Is It Safe to Mix Sleeping Pills with Prescription Opioids?

Combining prescription medications without the permission and approval of your healthcare provider can be risky, as some prescription medications may have dangerous interactions with other prescription medications or even over-the-counter medications. One example of this is seen with CNS depressants such as prescription sleeping pills and opioids, as both medications can trigger the onset of unwanted and life-threatening side effects that can lead to a number of risks, including overdose and death.¹ 

This article will dive deeper into the effects of sleeping pills and prescription opioids both independently and collectively, the risks of overdose, and how to prevent misuse and addiction.

Combining Sleep Aids and Opioids

There are several reasons why someone may combine sleep aids and opioids. For example, some individuals may take the two simultaneously and not recognize the dangers of doing so while others may mix them intentionally for their own personal purposes. This can include attempting to self-medicate pain and/or sleeping problems or to increase sedative effects.¹ In some cases, unintentional misuse can occur if a prescription opioid or sleep aid obtained illicitly is cut with another substance, such as fentanyl.¹

Effects of Sleeping Pills

Sleeping pills are central nervous system depressants (CNS depressants) that are commonly prescribed to treat sleep disorders such as insomnia.² When taken as prescribed, sleeping pills can be highly beneficial in reducing symptoms of sleep disorders and therefore, increase the quality of one’s life. However, when taken outside of the guidelines prescribed by a professional, sleeping pills can be dangerous.

There are several types of medications used to treat sleep disorders, including benzodiazepines (Restoril, Halcion), antihistamines (Benadryl, Unisom), and hypnotic sleep aids like Ambien and Lunesta.³ These medications work to  either induce or maintain sleep and reduce arousal and stimulation.² While this is a purposeful effect of these medications, there are many additional side effects that can be associated with sleeping pills, including:³

• Drowsiness.
• Dizziness.
• Headache.
• Lightheadedness.
• Involuntary movements.
• Diarrhea.

Effects of Opioids

Prescription opioids are also CNS depressants and are designed to help treat moderate to severe pain.⁴ They bind to opioid receptors throughout the brain and body, allowing for temporary pain relief.⁴ When used as directed, prescription opioids like OxyContin and Vicodin can help bring comfort to those experiencing physical pain. However, prescription opioids can be habit-forming, as the sedative effects they produce can be highly desirable.⁴

Both the controlled use and misuse of these prescription medications can cause several unpleasant opioid effects, including but not limited to, the following:⁴

• Confusion
• Drowsiness
• Constipation
• Nausea

Slowed breathing, a possible effect of prescription opioid misuse, can lead to the development of a condition known as hypoxia, which occurs when not enough oxygen is reaching the brain.⁴ Hypoxia can be extremely dangerous and even fatal, potentially leading to irreversible brain damage, coma, and death.⁴

Effects of Combining Sleeping Pills and Opioids

Prescription sleeping pills and prescription opioids each have their unique and potentially dangerous side effects. When combined, these side effects can be amplified. Mixing these prescription medications together can heighten the risk for serious complications such as damage to the brain and other organs, overdose, and death.¹ Additional effects of using sleeping pills with opioid painkillers can include:¹

• Passing out.
• Weak pulse.
• Altered mental status.
• Confusion.
• Slowed breathing.

These effects are short-term, however the continued misuse of these types of prescription medications can lead to further long-term effects.

Long-Term Risks

As previously mentioned, the combined use of sleeping pills and prescription opioids can cause damage to the brain and other organs, which can create several long-term problems that last even after misuse has ceased.¹ An unfortunate long-term risk of this type of substance misuse is the potential for the development of dependence and addiction.

Dependence occurs when physical adaptations have developed because of substance misuse, causing the onset of withdrawal symptoms when drugs or alcohol are reduced or discontinued.⁵ Someone who is experiencing dependence on CNS depressants like sleeping pills or opioids can develop withdrawal symptoms ranging from anxiety and insomnia to seizures and hallucinations, depending on the exact CNS depressant they have been consuming.⁶

Addiction is not the same as dependence, as this term refers to the inability to control urges to consume drugs or alcohol despite the negative consequences that misuse may cause.⁵ Unfortunately, the continued misuse of sleeping aids and opioids can lead to dependence and/or addiction, both of which are considered very costly long-term risks, as they can both be fatal.

Dangers of Overdose

Overdosing on CNS depressants like sleeping pills and opioids can occur and can lead to severe symptoms and potentially death.⁶

Someone who is overdosing on opioids may exhibit the following symptoms:

• Bluish color around fingernails or lips
• Vomiting
• Inability to be aroused
• Slowed breathing
• Slowed heartbeat

Depending on the type of sleeping pill an individual is misusing, there may be several symptoms that occur during an overdose, including, but not limited to, the following:^8,9,10

• Impaired consciousness
• Coma
• Slowed breathing
• Severe drowsiness
• Sedation
• Cardiac arrest

An overdose is more likely when both sleeping pills and opioids are combined.

Legitimate Prescriptions and Safety

According to the Centers for Disease Control and Prevention, there are approximately one in six adults with a diagnosed sleep disorder.¹¹ In the United States, one in eight individuals with problems sleeping use sleep aids.¹¹ Additionally, more than 142 million opioid prescriptions were written in the United States in 2020 alone.¹² With these medications being as widely prescribed as they are, it is imperative to be sure that you are consuming them safely. Some ways that you can ensure that you are taking your prescription medications properly can include the following:¹³

• Follow all provided instructions
• Take all medications on time
• Speak with your doctor if you are having any problems with your medication
• Always ask your doctor before suddenly stopping your medication
• Do not share your medication with others

Treatment for Polydrug Misuse

It is a common misconception that prescription drugs are not dangerous, especially since they are most often provided by a doctor, but they do come with side effects and risk factors. If you are struggling with the misuse of prescription sleeping pills or opioids, know that you are not alone. Seeking professional treatment can help you overcome the challenges you are experiencing and begin living a fulfilled life.

At our inpatient rehab in New Jersey, we provide various types of addiction treatment that can help you put a stop to your active addiction so you can reclaim your life. Call us right now at to be connected with one of our rehab admissions navigators. They can help answer all of your questions, including those about insurance coverage for rehab and paying for rehab.

Do not wait any longer. Take the first step in your recovery right now and have your insurance verified by filling out our