Anti-anxiety drugs and abuse

Anti-anxiety drugs, or “anxiolytics”, are powerful central nervous system (CNS) depressants that can slow normal brain function. They are often prescribed to reduce feelings of tension and anxiety, and/or to bring about sleep. Anti-anxiety medications are among the most abused drugs in the United States, obtained both legally, via prescription, and illegally, through the black market. These drugs are also known as sedatives.

The drugs associated with this class of substance-related disorders are the benzodiazepines [such as diazepam (Valium),  chlordiazepoxide (Librium), alprazolam (Xanax), triazolam (Halcion), and estazolam (ProSom)], the barbiturates [such as Seconal and pentobarbital (Nembutal)], and barbiturate - like substances including Quaalude, Equanil, and Doriden. Any of these drugs is capable of producing wakeful relief from tension, or sleep, depending upon dosage. Some non-psychiatric uses of anti-anxiety medications include treatment and prevention of seizures, muscle relaxants, anesthetics, and drugs to make other anesthetics work more effectively (known as “adjuvants”).

Although the types of central nervous system depressants work differently, they all produce a pleasant drowsy or calming effect. If used over a long period of time, tolerance develops, and larger doses are needed to achieve the initial effects. Continued use can lead both to physical dependence when use is reduced or stopped, and to withdrawal symptoms. When combined with each other or other CNS depressants, such as alcohol, the effects are additive.

In addition to the drugs available in the United States by prescription, there are three other drugs that are predominantly central nervous system depressants with significant potential for abuse. These are:

• gamma hydroxybutyrate (GHB)
• flunitrazepam (Rohypnol)
• Ketamine

GHB has been abused in the United States since about 1990, for its euphoric, sedative, and anabolic (bodybuilding) effects. It was widely available over the counter in health food stores until 1992. Bodybuilders used it to aid in reducing percentage of body fat, and to build muscle. Street names for GHB include “Liquid ecstasy,” “soap,” “Easy lay,” and “Georgia home boy.”

Rohypnol has been of particular concern during the last few years because of its abuse in date rape. When mixed with alcohol, Rohypnol can incapacitate its victims and prevent them from resisting sexual assault. It can also lead to anterograde amnesia, in which individuals cannot remember what they experienced while under the influence. Rohypnol can be lethal when mixed with alcohol and/or other depressants. Rohypnol is not available by prescription in the United States, and it is illegal to import it. Even so, illegal use of Rohypnol started appearing in the United States in the early 1990s, where it became known as “rophies,” “roofies,” “roach,” and “rope.”

Ketamine is an anesthetic used predominately by veterinarians to treat animals. It can be injected or snorted. Ketamine goes by the street names of “Special K,” or “Vitamin K.” At certain doses, ketamine can cause dream-like states and hallucinations. It has become particularly common in club and rave (large, all-night dance marathon) settings, and has been used as a date rape drug. At high doses, it can cause delirium, amnesia, impaired motor functioning, high blood pressure, and depression. It can also cause potentially fatal respiratory problems.