Expert: Jacqui - 5/17/2011

Question
hello,
i am a 34 year old woman.  i have been addicted to ambien for almost 5 years.  i now take it recreationally.  i take it when i get home from work and i chew it.  theni take more at night so i can sleep.  i have lost interest in going out after work and feel very socially awkward as well so i dont make an effort.  i want to get pregnant and have children and my husband and i want to start very soon. i do not want to be addicted to ambien.  one of the reasons i do it so much is because im bored. but im also totally unmotivated to do anything.  do you think i need to go to rehab?  how can i get myself to stop using this?  is there a "crutch" i can do to try and get through it?  thank you

Answer
Hey Carrie,

This is kind of tricky, because the Ambien itself is a bit of a crutch.  You say that you are taking it recreationally, and I assume you mean for enjoyment purposes, as opposed to occasionally (which is what sometimes people mean by reacreational).  Anyway, there can be withdrawal effects from Zolpidem (Ambien) and if you want to stop, you need to do it slowly, and preferably with medical support.  

I wonder about the increased anxiety, and ask whether you began taking it because you are anxious.  Although Zolpidem is technically not a benzodiazepine like diazepam or alprazolam, it is kinda the same.  All of these drugs are meant for short term use.  If people with anxiety use them, they work for a while then people get "break through" anxiety.  So in fact, the continued use of the drug increases the anxiety problem that it originally helped. I realise Ambien is a sleeping tablet, and difficulty sleeping can often be a sign of anxiety.  Have you had anxiety problems in the past, in particular social phobia/anxiety?  The best treatment for this is psychotherapy, not medication, as the medications just mask the symptoms.  

There is no quick fix for this unfortunately.  You are probably not motivated for a couple of reasons, one because the drug is making you lethargic, but also because you are so psychologically dependent on it to feel good, you have convinced yourself you can't enjoy life without it.  It can be a difficult step stopping, and dont' get me wrong, I am not one of those AA types that thinks that you are going to suffer for the rest of your life, and you need to spend the rest of your days telling yourself you are addicted to Ambien even if you haven't taken it for years, but I do think it can still be hard to get out of the psychological and physical habit.

I can't recommend anything further until I know more:
- do you ever have withdrawal effects when you don't take it (electric shock feelings, depression, seizures, general feeling of not well, craving the Ambien)
- are you financially able to access a psychologist for therapy?  (I am assuming you are in the US where it isn't available via Medicare)
- Are you willing to try to really motivate yourself, and force yourself to get out there, even if you feel anxious and don't really feel motivated.

Get back to me re the above.

Also, please remember (and I say this to everyone) you are not a bad person for taking these substances - don't kick yourself.  You are human and just need to deal with an issue.  

I hope I hear from you soon,

Jacqui