The next major category of drugs is depressants. These drugs are often referred to as "downers", as they have the opposite effect as the stimulant "uppers." Once again, there are legal and illegal versions of drugs abused in this category that will be covered. The artcle will look into the different types of depressants, how they are used in medical and non-medical settings, and what evidence of their usage you can see in a user. Also in the discussion will be the side effects, both short and long term, of depressant usage and what to expect in treatment and recovery from depressant abuse.

What Are Depressants?

Drugs that are categorized as depressants are often have a calming and relaxing effect on the user. Many types of depressants are used as sleep aids, anti-seizure medication, to treat anxiety, and muscle relaxers. Certain mental illnesses also include depressants as a part of their medication treatment. Some depressants are referred to as Central Nervous System (CNS) depressants, as they help calm a person's nervous system on a chemical level. They are also referred to as tranquilizers and antipsychotics. These types of drugs are manufactured by pharmaceutical companies for as legitimate medication, although many are misused for non-medical purposes.

The conditions that depressants treat often require medication as part of their treatment, sometimes for long stretches of time. As a result, many legitimate users develop a dependence on the depressants they take. Many of these drugs are not accessible without a prescription, but that does not necessarily impede access for those who intend to abuse them. Users and distributors who do not have a medical usage often steal the drugs from family and friends who do, purchase through illicit markets on the internet, or fake medical issues in order to get a prescription.

As stated above, depressants are manufactured by legitimate companies. Many of the depressants that are used in the United States are generated by American companies, with a few exceptions. Rohypnol, frequently used as a date-rape drug, isn't even manufactured or sold through legal means in the United States. However, it's is still used and sold through illicit markets throughout the country.

The National Survey on Drug Use and Health from SAMHSA found that there were about 1.9 million non-medical depressant users aged 12 years or older. Unlike stimulants and other drug types, there has not been any significant change in the amount of users compared to previous surveys and studies. Although alcohol is considered a depressant, it is usually studied and surveyed as a separate substance, so it is not included in SAMHSA's findings or in this article.

Some depressants include:

• Barbiturates--Barbiturates are the original depressants and have a long history. Hollywood's usage of illicit substances and their usage by studios to control stars was mentioned. The combination of barbiturates and amphetamines were fairly standard to keep young stars working and one famous example is Judy Garland, who developed an addiction to barbiturates and eventually died of an overdose. Barbiturates have a high rate of dependency, which means that many users are unable to sleep or relax without the drug. As their tolerance builds, the dosage necessary increases and the chances of coma or death rise. Some barbiturates include phenobarbital, Seconal, Nembutal, butalbital, and Pentothal.

• Benzodiazepines--Benzodiazepines, or benzos, were initially designed with the intent of creating a "safe" barbiturate alternative. While they do have a lower dependence potential, they still carry many of the same risks as barbiturates. Many of the same side effects that patients experience when taking benzos are similar to those they would experience with barbiturates. Examples of name brand benzos include Valium, Restoril, Xanax, Ativan, and Halcion. Rohypnol is also a benzodiazepine drug.

• CNS Depressants--Depressant drugs that do not qualify as barbiturates or benzodiazepines are simply referred to as CNS depressants. Many of them are sedatives that are intended for temporary relief for insomnia sufferers, and are not meant to be used long-term. Like benzos, these drugs were designed as a safer and less dependent alternative to barbiturates. As a result, they do share some similar qualities. Some examples include sleep aids like Sonata and Ambien, meprobamate, and methaqualone or Quaalude. GHB, an illicit drug that is also used as a date-rape drug, is also a CNS depressant.

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Compared to other categories, there is less variety for depressants in regards to their known appearance and usage. The vast majority of depressants are available in a pill and tablet form. It's also the standard format for prescription depressants, as this is the easiest form for usage. The pills can come in a variety of colors and shapes, many of which are specific to the brand name. They can also come as syrups and liquids, although these forms are less common and not available for all depressants.

These limited formats mean there are limited ways that they can be used. All three forms can be taken orally, either by themselves or mixed into a liquid for ease of use. Users have also been known to mix it into alcohol to cut the taste some depressants have, both for their own ingestion and to drug others. The liquid formats can be injected intravenously. Many teenage and young adult users have reported crushing benzodiazepine pills into a powder and then snorting it. The drug GHB--Gamma-Hydroxybutyric acid--is available in a fourth format, a white powder. This is often the format that is used when GHB is applied as a date-rape drug.  

Signs of Usage

Depressants have a strong neurological-based effect, so many of the signs of usage are neurologically based. While their primary functions impact the mind, depressants do have some physical effects. The majority of the following signs present themselves when the person has taken more than the prescribed dosage of the depressant.

• Psychological Signs--Most of the psychological signs of usage for depressants are going to be a result of the drug's primary function. Users may come across as very relaxed and mentally-not-there. Their reaction time, mental function, and though process may be slowed and they may seem confused. It is possible that a user may not have any memory of what occurred while the drug is in their system, and may have temporary amnesia. Many users tend to have poor judgement while under the influence, and may make decisions that are illogical. They may also seem emotionless or respond to things with irritation.

• Physical Signs--Due to compromised mental coordination, users may stumble or stagger as they walk. Many depressants act as muscle relaxers, so a user's limbs may not move as they are meant to. Blood pressure and breathing normally decreases under normal dosages, occasionally enough to lull the person to sleep. Users may have dilated pupils and a slow pupillary response while under the influence. Higher dosages will do the same and possibly make the person very lethargic if they remain conscious. It is possible that a person abusing depressant, when under the influence, could be mistakenly identified as being drunk.

The Side Effects

Depressants are rarely prescribed for long term use due to their risk for dependence and how quickly tolerance can develop. However that does not mean depressant users are safe from side effects if they use for a short amount of time. As with other drugs di there are short term and long term side effects that users can potentially have.

• Short Term Effects--The majority of the short-term side effects a user may experience are continuations of the signs listed previously. These effects may remain for some time after the drug is out of the person's system. Additional problems may arise, and persist for several hours to a few days after usage. Common effects include fatigue, sluggishness, a lack of coordination, confusion, and dizziness. Users who experience memory problems while under the influence may have some difficulty remembering things later on. Some users have developed a fever afterwards, as well as instances of paranoia and visual disturbances.

• Long Term Effects--As users develop a tolerance and need to increase their dosage in order to feel the drug's effects, their chances of developing serious long term effects also increase. Long term usage often leads to instances of depression, which can be coupled with suicide thoughts. Permanent sleep problems, such as persistent insomnia, can occur and the user may need additional medication in order to sleep. Due to the relaxing effect that depressants can have on a person's heart rate and breathing, many users develop breathing difficulties. Cravings for the drug can cause a person to develop anxiety and panic attacks, especially if there is someone or something preventing them from getting another dosage.

Additional side effects of depressant usage include an increased risk of certain conditions. These are not standard for all users and can occur during the time that a user is abusing. On a chemical level, depressants have the potential to increase a person's risk for diabetes and high blood sugar. Some users who had no family history of diabetes and nothing in their personal medical history developed the condition after long term usage. Diabetes, on its own, can cause health issues beyond high blood sugar. Many diabetics--as well as depressant users who develop symptoms--experience weight gain and difficulty losing weight. This, too, can lead to further health complications if not properly addressed.

Treatment and Recovery

Treatment and recovery for depressant users often requires special care. A unique, but dangerous, effect that that depressants have is the symptoms of withdrawal a user can go through. Withdrawal from depressants is highly dangerous and can have disastrous results if not done under medical care. Even when used according to a doctor's instructions, withdrawal from depressants can generate severe symptoms. Users who go into the beginning stages of withdrawal have reported experiencing intense insomnia, nausea, and physical weakness. Increases in body temperature and agitation have been known to occur in users who consistently took high dosages. Convulsions and seizure-like symptoms have occurred during withdrawal for depressant users. Any person who abuses depressants and chooses to seek treatment--or is unable take another dosage of the drug--will need medical attention for withdrawal. Under no circumstances should a person withdrawal from depressant usage without medical supervision.

Since prescription depressants were initially given to the person to treat a mental health condition, there is the possibility that a treatment plan for both the condition and the person's addiction will be necessary. Such instances are usually referred to as co-occurring disorders or dual diagnosis. There are additional issues that can arise with co-occurring disorders, as there may be some overlap in terms of symptoms. It is possible that treatment for one condition may interfere or compromise the treatment for the other, so things may get complicated. These circumstances may affect a person's path towards recovery and their risk of relapse.

When a depressant user does complete treatment and enters into recovery, it is possible that they may have to seek additional treatment. The long term effects of depressant use, as mentioned earlier in this article, can cause additional problems and should not be ignored. Any care that a person seeks for those effects will need to be mindful of the person's addiction, and especially so if there is a co-occurring condition present as well. While this may complicate their recovery, it does not make it impossible.