Transcript Depressants

Classes/Types of Depressants
 1. Anesthetics
(ex. ether, nitrous oxide)
 2.
Barbiturates
 3. Benzodiazepines (anxiolytics - ex. ? )
 4. Buspar
 Many
labels have been used to describe
them, which can be confusing:
-tranquilizers
-anti-anxiety pills
-sleeping pills
-sedatives
Depressants
 Mechanism
of action:
• GABA: acts mainly on inhibitory receptors
– taking off the brakes
– e.g. GHB (gamma hydroxy butyrate)
• Separate receptors identified for
barbiturates and benzos
Etherdome
History / Development
of Depressants

Nitrous oxide (1776)
(laughing gas)

• development of ether
(MGH-etherdome)
• flammable liquid which vaporizes at room
temperature
Chloral hydrate, bromides, paraldehyde

Barbiturates came next in 1860s
• developed in Germany
• drug names end with ‘-al’ (phenobarbital)
• On street, named for color of pills
– “blues”, “reds”
Barbiturates
 USES:
• some used as anesthetics if they work
quickly and then wear off
• others used to prevent seizures because
their sedating effects lasted longer
• often used as sleeping pills and anxiolytics
Barbiturate Use 2002-2003
Total
12-17 18-25 26+
2002
1.4%
.1%
.4%
1.8%
2003
1.4%
.2%
.3%
1.7%
For example, Nembutal®, Pentobarbital, Seconal®,
Secobarbital, or Butalbital.
Source: SAMHSA, Office of Applied Studies, National
Survey on Drug Use and Health.
BARBITURATE USE declined due to
their unwanted effects:
-drunken euphoria and loss of behavioral and
emotional control
- respiratory depression
- tolerance and addiction develop rapidly
- lethal dose is low and nearer to drug’s ED
compared with other drugs, so potential for
overdose is high
withdrawal SX similar to alcohol:
– rebound insomnia
– rebound in REM sleep > vivid dreams/nightmares
Quaaludes (Methaqualone)
came next in the 50s and 60s and were
developed as alternatives to barbs for
sleep/anxiety disorders
 they became a street drug; not much
different than barbiturates
 now a schedule I drug
 no longer produced for medical reasons
Depressants (con’t)
 Benzodiazepines
• classic anti-anxiety drugs
• synthesized initially in 1950s
• more potent in 1960s with the advent of
Valium
• similar to barbs but less dangerous in that:
– tolerance develops more slowly, and to primarily
the sedative not anxiolytic effects
– need higher doses for tolerance to occur
Benzodiazepine Use 20032004
Total
12-17 18-25 26+
2003
.18%
.14%
.30%
.22%
2004
.20%
.14%
.29%
.25%
Includes Klonopin® or clonazepam, Xanax®, or alprazolam, Ativan®, or
lorazepam, Valium® or diazepam, Librium®, Limbitrol®, Rohypnol®, Serax®,
and Tranxene®.
Depressants
 Benzodiazepines
• Withdrawal symptoms: increased
anxiety, insomnia, tremors, sweating
• Dangers: cross tolerance and
potentiation
 what
are the clinical implications of
treating anxiety with drugs?
 difficult to estimate non-medical misuse
or abuse of sedatives and tranquilizers
The case of Rohypnol
(flunitrazepam)
 a.k.a.
roofies, rib, circles, wolfies, rope,
ropies, ruffies, roach-2, “roaches” after
drug company Hoffman-La Roche
• a Benzodiazepine used in the short-term
treatment of insomnia and as a preanesthetic medication
• similar to valium in effect but 10 times
stronger
• effects begin within 30 minutes, may last for
8 hours or more
Rohypnol

made in Europe and Latin America and sold
by prescription there, not in U.S. so it is
usually smuggled via mail into country, or
comes across Mexican border
 distribution
and abuse especially in
southwest & south (Texas & Florida most)
 low cost < $5 per tab
 popularity among young people; “Said to be
south Florida’s fastest growing drug problem”
Rohypnol
2
COMMON MISPERCEPTIONS:
• the drug is safe and “pure” because it
comes in pre-sealed bubble packages
• can’t be detected through urinalysis
Adverse Effects of Rohypnol

memory impairment, drowsiness, dizziness,
confusion; can induce excitability or
aggressiveness in some users

can cause dependence: tolerance may develop;
withdrawal symptoms include - headaches,
anxiety, muscle pain, confusion, restlessness,
numbness, tingling of extremities, convulsions
and cardiac problems
Rohypnol
 used
in date rape situations….WHY?
• it’s odorless, (initially) colorless, tasteless and
produces drunkenness, stupor, and blackout
• Federal law, since 1996, dictates a 20-year
sentence for use of this drug in connection with
sexual assault or other violence
 used
to augment an alcohol high without
elevating BAL

used as a “parachute” or remedy for depression
that follows a stimulant high
Inhalants
 USES:
varied as products “huffed”
include gasoline, glues, solvents, paint..
 Mostly young kids, adolescents
 highly destructive to brain with OD
potential