Amity Institute of Psychology and Allied Sciences

Depressant Use
Disorders

1
 Amity Institute of Psychology and Allied Sciences

•
What are Depressants?
Central nervous system (CNS) depressants are drugs that slow down brain
activity, making them effective for treating many conditions. These drugs
operate by affecting the neurotransmitter gamma-aminobutyric acid
(GABA), which leads to side effects such as drowsiness, relaxation, and
decreased inhibition. Central nervous system depressants are used to treat
a number of different disorders, including: insomnia, anxiety, panic attacks,
stress, sleep disorders, pain, and seizures. There are three major types of
CNS depressants: sedatives, hypnotics, and tranquilizers.
• Doctors often prescribe them for people who are anxious or can’t sleep.
When taken as directed, they can be safe and helpful. But when people
take someone else’s prescription drugs or take the drugs for entertainment
or pleasure, they may experience dangerous consequences.
• Depressant drugs, also known as “downers”, refer to a large number of
familiar, widely used chemicals. They are also described as sedative
hypnotics, benzodiazepines, or barbiturates. Occasionally, some of these
drugs are prescribed for medical purposes but many people use them
recreationally to “relax”, “mellow-out”, or to take off the “edge” felt by using
an “upper” (energizing drugs like speed or cocaine). 2
 Amity Institute of Psychology and Allied Sciences

What drugs fall under this

category?
• Alcohol
• Barbiturates
• Benzodiazepines
• Many sleeping pills
• Opioids
3
 Amity Institute of Psychology and Allied Sciences

What are common street

names?
• Common street names for depressants
include:
Barbs, Benzos, Downers, Georgia Home
Boy, GHB, Grievous Bodily Harm, Liquid X,
Nerve Pills, Phennies, R2, Reds, Roofies,
Rophies, Tranks, and Yellows

4
 Amity Institute of Psychology and Allied Sciences

Alcohol
• Alcohol is one of the most widely used drugs in the world. The degree to
which the brain is affected by this central nervous system depressant
depends on how much, and how fast, a person drinks. Due to the initial
positive behavioral effects of alcohol, many people don’t realize that the
substance is a CNS depressant.
• For example, when someone first begins to drink, he or she may feel less
reserved and more relaxed because of the chemical changes alcohol
causes within the brain. However, the more someone drinks, the more
the brain is affected and the likelihood that a negative emotional
response will take over. Alcohol can actually increase anxiety and stress
rather than reduce it, and elicit other negative reactions such as anger,
aggression, and depression. Chronic alcohol use can also lead to
dependence, addiction, and withdrawal symptoms when attempting to
stop usage of the drug.
5
 Amity Institute of Psychology and Allied Sciences

Barbiturates
• Barbiturates, or “downers,” are a type of CNS depressant that are
prescribed to treat anxiety, tension, and sleep disorders. Common
barbiturates include Amytal, Luminal (Phenobarbital), Mebaral, Nembutal,
and Seconal. Barbiturates were previously regarded as a generally safe
depressant, but problems with abuse, addiction, and overdose quickly
became apparent after widespread prescription. These drugs can
generate a sense of euphoria and relaxation even when taken in small
doses, which encourages abuse in some.
• Barbiturates have also shown to have a dramatic impact on sleep
patterns, resulting in suppressed REM sleep. In response to particularly
high abuse rates from the 1950s to the 1970s, benzodiazepines, which are
generally regarded as less addictive and less likely to cause overdose,
were developed and popularized. Because the potential for addiction and
overdose is so high, the drugs are no longer commonly used to treat
anxiety and sleep problems.
6
 Amity Institute of Psychology and Allied Sciences

Benzodiazepines
• Sometimes called “benzos,” benzodiazepines are central
nervous system depressants that are prescribed to treat
anxiety, sleep disorders, convulsions, and other acute stress
reactions.
• Common benzos include Valium, Xanax, and Ativan.
• Benzodiazepines are highly effective in treating anxiety and
insomnia due to the sleep-inducing, sedative, and muscle-
relaxing properties. While considered safe for short-term
treatment, long-term or illicit use can lead to the
development of a tolerance, addiction, and withdrawal
symptoms upon cessation or rapid reduction in use.
7
 Amity Institute of Psychology and Allied Sciences

Sleeping Pills
• This category of CNS depressants includes non-
benzodiazepine sleep aids, or “z-drugs,” such
as Ambien, Sonata, and Lunesta. These drugs are designed to
specifically treat insomnia and other sleep disorders. These
sleeping pills are chemically different from other central
nervous system depressants, and they work by stimulating
the GABA neurotransmitter in a different way. Unlike
benzodiazepines, Z-drugs do not reduce anxiety. The drugs
are thought to have fewer side effects and risk of addiction
compared to benzodiazepines; however, long-term use can
still result in dependence and addiction.
8
 Amity Institute of Psychology and Allied Sciences

Opioids
• Opioids are the most commonly prescribed pain medications in the United
States and in much of the world. Some opioids, such as methadone, are
also used for other purposes such as opioid addiction treatment. There
are a number of different opioids, including legal prescription
medications such as codeine and hydrocodone, and illegal street drugs,
such as heroin.
• While opioids vary tremendously in strength, addictive potential, and
other aspects, they tend to be very chemically similar and typically have
similar effects. While opioids are considered extremely effective for
treating pain, they are also some of the most addictive and dangerous
drugs in the world. Every year, opioid overdose takes the lives of tens of
thousands of Americans.

9
Amity Institute of Psychology and Allied Sciences

10
 Amity Institute of Psychology and Allied Sciences

How do they look like?

• Depressants come in the form of pills,

syrups, and injectable liquids.

11
 Amity Institute of Psychology and Allied Sciences

How do Depressants work?

• Different classes of CNS depressants work in different ways, but all have
the ability to reduce activity in the central nervous system and lower levels
of awareness in the brain. While CNS depressants all share this ability,
there are significant differences among substances within this drug class. In
particular, some are generally considered to be safer and are prescribed
more than others. However, it’s important to note that almost all
depressants have the potential to be addictive and should only be used as
prescribed. Central nervous system depressants are sometimes called
sedatives or tranquilizers, although those terms are more properly applied
to specific categories of CNS depressants.
• Depressant drugs cause sedative effects such as relaxation, drowsiness
and a feeling of being “mellow” at low doses. At high doses, they cause
hypnotic effects, that is, they induce sleep. Because of this effect, these
drugs have also been called sleeping pills.

12
 Amity Institute of Psychology and Allied Sciences

• Their primary effect is to depress or slow down central nervous

system activity, resulting in slowed body and mental functions.
• Depressant drugs can cause effects closely resembling alcohol
intoxication. As with alcohol intoxication, the operation of an
automobile and other machines is especially dangerous. Motor
coordination and visual perception may be greatly impaired.
• These effects are intensified in higher doses. In other words, the
more you take it, the more depressed your system becomes. This
can eventually cause your body to just “shut down” and can cause
death. Different drugs are lethal in different amounts or in different
combinations.
• Long term use, as well as an occasional or one-time use of larger
doses, may interfere with rapid eye movement (R.E.M.) sleep, which
is essential for normal healthy functioning. The effects of a single
dose of a depressant drug usually last from four to six hours,
although the effects of Phenobarbital last considerably longer.
13
 Amity Institute of Psychology and Allied Sciences

What is their effect on the mind?

• Depressants used therapeutically do what they
are prescribed for: • To induce sleep, relieve
anxiety and muscle spasms, and prevent
seizures
• They also: • Cause amnesia (leaving no
memory of events that occur while under the
influence), reduce reaction time, impair mental
functioning and judgment, and cause confusion
Long-term use of depressants produces
psychological dependence and tolerance
14
 Amity Institute of Psychology and Allied Sciences

What is their effect on the body?

• Some depressants can relax the muscles.
Unwanted physical effects include: •
Slurred speech, loss of motor
coordination, weakness, headache,
lightheadedness, blurred vision, dizziness,
nausea, vomiting, low blood pressure, and
slowed breathing

15
 Amity Institute of Psychology and Allied Sciences

What are the effects of

combining drugs?
• The use of a combination of depressant drugs is very dangerous.
Because of the way that most depressant drugs react with each
other, taking one dose of one depressant drug and one dose of
another may have a combined effect of three doses, or seven or
even more.
• Depressants used in combination create effects which multiply: one
plus one does NOT equal two. The more potent or stronger the
depressant, the more likely that this reaction will occur. Therefore,
using any depressant drug while drinking alcohol IS NOT SAFE.
Alcohol ties up the liver in its metabolization, so other drugs continue
to circulate through the body prolonging their effects

16
 Amity Institute of Psychology and Allied Sciences

What about tolerance and

Dependence?
• A regular user of depressant drugs over a long period of time may
develop tolerance to the effects of these drugs. This individual may
require an increasing dose to produce the desired effects.
Eventually, dependence/addiction develops and physical, as well as
psychological withdrawal symptoms may occur when the drugs are
no longer taken.
• Prolonged use of depressants can lead to physical dependence
even at doses recommended for medical treatment. Unlike
barbiturates, large doses of benzodiazepines are rarely fatal unless
combined with other drugs or alcohol. But unlike the withdrawal
syndrome seen with most other drugs of abuse, withdrawal from
depressants can be life threatening.
17
 Amity Institute of Psychology and Allied Sciences

How are they abused?

• Individuals abuse depressants to
experience euphoria. Depressants are
also used with other drugs to add to the
other drugs’ high or to deal with their side
effects. Users take higher doses than
people taking the drugs under a doctor’s
supervision for therapeutic purposes.
Depressants like GHB and Rohypnol are
also misused to facilitate sexual assault.
18
 Amity Institute of Psychology and Allied Sciences

Signs of CNS Depressant Abuse

• The foremost sign of CNS depressant abuse is taking the drugs without medical
direction, or outside a doctor’s prescribed guidelines. Examples of this include
taking higher doses to intensify intoxication and taking someone else’s
prescription. Other warning signs include:
• Secretive or abnormal behavior
• Decreased social activity or work productivity
• Mood swings
• Periods of depression or apathy
• Lack of energy or motivation
• Withdrawal symptoms when not using depressants
• Failing in attempts to stop using the drugs
• Another telling sign of abuse is mixing CNS depressants with other drugs, including
opioids and alcohol, to increase their effects. This may lead to severe adverse
health reactions and possibly life-threatening consequences.
19
 Amity Institute of Psychology and Allied Sciences

Central Nervous System

Depressant Withdrawal
• Discontinuing use of CNS depressants can lead to withdrawal.
Because of the way that depressants affect brain chemistry
and slow activity, withdrawal can be severe and sudden when
an individual stops taking them. Withdrawal symptoms
typically begin 12 to 24 hours after the last dose of the drug
and are most severe between 24 and 72 hours after this dose.
Withdrawal symptoms generally begin to fade after this initial
period, known as acute withdrawal; however, some
symptoms, known as post-acute withdrawal symptoms
(PAWS) may last for up to 24 months.

20
 Amity Institute of Psychology and Allied Sciences

• Additionally, many people going through benzodiazepine or

barbiturate withdrawal will also experience a rebound effect
in which the condition that they were originally taking the
sedative for will come back stronger than before. For
example, someone that was taking Xanax for anxiety will
often experience worse anxiety upon cessation of the drug.
Someone thinking about ending their use of a CNS
depressant, or who has stopped and is suffering from
withdrawal, should immediately seek medical treatment.

21
 Amity Institute of Psychology and Allied Sciences

• Common central nervous system • Anxiety

depressant withdrawal symptoms • Panic attacks
include: • Body tremors
• Seizures
• Insomnia
• Depression
• Restlessness • Muscular stiffness or pain
• Nausea • Changes in perception
• Vomiting • Heart palpitations
• Tension
• Shaking
• Stress
• Weakness • Memory issues
• Excessive sweating • Increased blood pressure and pulse
• Irritability • Hypersensitivity to light and sound
• Aches and pains
• Hallucinations

22
 Amity Institute of Psychology and Allied Sciences

• Withdrawal from depressants can have

potentially-life threatening complications.
These risks are amplified when someone quits
use of these drugs on their own or tries to
stop taking them “cold turkey.” Medically-
assisted detox is the safest way to withdraw
from CNS depressants, as physicians can
gradually decrease use and prescribe any
medications to assist with debilitating
withdrawal symptoms.
23
 Amity Institute of Psychology and Allied Sciences

Kicking the habit

• Dependence on depressant drugs is potentially one of
the most dangerous of all chemical dependencies. If a
person abruptly stops using a depressant drug,
progressive restlessness, anxiety, irritability and possibly
delirium and convulsions may occur. These symptoms
may be fatal without proper medical attention. The
withdrawal process from all depressant drugs, including
alcohol, should be medically monitored

24
 Amity Institute of Psychology and Allied Sciences

Treatment
• Treatment for addiction to a central nervous system
depressant begins with detox to allow the drugs to
exit the system, preferably in rehab or medical
facility. After detoxification, a patient will typically
move onto a
residential inpatient or outpatient treatment
program. Drug abuse often co-occurs with other
psychological issues, such as depression, and rehab
affords individuals struggling with addiction the
opportunity for these issues to be addressed with
licensed professionals. 25
 Amity Institute of Psychology and Allied Sciences

• Treatment facilities will tailor treatment plans to the

individual and include different types of therapies to
help the patient replace negative behaviors with
healthier ones. Cognitive behavioral therapy (CBT) is
particularly helpful in treating CNS depressant abuse.
This type of therapy focuses on modifying a patient’s
thinking, expectations, and behaviors while
simultaneously increasing their skills for coping with
various life stressors. Additionally, CNS depressants
are often used in conjunction with another drug or
substance, and treatment plans will also address any
polydrug abuse to ensure lasting recovery.
26