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Ambien Abuse and Addiction

How Long Does Ambien Stay in Your System?

Zolpidem is sold under the brand name ‘Ambien’. It is a sedative that is used to treat people suffering from insomnia. The drug starts working within fifteen minutes of consumption. Ambien has a mechanism of action similar to Benzodiazepines but is structurally different from it. Ambien works on the GABA receptors to initiate the sedative and hypnotic effects. It binds to the alpa-1 subunit of GABA receptor and functions as a full agonist. There are many adverse effects caused by the drug such as headaches, palpitations, dry mouth, back pain, sinusitis, abdominal pain, sore-throat, rash, and constipation. Some of the severe adverse effects include memory impairment and hallucinations in long-term users of Ambien. Many people are inclined to stop the use of a drug due to its side-effects. They are interested in knowing the clearance process of drug from the body.

How long does Ambien stay in your system?

The active ingredient of Ambien is Zolpidem. It has a half-life of about 2-3 hours. Many sources have estimated it to be 2.3 hours. It means 50 % of the drug will get eliminated from the body within few hours duration. To complete the excretion of 100 % of the drug from the body, the expected time duration is 11-16.5 hours. On an average, people will tend to eliminate Ambien within 14 hours after the last ingested dose.

Some studies report that the metabolites of Zolpidem like Zolpidem phenyl-4-carboxylic acid (ZPCA) and Zolpidem 6-carboxylic acid (ZCA) linger in the body for longer durations. It has been observed that metabolites will take 3 days to get eliminated from the body system.

Factors that influence how long Ambien stays in your system

As already mentioned, Ambien has a half-life of two to three hours. The complete drug will take about 14 hours to get eliminated from the body. However, it is just an average figure and the time duration is highly variable among individuals, depending on many factors. Such factors include individual attributes, dosages, co-administered agents, frequency and duration of use.

Individual Attributes:

These include age, body mass, genetics, hydration, liver and kidney functions.

  • Age: The clearance process is slower in an elderly person due to lower levels of free testosterone, reduced hepatic flow, and concomitant use of medicines for other health conditions. Younger people have higher metabolization and excretion rate of Ambien than elderly individuals.
  • Body Mass:  People having a larger body mass are capable of metabolizing and excreting the drugs at faster rates. A large individual having a tall height will excrete the drug sooner than his counterpart having a small height and low weight.
  • Genetics:The genetics also play a role in determining the duration of a drug clearance from the body system. Individuals carrying CYP3A4’18 allele have more expression of CYP3A4 isoenzymes. These are involved in the basic metabolism of Zolpidem. Enhanced expression leads to a faster metabolism. Where as individuals expressing CYP2C19’2 have slower rates of metabolism.
  • Food intake:The absorption rate of drug is slower on a full stomach than an empty stomach. Moreover, some foods can also affect the absorption time of Zolpidem.
  • Liver Functions: Hepatic enzymes are involved in the process of metabolism. Any impairment of liver processes can slow down the metabolism. It has been found that the half-life of Zolpidem was extended to 10 hours in the cirrhotic patients.
  • Basal Metabolic Rate (BMR):People having a high BMR burn more energy during rest so they are capable of metabolizing Zolpidem faster than people with a low BMR.
  • Sex: It also plays a role in the case of Zolpidem. Men have higher metabolizing rates than women. It is based on higher testosterone levels in males.
  • Urinary pH: The acidic pH prevents the reabsorption of Zolpidem through the kidney tubules so the whole of the drug gets excreted. Individuals exhibiting alkaline pH have a slower rate of drug elimination through urine. The pH, in turn, is dependent on the type of food eaten by a person. Carrots, limes, dates, and fig turn the pH towards alkalinity.

Dosages:

The higher the doses taken by a person, the more is the time taken by the elimination processes. Larger doses take more time to get metabolized and get excreted. More amount of a drug is circulating through the body and makes a person susceptible to reabsorption process through the kidney tubules.

Co-administration of drugs:

Many medicines and supplements can affect the liver enzymes. Some of the drugs can enhance the rate of metabolism while others tend to slow it down. Drugs like Indinavir, Ritonavir, Clarithromycin, Ketoconazole, and Nelfinavir have inhibitory effects on liver enzymes. Carbamazepine, Phenobarbitol, Oxcarbamazepine, and Rifampicin tend to enhance the functioning of liver enzymes.

Frequency and Duration:

The frequent administration of drug results in higher accumulation and slower excretion of Zolpidem. Duration of use also contributes towards the drug elimination time from the body. The longer duration leads to a more prolonged drug clearance.

Ambien absorption, metabolism, and excretion:

After oral ingestion, the active ingredient is quickly absorbed through the gastrointestinal tract. The hypnotic effects get elicited within 15 minutes and the peak concentration is reached in thirty minutes to three hours after the consumption.

Zolpidem undergoes the first pass metabolism in the liver. The CYP3A4 enzyme, CYP2C9, CYP2D6, CYP1A2, and CYP2C19 enzymes take part in the metabolism of Ambien. All these enzymes act on the drug to break it down into Zolpidem 6-carboxylic acid (ZCA) and Zolpidem phenyl-4-carboxylic acid (ZPCA) metabolites. These are pharmacologically inactive and elimination half-life is 2.6 hours. So the minimum time taken by the metabolites to get cleared from the body is about 13.5 hours.

The process of elimination takes place through the kidneys. Approximately 56 % of metabolites are excreted in urine and 37 % in the feces.

Different types of Ambien drug tests:

The standard tests like SAMHSA-5 cannot detect Zolpidem in the body. However, many extensive tests are available that can detect the metabolites of Zolpidem. The tests that can be utilized for this purpose are blood tests, urine tests, saliva tests and hair tests.

  • Urine Tests:

Only 1% of unchanged Zolpidem is excreted through urine. So the tests are designed to assess the presence of Zolpidem metabolites. A prominent metabolite is Zolpidem phenyl-4-carboxylic acid (ZPCA). The drug can be recognized in urine samples for up to three days after the last ingestion. Minimum levels of a drug that can be identified are 2ng/ml. Gas chromatography/mass spectrometry (GC/MS) is used for analysis of urine samples. Urine sampling is a preferred way for Ambien detection because it is non-invasive, a convenient test, and gives accurate results.

  • Blood Tests:

Blood tests are not routinely done as they are invasive and provide a shorter window for detection. They are used by medical professionals to diagnose the cases of overdose and intoxication. The blood levels are attained within few minutes of drug consumption so blood samples will show the presence of the drug in less than half an hour.

After ingestion of 5mg of Ambien, peak levels are reached within 1.6 hours. A 5mg dose has a peak concentration of 0.06mg/l and peak level of 10 mg dose is 0.20mg/l. Generally, a higher the dose is consumed, the detection becomes easier in blood tests.

  • Hair Tests:

Zolpidem gets accumulated in the hair follicles. The test is used for detection of Ambien up to 2 months after the last ingestion of drug. Hair analysis involves the collection of head hair follicles of more than 3 cm length. A single dose of Ambien can result in accumulation of 1.8 pg/mg – 9.8 pg/mg in the hair. It is an accurate test and is mostly reserved for the investigations in criminal cases.

  • Saliva Tests:

It is used for immediate detection of drug levels in the body. A sample of oral fluid can show the traces of Zolpidem in 15 minutes. Research studies have confirmed the presence of Zolpidem in oral fluids for up to eight hours. The salivary tests are easy to perform and are non-invasive tests. Moreover, they are precise and drug levels appear within minutes. Many more tests are under trials that will further improve the accuracy of salivary tests.

Tips to clear Ambien from the system faster:

There are some methods that can expedite the clearance process of Ambien.

  • A person has to completely abandon the drug for several days. Even the minute quantities will affect the duration of achieving a drug-free body system.
  • Foods such as grains, meats, and chocolates can reduce the urinary pH. The pH range in the acidic zone is helpful in the excretion process.
  • Maintain adequate hydration as it improves the urinary flow rate. It is important to take the suitable amounts of fluid. Too much excess is dangerous too.
  • Taking supplements that can induce CYP3A4 enzymes can increase the metabolism of the drug. This must be taken after the proper consultation of doctors.

Some facts and figures on Ambien abuse:

Use of prescription medications is a widespread problem in United States. People who abuse it also frequently combine it with other drugs and alcohol which significantly increases its harmful effects.

  • A National Survey on Drug Use and Health conducted in 2013 revealed that over 250,000 Americans were abusing Ambien and other sedatives.
  • About 70% of emergency room visits involving Ambien were by female patients. It shows that women are more likely to abuse Ambien than men.
  • About 500,000 Americans are currently abusing Ambien and other sedatives.
  • The number of Americans who think abusing prescription drugs is not associated with any significant side effects is alarming.

If you suspect a loved one of abusing Ambien, keep a close check on them and look for signs and symptoms of abuse. Get them the help they need as soon as you are sure about their addiction.