Tranquilizers are a group of drugs which are also referred to as sedatives or depressants. All of these terms have the same root meaning, which is to slow down activity. Tranquilizers slow the central nervous system's functioning, resulting in a decrease in activity across the body's major systems. They are abused frequently because they produce euphoria, relaxation, and intoxication, similar to the effects of alcohol. Included among the category of tranquilizers are three main types. The first type is benzodiazepine tranquilizers, or benzos, the most commonly prescribed tranquilizer in America. This medication is used primarily to treat anxiety and includes popular drugs like Xanax and Valium. These drugs are incredibly addictive and dangerous despite their overuse. Benzos are also used to treat seizures and muscle spasms, and anxiety before medical procedures. Rohypnol (flunitrazepam) is a short-acting benzodiazepine that is ten times stronger than Valium. Rohypnol has been used as a "date rape" drug and is no longer legal in the United States.
The second type, barbiturates, is not used as much for medical purposes anymore. They were the treatment of choice for insomnia and anxiety until benzodiazepines replaced them. This was because of the drug's propensity to cause addiction and life-threatening withdrawal symptoms and the thought that benzodiazepines were safer. Ultimately this was proven to be untrue. Certain barbiturates are still employed as anticonvulsants (phenobarbital) and to induce anesthesia (thiopental). Other examples of this group are Seconal, Amytal, and Butisol.
The third type of tranquilizer drug is somewhat newer and more specialized than the two previous forms. The story begins the same, with a fruitless search for a less-addictive cousin of the modern tranquilizer, benzodiazepines. The result was "non-benzodiazepine" Z-drugs, a chemically similar medicine that acts on some of the same receptors as benzodiazepines. They are called Z-drugs because their chemical name usually begins with the letter Z. These drugs work on a specific type of receptor in the central nervous system called BZ1, which makes their action as a sleep aid very limited. Some examples of "Z-drug" medications include Ambien, Lunesta, and Sonata. Hallucinations and psychosis have been reported in some people who take these drugs, and they're not intended for long-term use. They are prescribed to treat sleep because of their rapid onset and the supposition that they don't alter the natural stages of sleep, such as REM. Yet, they too were discovered to cause addiction and dependence and a host of other odd side-effects, such as performing complex motor tasks while in a "blackout" state of non-consciousness, like driving. This can be extremely dangerous for obvious reasons.
These medications are all controlled substances, meaning that they are only legally available by prescription to treat medical or psychological conditions. But, they are often obtained and diverted to the United States' illegal drug market, making them available to virtually anyone who seeks them out. When purchased or sold in this way, they are often referred to by street or slang names.
Some street names for barbiturates include: Barbs, Downers, Sleepers, Stumblers, Yellow Jackets, Red Dolls, Tootsies, Rainbows.
Street names for benzodiazepines include: BZDs, Downers, Goofballs, Heavenly Blues, Qual, Robital, Stupefy, Tranx, Valley Girl. Z-drugs have already been given a slang name. Individual drugs may have nicknames colloquially.
The History of Tranquilizers
The first drug of this class developed were barbiturates. Barbituric acid was first synthesized on November 27, 1864, by a German chemist. But this substance itself was not of medical value. But in 1903, two German scientists working at Bayer discovered barbital and found it was very useful in putting dogs to sleep. Bayer then marketed barbital under the trade name Veronal. Other similar compounds followed, and it became a heavily prescribed class of drugs used to "treat" a variety of ailments like insomnia, anxiety, and even heat intolerance among soldiers. It was not until the 1950s that the behavioral disturbances and physical dependence potential of barbiturates became recognized, and they began to be used less. Benzodiazepine tranquilizers eventually replaced barbiturates.
Benzodiazepines became the drug of choice among prescribers fro treating anxiety, insomnia, and convulsions because they were touted to be safer and less addictive than barbiturates. The first such benzodiazepine, chlordiazepoxide (Librium), was discovered accidentally in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed the benzodiazepine diazepam (Valium) since 1963. In 1977 benzodiazepines were globally the most prescribed medications.
Z-drugs emerged in the last years of the 1980s and the beginning of the 1990s. By 1999, King Pharmaceuticals had finalized approval with the Food and Drug Administration (FDA) to market zaleplon (Sonata) across the US. In 2005, the FDA approved eszopiclone (Lunesta). That same year, 2005, the FDA finalized approval for Ambien CR, or extended-release zolpidem. Most recently, in 2012, the FDA approved Intermezzo, which is marketed for middle-of-the-night insomnia, available in doses only half of the strength of immediate-release zolpidem.
What do Tranquilizers Look Like?
There are many different types of tranquilizers. Here are a few examples:
Effects of Tranquilizers
Prescription sedatives and tranquilizers can cause euphoria. They slow normal brain function, resulting in slurred speech, shallow breathing, sluggishness, fatigue, disorientation, and lack of coordination. During the first few days of taking a prescribed sedative or tranquilizer, a person usually feels sleepy and uncoordinated. Still, as the body becomes accustomed to the drug's effects, these feelings begin to disappear. This is not a good thing since it means that tolerance and dependence have already started. Higher doses cause impairment of memory, judgment, and coordination, irritability, paranoid and suicidal ideation. Some people experience a paradoxical or adverse reaction to these drugs and become agitated or aggressive instead of calm. Using sedatives and tranquilizers with other substances, particularly alcohol, can slow breathing, slow both the heart and respiration and possibly lead to death.
The effects of using sedatives can resemble those of alcohol. In addition to their desired calming effects, sedative use can cause:
- Drowsiness, dizziness, and confusion
- Problems with movement and memory
- Increased risk of falls and injury
- Worsening of depression and anxiety symptoms
- Impaired attention and judgment
- Mood swings and inappropriate behavior
- Risk of dependence and addiction
- Risk of death from overdose, either intentional or unintentional
Aside from the well-documented effects of these drugs, as they become more prevalent in today's society fraught with addiction, we learn more about them. Teens are abusing benzodiazepines at alarming rates, and some startling trends are emerging. High doses of benzos cause amnesia and a state similar to blackout, where the person is behaving out of their own full control. Additionally, they heavily affect judgment a have a propensity to make users shoplift. This peculiar phenomenon is just beginning to be documented and studied and is more than a coincidence, as similar reports continue to flood in.
Some of the more insidious effects of long-term sedative use are:
- The distress caused to the individual and the individual's family by dependence
- More accidents – in the house, at work, and on the roads (due to poor muscle coordination and impaired visual-spatial ability)
- Increased risk of antisocial acts such as shoplifting (because of disinhibition and amnesia)
- Domestic disharmony and poor social interaction (arising from emotional and cognitive impairment)
- Difficulty either keeping a job (due to poor performance or prolonged illness) or finding one (due to lack of activity and motivation).
- Greater health care expenses from treating the adverse effects of dependence
- Increased risk of severe adverse effects when combined with other substances, becoming increasingly common as tolerance increases
Continued use can lead to physical dependence and withdrawal symptoms may occur when the person stops taking tranquilizers or runs out. Because all prescription sedatives and tranquilizers work by slowing the brain's activity, when a person stops taking them, there can be a rebound effect, possibly leading to seizures and other harmful consequences. Withdrawal symptoms from any drug are always the opposite effects of that the drug caused, so in the case of tranquilizers, the person's brain becomes overstimulated. Their bodily systems go into overdrive, and the experience is incredibly dangerous, uncomfortable, and protracted. Many people attempting to recover from tranquilizer addiction do not feel well for months afterward. This can make the process seem daunting; however, complete recovery is possible.
Overdoses of sedative medications constitute a leading cause of drug overdose deaths in the USA. Drug overdose deaths involving benzodiazepines rose from 1,135 in 1999 to 11,537 in 2017. As sedatives work by depressing the central nervous system, the overuse of the drugs can slow body functions to such a degree as to cause unconsciousness, respiratory failure, and death. An overdose may be a deliberate attempt to commit suicide. Sedatives are commonly used in this way because they are perceived to cause no pain. However, not all suicide attempts are successful. Vomiting is expected when the drug is taken in excess, which is the body's effort to survive toxicity. If this happens, the person may survive but end up with brain damage due to the lack of oxygen. By contrast, an accidental overdose can occur if the user takes too much of a sedative or combines it with other drugs the enhance the depressive effects. A person can become dependent on sleeping pills but, over time, become less responsive to the drug. In a desperate attempt to get sleep, a person may end up taking too many. From 2002 to 2015, the rate of overdose deaths involving the combined use of sedatives and opioids has doubled. Today, the majority of sedative-related overdose deaths occur for this reason.
Symptoms of a sedative overdose include:
- Slurred speech
- Difficulty breathing
- Dizziness or fainting spells
- Inability to think or respond normally
- Slowed respiration
- Slowed heartbeat
- Increasing coldness of the skin
- A bluish tinge to the lips, fingers, and skin (cyanosis)
People who have overdosed on sedatives should be admitted to the hospital immediately and monitored closely, usually in intensive care. Approximately one in four overdose deaths occur after a person has been admitted. Treatment may involve some or all of the following:
- A stomach pump
- Administration of activated charcoal to absorb the excess drug
- Medications to flush the drug through the bowels or urinary tract
- Administration of intravenous fluids to prevent dehydration and stabilize body functions
- A respirator if breathing has been impaired
- Dialysis to better clean the blood, particularly if renal damage is suspected
- Medications to stabilize heart function
People can recover from a sedative overdose if treatment is started early. Unless a person has experienced prolonged oxygen deprivation, the overdose's effects tend to last only as long as the drug remains in the system.
Addiction to tranquilizers can occur relatively quickly and could happen to anyone. Like with any substance, addiction to tranquilizers begins with a problem. But the problem is not the drug, yet. The problem could be anything from physical pain to mental or emotional distress, including insomnia.
If the person is struggling to sleep, there are many reasons this could be happening. But when tranquilizers are used to treat insomnia, it only provides temporary relief, if any. If the person is struggling badly, they may be desperate for answers and so be willing to use them as a band-aid until they can resolve the underlying reasons for their insomnia. Sadly, many never care to take a more in-depth look at their lifestyle and nutrition to make the real changes needed. So, tranquilizers have become a go-to in America for many.
The problem is, they work. Drugs like benzodiazepines are very effective at inducing sedation, causing the person to feel good. This combination can cause addiction rapidly. The next morning, the person feels rested for the first time in months. They have a great day, finding themselves in an exceptionally relaxed and happy mood. Of course, they retake it that night. And the next night as well.
But after only a few nights, it stops working as well. They wake up two hours before their alarm is set and feel like they are going backward. So, they take two that night to ensure sleep. There's an important meeting the next morning.
They think they've found a solution in drugs. It's the only thing that's solved their problem. When the doctor discontinues the prescription after two weeks, they are overcome with anxiety. It was never supposed to be a permanent solution.
The first night they don't sleep at all. Their anxiety about not sleeping does not help. The second night is no better. They are falling apart at work, and their insomnia is worse than ever. People begin to comment on their appearance and performance. They perceive that their career is at risk and become desperate.
Doctor shopping is a term used to describe the practice of seeing multiple physicians, often under pretenses, in pursuit of prescription drugs. The first time a person does this, it may be because they do not feel understood or helped by their doctor. But as the addiction grows, the practice can become manipulative and calculated.
This person goes to another physician and fails to mention that they just went through a prescription of tranquilizers from another doctor. They are given another 14 or so pills, and their addiction worsens. This process may repeat indefinitely or until the person is caught and denied treatment. They may also discover that they can purchase the drugs illegally for a higher price but far less effort.
Eventually, the person becomes trapped. They cannot continue their addiction because of various reasons, such as no money, no access to the drugs, or a desire to change. But they can't stop because withdrawal symptoms include the risk of seizure and death. Whenever they run out, they shake violently until they find more.
Many who struggle with tranquilizer addiction suffer seizures or other health consequences before engaging in treatment. Often, this can be what alerts loved ones to their struggle.
In 2018, 53 million or 19.4% of people aged 12 years and older used illegal drugs or misused prescription drugs in the previous year.
Approximately 6.1 million people misused prescription tranquilizers according to a report from SAMHSA in 2015, representing 2.3 percent of the population aged 12 or older.
How to help a loved one addicted to Tranquilizers
Tranquilizer addiction is quickly becoming one of the biggest problems in America. If someone you know or love is addicted to tranquilizers, you should help them immediately. These drugs are so dangerous because of the physical dependence they cause, and soon they may not be able to safely stop taking the drugs with medical intervention due to the risk of deadly withdrawal symptoms. They are caught in a literal catch-22 where they will die either way unless they get help, and the sooner, the better.
One of the biggest myths about tranquilizers is that they are safe. These drugs are commonly used to treat anxiety and have been glamorized in popular culture. This has led many youths to become addicted to drugs like Xanax and not knowing how dangerous their situation is. People frequently have seizures because they are withdrawing from tranquilizers but don't even know it. They think they're just having another anxiety attack and need another pill, then wake up in the hospital (hopefully). But sometimes they never wake up and never even knew that they had a problem.
This is why you should act on any suspicions you may have about a loved one's drug use. Usually, if you think something is up, you're right. This doesn't mean that you should be confrontational or aggressive. If they are hiding drug use from you or just haven't realized that they are hooked, people can be very defensive. Deep down, we know the difference between right and wrong.
Instead of giving them an opportunity to lie off justify, just tell them your concerns and that you want to help. Be prepared for them to lie or become angry or even begin to blame you. No matter what happens, you must not get angry or become upset with them. You are not actually dealing with them; you are dealing with the drugs. Any anger or attempt to get out of the conversation should be viewed as confirmation that you are correct, regardless of what they are saying to you.
If you do this well and are patient, they just may be honest with you. But they also may not, since they fear repercussions and know that you do not approve. If they lie and continue using drugs, you should look into getting some professional assistance. You can always call the number on this page and discuss treatment and intervention options at any time. It is important to have this information when you go to confront them so in the event they agree to get help, you can move quickly while they are still willing. They may change their mind the next time they use drugs, and if you are waiting for days to get them in somewhere, this could end in tragedy.
Treatment of tranquilizer and sedative addiction can be somewhat trickier than other substances. This is because Abrupt cessation of benzodiazepines after a period of 1–6 months of continued use can cause life-threatening seizures, so the dose should be gradually reduced.
The duration of weaning depends on tolerability and the starting dose. While not specifying a withdrawal period, most primary care studies have found that gradual withdrawal over at least ten weeks successfully achieves long-term abstinence. This is longer than most rehabilitation programs are, so complicates things. A patient may ask their doctor to wean them off the medication in this manner, but without drug rehabilitation of some type, this is usually unsuccessful.
This predicament leads many to attempt self-detoxification or simply surrendering to maintenance therapy. Maintenance therapy is where the person is placed on a less-potent, longer-acting tranquilizer for the rest of their life. It is a harm reduction approach, and so is not a form of treatment or rehabilitation, which, by definition, aims to restore a person to their previous state—the state of being drug-free.
Thankfully, medical detoxification facilities exist to help get people off tranquilizers relatively rapidly. Over days or a couple of weeks, they can be tapered down to a dose where it is safe to discontinue them entirely. They should enter treatment immediately since detoxification is a pre-treatment step that allows the person to now be treatable.
At this point, the person can either enter inpatient or outpatient drug treatment. Inpatient treatment is recommended since it consists of the patient living there for their treatment duration. In most cases, the patient must remain on-site at all times and is drug tested regularly. These restrictions ensure a safe environment where patients can focus on recovery without temptations.
Outpatient treatment exists to serve those who completed inpatient treatment and seek additional support transitioning to achieve independence in recovery. It can also be utilized by those who simply cannot attend inpatient treatment due to extenuating circumstances. It consists of the patient living at home but traveling to the facility for treatment sessions. These sessions may be daily at first, then as infrequent as once per week as the patient becomes more stable and confident.
Among these two forms of treatment, there are many different methods—these range from the traditional twelve-step programs to holistic treatment programs and faith-based options. There can be significant differences between these, so take care to choose a program that will be effective for you. This usually means that the program is challenging and not the easy route. If it sounds ideal, it likely isn't what the person needs.
To get help, start by speaking with different facilities and asking questions. They will take you through a screening process, where they ask questions about your drug history. Take care to answer these questions honestly and thoroughly because they are using this information to decide if their program is the right level of care for your needs.
You may want to attend a facility that is far from home or even out of state. While this may sound strange, it is one of the most effective ways to ensure that you see it through. If you can easily walk home, catch a cab, or call a friend, it may be much easier to throw in the towel when treatment becomes difficult.
In 2015, 18.9 million people aged 12 or older (7.1 percent) misused prescription psychotherapeutic drugs in the past year. This number included 3.8 million people who misused prescription tranquilizers and sedatives.
Among past year misusers of tranquilizers, the most commonly reported reasons were to relax or relieve tension (44.9 percent) or to help with sleep (20.4 percent).
Of the 18.9 million people aged 12 or older in 2015 who misused prescription psychotherapeutic drugs in the past year, 1.5 million were youths aged 12 to 17, 5.3 million were young adults aged 18 to 25, and 12.1 million were adults aged 26 or older. Although adults aged 26 or older were more likely than people in other age groups to have used prescription drugs in the past year, young adults were more likely than youths and adults aged 26 or older to have misused prescription psychotherapeutic drugs in this period.
The number of people with prescriptions for benzodiazepines increased by 67% between 1996–2013. Public health surveillance data shows that roughly 1.5 million adolescents reported past year tranquilizer/sedative use or misuse in 2016, and the prevalence of abuse has remained stable in recent years. Also, benzodiazepine use/misuse is associated with negative health-related outcomes, as the number of benzodiazepine related emergency department visits increased 160% from 2004–2011 and overdose deaths increased by 137% between 2007–2016.
Approximately 86% of benzodiazepine deaths also involve the use of opioids.
In the United States, fatal benzodiazepine overdose increased by over 400% from 1996 to 2013, with a nearly 300% increase because of benzodiazepine and opioid co-ingestion, and emergency department visits increasing by over 300% from 2005 to 2011 because of benzodiazepines and opioid co-ingestion
Although more than 2,000 different benzodiazepines have been produced, only about 15 are currently FDA-approved in the United States.
Common Terminology Surrounding Tranquilizers
|Drug misuse||The use of illegal drugs or prescription drugs in a manner other than directed by a doctor, such as use in larger amounts, more often, or longer than told to take a drug or use someone else's prescription.|
|Nonmedical use||Taking prescribed or diverted prescription drugs (drugs not prescribed to the person using them) not in the way, for the reasons, in the amount, or during the time period prescribed.|
|Opioid||Natural, synthetic, or semi-synthetic chemicals that interact with opioid receptors on nerve cells in the body and brain and reduce the intensity of pain signals and feelings of pain. This class of drugs includes the illegal drug heroin, synthetic opioids such as fentanyl, and pain medications available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others.|
|Overdose||Injury to the body (poisoning), which happens when a drug is taken in excessive amounts. An overdose can be fatal or nonfatal.|
|Physical dependence||Adaptation to a drug that produces symptoms of withdrawal when the drug is stopped.|
|Tolerance||Reduced response to a drug with repeated use.|
|Benzodiazepines||Sometimes called "benzos," these are sedatives often used to treat anxiety, insomnia, and other conditions. Combining benzodiazepines with opioids increases a person's risk of overdose and death.|
|Illicit drugs||The nonmedical use of a variety of drugs that are prohibited by law. These drugs can include amphetamine-type stimulants, marijuana/cannabis, cocaine, heroin, other opioids, and synthetic drugs, such as illicitly manufactured fentanyl (IMF) and ecstasy (MDMA).|
|Narcotic drugs||Originally referred to any substance that dulled the senses and relieved pain. Some people use the term to refer to all illegal drugs, but technically, it refers only to opioids. Opioid is now the preferred term to avoid confusion.|
|Sedative||Any medication which causes the person to become sleepy and lethargic by slowing the functioning of the brain and major systems of the body.|