Definition of Sedatives
Sedatives represent a variety of medications and drugs made for the purpose of relaxing the central nervous system. Downers are also referred to a CNS (central nervous system) depressants and tranquilizers. There are several types of drugs that fall under the category of downers, including the following:
- Opioid narcotic medications
- Some herbal remedies
- Non-benzodiazepine sedative-hypnotics
- Some kinds of antihistamines
Alcohol was the most commonly recommended downer for the management of insomnia and anxiety before there was modern medicine. Because it was found to be beneficial to some, it became very popular and is still the most commonly abused downer in the US.
Bromides were first discovered in 1826 as a downer to be used in place of alcohol. Bromides became very popular as a downer until it was discovered that it can build up in the body, resulting in toxic effects.
In the early 20th Century, barbiturates began to replace bromides, largely because of the toxicity of the latter. They were initially believed to be safe and effective drugs for sedation but were quickly found to have problems with tolerance, drug dependence, and fatal overdoses. The safety margin for barbiturates was felt to be too narrow, so researchers began to look for downers that could be both effective and safe.
Benzodiazepines were the next downer to be tried on people requiring a sedative drug in the mid-1950s. They were initially believed to be completely free of withdrawal symptoms, tolerance, and dependence but it has since been discovered that, while benzodiazepines could be an effective downer, it has the same negative side effects when used for long periods of time.
Downers were popularly prescribed in the 1970s and 1980s for conditions as diverse as anxiety and insomnia. Even now, benzodiazepines are frequently prescribed, even as physicians understand its abuse and addictive potential.
Mechanism of Action and Effects
Downers come under a variety of classifications and each acts on the body in different ways. Each downer has its own mechanism of action toward the central nervous system. There doesn’t appear to be any one receptor or mechanism of action that applies to the different types of sedatives.
For example, barbiturates result in a generalized mechanism that blocks the activity of most nerve cells. They are considered to be nonselective because they act on different brain functions. This is why the use of barbiturates is associated with impairments in cognitive function.
On the other hand, benzodiazepines have a selective effect on the nerve cells that have GABA receptors on their surface. GABA is a critical neurotransmitter that inhibits the function of several parts of the brain. When benzodiazepines are used, GABA has an increase in its inhibitory effects on the brain. Benzodiazepines are considered selective sedatives.
Most downers are absorbed rather quickly and go through the GI tract. Both barbiturates and benzodiazepines are generally absorbed by the small intestine, where they travel throughout the bloodstream and pass through the blood-brain barrier. They are metabolized by the liver cells and eliminated by the body by means of the liver.
There is a classification of downers, including the sleeping pills known as Sonata, Ambien, Lunesta, Seconal, and Amytal. The last two drugs are considered barbiturates. All of these drugs result in sleepiness, drowsiness, and anxiety reduction. They have physiological effects, such as a lowering of the heart rate and the suppression of respirations. An overdose can cause respiratory depression and death. The effect is potentiated when downers are taken with opioids or alcohol.
One of the major side effects of downers is their ability to be addictive and their potential for causing drug abuse. Tolerance can quickly develop, which means that more of the drug is necessary to have the same effect as the lower dose. It can occur when the drug is prescribed by the physician or is used as an illicit drug.
People who take a dose too soon after the previous one or take an excessive amount trying to experience euphoria, overdoses are more likely. This can result in developing a coma or dying from an overdose.
Those who take downers may appear to be drowsy, may stagger when walking, may have slurred speech, trembling of the hands, dilated pupils, a weak pulse, and poor coordination. Confusion may be present, and the individual taking sedatives can appear to be depressed, disoriented, or confused. There may be mood swings from an elevation in mood to a severe reduction in mood.
Negative Side Effects
People taking downers may experience these negative effects:
- Loss of their normal personality
- Aggression towards others
- Increased anxiety
- Thoughts of self-harm or suicide
- Depressive symptoms
At times, the individual’s doctor may become concerned that the patient is on the sedative for too long a period of time. This can result in a cutting off of the drug. In response to this, the patient may doctor shop, purchase the sedative on the black market, get the drug from the internet, or resort to fraudulent activities.
Donwers sometimes hang on in the body longer than expected, especially when the drug is taken in quantities suggestive of abuse. The person may lack the ability to drive a car, be productive at work, get an education, or care for their children. The use of sedatives can ruin a person’s life. The abuser of sedatives can lose the ability to enjoy activities they used to find pleasure in. The risk of overdose and death lies over the head of any individual that chooses to take sedating medications.
If you or a loved one is addicted to downers and wants to get over their addiction, a professional who deals with addictions should be contacted. Withdrawing from sedatives abruptly can lead to seizures, delirium, and possible death. The addict may need to stay in a medically-supervised detoxification program before entering treatment for their addiction.
When taking an overdose of a benzodiazepine without taking any other downer will rarely cause significant morbidity or mortality. If the drugs are mixed with other drugs, the effect of the sedative can be potentiated. Intravenous use of benzodiazepines is linked to increased degrees of respiratory depression.
Typical signs and symptoms of a benzodiazepine abuse may include these findings:
- Blurry vision
Physical findings can reveal the following:
- Cognitive impairment
- Muscle weakness
- Decreased muscle tone
- Slurred speech
- Low blood pressure
- Respiratory depression
- Paradoxical agitation
Even when taken in the right doses and under the guidance of a physician, sedative abuse can happen to anyone. When this occurs, the individual may need to seek treatment in order to detoxify from the drug and begin the process of addiction treatment.