SEDATIVE-HYPNOTICS

What are sedative-hypnotics?
Sedative-hypnotics are drugs which depress or slow down the body's functions. Often these drugs are referred to as tranquilizers and sleeping pills or sometimes just as sedatives. Their effects range from calming down anxious people to promoting sleep. Both tranquilizers and sleeping pills can have either effect, depending on how much is taken. At high doses or when they are abused, many of these drugs can even cause unconsciousness and death.

What are some of the sedative-hypnotics?
Barbiturates and benzodiazepines are the two major categories of sedative-hypnotics. The drugs in each of these groups are similar in chemical structure. Some well-known barbiturates are secobarbital (Seconal) and pentobarbital (Nembutal). Diazepam (Valium), chlordiazepoxide (Librium), and chlorazepate (Tranxene) are examples of benzodiazepines. A few sedative-hypnotics do not fit in either category. They include methaqualone (Quaalude), ethchlorvynol (Placidyl), chloral hydrate (Noctec), and mebrobamate (Miltown). All of these drugs can be dangerous when they are not taken according to a physician's instructions.

Can sedative-hypnotics cause dependence?
Yes. They can cause both physical and psychological dependence. Regular use over a long period of time may result in tolerance, which means people have to take larger and larger doses to get the same effects. When regular users stop using large doses of these drugs suddenly, they may develop physical withdrawal symptoms ranging from restlessness, insomnia and anxiety, to convulsions and death. When users become psychologically dependent, they feel as if they need the drug to function. Finding and using the drug becomes the main focus in life.

Is it true that combining sedative-hypnotics with alcohol is especially dangerous?
Yes. Taken together, alcohol and sedative-hypnotics can kill. The use of barbiturates and other sedative-hypnotics with other drugs that slow down the body, such as alcohol, multiplies their effects and greatly increases the risk of death. Overdose deaths can occur when barbiturates and alcohol are used together, either deliberately or accidentally.

Can sedative-hypnotics affect an unborn fetus?
Yes. Babies born to mothers who abuse sedatives during their pregnancy may be physically dependent on the drugs and show withdrawal symptoms shortly after they are born. Their symptoms may include breathing problems, feeding difficulties, disturbed sleep, sweating, irritability, and fever. Many sedative-hypnotics pass through the placenta easily and have caused birth defects and behavioral problems in babies born to women who have abused these drugs during their pregnancy.

What are barbiturates?
Barbiturates are often called "barbs" and "downers." Barbiturates that are commonly abused include amobarbital (Amytal), pentobarbital (Nembutal), and secobarbital (Seconal). These drugs are sold in capsules and tablets or sometimes in a liquid form or suppositories.

What are the effects of barbiturates when they are abused?
The effects of barbiturates are, in many ways, similar to the effects of alcohol. Small amounts produce calmness and relax muscles. Somewhat larger doses can cause slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. These effects make it dangerous to drive a car or operate machinery. Large doses can cause unconsciousness and death.

How dangerous are barbiturates?
Barbiturate overdose is a factor in nearly one-third of all reported drug-related deaths. These include suicides and accidental drug poisonings. Accidental deaths sometimes occur when a user takes one dose, becomes confused and unintentionally takes additional or larger doses. With barbiturates there is less difference between the amount that produces sleep and the amount that kills. Furthermore, barbiturate withdrawal can be more serious than heroin withdrawal.

What other sedative-hypnotics are abused?
All the other sedative-hypnotics can be abused, including the benzodiazepines. Diazepam (Valium), chlordiazepoxide (Librium), and chlorazepate (Tranxene) are examples of benzodiazepines. These drugs are also sold on the street as downers. As with the barbiturates, tolerance and dependence can develop if benzodiazepines are taken regularly in high doses over prolonged periods of time. Other sedative-hypnotics which are abused include glutethimide (Doriden), ethchlorvynol (Placidyl), and methaqualone (Sopor, Quaalude).

What is methaqualone?
Methaqualone ("Sopors," "ludes") was originally prescribed to reduce anxiety during the day and as a sleeping aid. It is one of the most commonly abused drugs and can cause both physical and psychological dependence. The dangers from abusing methaqualone include injury or death from car accidents caused by faulty judgment and drowsiness, and convulsions, coma, and death from overdose.

What are sedative-hypnotic "look-alikes"?
These are pills manufactured to look like real sedative-hypnotics and mimic their effects. Sometimes look-alikes contain over-the-counter drugs such as antihistamines and decongestants, which tend to cause drowsiness. The negative effects can include nausea, stomach cramps, lack of coordination, temporary memory loss, becoming out of touch with the surroundings, and anxious behavior.

Source: National Institute on Drug Abuse, 1984

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MISSOURI DEPARTMENT OF MENTAL HEALTH
Division of Alcohol and Drug Abuse
1706 East Elm; P.O. Box 687
Jefferson City, Missouri 65102

RSmith:12-13-93