Uses Drugs of Abuse—Origins and Effects - Depressants

The Controlled Substances Act regulates depressants because they have a high potential for abuse and are associated with both physical and psychological dependence. Taken as prescribed by a physician, depressants may be beneficial for the relief of anxiety, irritability, and tension, as well as for the symptomatic relief of insomnia. When taken in excessive amounts, however, they produce a state of intoxication very similar to that of alcohol. Unlike most other illegal drugs, depressants (except for methaqualone) are rarely produced in secret laboratories. Instead, they are generally obtained through theft and fraudulent prescriptions and sold illegally on the black market.

Chloral Hydrate

The oldest of the hypnotic (sleep-inducing) drugs, chloral hydrate was first synthesized in 1832 and soon replaced alcohol, opium, and cannabis for bringing about sedation and sleep. Its effects are similar to those of alcohol, and withdrawal symptoms resemble delirium tremens (the "DTs"). Cases of poisoning have occurred from mixing chloral hydrate with alcohol. Older adults are the most common abusers of this drug; it is not a street drug of choice.

Barbiturates

According to Charles E. Ophardt in Virtual Chembook (http://www.elmhurst.edu/~chm/vchembook/6673barbit.html), about twenty-five hundred derivatives of barbituric acid have been synthesized, but only fifteen are used medically. Small therapeutic doses calm nervous conditions; larger doses cause sleep within a short period of time. A feeling of excitement precedes the sedation. Too large a dose can bring a person through stages of sedation, sleep, and coma and ultimately cause death via respiratory failure and cardiovascular complications.

Barbiturates are classified as ultrashort-, short-, intermediate-, and long-acting. Ultrashort-acting barbiturates produce anesthesia within one minute of intravenous delivery into the system. Pentathol, Brevital, and Surital are among those currently in medical use. Because of the rapid onset and brief duration of effect, drug abusers find these drugs unattractive.

Short-acting and intermediate-acting barbiturates, including Nembutal, Seconal, and Amytal, with durations of up to six hours, are much more in demand by thrill-seekers. Long-acting barbiturates, such as Veronal, Luminal, and Mebaral, have onset times of up to one hour and durations of up to sixteen hours. These are used medicinally as sedatives, hypnotics, and anticonvulsants.

Glutethimide and Methaqualone

Glutethimide (Doriden) was introduced in 1954 and methaqualone (Quaalude, Sopor) in 1965 as safe substitutes for barbiturates. Usually prescribed for pain and sleep disturbance, in medically approved doses they cause feelings of calm, drowsiness, and euphoria. They are administered orally; in large doses they can cause tremors and altered sleep patterns. In 1991 glutethimide was transferred to Schedule II because of its potential for abuse.

Not long after its introduction, methaqualone became a drug of choice among drug users who thought it was both nonaddictive and an aphrodisiac. Extensive use and abuse of methaqualone can cause hallucinations, anxiety, numbness, tingling, and even serious poisoning. In 1984 the United States stopped production and distribution of methaqualone pharmaceutical products because of growing abuse, and the drug was transferred to Schedule I of the Controlled Substances Act. Counterfeit copies containing diazepam (Valium), flurazepan, and phenobarbital are prevalent on the U.S. illicit drug market.

Benzodiazepines

Benzodiazepines are depressants that relieve anxiety, tension, and muscle spasms; produce sedation; and prevent convulsions. They have a relatively slow onset but long duration of action. They also have a greater margin of safety than other depressants. According to the DEA, benzodiazepines are among the most widely prescribed medications in the United States. Xanax (alprazolam), Librium (zepoxide), and Valium (diazepam) are in this group.

Prolonged use of excessive doses may result in physical and psychological dependence. Because benzodia-zepines are eliminated from the body slowly, withdrawal symptoms generally develop slowly, usually seven to ten days after continued high doses are stopped. When these drugs are used illicitly, they are often taken with alcohol or marijuana to achieve a euphoric "high." Since benzodiazepines are legal, they are usually obtained by getting prescriptions from doctors or forging prescriptions. They are also bought illegally on the black market.

Rohypnol (flunitrazepam), another benzodiazepine, has become increasingly popular among young people. The drug, manufactured as a short-term treatment for severe sleeping disorders, is not marketed legally in the United States and must be smuggled in. It is widely known as a "date-rape drug," because would-be rapists have been known to drop it secretly into a woman's drink to facilitate sexual assault. Several states—including Florida, Idaho, Minnesota, New Mexico, North Dakota, Oklahoma, and Pennsylvania—placed the drug under Schedule I control, and the United States has banned its importation and imposed stiff federal penalties for its sale. Responding to pressure from the American government, the Mexican producer of Rohypnol, Roche, began putting a blue dye in the pill so that it could be seen when dissolved in a drink.