From Chapter Two of the book
How to Quit Drugs for Good
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The depressants include a vast array of synthetic drugs. All but two of them are manufactured as prescription medications by U.S. pharmaceutical companies.
The depressants, also called “downers,” have one thing in common. Like alcohol, they depress the central nervous system (CNS), meaning that they reduce the overall nervous activity in the brain and the nervous system. In other words, they calm us. They can reduce anxiety, and they can help us sleep. For this reason, we refer to this whole class of drugs as sedative-hypnotics: “sedative” because of their calming effect and “hypnotic” because they induce sleep. We also know them as “tranquilizers,” “anxiolytics,” and “anti-anxiety medications.”
Chloral hydrate. Synthesized by chemists in the 1800s, this became the first depressant to be widely prescribed, usually as a hypnotic. Over the years, however, its use decreased, especially after the advent of barbiturates in the early 1900s and of benzodiazepines in the 1950s, yet it’s still prescribed occasionally today. It has been marketed as a potable syrup and in soft gelatin capsules (trade names: Chloral Hydrate, Notec, Somnos, Felsules). Small doses of this substance, when added to alcohol, will cause an individual to pass out. This led to one of the illegal uses of this drug: spiking someone’s drink to knock the person out. Because of this, chloral hydrate acquired the less-than-savory nickname “knockout drops” and, when combined with an alcoholic beverage, became known as a “Mickey Finn.”
Barbiturates. The first barbiturate, Barbital, became available as a medicine in the late 1800s. By the 1930s, physicians were prescribing many varieties of barbiturates for numerous complaints. The barbiturates’ strong potential for addiction became known by the late 1940s, and by the 1960s pharmaceutical companies began withdrawing products from the market. Besides, these companies began marketing what they called a “safer” and “less addicting” group of depressants known as benzodiazepines. The benzos, it turns out, are just as highly addicting as the barbs, but they do have a much lower potential to cause death by overdose. At one time there were nearly 50 different barbiturates available. Today there are only about 15. The barbs became one of the most widely abused classes of drugs in the 1960s and 1970s. AKA for barbiturates in general: Barbs, Downs, Bears, Goofballs, Fool Pills, Sleeping Pills, Stumblers.
Researchers classify the barbiturates into four categories, depending on the duration of their effects and how quickly their effects begin. The ultra-short-acting produce anesthesia within about one minute after injection. Those in current use (along with trade names) include methohexital (Brevital), thiamylal (Surital), and thiopental (Pentothal). Short-acting and intermediate-acting barbs include pentobarbital (Nembutal), secobarbital (Seconal), amobarbital (Amytal), and a combination of amobarbital and secobarbital (Tuinal). Typically, these have been the preferred barbiturates among barb abusers. Other short-acting to intermediate-acting barbs include butalbital (Axotal, Esgic, Fiorinal, Fioricet), butabarbital (Butisol), talbutal (Lotusate), and aprobarbital (Alurate). The onset of action for these is 15 to 40 minutes, and the effects last up to six hours. Physicians prescribe these for both their sedative and their hypnotic effect. Long-acting barbs include phenobarbital (Luminal) and mephobarbital (Mebaral). The onset of action for these is one hour, and the effects last up to 12 hours. Physicians prescribe these for seizure disorders or the treatment of anxiety. AKA for Amytal: Blues, Blue Devils, Blue Tips, Blue Birds, Blue Heavens, Blue Dolls, Blue Bullets. AKA for Luminal: Purple Hearts. AKA for Nembutal: Nebbies, Nimbies, Yellows, Yellow Jackets, Yellow Dolls, Yellow Bullets. AKA for Seconal: Reds, Red Devils, R.D., Seekies, Red Birds, Mexican Reds.
Barbiturate-like drugs. Pharmaceutical companies developed two depressants, glutethimide and methaqualone, as “similar but safe alternatives” to barbs. However, both proved to be just as addicting as barbiturates, and their potential for overdose was just as great. Even worse, emergency medical personnel find overdoses from these two drugs more difficult to treat than overdoses from barbiturates. Glutethimide (trade name: Doriden) was first available in 1954 and methaqualone (Quaalude, Sopor) in 1965. Because of the frequency of overdose deaths from these two drugs, U.S. pharmaceutical companies stopped manufacturing methaqualone in 1984, and the U.S. Drug Enforcement Agency put tighter controls on glutethimide in 1991. There was some underground production of methaqualone after 1984, but the drug kept losing in popularity and by the mid-1990s was virtually unavailable on the streets. Other barbiturate-like medicines include ethchlorvynol (Placidyl), ethinamate (Valmid), and methyprylon (Noludar). Physicians don’t prescribe the barbiturate-like medicines very much anymore. When they do, it’s usually as hypnotics. AKA for methaqualone: Ludes, Soapers, Quads, Sopes.
Meprobamate. First marketed in 1965, this drug reduces anxiety and muscle spasms. Also, at therapeutic doses it’s not as toxic as the barbiturates or barbiturate-like drugs. It’s still occasionally prescribed today. Trade names: Miltown, Equanil.
Benzodiazepines. In 1957, the first benzodiazepine (trade name: Librium) entered the scene. Today, about 15 benzodiazepines are marketed in the United States and another 20 in other countries. They’re some of the most widely prescribed drugs in the world, and it’s no wonder. This group of sedative-hypnotics does it all. They produce sedation, relieve anxiety, induce sleep, decrease muscle spasms, prevent seizures, and act as an adjunct to anesthesia.
Shorter-acting benzos, used mainly as hypnotics, include estazolam (ProSom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril), and triazolam (Halcion). Longer-acting benzos, prescribed mainly as sedatives, include alprazolam (Xanax), chlordiazepoxide (Librium), chlorazepate (Tranxene), diazepam (Valium), halazepam (Paxipam), lorazepam (Ativan), oxazepam (Serax), and prazepam (Centrax). Doctors prescribe clonazepam (Klonopin) mainly for seizure disorders and midazolam (Versed) as an aid to anesthesia. One benzo, Flunitrazepam (Rohypnol), has been gaining popularity as a party drug. It’s not marketed in the United States, but it is smuggled in from other countries where it’s legal. AKA for Librium: Libs, Libbies. AKA for Valium: V. AKA for Rohypnol: Roofies, Ruffies, Roaches, Trip-And-Fall, Mind Erasers, Mexican Valium.
GHB (Gama-hydroxybutyrate). GHB is another CNS depressant. It causes intense drowsiness, sometimes unconsciousness, and even coma. It can also cause amnesia: the loss of memory for what happened when you were high. This drug is not legally produced in the United States but comes out of clandestine laboratories. Like Rohypnol, it has gained recent popularity as a party drug. AKA: GBH, Grievous Bodily Harm, Liquid Ecstasy, Liquid X, Georgia Home Boy, Easy Lay.
Combinations. Many heroin and cocaine users also take depressants—sometimes to augment their buzz on heroin or cocaine and sometimes to ease their tensions when coming down. Some people get addicted to various combinations of ups and downs, often taking ups all day long and downs at night. A combination of Doriden and codeine has become popular with some users (AKA: Dors and Fours).
How They’re Used
Almost invariably, people take depressants orally by capsule or tablet or in liquid preparations. The onset of action for the depressants varies from one minute to one hour, and the duration of the high varies from a half-hour to half a day. GHB comes as a white powder that users often mix with water and then drink.
SAMHSA’s 1996 National Household Survey on Drug Abuse divided the depressants into two groups of drugs: “sedatives” and “tranquilizers.” The sedatives included all the barbiturates, the barbiturate-like drugs, the hypnotic benzos, and chloral hydrate. The tranquilizers included the remaining benzos and meprobamate. Respondents were not asked about Rohypnol and GHB.
The survey showed that 2.3% of Americans have used illicit sedatives at some time in their lives. About 0.3% have used illicit sedatives in the past year, and 0.1% have done so within the past month. That’s about 232,000 current users. The percentages who used illicit tranquilizers were 3.6% lifetime, 1.1% during the past year, and 0.4% during the past month. That’s 952,000 current users. (Note: These two categories aren’t mutually exclusive. Some people who abused sedatives might have also abused tranquilizers.)
The Joy of It
When we pop a downer, the tension floats away. Our cares float away. Everything is relaxed. Everything’s soft—no hard edges here, no raw nerves.
On downers, we get that peaceful, easy feeling. We feel calm inside. Some of us feel smoother in social situations.
When completely downed out, the body seems to disappear while the brain enjoys complete tranquility. In this deep chasm of thought, the body often remains statuesque, acting as if any movement from it would disturb some significant portion of the universe.
The Problems They Cause
Impaired performance. At feel-good doses, the depressants cause slurred speech, dizziness, poor coordination, and poor performance on physical tasks, such as driving a car.
Impaired thinking. When high, users become easily confused and disoriented. They typically experience poor memory, decreased comprehension, faulty judgment, and the inability to focus their attention.
Decreased REM sleep. REM stands for “rapid eye movement.” During sleep, REMs occur when we’re dreaming. They’re a key component of restful sleep. The depressants suppress REMs, creating an interesting dilemma. Although most depressants can be used to help us get to sleep, they diminish the quality of sleep. This causes us to sleep longer than we normally would and to feel sleepy when we awaken.
Nausea. The use of chloral hydrate or GHB causes nausea in most people and vomiting in some.
Seizures. GHB causes epileptic seizures in some users.
Date rape drugs. In recent years, two different drugs (Royhpnol and GHB) have been used in many reported cases of date rape. When combined with alcohol, small doses of either of these drugs can produce physical helplessness, unconsciousness, and amnesia. A perpetrator will drop one of these drugs into an alcoholic beverage that he then hands to a potential victim. After this crime, the perpetrator then commits another: When the victim becomes helpless to resist, he rapes her.
What’s happening here? It’s one thing to take a chance by putting a drug into your own body. It’s quite another thing to sneak a drug into someone else’s body. From one viewpoint, it’s downright pernicious. From another, it’s immoral and just plain mean. A few of these victims have died. The reason? Alcohol and downers potentiate each other and when combined at even moderate doses can cause death.
(Note: It’s illegal to administer a drug to another person without that person’s knowledge and with the intent to commit a crime of violence. This is punishable by up to 20 years in prison and a fine.)
Danger of overdose. The potential for overdose runs high for the barbiturates, the barbiturate-like drugs, and chloral hydrate. In overdose, these drugs can produce any or all of the following: respiratory arrest, circulatory collapse (due to extremely low blood pressure), depressed heart function, stupor, coma, and death.
Users of benzos run a lower risk of overdose than users of other depressants. However, the risk of overdose from all the depressants, including benzos, increases dramatically when any of these drugs are combined with each other or with other CNS depressants, such as alcohol, opiates, or inhalants.
Of all the drugs of abuse, the downers produce the most dangerous withdrawal syndrome. In fact, breaking off a moderate to heavy habit, cold turkey, can kill you. Seizures, high blood pressure, and heart attack can take you away. The more extensive your addiction, the more severe the withdrawal symptoms become. These symptoms include anxiety, agitation, irritability, increased heart rate, panic attacks, hyperactive reflexes, and insomnia. Some symptoms can last up to six months or perhaps even as long as a year.
You can also experience nausea and vomiting as well as confusion, delirium, and hallucinations. These symptoms usually disappear within a few days to a few weeks.
(Note: If you have a moderate to heavy habit, find a physician to manage your withdrawal. Under medical supervision, you’ll step down to gradually lower doses over a six- to 12-week period.)