The need for effective opioid use and addiction treatment has become a critical public health issue and initiative for struggling individuals across the country. The most effective treatment currently used for opioid dependence is medication-assisted treatment (MAT). This treatment combines the use of medicines to treat symptoms of opioid withdrawal with behavioral counseling.
One of the medications that have been used to treat symptoms of opioid withdrawal is zolpidem, also known as Ambien. This can help alleviate the uncomfortable yet common experience of insomnia during opioid detox.
Despite Ambien’s effectiveness for sleep, there are also some risks to using it for opioid withdrawal. One of these risks is Ambien’s own potential for use and dependence, especially in people with a previous history of prescription drug use.
Why Is Ambien Used For Opioid Dependence?
Ambien (zolpidem) is a sedative-hypnotic that can effectively treat sleep difficulties when used for no more than a few weeks. Insomnia, which refers to trouble falling or staying asleep, is one of the most common symptoms experienced during opioid withdrawal. It is also considered one of the most uncomfortable.
By acting on certain GABA receptors in the brain, Ambien can slow brain activity in a short amount of time, helping people fall and stay asleep for at least seven to eight hours. For people experiencing insomnia during opioid withdrawal, this effect can come as a significant relief.
When first brought onto the drug market, Ambien was considered safer than benzodiazepines, another type of sedative, due to its lower risk for addiction. This is not a consistent finding, however. Several studies on the use potential of Ambien and similar non-benzodiazepine sedatives have demonstrated a high risk for drug dependence with chronic use. This poses some risk for people who are undergoing withdrawal or recovering from the use of other prescription drugs.
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What Are The Risks Of Using Ambien For Opioid Withdrawal?
Although Ambien can be an effective sleep aid for short-term use, its use within a treatment plan for opioid withdrawal carries some risks. The primary risk is Ambien’s potential for use and dependence, which is greater in people with a previous history of substance use.
People may also experience negative side effects from taking Ambien, or suffer a negative reaction from mixing Ambien with other withdrawal medicines.
Risk For Ambien Dependence And Use
People with a previous history of substance use or mental health struggles are at increased risk for abusing other substances. Ambien is a medication that can produce effects that are similar to opioids, which may pose a challenge to people working to overcome their problem.
People can also develop a tolerance to Ambien within as little as a couple weeks. For people with chronic insomnia either as a result of opioid withdrawal or other causes, this can leave a person feeling as if they have no other option but to increase their dose.
Ambien is not considered safe for long-term use. The longer a person continues to use Ambien, the more likely they are to develop a physical dependence, and potentially, a psychological addiction to its effects.
Risk For Polysubstance Use
In recent years, there have been higher recorded rates of people mixing benzodiazepines or prescription sleep aids such as Ambien with opioids to achieve stronger effects. To address this, the FDA issued a report in 2016 warning doctors about prescribing opioids with these other drugs at once.
Although they are often mixed to experience more intense euphoria or relaxation, this can also be dangerous, leading to quicker overdose and greater risk for death.
Side Effects Of Ambien
Ambien is a powerful sleep aid with a long list of potential side effects. These side effects have the ability to complicate the withdrawal process or may otherwise create greater discomfort.
Potential side effects of Ambien include:
- daytime drowsiness
- mental grogginess
- memory problems
- unsteady walking
- constipation or diarrhea
- unusual dreams
- bizarre behavior, including sleepwalking
Negative Interaction With Other Opioid Dependence Drugs
Buprenorphine (Suboxone/Subutex) is a common medication used to ease uncomfortable withdrawal symptoms. It can also shorten the length of withdrawal. As a result of its depressant effects, Ambien can interact negatively with buprenorphine. Mixing the two can cause severe side effects, including respiratory depression, coma, and even death.
Recommended medications for effectively treating sleeping problems during opioid withdrawal include moderate doses of Benadryl (diphenhydramine), Vistaril (hydroxyzine), or Desyrel (trazodone). Unlike Ambien, these are less likely to have a severe, negative interaction with buprenorphine.
What Other Medications Can Be Used For Opioid Withdrawal?
Ambien or any other sedative alone isn’t capable of providing comprehensive relief for all symptoms of opioid withdrawal. Several other withdrawal symptoms, including anxiety and drug cravings, may require other treatments to be effectively managed.
In 2018, a drug called lofexidine (Lucemyra) became the first FDA-approved drug to treat opioid withdrawal symptoms, with the recommendation that it not be used for more than 14 days. Lofexidine is not a comprehensive treatment by itself, however, and should be used in conjunction with other treatments.
Other medications that may be used to ease symptoms of opioid withdrawal include:
- clonidine: to ease symptoms of anxiety, agitation, runny nose, cramps, sweating and muscle aches
- buprenorphine: partial opioid agonist to treat withdrawal symptoms and drug cravings, and shorten the length of the withdrawal process
- methadone: a long-acting opioid to ease withdrawal for people with severe dependence; it is also used for people who are pregnant undergoing methadone maintenance treatment
- other medications: to treat nausea, diarrhea, or insomnia
The most effective way for people to receive adequate support during opioid withdrawal is to enter a medical detox program. Medical detox is a medically-supervised detox service that offers 24-hour supervision and medical support for drug and alcohol withdrawal. Within this setting, patients can be monitored for health concerns, receive fluids for hydration, and receive medicines to ease symptom-related discomfort.
Find Help For Opioid Withdrawal Today
Finding the medical support necessary to undergo withdrawal and avoid relapse can be an essential first step on the road to addiction recovery.
If you are struggling with opioid dependence, Vertava Health can help. Our treatment specialists are available 24/7 to offer confidential support in finding opioid detox and treatment options that meet your needs.