ClassesTypes of Depressants

1
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 -ant
  i-anxiety pills -sleeping pills
  -sedatives

2
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

3
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

4
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

5
Barbiturate Use 2002-2003
For example, Nembutal, Pentobarbital, Seconal,
Secobarbital, or Butalbital.Source SAMHSA,
Office of Applied Studies, National Survey on
Drug Use and Health, 2002 and 2003.
6

• 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 drugs ED
  compared with other drugs, so potential for
  overdose is high
• withdrawal SX similar to alcohol
• rebound insomnia
• rebound in REM sleep gt vivid dreams/nightmares

7
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

8
Depressants (cont)

• Benzodiazepines
• classic anti-anxiety drugs
• synthesized mainly 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

9
Benzodiazepine Use 2003-2004
Includes Klonopin or clonazepam, Xanax,
alprazolam, Ativan, or lorazepam, Valium or
diazepam, Librium, Limbitrol, Rohypnol,
Serax, and Tranxene.
10
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
• NHSDA 2001 (9.6, 2.0, .7)

11
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 pre-anesthetic medication
• similar to valium in effect but 10 times stronger
• effects begin within 30 minutes, may last for 8
  hours or more

12
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 lt 5 per tab
• popularity among young people Said to be south
  Floridas fastest growing drug problem

13
Rohypnol

• 2 COMMON MISPERCEPTIONS
• the drug is safe and pure because it comes in
  pre-sealed bubble packages
• cant be detected through urinalysis

14
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

15
Rohypnol

• used in date rape situations.WHY?
• its 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

16
Inhalants

• USES varied as products huffed include
  gasoline, glues, solvents, paint..
• Mostly young kids, adolescents
• highly destructive to brain with OD potential
• NHSDA data
• 2001 8.1, 0.9 , 0.2