The three major classes of downers (depressants), include
opiates/opioids, sedative-hypnotics, and alcohol. The four minor classes
are skeletal muscle relaxants, antihistamines, over-the-counter
depressants, and look-alike depressants. Generally downers depress the
central nervous system.
Desired effects include pain relief, sedation, anxiety control, muscle
relaxation, suppression of inhibitions, and drowsiness. Undesired effects
include depressed respiration, slowed heart rate, constipation, and
slurred speech. If grossly misused the effects can include
unconsciousness, coma, and death. They work by either inhibiting pain
and stimulatory neurotransmitters or by mimicking the body’s natural
A prescription drug epidemic of mostly depressant drugs (opioid
painkillers and benzodiazepine sedatives) that begin during the first
decade of the second millennia has led to expansion of medication
diversion difficulties, many overdoses, and new addiction problems.
This chapter surveys the different types of opiates and opioids (e.g.,
heroin, codeine, morphine, methadone, buprenorphine, fentanyl,
Vicodin® and OxyContin
), along with their history, effects, and side
effects. It then examines the sedative-hypnotics (e.g., benzodiazepines,
barbiturates, and z-hypnotics), their effects, side effects, drug
interactions, synergism, addictive qualities, cross-dependence, and
cross-tolerance. Alcohol is covered in Chapter 5.
Finally, this chapter discusses other problems with depressants such
as drug interactions, misuse, and diversion. It also examines prescription
drugs, over-the-counter medications and the pharmaceutical industry as
to its role in the depressant prescription drug epidemic and development
of a prescription drug-dependent society.