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Sedative Drug Overview

What Is a Sedative?

Woman taking an anxiety medication

Along with stimulants and opioids, sedatives are a class of substances with both medical and nonmedical uses. Different sedative agents may also be known by other names including:1

  • Central nervous system (CNS) depressants.
  • Anxiolytics.
  • Tranquilizers.
  • Hypnotics.

Although various drugs that fall under the umbrella of “sedatives” will differ greatly, many share the ability to create a sense of calm and drowsiness. 1 This is why sedatives, depending on the specific medication being used, are often prescribed for anxiety, panic, and sleep disorders.1

Prescription Sedatives

Not all sedatives are the same. 3 common types of prescription sedatives are:2,3,4

Sedatives, while very effective when taken for a brief period of time, do have risks, including the potential for abuse, dependence/withdrawal, and addiction.5 They can also be very dangerous when taken in combination with alcohol and opioids, as the combined effects can result in profound over-sedation and respiratory depression, placing individuals at high risk of deadly overdose.6

Additionally, it has been found that when benzodiazepines are taken daily for longer than a month that they may actually worsen anxiety and insomnia.6

List of Common Sedative Drugs

There are many substances that fall into a broad grouping of sedatives. These prescription drugs may be identified by both generic and brand names, in most cases.1

  • Barbiturate types:
    • Phenobarbital
    • Butalbital (Fiorinal)
  • Benzodiazepine varieties:
    • Alprazolam (Xanax)
    • Clonazepam (Klonopin)
    • Diazepam (Valium)
    • Lorazepam (Ativan)
    • Chlordiazepoxide
  • Sleep medications (sometimes called “z-drugs”):
    • Zolpidem (Ambien)
    • Zaleplon (Sonata)
    • Eszopiclone (Lunesta)

What Do Sedatives Do?  

Most sedatives work by increasing the activity of a specific brain chemical called gamma-aminobutyric acid (GABA). GABA is a neurotransmitter than inhibits brain activity which can induce sleepiness and feelings of relaxation. Such effects makes these drugs very effective for people suffering from anxiety and insomnia.1

When taken at higher doses, sedatives may create an intoxication very similar to the one caused by alcohol. At times, the two forms of intoxication can be challenging to differentiate from each other.4

Along with the desired effects, sedatives can come with may uncomfortable, sometimes dangerous, side effects.

Short and Long-Term Effects of Sedatives

Possible short-term side effects of sedatives include:7

  • Drowsiness and sedation.
  • Impaired ability to focus.
  • Impaired judgment and memory.
  • Dizziness.
  • Poor coordination.
  • Slurred speech.
  • Lowered blood pressure.
  • Slowed breathing.

When a sedative is misused, these effects can be very intense. Excessive use of sedatives can lead to significant toxicity and overdose. Overdose becomes an even more serious risk when the sedative is combined with alcohol, opioids, or other substances that exert similar effects.8

Sedative Overdose

Sedatives taken as prescribed are unlikely to result in overdose; however, misuse (for example taking more than prescribed or taking it to get high) may lead to overdose. Barbiturate overdose is possible from high doses, but overdose from benzodiazepines is rare, unless the drugs are combined with other substances—such as opioids and/or alcohol—that slow certain physiological processes like breathing.2

In 2017, nearly 17,000 people died from overdose involving CNS depressants.5 More than 2/3 of these overdoses involved benzodiazepines, and many of those were caused by the combination of benzodiazepines and opioids.5  In fact, people prescribed both benzodiazepines and opioids have a 15x higher risk of drug-related death than individuals not prescribed either drug type.8

Signs and symptoms of sedative overdose include:2

  • Extremely slow or stopped breathing.
  • Clammy skin
  • Dilated pupils
  • Weak but rapid pulse.
  • Coma.
  • Death.

If you suspect your loved one has overdosed on sedatives, contact 911 immediately. Early treatment can save their life.1

Do All Sedatives Cause Withdrawal?

Many sedatives are intended for use in the short-term only. For example, the makers of the benzodiazepine Ativan recommend the drug be prescribed for only 2 to 4 weeks at a time and never encourage continuous long-term use because of the risks of dependence and addiction. Despite this, many people use sedatives for much longer periods. 7,9

Physical dependence is not always a sign of misuse; it can develop to some degree even when the person uses sedatives as directed. Once these drugs are regularly in the system, the body begins to adjust and adapt to their presence.6  Once a significant amount of dependence is established, which can happen quickly with sedatives, withdrawal becomes increasingly likely when the person goes off the sedative.

Woman with tremors

Sedative Withdrawal Symptoms

The signs and symptoms of sedative withdrawal include:10

  • Insomnia.
  • Increased anxiety.
  • Hallucinations.
  • Increased sweating.
  • Quicker heart rate.
  • Nausea and vomiting.
  • Restlessness and unintended movements.
  • Shaky hands.
  • Seizures.

The timing of these symptoms differs greatly depending on the specific substance or substances used. A person using a short-acting medication can begin feeling symptoms just hours after the last dose, but another person could not experience symptoms for a week.10

The symptoms can peak anywhere from a few days to a few weeks after they emerge. Worse, some of the effects of sedative withdrawal can last for months after the last use.10

Getting off Sedatives Safely

All substance withdrawal has the potential to be uncomfortable, but sedative withdrawal can prove deadly. As many as 30% of people withdrawing from sedatives will have a seizure without proper treatment, and many will display a significant break from reality with hallucinations and delusions. 10

Anyone thinking about quitting sedatives should always seek professional treatment to ensure safety. Professional detoxification treatment at Desert Hope involves 24/7 patient monitoring so that, should any complications arise, you’ll be treated immediately.

Addicted to Sedatives?

Dependence and tolerance are physiological reactions to the drugs, but addiction involves more than just a physical reliance on the drug. Signs you may be suffering from an addiction to sedatives include: 10

  • Taking sedatives more often or in larger amounts than intended.
  • Trying but failing to quit or cut back on sedatives.
  • Spending a lot of your time getting, using, and recovering from sedatives.
  • Feeling a strong desire to use sedatives when none are available.
  • Avoiding obligations at home, work, or school in favor due to sedative use.
  • Experiencing new or worsening relationship conflicts having to do with your drug use.
  • Continuing to use sedatives despite the known negative consequences of doing so.

Need Treatment but Worried About Anxiety?

Someone ending their sedative use could face challenges to their recovery in the form of new, returning, or worsening anxiety. This risk should not discourage you from seeking treatment, though. Professional treatment like the co-occurring disorder programs at Desert Hope can simultaneously address both addiction and mental health concerns.

Quality addiction treatment often incorporates natural ways to cope with stress and anxiety, such as: 11

  • Yoga and meditation.
  • Relaxation techniques including:
    • Deep breathing.
    • Guided imagery.
    • Progressive muscle relaxation.
    • Autogenic training.
    • Biofeedback therapy.
  • Exercise.
  • Thought techniques to reduce worry.

Treatment programs that work with patients with co-occurring disorders may also prescribe non-addictive medications as alternative treatments for sedatives.

If you’re addicted to sedatives, you don’t need to continue suffering. At Desert Hope, we specialize in the care of addiction and mental health disorders. Discover the many programs we offer for those ready to begin their recovery. 12

References:

  1. National Institute on Drug Abuse. (2018). DrugFacts: Prescription CNS Depressants.
  2. Drug Enforcement Administration. (2017). Drugs of Abuse.
  3. Harvard Health Publishing. (2014). Benzodiazepines (and the alternatives).
  4. Weaver M. F. (2015). Prescription Sedative Misuse and AbuseThe Yale journal of biology and medicine88(3), 247–256.
  5. National Institute on Drug Abuse for Teens. (2019). Prescription Depressants.
  6. Lembke A., Papac J., Humphreys K. (2018). Our other prescription drug problem. N Engl J Med., 378, 693-695
  7. Substance Abuse and Mental Health Services Administration. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health.
  8. Schmitz A. (2016). Benzodiazepine use, misuse, and abuse: A review. The mental health clinician6(3), 120–126.
  9. S. National Library of Medicine: DailyMed. (2011). Ativan.
  10. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  11. American Psychiatric Association. (2017). What Are Anxiety Disorders?
  12. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide.