Plugging Ambien: The Dangers Rectal Zolpidem Use

Putting Ambien up the rectum, commonly called “plugging,” is one of the more dangerous and uncommon methods of drug abuse. This practice involves inserting the medication directly into the rectum, where it’s absorbed through the intestinal walls and enters the bloodstream more quickly than oral administration. While some people with addiction believe this method is safer than injecting drugs because it avoids needle-related risks like HIV or hepatitis, plugging Ambien creates its own health dangers.

The rectal tissue is delicate and not designed to handle foreign substances like crushed pills or dissolved medications. This method can cause severe damage including diarrhea, ulcers, tears in the rectal lining, bowel dysfunction, and serious infections. When the protective membranes in the rectum are damaged, it creates open wounds that significantly increase the risk of sexually transmitted infections and other complications. In severe cases, the damage can be so extensive that medical procedures like colostomy surgery become necessary. This practice is also known by other names including shelving, boofing, butt chugging, or shafting.

Ambien Plugging: Why Do People Do It?

In addition to the belief that plugging Ambien is safer than injecting it (it’s not), some believe that rectal administration will make the euphoria and ‘high’ last longer than smoking, snorting, or swallowing the drug.

Research suggests rectal administration generally produces a faster onset than oral ingestion due to higher bioavailability, but the effects also fade more quickly. The belief that plugging makes a high last longer is not supported by the evidence. If anything, the opposite is true.

The more a medication is prescribed, the higher the rate of misuse is for that drug. Ambien is one of the most commonly prescribed medications in the United States, and it also has high rates of misuse. Not to mention, this specific drug has been getting a lot of attention for some of its side effects.

About Ambien

Ambien is a sleeping pill prescribed for the treatment of insomnia and is the brand name of generic medication, zolpidem. Ambien is one of three ‘Z-drugs‘, including zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta).

Z-drugs were initially believed to carry lower dependence risk than benzodiazepines, but this has since been revised. Current FDA guidance and prescribing recommendations reflect that Z-drugs carry a real risk of dependence and misuse, particularly with long-term use.

When prescribed, there is a disclaimer that people should take Ambien as short-term as possible. Over time, Ambien can stop helping people fall asleep and lead to an increased risk of developing dependence and addiction. Continuing to use Ambien after a prescription is gone is considered drug abuse.

Signs Of Ambien Abuse

Abusing Ambien has become increasingly popular in online communities like Reddit, where users share stories about their experiences with the drug. From 2005 to 2010, emergency room visits related to Ambien reactions increased by over 200 percent, with most people reporting hallucinations, agitation, sleepwalking, and dangerous daytime drowsiness. The documented cases of severe reactions have been so concerning that the FDA mandated dosage reductions for certain people.

Reported side effects and dangerous behaviors from Ambien abuse include:

• a 45-year-old man with no history of violence who murdered his wife with no memory of the event
• a 62-year-old woman with no history of violence who killed her husband
• sleep-eating episodes where one person gained 50 pounds in 12 months
• a California woman who struck a pedestrian while driving under the influence of Ambien
• bizarre behavior with complete memory loss of the events
• complex sleep activities like cooking or cleaning while unconscious
• increased or hypersexual behaviors
• severe mobility problems and coordination issues
• complete blackouts lasting hours
• extreme aggression and irritability
• acting far more uninhibited than normal personality would suggest

These behaviors have made Ambien abuse a serious public health concern, leading to stricter prescribing guidelines and increased awareness about the drug’s potential for misuse.

It’s also worth noting that these extreme cases (homocides) represent the outer edge of documented Ambien reactions and are not typical outcomes. They are included to illustrate the documented potential for complex sleep behaviors and complete amnesia, not to suggest that Ambien misuse predictably causes violence.

Dangers Of Plugging Ambien

Beyond the already serious risks that come with abusing Ambien, plugging the medication creates additional physical dangers that can cause lasting damage to your body. The rectal tissue is extremely delicate and wasn’t designed to handle foreign substances like crushed pills or dissolved medications. When Ambien is inserted rectally, it can cause tears in the colon, severe rectal bleeding, and painful infections in the rectal lining that may require medical treatment to heal properly.

The damage from plugging Ambien can also lead to long-term complications that affect your quality of life. Many people experience a complete loss of bowel control, chronic pain in the affected area, and impaired blood flow to the rectum and surrounding tissues. These injuries can become permanent and may require surgical intervention or ongoing medical care. The combination of Ambien’s dangerous side effects with the physical trauma of rectal administration creates a particularly high-risk situation that can result in emergency medical situations.

Inserting a pill can introduce problematic bacteria into the area, as well as transfer fecal matter to areas outside the body, increasing the possibility of infection. Dissolving the pill in water and using an oral syringe can increase the risk of tearing or perforation of the thin membrane in the anal cavity.

Treatment For Ambien Abuse

It is important to seek substance use disorder treatment if you or a loved one is abusing or is addicted to Ambien. This sedative-hypnotic non-benzodiazepine carries a variety of dangerous side effects, some with permanent consequences.

Treatment options may include:

• cognitive behavioral therapy (CBT)
• dialectical behavior therapy (DBT)
• cognitive behavioral therapy for insomnia (CBT-I)
• dual diagnosis treatment
• inpatient treatment
• outpatient treatment
• medical detoxification
• case management
• counseling
• aftercare

Additionally, people who have been using Ambien regularly and want to stop should not do so abruptly. While Ambien withdrawal is generally less dangerous than benzodiazepine or alcohol withdrawal, it can cause rebound insomnia, anxiety, tremors, and in some cases seizures, particularly with long-term or high-dose use. A gradual taper under medical supervision is the recommended approach.

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Written by the Addiction Resource Editorial Staff