Substance Abuse (Depressants)

What Is It?

Depressants are medications that slow down or "depress" the activity of the brain. They include calming sedatives, sleeping pills and anti-anxiety tranquilizers (all prescribed by doctors), as well as related chemicals that are not legally available in the United States. The most commonly abused depressants are barbiturates (Amytal, Nembutal, Seconal, phenobarbital) and benzodiazepines (Ativan, Halcion, Librium, Valium, Xanax, Rohypnol). Other drugs in this group include chloral hydrate (which when mixed with alcohol was once known as "knockout drops" or a "Mickey Finn"), glutethimide (Doriden), methaqualone (Quaalude, Sopor, "ludes") and meprobamate (Equanil, Miltown and other brand names). Although alcohol is also a depressant, the widespread abuse of alcohol in our society has prompted health experts to classify alcohol-related problems separately.

Tolerance is a feature of all these medications with continued use. That is, the body adjusts to them in such a way that it takes a higher and higher dose to achieve a "high," much like alcohol. Dependence also can develop, meaning that the person will experience withdrawal symptoms if he or she suddenly stops taking the drugs.

Many of these drugs have legitimate uses. Benzodiazepines are good for anxiety and sleep disorders. Barbiturates still are used for seizure disorders and anesthesia. But the use of these drugs solely for purpose of getting "high" has a distinctly different and potentially more dangerous pattern than their use for medical purposes. When used in therapeutic doses, they usually are effective in providing and maintaining relief from symptoms of an illness. When the purpose is to achieve euphoria, distraction or another state of mental distortion, higher and higher doses are required to achieve the same "high" effect as tolerance develops. The danger comes if a person accidentally takes too much or if the supply is cut off.

Barbiturates are quite dangerous in an overdose. There is a relatively small difference between the dose that will cause the desired effect and that which can cause an overdose. A small miscalculation, easy to make, can lead to coma, respiratory distress (when breathing slows or stops) and death. Withdrawal from barbiturates is similar to, and sometimes more severe than, alcohol withdrawal. Seizures are possible and death can occur.

Benzodiazepines generally are safer drugs capable of causing sedation, but rarely respiratory depression or death. They do, however, have the potential to be psychologically harmful when taken excessively. They can cause over-sedation, memory impairment, poor motor coordination and confusion. Withdrawal reactions can be extremely uncomfortable.

Any of these drugs, taken in combination with each other, or with alcohol, has the potential to cause serious impairment and death. However, these drugs often are taken in combination, for example, to augment a high or to counter the unpleasant side effects of other street drugs.