The Curse Of Ambien
You might have forgotten that I have a paid daily newsletter, Daily Dreher (see info on how to subscribe here).
In the newsletter, I focus on uplifting things, in which I include things that give meaning to life. I wrote last night about my struggle this week to kick my dependence on the sleep drug Ambien. Why would I put it on a newsletter focusing on positive things? Because it’s an example of me putting into action the words I’ve been preaching for a while now about accepting suffering in a spirit that allows us to turn it into a means of becoming holier people, or at least stronger. I don’t think being dependent on a prescription sleep medication has anything to do with holiness one way or the other, but I do believe that kicking the habit is a good thing to do.
I wrote about it last night for my subscribers. One of my readers said that I should republish it here, on my blog, because it might educate and inspire others to avoid the drug, or to get off of it. I am reluctant to make content that people paid for available for free, but I will make an exception in this case, on the grounds that it might give hope and conviction to others who are caught in the same Ambien trap:
I have something kind of serious to talk about tonight, though I like to think of it as hopeful, because I’m taking my own advice about suffering.
Around 2008, I think it was, I was having a lot of trouble sleeping because of anxiety over a family medical issue. My doctor at the time prescribed Ambien, a widely-prescribed sleep aid that was supposed to have none of the addictive properties of benzodiazepine drugs (e.g., Valium, Halcion, Xanax). It was a wonder drug, let me tell you. It was like sliding down a silky chute to a bed made of pink clouds, having a cheerful swarm of Tinkerbells tuck you in under a goosedown comforter, and Burl Ives singing lullabies as you drifted off to sleep. It was not at all like the over-the-counter sleep aids (Unisom, for example) that left me feeling groggy in the morning. Those were like being beaned by a mallet; Ambien was like being bonked ever so gently by a marshmallow hammerhead.
I loved Ambien, as you can tell. If you have ever had difficulty getting to sleep, well, Ambien was here to solve all your problems. Taking an overnight flight abroad? Ambien helps you sleep on the plane. There were no sleep problems that Ambien couldn’t solve.
Then one day, I realized that I couldn’t get to sleep without it. This alarmed me, a bit, but there are bigger things in the world to be concerned about than being dependent on a sleeping pill, so I didn’t really worry about it. It has been many years since I experienced Ambien use as a pleasurable journey to sleepytime. Now, it has to happen if I’m going to sleep at all.
I tried to quit it several times over the years, but the misery was pretty intense. Ambien works by slowing down the brain, making it easier to sleep. Years ago, on one of my aborted attempts to wean myself from the drug, I described a night without Ambien to a friend as like trying to land a plane, but always bouncing back up just before touchdown. It was so difficult, and left me so completely wrecked the next day, that I always just gave up and started taking it again.
As you may recall, I’ve been living in a back bedroom suite at my house, quarantining while awaiting the Covid test results from my wife and daughter, who were both exposed to the virus, and have been feeling under the weather. Three nights ago, I noticed that my bottle of Ambien was missing. I turned the room upside down looking for it, with no success. This was a problem, because not only can I not sleep without Ambien, my brain races like crazy without it. There was a bottle of Advil PM in the bathroom, so I tried that.
It was like trying to gain liftoff in a Cessna powered by a lawnmower engine. I had a truly awful night. I described it to my wife like this: imagine that you are stuck in the cab of a 4WD pick-up truck, stuck in the mud, with the gas pedal also stuck to the floor. Your wheels are spinning at maximum speed, but you can’t go anywhere. Imagine too that your radio is on a station you hate, but the knob is broken, so you can’t change channels, and the volume knob is also broken, stuck at 11. And the electric windows and door locks are not working, so you’re bound to be there until somebody finds you.
That was my Sunday night. On Monday morning, I searched again for the Ambien, without luck. Then I decided that maybe I should take a lesson from what I’ve been saying over and over in this space, about accepting suffering as a way to grow: I decided that I was going to go cold turkey on Ambien, and beat this dependence once and for all.
This is not advised medically, the cold turkey thing. Though Ambien is not as addictive as benzos, it is chemically similar, and withdrawal can be bad. I thought about poor Jordan Peterson, who became addicted to benzos in a similar way: a doctor prescribed them for his anxiety. He nearly died coming off of them. The Internet medical sites say that the smartest thing to do is to work with your doctor to transition to smaller doses, and eventually to go off them entirely in a gradual process. I would have loved to have done that, but as Ambien is a controlled substance, it might have been difficult to get a new scrip for it with the old one only half-done.
I decided to stick with the cold turkey strategy. Last night — Monday night — was almost as bad as Sunday, but a little bit better. I didn’t get to sleep until around four a.m., and when I woke up at 10:30, I had been so restless that all my blankets were on the floor. After I finished the coffee my wife brought to me, I picked up the blankets and started making the bed … and there was the lost bottle of Ambien. It had apparently gotten lost in the folds of one of the blankets when I was making the bed up after the first night.
No more excruciating sleepless nights, with my brain going berserk! All I would have to do is take the little blue pill, and back to sleep I would go.
On the other hand, I have never made it through two and a half days of no Ambien, not in twelve years. Now I had. The worst days of Ambien withdrawal are days three and four, say medical websites. Today was day three. Tonight promises to be a bad night too. But if I can power through tonight, and maybe tomorrow night, I think I can be free of this stuff.
So that’s what I’ve committed to doing. I’m going to give my wife the Ambien when she brings me my supper, and tell her to keep it away from me. I can’t allow the suffering of these past three days and nights be in vain.
I guess this sounds like a big drama concocted out of nothing, but if I’m honest, it has given me more compassion for addicts. I don’t know that I would properly be called an “addict” — from what I read, doctors recognize a difference between “dependence” and “addiction.” Someone who is dependent on a drug treats it like I treated Ambien: as something I need to live a normal life. An addict, on the other hand, will wreck his life, and the lives of others, in pursuit of the drug, and will seek to ingest greater quantities of it to achieve the same high. All addicts are dependents, but not all dependents are addicts.
I can see the meaningful distinction there, and it’s certainly true that taking Ambien doesn’t affect my life in ways that, say, being addicted to opioids, or being an alcoholic would. Nevertheless, I don’t want to be dependent on a drug to get to sleep, and it’s scary to me that ceasing to use a drug causes such extraordinarily miserable effects that I have always gone back to using it rather than suffer through a second night of buzzsaw sleeplessness. So, cold turkey it is.
In talking over the years with other long-term Ambien users, I’ve found that every one of us wish we had never taken the drug. Part of the problem, I think, was that people don’t think of sleeping pills as something to which you can become dependent. I know I didn’t, at least. It seemed like a minor thing when the doctor first prescribed them. This was a category error: I assumed that the dangerous drugs, regarding risk of dependence, were opioids, benzos, and amphetamines. What is Ambien other than a professional-grade Sominex? Turns out that it’s a more powerful drug than I imagined. Now I tell everybody: never, ever start taking these sleep drugs. If I had known when I first started taking Ambien how hard it would be to stop taking it, I never would have tried it.
Why am I bringing all this up in this newsletter? For a couple of reasons.
First, I wanted to talk about how I am attempting to apply lessons I talk about at lot in this space to something in my own life. I wouldn’t consider it a significant moral failure if I went back to taking Ambien, but I will consider it a moral victory if I can make it to the end of this week free of Ambien, because by then, they say, it’s been flushed from your body. This has been a very hard thing to beat, and rather than panic when I lost the pills, I chose to frame this as an opportunity to do something I’ve wanted to do for many years: beat this dependence. The smart thing to have done would have been to talk to my doctor, lower my prescription dosage, and gradually taper off. Circumstances, however, threw me into the cold turkey situation — not ideal, but I accepted it.
Second, I wanted to express compassion for people struggling with dependencies and addictions. When Jordan Peterson’s dependence on benzodiazepine became public, some people made fun of him for being supposedly weak in character. This was cruel on its face, but especially cruel because Peterson was using the drug as prescribed, and didn’t seek to use them for pleasure. (Many who have become not just dependent on opioids, but addicted to them, started when they were prescribed them for pain.) I don’t think that I have ever actually had a conversation with someone who has been through detox and rehab about their experiences, specifically about the difficulty of withdrawal. To be honest, until now, I never really thought about what withdrawing from a substance would be like — except, of course, after a single night without Ambien, which was enough to put the question out of mind for years.
I’m thinking now about a friend who became an alcoholic — not a bad drunk, but still a drunk. I wasn’t around him a lot, but I know that all of us in his circle worried about him. I had a couple of talks with him, asking him to please get help. He wouldn’t admit he had a problem, though. He eventually died of something unrelated, but now I am thinking about how little I understood what I was asking of him. I regarded his drunkenness as a failure of character, in a come on, man, pull yourself together, you don’t want to be like this way. I resist the total medicalization of addiction, because thinking back to my friend’s life, there were times when he made a choice to lean into alcohol to deal with setbacks, rather than take them on in a more constructive way.
On the other hand, I learned from that same friend once that alcoholism runs in his family — as, alas, it does in mine. Over this past gloomy year, there have been a number of times when I was so bored, sad, and anxious that I would have done just about anything to escape this mood. I have a cabinet full of liquor, but over the past six or seven years, I have lost the ability to have more than one, maybe two, drinks at a time. Anything more and I feel physically bad — like having a hangover, without first having had the pleasure of being tipsy. If I’m honest, it is only the prospect of feeling like crap from even a little drink that has kept me from seeking relief in the bottle in my own bouts with the blues this last year. I thought about this last summer, and my poor buddy, the genial drunk who couldn’t handle his sorrows without booze, and thought for the first time in an alcohol context, There but for the grace of God go I.
I hope I’m not making too much of this. It’s just that as I get older, and see up close how it doesn’t take much for things to go wrong in a life, I find it easier to have compassion for others. I mean, look, being dependent on Ambien is not that big a deal, but lying there last night, desperate to sleep, with an alien in my brain spinning plates, I thought about how much courage it takes for someone who has a serious addiction to commit to detox. If my relatively piddly problem with Ambien is this hard, what must it be like for people hooked on harder stuff?
And I’ll tell you this too: after this experience, I will never let a doctor prescribe an anti-anxiety drug for me, except for one-off uses (like the dental work I had done recently).
Well, last night was another awful night, one in which I don’t think I drifted off till 4 am, and in which I had a nightmare about a nuclear meltdown. But it was a less awful night than the previous two, and I believe tonight will be less awful than last night. According to medical websites, the stuff should be out of my system a week or so after my last dose.
One weird thing about coming off of it is that waking hours are also kind of freaky. You feel not at home in your body, and have periods of fogginess. The good news, though, is that today I started to realize that my perception was clearer, and crisper — which tells me that in twelve years of continuous Ambien use, I had assumed that the thin fog it cast over everything was normal.
This is one of the hardest things I’ve ever done, but I’m really glad I committed to it. A physician friend who subscribes to my newsletter e-mailed me about it this morning. He called Ambien “poison — not for all, but for many,” and added:
It is an unnatural and dangerous drug due to selective neurologic manipulation–I truly think the drugs it was intended to replace–benzos and barbiturates–are less psychologically dangerous because they are general, rather than selective, depressants and modulators.And Ambien–like Oxycontin–is certainly addictive, despite the sales pitches from attractive pharmaceutical sales reps at their unveiling.
Yep. Like I said in last night’s newsletter, every single person I’ve met over the years and talked to about Ambien has said the same thing: they want to be free of it, but can’t, because it’s too hard to come off of it. The withdrawal has been so awful that if I had had any idea that I would easily become dependent on it, and that getting off the stuff was so difficult, I would have refused it when my Dallas doctor first prescribed it. I cannot urge you readers strongly enough never, ever to use a prescription sleep drug, or use it for more than one or two nights. I was so naive, thinking that it was just a sleep aid, and the doctor said it would help, so what could it hurt? To be clear, I never abused Ambien, and used it only as prescribed. And I still got dependent on it.
When I posted that newsletter last night, I still had hours ahead of me until I could finally get to sleep, if “sleep” is what you call what I had. As I struggled to calm my racing brain down, I thought over and over about poor Jordan Peterson, and what he dealt with. I wish I had prayed more often for him when news first broke about what he was dealing with. He started taking prescription benzodiazepine to help him deal with intense anxiety after his wife was diagnosed with cancer. Had I been in his position, I would probably have asked my doctor for the same medication. You might have done so too. I can’t get it out of my head how easy it was to walk into the Ambien trap. I really was tormented by anxiety back then (like Peterson, one of my family members had had a terrible diagnosis), and Ambien came as blessed relief. If I had stopped using it after two weeks, maybe I would have been fine, but nobody told me about the possibility of dependence or addiction, and even if the doctor had, I probably would have ignored him, thinking that dependence or addiction is something that happens to other people.
Again, I don’t want to make too big a deal about this. I just want to leave you with two things:
- Be merciful to those who are trying to kick a chemical dependence or addiction — to booze, to pills, to cigarettes, etc. — because they’re fighting a huge battle, the difficulty of which you may not appreciate until you find yourself having to do it; and
- Never, ever, ever start using Ambien! It is awesome at first, but it will own you.
UPDATE: Thanks for all the good wishes. Last night — the fourth without Ambien — was the best night so far. I had something resembling normal sleep. I used magnesium and melatonin to calm my brain down, and prayed one round of my prayer rope as I lay in bed. That got me to sleep. Trouble was, I had really terrible nightmares, which I almost never have. Coming off this drug reminds me of the accounts I’ve read of exorcism; the thing is fighting hard not to let me go. But I’ve definitely gotten over the hard part, so this is pretty much a done deal now.
I will say that if I had it to do over again, I would work with my doctor on tapering off the stuff. Cold turkey was a real shock to my system, and, based on things I’ve read this week, unwise.
On the up side, I am startled by how much more alert and energetic I am becoming as this garbage works its way out of my system.