interacts with benzodiazepine receptors, the care provided by paramedics and physicians closely mirrors the care provided in benzodiazepine overdoses. 

While in medical care, ventilation may be required, as oxygen levels remain the primary concern. Medical professionals may administer Flumazenil to reverse Ambien’s effects on benzodiazepine receptors, and they often also give intravenous fluids. They provide supportive care and closely monitor vitals until the individual regains stability. Intensive care may be needed under some circumstances. 

Other Dangers of Combining Alcohol with Ambien

In general, the side effects of Ambien become more likely to occur when taken alongside alcohol. Complex sleep behaviors like eating or driving may become more likely. Combining these activities with impairment carries the potential for disastrous outcomes. The use of medications like Ambien alone has raised safety concerns, prompting the FDA to require that updated warnings be provided with every prescription. 

For those managing a history of alcohol abuse, it is important to consider the potential impact on liver function. Ambien is metabolized by the liver, so any concerns with liver function may influence how well the body processes Ambien. Lower doses of Ambien are recommended for individuals with established liver disease. Ambien is unlikely to cause liver damage, but side effects may be more likely if liver function is reduced. 

Treatment Options for Ambien and Alcohol Misuse

Using multiple substances has the potential to become very dangerous. These substances can quickly create a larger effect, catching users off guard with disastrous consequences. If you or someone you care for is struggling with Ambien or alcohol use or has used the two substances at the same time, it is important to remember that this combination can be deadly. Quality support can help you turn the tide. 

Treatment options are available and can be individualized to fit your needs. Medically supervised detox provides safety and comfort during any potential withdrawal process, often including scheduled tapers to reduce medications slowly over time to minimize symptoms. This can be accomplished in residential programs or outpatient clinic visits, which allow you to return to home or work after treatment. The longer-term focus is on psychological and social support, giving you the tools you need to manage stressors, triggers and any underlying mental health concerns that may impact relapse or your day-to-day life. 

The Recovery Village Indianapolis Drug and Alcohol Rehab facilities are staffed by compassionate experts dedicated to helping you discover and continue on your best path forward. A multi-disciplinary approach helps ensure your care is individualized, giving you the specific tools you need. Connect with us today. Calling for more information is confidential and free, and our caring staff will assist you with any questions you may have.

Sources

Bhaskar, Swapna; Hemavathy, D.; & Prasad, Shankar. “Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities.” Journal of Family Medicine and Primary Care, October 2016. Accessed October 8, 2023.

Centers for Disease Control and Prevention. “Sleep Medication Use in Adults Aged 18 and Over: United States, 2020.” January 2023. Accessed October 8, 2023.

Schifano, Fabrizio; Chiappini, Stefania; Corkery, John M.; & Guirguis, Amira. “An Insight into Z-Drug Abuse and Dependence: An Examination of Reports to the European Medicines Agency Database of Suspected Adverse Drug Reactions.” International Journal of Neuropsychopharmacology, January 2019. Accessed October 8, 2023.

National Institutes of Health. “Ambien- Zolpidem Tartrate Tablet, Film Coated.” February 2019. Accessed October 8, 2023.

Edinoff, Amber N., et al. “Zolpidem: Efficacy and Side Effects for Insomnia.” Health Psychology Research, June 2021. Accessed October 8, 2023.

National Institute on Alcohol Abuse and Alcoholism. “Mixing Alcohol With Medicines.” November 2020. Accessed October 8, 2023. 

Tardelli, Vitor S., et al. “Overdose deaths involving non-BZD hypnotic/sedatives in the USA: Trends analyses.” The Lancet Regional Health – Americas, January 2022. Accessed October 8, 2023.

National Library of Medicine. “Zolpidem.” Medline Plus, November 2019. Accessed October 8, 2023.

National Library of Medicine. “Zolpidem.” StatPearls, October 2022. Accessed October 8, 2023.

Gunja, Naren. “In the Zzz Zone: The Effects of Z-Drugs on Human Performance and Driving.” Journal of Medical Toxicology, March 2013. Accessed October 8, 2023.

U.S. Food & Drug Administration. “FDA requires stronger warnings about rare but serious incidents related to certain prescription insomnia medicines.” April 2019. Accessed October 8, 2023.

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