After a long, stressful day, the idea of a glass of beer or wine to unwind, followed by an Ambien to ensure sleep, can seem like a perfect recipe. However, this common combination is a dangerous cocktail that can have tragic, and sometimes fatal, consequences.
Ambien (zolpidem) is one of the few FDA-approved drugs for insomnia. As such, it is one of the most popular so-called Z-drugs that people take for insomnia, especially those over 65 years of age. And it’s not at all uncommon that they take it along with alcohol, presumably to relax.
This is called polydrug use and can be a very dangerous thing to do as both drugs are depressants and have similar effects on the brain. Ambien is a sedative-hypnotic and alcohol is a Central Nervous System depressant. But combining them exponentially increases the risks, leading to a number of very risky behaviors such as sleep-eating, sleep-walking, and even sleep-driving. In this article, I explain this phenomenon, its causes, and impacts on health.
How Ambien and Alcohol Work In the Brain
Ambien
Ambien works by selectively binding to the GABA-A (gamma-aminobutyric acid) receptors in the brain. This amplifies the effect of the GABA neurotransmitter, a key chemical that inhibits brain signaling. This acts powerfully and quickly to suppress the central nervous system, promoting sedation and facilitating the onset of sleep.
On its own, Ambien can cause dizziness and drowsiness. It can also impair motor coordination and increase the risk of falls; produce memory impairments, including memory blackouts; and promote behaviors during sleep for which patients have no recall, such as sleep-eating, sleep-walking, and even sleep-driving [1].
Ambien is addictive, meaning you need a higher dose over time to achieve the same sleep effect, and you will experience withdrawal symptoms if stopped abruptly. Psychological reliance develops with the belief that sleep is impossible without this medication.
Ambien overdose may result in:
- Extreme drowsiness and dizziness
- Severe impairment of motor control, reaction time, and coordination (increasing fall risk)
- Profound confusion and disorientation
- Significantly increased risk of respiratory depression (slowed or stopped breathing), which can be fatal
- It requires immediate medical attention
Ambien overdose can cause [2]:
- Coma
- Cardiovascular problems
- Breathing cessation
- Death
Alcohol
Alcohol primarily enhances the effect of GABA, the brain’s main inhibitory neurotransmitter, slowing down brain activity and producing sedation. It also blocks glutamate, a key excitatory neurotransmitter, further depressing brain function. This dual action impairs judgment, coordination, and reaction times.
Alcohol is well-known for its dangerous effects on judgment, coordination, and memory.
Ambien and Alcohol: A Deadly Combination
Both substances amplify each other’s sedative effects, so, when taken together, the effects of Ambien and alcohol compound. Alcohol can affect how Ambien is metabolized. Ambien can speed up the processing of alcohol, causing higher blood-alcohol concentrations. Alcohol can also impact how effectively Ambien works [3].
Symptoms include:
- Amnesia and “Blackouts”: Inability to form new memories, leading to gaps in recall.
- Paradoxical Reactions: Increased risk of agitation, hallucinations, and aggressive behavior.
- Impaired Judgment: Leading to incredibly risky decision-making, the user would never make while sober.
The use of these two drugs together may lead to life-threatening risks such as slowed breathing, slowed heart rate, and even coma or death. Ambien overdose is frequently linked with alcohol consumption and often requires admission to intensive care in the emergency department.
Ambien mixed with alcohol can lead to [4]:
- Breathing problems
- Lack of motor control
- Memory problems
- Worsening drowsiness and dizziness
- Odd behavior
- Ambien overdose
Long-term simultaneous misuse can cause lasting complications, including:
- Increased strain on the liver, which metabolizes both substances.
- Worsening of underlying mental health conditions, such as depression or anxiety.
- Development of tolerance and physical dependence on one or both substances.
5 Practical Tips for Harm Reduction
These guidelines can help you safely take Ambien.
- The Golden Rule is: Never consume alcohol while taking Ambien.
- You should avoid alcohol entirely on days you take Ambien. If you do drink, a strict separation of several hours (e.g., 6-8+) is often recommended, but the safest choice is complete avoidance.
- It’s very important to read the labels and medication guide and listen to your doctor and pharmacist.
- Be honest with your doctor about your alcohol consumption.
- Ensure family or roommates are aware of your medication and the risks, so they can recognize dangerous behavior.
7 Alternative Ways to Deal With Insomnia
Try these tips to improve your sleep without Ambien or drinking [5]:
- Do mindfulness meditation to relax your mind and body.
- Do progressive muscle relaxation of each part of your body in sequence.
- Practice deep breathing exercises.
- Maintain a consistent sleep schedule 7 days a week.
- At least several hours before bedtime, avoid heavy meals and screen time.
- Do daily exercise, finishing vigorous workouts well before bedtime.
- Reduce daytime naps to 20–30 minutes.
Treatment Is Available for Polysubstance Use
If you or a loved one is coping with alcohol abuse and using Ambien, help is available.
Treatment typically includes:
Medically-supervised detoxification
In a medically-supervised setting, the focus is to manage withdrawal to safely remove alcohol and Ambien from the body, sometimes aided by appropriate medication.
Inpatient or residential treatment
This setting is recommended for those with addictions, especially polydrug ones like alcohol and Ambien abuse, or with co-occurring medical or mental health conditions. Residents live in the facility and receive 24/7 care in a supportive setting.
Day/Partial Hospitalization Program (PHP)
A step-down from residential treatment, PHP is a structured program that allows you to live at home. It usually takes place 5 days a week and on weekends and offers individual and group therapy as well as education and skill-building activities to develop strategies for relapse prevention.
Intensive outpatient treatment programs (IOP)
IOPs offer a similar program as PHP but with less hours of commitment.
Outpatient counseling
Outpatient counseling is a fit for someone who has a mild polysubstance use disorder or aftercare following IOP. It usually involves seeing a therapist once per week to help maintain abstinence and deal with stressors to prevent relapse.
Therapies
There are a variety of types of therapy that can help you examine your use patterns and make healthy changes.
Cognitive Behavioral Therapy (CBT) helps a person examine negative patterns in their thoughts, emotions, and behaviors and learn new ways to view these and act upon them.
Contingency management (CM) is another commonly used behavioral therapy that provides rewards when a person achieves a specific goal, such as abstinence for a defined period of time.
Motivational interviewing (MI) helps a person sort through their conflicting feelings about substance use and increase their motivation for healthy change.
Help Is Available at Hideaway Recovery
At Hideaway Recovery, we proudly serve men from Cathedral City, Palm Springs, Palm Desert, throughout the Coachella Valley, and beyond. Offering substance abuse detox, residential addiction treatment, and dual diagnosis care, our programs are designed to meet the unique needs of every client. Whether you’re seeking addiction recovery services or support for co-occurring disorders, our compassionate team is here to guide you every step of the way. Contact us today!
Sources
[1] National Institute on Alcohol Abuse and Alcoholism. 2025. Alcohol-Medication Interactions: Potentially Dangerous Mixes.
[2] U.S. Food and Drug Administration. (n.d.). Ambien highlights of prescribing information.
[3] Bapat M. 2025. Mixing Ambien with Alcohol. Alcohol.org.
[4] National Institute on Alcohol Abuse and Alcoholism. 2014. Alcohol’s Effects on Health. Harmful Interactions.
[5] Hazelden Betty Ford Foundation. 2025. Ambien and Alcohol: A Dangerous Combination