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Substances in the Depressants Category

Opioids, tranquilizers, sedatives, and alcohol are all depressants.

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Depressant drugs, commonly referred to as central nervous system depressants (CNS depressants), are substances that slow down the functioning of the brain.

These drugs do this through many different mechanisms of action. Most often, they increase the amount or effectiveness of inhibitory neurotransmitters in the brain like gamma-aminobutyric acid (GABA).

Many of the drugs in this category have important medical uses like controlling the experience of pain, reducing anxiety, blocking seizure activity, and assisting with sleep.

Types of Depressant Drugs

The major categories of prescription drugs in this classification include opioids, tranquilizers, and sedatives (or hypnotics). Opioid medications are primarily designed to address issues with pain; tranquilizers can be used to manage anxiety or seizures; and sedatives are typically designed to assist with sleep or treat muscle spasms.

There is some overlap in how these drugs are prescribed. For instance, certain tranquilizers cause drowsiness and may be used to encourage sleep, whereas certain sedatives may also be used to address anxiety.

In addition to the prescription medications listed above, the most commonly used CNS depressant drug is alcohol. Alcohol has similar effects to many of the drugs listed above.

Opioids

Opioid drugs are derived from the Asian poppy plant (from opium), or they are synthetic (man-made) substances that resemble the compounds that are extracted from or found in opium.

Here are some examples of prescription opioids:
  • Morphine
  • Vicodin, Lortab, and Norco (acetaminophen and hydrocodone)
  • OxyContin (oxycodone)
  • Fentanyl
  • All substances containing codeine
  • Methadone

There are also illicit opioids like heroin that have the same properties as the drugs above, but they are not deemed to be medically useful in the United States. Some other countries allow limited prescriptions of heroin.

Opioid drugs work by attaching to the endogenous opioid receptors in the brain, which are involved in your natural ability to deal with pain and stress.

The major medical use of prescription opioids is for the control of pain, although these drugs also have some other medical uses. When they are used to control pain, according to the prescribing physician’s instructions, people do not develop substance use disorders (opioid use disorders) as often as people who obtain these drugs without a prescription and use them to induce euphoria or for other reasons. Organizations like the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) estimate that probably only around 10 percent of people who have prescriptions for these medications develop opioid use disorders.

Tranquilizers

Medications listed as tranquilizers by SAMHSA include benzodiazepines and barbiturates.

These medications slow the functioning of the central nervous system by increasing the availability of GABA. They are primarily designed to treat

the anxiety that occurs with mental health disorders (like anxiety disorders, depressive disorders, and other disorders), to treat seizures, and as potential sleep aids. They may be useful in treating withdrawal from other tranquilizers or alcohol.

The earlier class of these drugs, barbiturates, include these drugs:
  • Seconal (secobarbital)
  • Luminal (phenobarbital)
  • Mebaral (mephobarbital)
  • Nembutal (pentobarbital)

Barbiturates were once widely prescribed for the treatment of anxiety, but these drugs also became major drugs of abuse, and many overdoses occurred. The development of benzodiazepines resulted in barbiturates being prescribed less often. These days, barbiturates are more often used in clinics or hospitals than they are prescribed outside of these environments.

Benzodiazepines were considered a safer alternative to barbiturates, but they have also become significant drugs of abuse.

These are the major benzodiazepines:
  • Valium (diazepam)
  • Xanax (alprazolam)
  • Klonopin (clonazepam)
  • Halcion (triazolam)

Nonbenzodiazepine Sedatives-Hypnotics

Sedatives (hypnotics) are primarily designed to act as sleep aids, although benzodiazepines like Xanax are also used for this purpose.

Sedative drugs also work on GABA and have actions similar to benzodiazepines, but they are often not as potent as benzodiazepines and not useful in treating seizures or alcohol withdrawal. In some cases, they might be useful for decreasing mild levels of clinical anxiety, but they are not commonly prescribed for this purpose.

The following are some of the most popular sedative drugs:
  • Sonata (zaleplon)
  • Lunesta (eszopiclone)
  • Ambien (zolpidem)

Alcohol

You probably need no introduction to the different types of alcoholic beverages that are available.

Ethyl alcohol (EtOH), the alcohol that is contained in alcoholic beverages, is also a powerful central nervous system depressant that has many actions similar to the prescription drugs described above. It can reduce the sensation of pain, decrease anxiety, and initiate sleep.

Use Statistics

  • In 2016, about 6.1 million people reported misusing a tranquilizer within the year prior to taking the SAMHSA survey. In 2017, this figure was about 5.9 million.
  • In 2016, about 2 million people reported misusing a tranquilizer within the month prior to taking the survey. In 2017, this number was 1.7 million.
  • In 2016, about 1.5 million people reported misusing a sedative at least once during the year prior to the survey. In 2017, this figure was about 1.4 million.
  • In 2016, about 497,000 people reported misusing a sedative within the month prior to taking the survey. In 2017, the figure was 352,000.
  • In 2016, about 11.8 million people reported misusing an opioid drug within the year prior to the survey. In 2017, this figure was 11.4 million.
  • In 2016, about 3.6 million people reported misusing an opioid in the month prior to the survey. In 2017, this figure was 3.5 million.
  • In 2017, it was estimated that nearly 15 million people in the United States over the age of 18 would qualify for a diagnosis of an alcohol use disorder.

Misuse of a medication refers to using the medication for a reason other than its medicinal or prescribed purpose. Abuse is a chronic pattern of misuse.

Sedatives and tranquilizers are rarely primary drugs of abuse. When they are abused, they are often taken in conjunction with opioid drugs or alcohol.

Signs of Abuse

The following are some of the signs that someone might be misusing or abusing a CNS prescription medication:

  • They have a prescription for it and they take the medication in a larger dose than prescribed, take it more often than prescribed, or take it in a manner that is inconsistent with the way it should be taken. They may crush pills and sorting the powder or consistently take the medication with alcohol.
  • They seek to get multiple prescriptions from different physicians.
  • They take someone else’s prescription medication.
  • They buy the medication illegally.
  • They frequently take the medication to deal with stress or get high.

Withdrawal and Overdose

People who develop substance use disorders to CNS depressants (alcohol use disorders; sedative, hypnotic, or anxiolytic use disorders; or opioid use disorders) often experience withdrawal symptoms if they suddenly stop taking these substances. Withdrawal symptoms associated with stopping alcohol, barbiturates, or benzodiazepines can be fatal because of the potential to develop seizures.

When a person is abstinent from using these drugs for a short period of time, their tolerance level decreases. They are then at a significant risk for overdose if they relapse.

Overdoses on any of the above drugs can be fatal. Anyone attempting to recover from any of these substance use disorders should understand that they may be at an extreme risk for serious consequences if they do not seek medical attention during the early stages of their recovery.

The first step in the recovery process after a full assessment is a medical detox program. In the case of opioid drugs, you would be given an opioid replacement medication like Suboxone (naloxone and buprenorphine) or methadone. These drugs can control withdrawal symptoms. Over time, your physician will slowly taper down the dosage as symptom severity declines.

In the case of tranquilizer abuse, sedative abuse, or alcohol abuse, you will most likely be administered a long-acting benzodiazepine on the same type of tapering schedule.

Medical detox should only be attempted under the supervision of a licensed physician. You should not attempt to try this yourself.

Therapy for Substance Abuse

During the detox process and in ongoing treatment, you’ll participate in substance use disorder therapy, get involved in peer support groups like 12-step meetings, and engage in any other interventions your treatment team recommends.

In therapy, you’ll learn how to remain abstinent, acquire tools to deal with temptations to use, and create a relapse prevention plan. The longer you remain in treatment, the better the chances of long-term recovery success.

In addition to treatment, successful recovery often depends on support from family members and friends. It is extremely important that you enlist the aid and support of people close to you to assist you. If you don’t have family or close friends to support you in this effort, you can build this support network in treatment.

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