Sedative Use Disorder

 

Sedatives, including tranquilizers and hypnotics such as Xanax®, Valium®, Lunesta® and Ambien®, are substances that can slow brain activity. They are often prescribed to treat anxiety and sleep disorders, however they can also cause slurred speech, poor concentration, confusion, dizziness, problems with movement and memory, lowered blood pressure, and slowed breathing. Long-term use can lead to tolerance and dependence.

What is a sedative?

Central nervous system (CNS) depressants, a category that includes tranquilizers, sedatives, and hypnotics, are substances that can slow brain activity. They are prescribed to treat anxiety and sleep disorders.

How are they used?

Commonly prescribed sedatives include:

  • Benzodiazepines, such as diazepam (Valium®), clonazepam (Klonopin®), and alprazolam (Xanax®), known as “benzos”, are sometimes prescribed to treat anxiety, acute stress reactions, and panic attacks. Usually, benzodiazepines are not prescribed for long-term use because of the high risk for developing tolerance, dependence, and addiction.

  • Non-benzodiazepine sleep medications, such as zolpidem (Ambien®), eszopiclone (Lunesta®), and zaleplon (Sonata®), known as “z-drugs”, have a different chemical structure but act on the same receptors in the brain as benzodiazepines. They are thought to have fewer side effects and less risk of dependence than benzodiazepines.

  • Barbiturates, such as mephobarbital (Mebaral®), phenobarbital (Luminal®), and pentobarbital sodium (Nembutal®), are used less frequently to reduce anxiety or to help with sleep problems because of their higher risk of overdose compared to benzodiazepines. However, they are still used in surgical procedures and to treat seizure disorders.

Short-Term Effects

Sedatives suppress heart rate and breathing. During the first few days of taking a depressant, a person usually feels sleepy and uncoordinated, but as the body develops a tolerance for the substance, these side effects begin to disappear.

Short-term effects can include drowsiness, slurred speech, poor concentration, confusion, dizziness, problems with movement and memory, lowered blood pressure, and slowed breathing.

Combining sedatives with other depressants such as alcohol and opioids further slows heart rate and breathing, which can lead to overdose and death. More than 30 percent of overdoses involving opioids also involve benzodiazepines. Studies have shown that people concurrently using both substances are at higher risk of visiting the emergency department or being admitted to a hospital for a drug-related emergency. (NIDA)

Long-Term Health Consequences

The long-term health consequences of sedative use are unknown. However, if one uses a sedative for a long period of time, a steady increase in dose may be required to achieve the desired therapeutic effects. Continued use can also lead to dependence and withdrawal when use is abruptly reduced or stopped. Because all sedatives work by slowing the brain’s activity, when an individual stops taking them there can be a rebound effect, resulting in life-threatening complications such as seizures.

Sedative Use Disorder Treatments

There are no FDA-approved medications to treat addiction to prescription sedatives; lowering the dose over time must be done with the help of a healthcare provider. Behavioral therapies are the standard of care when medications are not available.

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