Sedatives and tranquillizers
- In short
Sedatives and tranquillizers are intended to help with restlessness, anxiety and insomnia. They do not solve problems, they mask them. Sedatives and tranquillizers are prescribed by physicians. The most frequently substances today are referred to collectively as ‘benzodiazepines.’ Familiar trade names are: Diazepam, Lexotan, Transken, Rohipnol, Xanax, Dormikum, Neurotope etc.
- Addictive? Both psychologically and physically. Dependency can occur quite quickly and be quite strong, psychological dependency in particular.
- Increasingly more needed for the same effect? Yes.
- Short-term effects: Relaxation, grogginess, indifference, self-overestimation, reduced concentration, slowed reflexes (danger in traffic).
- Long-term effects: Weight gain, sluggishness, sometimes muscle weakness.
- Important: Combination with alcohol is dangerous.
- What are they?
Sedatives and tranquillizers are drugs intended to decrease restlessness, anxiety and insomnia. They are prescribed by physicians for different purposes. Some are prescribed mostly for insomnia while others are prescribed mostly for anxiety or restlessness. Nonetheless, they all work in about the same manner. Those prescribed most often today all fall under the collective name of ‘benzodiazepines.’
Benzodiazepines are marketed by pharmaceutical companies using their own trade names. Familiar trade names are: Diazepam, Lexotan, Transken, Rohipnol, Xanax, Dormikum, Neurotope etc. There are numerous other sedatives and tranquillizers available on the market, but they will not be considered further here.
- Where do they come from?
Insomnia is as old as humanity. Up until the beginning of the twentieth century, substances such as alcohol, opium and herbs were used to counter problems sleeping.
At the beginning of the twentieth century, a new substance was synthesized in the laboratory, namely the barbiturate called ‘barbital.’ Over time, however, it was discovered that barbiturates and barbital are very addictive and very dangerous. There is a major risk of overdose, which can sometimes be deadly. Severe withdrawal symptoms can also occur when use is stopped.
In 1956, benzodiazepines and their operation were discovered. Benzodiazepines appeared to be less dangerous than barbiturates, which represented progress. Benzodiazepines are not without their problems, however. That is, the ideal sedative or tranquillizer does not exist as yet.
- How do they work?
Benzodiazepines literally slow the brain down. Some have a calming effect while others induce sleep. For problems getting to sleep, a fast-working sedative is often prescribed. For a preoccupation with stress or worries throughout the day, a longer-working tranquilizer may be prescribed.
There are also long-working sedatives. These are prescribed for people who have both trouble getting to sleep and trouble staying asleep.
- Why are they used?
Many people have problems with nerves, anxiety, stress, fatigue or brooding which can also cause sleep disorders. The person who has trouble sleeping due to brooding, then, does not get a good night’s rest.
Benzodiazepines reduce the sensitivity of the brain to external stimuli. As a result, the surroundings appear to be more tranquil. In reality, of course, the environment is not more peaceful. Benzodiazepines do not solve any problems but, rather, mask them. The only thing which really helps, thus, is to track down the underlying causes of the problems and deal with these — if possible.
- How are they used?
- Sedatives and tranquilizers are prescribed as medications by a doctor. A willful usage of these medicaments is very dangerous. It is generally recommended not to use them for longer than 1 or 2 consecutive weeks with 2 months considered the maximum. Long-term benzodiazepine use only leads to dependence. Doctors should be very cautious when prescribing sedatives and tranquilizers. The regular contact between the doctor and the person taking benzodiazepines allows tracing and controlling the intake of the medication.
- Who uses them?
In Bulgaria 8,8% of the people at the age of 18 to 60 have used tranquilizers and sedatives at least once. According to the statistics the biggest group of users is woman after 40. A big part of the users take pills for long time, frequently and under medical prescription. Some benzodiazepines are used in the market of the illegal drugs because of the relaxation effects.
- What are the effects?
We can speak about the effects of the use of sedatives and tranquillizers only in general because a particular substance does not work the same for all people. The effects also depend on the actual drug itself, the amount of the active compound, the time of ingestion and just how long the substance has been used.
The person who uses benzodiazepines for the first time will indeed be more tranquil. He or she will sleep better, nervousness will lessen and anxieties or worries will be less apparent.
Viewed from a different perspective, the benzodiazepine user can be seen to become indifferent and experience a decreased capacity to concentrate. Annoying side effects can occur such as headache, major fatigue, an empty or hung-over feeling, dizziness and gloominess. The sex drive can also decline.
- Can you get addicted to them?
A distinction can be made between physical and psychological dependence. One speaks of physical dependence when the body protests after stopped usage of a substance (withdrawal symptoms occur). The use of benzodiazepines leads to physical dependence. When someone stops after long-term use, even seizures can occur.
Another physical phenomenon which occurs with the use of benzodiazepines is tolerance: The body quickly grows accustomed to the use of such a substance. After some time, a higher dosage is then needed to achieve the same effect.
Psychological dependence means that the user craves the substance to an increasingly stronger extent and really does not feel good without substance use. The risk of this is quite great with benzodiazepines. When someone stops after long-term use, he or she can really feel miserable. This is because the problems which were masked by the use of the benzodiazepines usually come back in full force.
Given the intensity of both the physical and psychological withdrawal symptoms, moreover, the propensity to start using again is quite large.
- What are the risks?
- The greatest risk is dependence. Other drugs and alcohol often give the user some time and space to realize that he or she is really only busy with the repression of problems. In the case of sedatives and tranquillizers, this is often the objective of use and thus makes the risk of dependence particularly great.
- The higher the dosage, the longer the body needs to break down the active compound and the longer the substance works. For certain drugs, the breakdown can take up to 60 hours or more. The individual who takes such substance on a daily basis thus ingests a new dose while the previous dose is still working. As a result of this accumulation of the substance, annoying side effects can emerge such as headache, fatigue, an empty or hung-over feeling, dizziness and gloominess.
- The combination of benzodiazepines with alcohol is dangerous. Both are anaesthetics. The mixture of substances can clearly magnify the effects which can be fatal in traffic. While the danger seems to be small because a little drink at the end of the day is assumed to be harmless, the benzodiazepines from the previous day are still at work and the effects of the alcohol can then hit really hard.
- Benzodiazepines are extremely dangerous in traffic. For at least some benzodiazepines, this is also clearly stated on the packaging.
- Benzodiazepines should not be taken when pregnant or breast feeding. A significant amount of the active compound in a benzodiazepine is known to end up in the mother’s milk.
- How to recognize problematic use
A problem user of benzodiazepines cannot always be detected. There are nevertheless tell-tale signs. Someone is in the danger zone when he or she:
- uses benzodiazepines without doing anything about the underlying causes of the problems;
- repeatedly requests prescription renewal; and/or
- uses benzodiazepines for more than 2 consecutive weeks.
- Is it difficult to stop?
The person who wants to stop after long-term use of benzodiazepines faces difficult times. The original complaints can come back in full force. New complaints will also show up such as headache, transpiration, speech and vision problems, dizziness, trembling, nausea and problems breathing. There are also people who become very irritable, aggressive or depressed as a result of stopping.
With a bit of luck, the withdrawal period will only last a few weeks. But some people continue to suffer any number of problems for an extended period of time.
- Handling of problematic use
Everyone can encounter someone who appears to be unwisely using sedatives or tranquillizers at some point in their lives. Attempts to prohibit use are of no avail. An open exchange of thoughts on the basis of adequate information and no prejudices can help. In such a manner, the frequency and amount of use but also the reasons for use can be brought up for discussion.
Heavy and long-term use clearly points to problems which need to be solved. This can be done by the user him/herself with the help of others, if necessary, and possibly professionals.
For both the problem user and his or her environment: Do not hesitate to ask for advice and/or seek help.
