Sedative-hypnotic drug, chemical substance used to reduce tension and anxiety and induce calm (sedative effect) or to induce sleep (hypnotic effect). Most such drugs exert a quieting or calming effect at low doses and a sleep-inducing effect in larger doses. Sedative-hypnotic drugs tend to depress the central nervous system. Since these actions can be obtained with other drugs, such as opiates, the distinctive characteristic of sedative-hypnotics is their selective ability to achieve their effects without affecting mood or reducing sensitivity to pain.
For centuries alcohol and opium were the only drugs available that had sedative-hypnotic effects. The first substance introduced specifically as a sedative and as a hypnotic was a liquid solution of bromide salts, which came into use in the 1800s. Chloral hydrate, a derivative of ethyl alcohol, was introduced in 1869 as a synthetic sedative-hypnotic; it was used notoriously as “knock-out” drops. Paraldehyde was introduced into clinical medicine in the 1880s and was followed by the synthesis of barbital in 1903. Phenobarbital became available in 1912 and was followed, during the next 20 years, by a long series of other barbiturates. In the mid-20th century new types of sedative-hypnotic drugs were synthesized, chief among them the benzodiazepines (the so-called minor tranquilizers).
Barbiturates were extensively used as “sleeping pills” throughout the first half of the 20th century. They also were used to reduce voluntary inhibition during psychiatric examinations (for which they have sometimes been dubbed “truth serums”). Among the most commonly prescribed kinds were phenobarbital, secobarbital (marketed under Seconal and other trade names), amobarbital (Amytal), and pentobarbital (Nembutal). When taken in high-enough doses, these drugs are capable of producing a deep unconsciousness that makes them useful as general anesthetics. In still higher doses, however, they depress the central nervous and respiratory systems to the point of coma, respiratory failure, and death. Additionally, the prolonged use of barbiturates for relief of insomnia leads to tolerance, in which the user requires amounts of the drug much in excess of the initial therapeutic dose, and to addiction, in which denial of the drug precipitates withdrawal, as indicated by such symptoms as restlessness, anxiety, weakness, insomnia, nausea, and convulsions. Analysis of electroencephalographic (EEG) patterns during barbiturate-induced sleep has further revealed that the use of some of these drugs produces sleep disruption.
The use of barbiturates declined after the development in the 1950s of the benzodiazepines. The latter are more effective in relieving anxiety than in inducing sleep, but they are superior to barbiturates because of the reduced dangers they present of tolerance and addiction and because they are much less likely to injuriously depress the central nervous system when used at high doses. They also require a much smaller dosage than barbiturates to achieve their effects. The benzodiazepines include chlordiazepoxide (Librium), diazepam (Valium), alprazolam (Xanax), oxazepam (Serax), and triazolam (Halcion). They are, however, intended only for short- or medium-term use, since the body does develop a tolerance to them and withdrawal symptoms (anxiety, restlessness, and so on) develop even in those who have used the drugs for only four to six weeks. The benzodiazepines are thought to accomplish their effect within the brain by facilitating the action of the neurotransmitter gamma-aminobutyric acid, which is known to inhibit anxiety.
Antipsychotic drugs (major tranquilizers), tricyclic antidepressants, and antihistamines can also induce drowsiness, though this is not their primary function. Most over-the-counter sleeping aids use antihistamines as their active ingredient.
Alcoholic beverages in particular are only of modest benefit in inducing sleep. On frequent exposure to alcohol, the nervous system adapts to the drug, and this results in early-morning awakening.
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Most often, people start experimenting with drugs due to the influence of such factors as depression, anxiety, tumultuous family history, and childhood abuse. The risks associated with drug experimentation vary from one drug to another. Potential dangers and risks of drug experimentation are best understood by examining the effects of a drug being used (Harrington, et al. 2011).
Most drugs, such as tranquilizers heroin, or alcohol have a sedative effect on the user, which slows down brain and body activity. These drugs cause drowsiness and affect brain coordination if taken excessively, and become fatal if taken in large quantities. Another major risk of using sedatives is addiction, which makes users become physically dependent on the drugs they take, so when they try to quit, they experience serious withdrawal symptoms and severe pain (Lyons, 2003). Stimulants drugs, such as cocaine, amphetamine, ecstasy, and crack stimulate the brain and provide individuals with energy; however, the same drugs cause panic attacks and anxiety. Other drugs commonly taken by young people are LSD and cannabis. These usually cause hallucinogenic effects by changing the way an individual sees, feels, tastes, smells, or hears (Cohen, 2003). Excessive use of these drugs causes users to suffer from disturbing hallucinations, which leads to dangerous, erratic behavior and mental instability.
The risks associated with drug experimentation depend on various factors, such as quantity, frequency of use, combinations used, and the way a certain drug is taken. An excess of sedatives leads to fatal overdoses. Stimulant and hallucinogenic drugs on the other hand lead to psychotic behavior and to the loss of the sense of reality. Besides, constantly increasing doses lends to drug tolerance: the user needs to take more of the narcotic substance to achieve the desired effect. High tolerance levels also prompt overdose and even death—this especially refers to heroin. Most of the cases of drug overdoses that have been reported involve combinations of tranquilizers, opiates, and alcohol (Lyons, 2003).
The manner in which a drug enters into the body influences the effect it has on the user and determines possible dangers. Injectable drugs produce an intense and quick effect; at the same time, it often leads to infection, especially in cases when equipment is shared between multiple users. HIV infection takes the lead in terms of infection followed by Hepatitis C and B (Lyons, 2003). Inhaling drugs has a quick but reduced effect. The types of drugs that are inhaled include solvents, such as gases, glues, and aerosols. In serious cases, inhaling solvents leads to suffocation. Inhaling butane or aerosols is fatal because the fumes freeze the airways. Substances like cocaine or amphetamine regularly damage nasal membranes.
The risks and effects of drug experimentation are extremely diverse. Personality factors and how the drug is used are important in assessing both the effects and the risks (Cohen, 2003). Most people experimenting with drugs are usually unsure about their actions and what can be the consequences, and lack experience. This lack of experience and ignorance themselves can be as dangerous as the drugs. The psychological and mental state of drug users influences the dangers and effects of drug use (Harrington, et al. 2011).
Cohen, A. (2003). Dangers of Drug Experimentation (4th ed.) San Francisco: Jossey-Bass.
Harrington, M., Robinson, J., Bolton, S., & Sareen, J. (2011) Longitudinal Study of Risk Factors for Incident Drug Use in Adults: Findings From a Representative Sample of the US Population. Canadian Journal of Psychiatry, New York: Palgrave Press.
Lyons, R. (2003). Youth and Drugs Wellington, New Zealand: Huia Publishers.
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