Understanding Recreational Depressants

Aug 30, 2024

Lecture Notes: Recreational Depressants

Introduction

  • Depressants vs. Stimulants
    • Depressants activate the parasympathetic nervous system.
    • Cause feelings of relaxation and sedation.
    • Opposite effects to stimulants.

Main Classes of Recreational Depressants

  1. Alcohol
  2. Benzodiazepines
  3. Opiates

Alcohol

  • Second most commonly used psychotropic substance (after caffeine).
  • Alters the GABA receptor enhancing GABA transmission.
  • Interacts with serotonin, dopamine, glutamate receptors, and ion channels.
  • Legal Status: Legal but not necessarily safe. High lethality and dependence potential.
  • Blood Alcohol Content Stages:
    • Mild euphoria to sedation, slurred speech, ataxic movements.
    • Severe intoxication can lead to stupor, unconsciousness, respiratory depression, and death.

Alcohol Withdrawal

  • Worse than stimulant withdrawal.
  • Delirium Tremens (DTs):
    • Occurs in chronic alcoholics.
    • Symptoms: Shaking, hallucinations, vital sign instability, seizures.
    • Treatment: Benzodiazepines.
  • Alcoholic Hallucinosis:
    • Differentiated by the lack of vital sign instability.

Treatment for Alcohol Dependence

  • Acamprosate (Campral): Helps ease living without alcohol.
  • Disulfiram (Antabuse): Causes adverse reaction to alcohol.
  • Metronidazole Interaction: Similar effect as disulfiram.
  • Behavioral Treatments: Alcoholics Anonymous, CBT, and others may be effective when matched to patient preferences.

Benzodiazepines

  • Used medically but have high abuse potential.
  • Similar effects to alcohol when intoxicating.
  • Withdrawal:
    • Anxiety, panic attacks, sympathetic nervous system effects.
    • Treatment: Controlled taper of benzodiazepines.
  • Overdose:
    • Treated with Flumazenil (antagonist).

Opiates

  • Includes both prescription drugs and recreational drugs like heroin.
  • Heroin:
    • Causes analgesia, respiratory depression, euphoria, drowsiness, constipation.
    • Withdrawal: "Cold turkey" symptoms like piloerection, diarrhea, dilated pupils.
    • Black Tar Heroin: Associated with botulism.

Treatment

  • Naloxone: Used for acute opiate overdose.
  • Naltrexone: Used for chronic dependence treatment.
  • Methadone, Buprenorphine: Used for opiate dependence.

Conclusion

  • Understanding the effects, withdrawal symptoms, and treatment options for depressants is crucial in both medical and public health contexts.