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Prescription Tranquilizers and Sedatives

What are Prescription Tranquilizers and Sedatives?

Prescription tranquilizers and sedatives (also often referred to as sedative-hypnotic drugs) are used primarily in the treatment of anxiety, panic attacks, and insomnia. Some medications in this category are used in medical procedures for sedation or anesthetization. They are also used to treat seizure disorders as well as drug and alcohol withdrawal symptoms.

Prescription tranquilizers and sedatives include barbiturates, benzodiazepines, and non-benzodiazepine sleep medications. As central nervous system depressants, their calming and hypnotic effects are achieved by slowing down the body’s various functions.

Barbiturates were widely prescribed back in the 1960s and 1970s. Unfortunately, they can cause coma and death if taken in high doses. One of the reasons they are rarely prescribed today is because they have a very “narrow therapeutic-to-toxic range”. In other words, the difference between a sedating dose and a lethal dose is very small.

Since the late 1970s, barbiturates have been largely replaced by benzodiazepines. Benzodiazepines are relatively fast-acting, effective medications, but much less likely to be fatal if taken in overdose. In recent years, the newer non-benzodiazepine medications, such as Lunesta and Ambien, are often prescribed in lieu of benzodiazepines for sleep problems. All three types of medication have a fairly high potential for addiction.

These drugs are typically available as tablets, capsules, or liquids (for intravenous use).

Barbiturates

Barbiturates are derived from a substance known as barbituric acid. Able to produce effects ranging from mild sedation to coma, they are categorized based on how quickly they work in the body: ultra-short, short, intermediate, or long-acting. Ultra-short barbiturates, such as Surital and Brevital, are used as intravenous anesthetics. Their anesthetic effects occur in about a minute, whereas the effects of long-acting barbiturates, such as Luminal, take about an hour.

They were developed in the early 1900s. Some of the more common barbiturates include:

  • Phenobarbital (Luminal)
  • Pentobartibal (Nembutal)
  • Butabarbital (Butisol)
  • Butalbital (Fiorinal)
  • Amobarbital (Amytal)
  • Secobarbital (Seconal)
  • Thiopental (Pentothal)


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Benzodiazepines

First produced in the 1960s, Benzodiazepines may also be classified as short-acting, medium-acting, or long-acting. These drugs are generally prescribed for short-term use (one week to four weeks at the most) due to their addictive nature. Commonly prescribed benzodiazepines include:

  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Diazepam (Valium)
  • Clonazepam (Klonopin)
  • Chlordiazepoxide (Librium)
  • Temazepam (Restoril)
  • Flurazepam (Dalmane)

Rohypnol (flunitrazepam) is also a benzodiazepine. Illegal in the U.S., it is often referred to as the date-rape drug. It is available via prescription in Europe, Latin America, and other parts of the world.

Non-Benzodiazepine Hypnotics

The sleep medications known as non-benzodiazepine hypnotics or “Z-drugs” were first produced in the late 1980s. They generally have fewer side effects than benzodiazepines. However, like benzodiazepines, they are potentially addictive and typically prescribed only for short-term use (a week to 10 days, and no longer than 4 weeks). They include:

  • Zolpidem (Ambien)
  • Eszopiclone (Lunesta)
  • Zaleplon (Sonata)

Federal Drug Classification

The federal drug classification of barbiturates varies depending on the type, ranging from Schedule II to Schedule IV controlled substances. Benzodiazepines and non-benzodiazepine hypnotics are classified as Schedule IV controlled substances.

Street Names

Prescription sedatives and tranquilizers have a variety of street names including:

Barbiturates – Barbs, Amys, downers, Mexican yellows, blue heavens, blue devils, yellows, yellow jackets, phennies, nembies, reds, red devils, F-40s, goof balls, purple hearts, gorilla pills, rainbows, pink ladies (to name a few).

Benzodiazepines – Benzos, downers, happy pills, rugby balls, totem poles, candy, moggies, tranks, Vals, Xanies, eggs, Non-benzodiazepine hypnotics – Pez, sleepeasy, zombie pills, tic-tacs, A-minus, no-go pills.

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How Prescription Tranquilizers and Sedatives Affect the Body

As CNS depressants, prescription tranquilizers and sedatives work by slowing down or “depressing” the activity in the brain. These medications target a particular chemical in the brain known as GABA (“gamma-aminobutyric acid”).

GABA is an inhibitory neurotransmitter that helps decrease excess brain activity. By exaggerating or mimicking the function of GABA, these drugs produce a calming or hypnotic effect.

Short-Term Effects of Prescription Tranquilizers and Sedatives

Prescription tranquilizer and sedative use and abuse produce numerous short-term effects. These may include:

  • A calm, relaxed feeling
  • Reduced pain
  • Sleepiness
  • Decrease in coordination
  • Slurred speech
  • Reduced anxiety
  • Decreased muscle tension
  • Shallow breathing
  • Dilated pupils
  • Tremors
  • Fatigue
  • Sluggishness
  • Vertigo 
  • Dry mouth
  • Headache
  • Problems with vision
  • Loss of appetite
  • Nausea and vomiting
  • Constipation
  • Diarrhea

In rare instances, they may also cause unusual and potentially dangerous behavior during sleep, such as preparing and eating food, using the phone, or driving.

If taken in a high dose, the short-term effects may also include:

  • Euphoria
  • Erratic moods
  • Paranoia
  • Impaired memory
  • Loss of inhibition
  • Slowed breathing
  • Irregular heart beat
  • Confusion
  • Excitement
  • Irritability
  • Aggressive behavior
  • Impaired thinking and judgment
  • Suicidal behavior
  • Dizziness

An overdose may cause:

  • Extreme sedation
  • Dangerous drop in blood pressure
  • Impaired breathing
  • Cessation of breathing
  • Stupor
  • Unconsciousness
  • Coma
  • Death

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Long-Term Effects of Prescription Tranquilizers and Sedatives

The long-term effects of prescription tranquilizer and sedative abuse or addiction can be very serious. It is not uncommon for rebound effects to occur, such as sleep problems or anxiety.

Other long-term effects may include:

  • Seizures
  • Increased tolerance
  • Addiction
  • Hostility
  • Irritable mood
  • Mood swings
  • Disturbing dreams
  • Apathy
  • Memory problems
  • Low libido
  • Impotence
  • Nausea
  • Rashes
  • Depression

Symptoms of Prescription Tranquilizer and Sedative Addiction

All of these drugs are potentially addictive. The indicators that suggest the presence of an addiction to them may include:

  • Coordination problems
  • Slurred speech
  • Sleep problems
  • Anxiety
  • Frequent drowsiness
  • Impaired thinking and confusion
  • Memory problems
  • Light-headedness
  • Depressed mood
  • Low blood pressure
  • Slow breathing

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Detoxing from Prescription Tranquilizers and Sedatives

Detoxing from any of the drugs in this category should be done under medical supervision. One of the reasons for this is the high risk of seizures during the withdrawal process. The risk of seizures is particularly high if the addictive drug is stopped abruptly or tapered too quickly. During the detox process, the drug is usually tapered very gradually.

In addition to seizures, other potential withdrawal symptoms may include:

  • Hallucinations
  • Fever
  • Tremors
  • Agitation
  • Sleep disturbances
  • Anxiety
  • Nausea and vomiting
  • Vivid or disturbing dreams
  • Cramping
  • Sweating

Once the detoxification process is completed, it should be followed by a drug rehab program. Drug rehab treatment helps addicts understand their addiction. They will learn healthy coping skills, ways to manage triggers and avoid relapse, and how to make lifestyle changes and develop new habits that will help ensure a successful recovery.

Other Facts and Effects Related to Prescription Tranquilizer and Sedative Abuse

  • Although barbiturate addiction and overdose is much rarer today than it was several decades ago, approximately 10 percent of barbiturate overdoses result in death.

  • Barbiturate overdose can harm a developing fetus and cause a miscarriage in pregnant women. If taken during pregnancy, the unborn child can become addicted to these drugs.

  • Barbiturate prescriptions make up less than 10% of all the prescriptions for sedative-hypnotic drugs in the U.S. today.

  • Barbiturates are often abused to counteract the stimulating effects of drugs like methamphetamine and cocaine.

  • Due to their highly lethal potential, barbiturates are often used to commit suicide.

  • Recent surveys of high school students suggest an increase in barbiturate abuse in the past decade.

  • Barbiturates have been used for euthanasia by veterinarians, for physician-assisted suicides, and in lethal injections for capital punishment cases.

  • Marilyn Monroe’s death was reportedly due to an overdose of barbiturates.

  • Many people become addicted to benzodiazepines that have been prescribed for them. This is most likely to occur because they regularly take more than the prescribed dose, or because they continue using them for an extended period of time.

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