Nervous system depressant drugs: characteristics and examples.

A summary of the characteristics of nervous system depressant drugs.

Drugs are substances that generate in the people who use them an effect on their mental life, which they tend to value as pleasant at the time it is expressed, but which ends up severely conditioning the way in which they carry out their daily activities.

And the fact is that all drugs involve (in some way) the manipulation of our central reward system, vitiating the "magnetism" of the compass that guides our motivations and goals in life. This is how the phenomenon known as "addiction" or "dependence" occurs.

The effects of any substance on our brain can be divided into three categoriesThese are: stimulant (generation of euphoria and increased activity), psychodysleptic (alteration of perception) and depressant (deep relaxation of physiological and cognitive activation).

In this article, we will deal precisely with the last of these, highlighting several of the most commonly used nervous system depressant drugs in most frequently consumed in the world. Special attention will be given to their effects and how they alter thinking and behavior.

Nervous system depressant drugs

Central nervous system depressant drugs have the property to induce states of deep muscular relaxation, as well as a laxity of the conscience and a slowing down at the cognitive level and physiological processes such as breathing or heart rate. All of them have the property of exerting synergistic effects when consumed in combination, so that the concomitant use of two or more of them can lead to coma or even death. In addition, they have been shown to be capable of generating tolerance and withdrawal syndrome (which is the opposite of the effect of intoxication).

Another aspect to be aware of is that of cross-tolerance. The consumption of a drug of this family means that each time a higher dose is needed to obtain the same effect that was achieved at the beginning, but all this is extended to all of them. Thus, if someone develops this process with alcohol, he will show an attenuated reaction to the effect of anxiolytics when he consumes them separately. Let us now see what these drugs are and their most important characteristics.

Alcohol

Alcohol is the generic name for ethanol.. It comes from the aerobic fermentation of sugar contained in some fruits (grapes, apples, etc.) and grains (rice, barley, etc.), mediated by the activity of fungi such as yeasts. In general, it is feasible to differentiate its presentation in two different categories: fermented beverages (wine, beer, etc.) and distilled beverages (whiskey, rum, gin, etc.), of which the latter contain a higher percentage of this substance (thirty degrees or more).

Alcoholic beverages are understood as all products containing at least 1% ethanol in their composition (or one degree, which would be an equivalent measure); and a very wide range of liqueurs and beers marketed as "non-alcoholic" fall into this category. The calculation of the grams of this substance would be made through the simple multiplication of its degrees (in each 100 cc of liquid) by 0.8, a figure that corresponds to its density.

When the substance is ingested, 80% of it is absorbed by the small intestine, and the remaining 20% by the stomach. In addition, the substance crosses the blood-brain barrier and the placenta, it crosses the blood-brain barrier and the placental barrier, so that it would reach the brain and the fetus in the case of the fetus.It would therefore reach the brain and the fetus in the case of pregnant women (acting as a very dangerous teratogen and increasing the risk of multiple problems in the newborn).

In turn, women become intoxicated more quickly and have a higher risk of the substance damaging their organism. When alcohol is mixed with gas (carbonated beverages) or used on an empty stomach, the onset of its effect is accelerated.

It could be said that alcohol-induced drunkenness involves the transit through a series of distinct stages. First of all, the person may experience well-being and a tendency to easy laughter, accompanied by talkativeness and behavioral disinhibition (so that he/she dares to interact with others in a less "apprehensive" way).

Progressively, as consumption continues, there comes a state of sedation and a dullness when trying to move about, with mumbling speech and a substantial loss of reflexes. Finally a state is reached in which consciousness is altered, lacunar amnesia and breathing difficulties arise. At this point, the risk of coma and death (due to respiratory depression) is present.

Despite being a drug that can be legally acquired without any problem, and even being a common guest at many celebrations and parties, alcohol generates addiction and is associated with multiple pathologies in different organs and systems. Its use is particularly harmful in the case of women.The reason for this is due to intersexual discrepancies in the body distribution of adipose tissues and the enzymes in charge of their metabolization.

2. Benzodiazepines

Benzodiazepines are drugs prescribed to treat some of the disorders included in the global category of anxiety, and more particularly those with a physiological symptom profile (e.g. panic). They act on our brain by affecting GABA, the most important inhibitory neurotransmitter for human beings, which reduces the basal level of cortical activation. Its effect begins about ten to fifteen minutes after oral consumption, through which it is easily absorbed.

Its impact on the organism attenuates the way in which the sympathetic nervous system precipitates one's own anxious physiology.. That is why it is used in the treatment of this symptom, despite the fact that it can generate addiction among those who consume it for long periods. Thus, it has been described the appearance of both withdrawal syndrome (discomfort when consumption is abandoned or this compound is not available) and tolerance (need to increase the dose to achieve the same effect that was obtained at the beginning). In some cases, it also leads to hostility and irritability.

When consumed in higher doses, they can induce sleep, or, in other words, acquire hypnotic properties (reducing the time between going to bed and falling asleep). However, their use modifies its structure: it shortens phase 1 (light sleep), prolongs phase 2 and practically cancels phases 3 and 4 (deep sleep). It is for this very reason that it is a priority to provide sleep hygiene strategiesThe drug should be reserved only for cases of extreme need, and should be maintained for a maximum of three or four weeks.

In addition to the anxiolytic/hypnotic effects, this medication induces myorelaxation due to its action on the basal ganglia, cerebellum and spinal cord; and Anticonvulsant effects, including the spasms that occur in the context of alcohol withdrawal. That is why its use can be extended to health problems other than anxiety, such as contractures in muscle fibers and detoxification of other substances.

Side effects of its administration include dizziness (especially in elderly patients whose liver and/or kidney function is impaired), excessive sedation, headaches, inhibited sexual desire, erectile dysfunction, insufficient lubrication, articulatory compromise during language production (dysarthria/dysphasia), tremor, diarrhea or constipation. Cases of anterograde amnesia, i.e., a slowing of the information storage process in the long-term memory store, have also been detected.that is, a hindering of the information storage process in the long-term memory store. Such problems hinder academic and work activities and significantly reduce the quality of life.

Nevertheless, these drugs have a better safety profile than those used before them: barbiturates. Adhering to what the physician stipulates through clinical judgment, without increasing the dose or prolonging the treatment time, is essential to minimize the risk of addiction.

3. Barbiturates

Barbiturates are non-selective nervous system depressants. They consist of barbituric acid (a combination of urea and malonic acid from apples) and two carbon radicals.

Until the 1960s it was the most commonly used anxiolytic.Despite being sadly famous for the high number of fatal intoxications it produced throughout the world (since therapeutic and fatal doses are too close together). This fact, together with its enormous addictive capacity, made necessary its therapeutic inadvisability and its substitution by the new anxiolytics (when they were synthesized).

At present, they are only used for anesthesia are only used for intravenous anesthesia in certain surgeries, and also for the resuscitation of cranioencephalic trauma. of cranioencephalic trauma. Finally, phenobarbital sodium is still used for epilepsy, being one of the substances that causes the most deaths due to respiratory depression in the world (especially when combined with alcohol).

4. GHB

GHB (gamma-hydroxybutyrate) is another of our brain depressant drugs, which is very often labeled as liquid ecstasy. very often labeled as liquid ecstasy.. The truth is that this is a misnomer, since ecstasy (or MDMA) is a chemical compound whose effect and mechanism of action are different from those of GHB. The latter is usually presented as a clear, slightly salty liquid, which makes it easy to "camouflage" in drinks of all kinds with virtually no change in taste, which is dangerous for those who may inadvertently take it (as it enhances the effect of alcohol and facilitates an eventual overdose).

It is a popular drug at rave parties, which were traditionally held underground and used all kinds of substances along with electronic music and colored lights. The use of GHB induces a state of "euphoria" and disinhibition due to depression of the prefrontal cortex, which often ends up being expressed as acts of violence.which in many occasions ends up expressing itself as acts of violence. Many of those who use it recognize hallucinations in visual mode, so that a response of agitation and nervousness is consequently precipitated, leading to the collapse of emotions.

The effect of the substance reaches its peak approximately 10-20 minutes after consumption, which is why it was once postulated for use as a sleep inducer and anesthetic. Later it had to be discarded because of the perceptual alterations it caused and also because of its numerous and disabling side effects (dizziness, nausea, diplopia, drowsiness and headaches). The effect of the drug is prolonged for two hoursbut with a residual phase that doubles the duration. Its origin is synthetic (it comes from artificial synthesis in a laboratory).

Sometimes its presentation is in the form of a whitish powder, which makes it easier to assess the associated effect according to the dose administered (in grams). It is estimated that from four grams it can induce a state of sleep that is extremely difficult to interrupt, as well as a dissolution of consciousness that ultimately involves comatose states.

5. Kava

Kava is a substance that is sold as an alternative medicine for the treatment of acute states of anxiety, although there is still no evidence of its possible beneficial effect in this sense. It comes from a plant of Polynesian origin (piper nigrum) directly related to the pepper tree, and is widely used in regions distributed along the Pacific Ocean. Its effects are similar to those of other depressant substances described in this text, and include a state of calm and relaxation in which the full integrity of higher cognitive functions is maintained..

Although there are some studies on the substance from which addictive properties are inferred, the truth is that there is still no definitive evidence on this point. It is usually presented in the form of a drink, and its active ingredients are called kavalactones. All possible harmful effects that could be attributed to this substance, including hepatotoxicity and possible tissue apoptosis, are still under study.

6. Heroin

Heroin is one of the most addictive drugs ever documented.. It is made from morphine, which in turn is extracted from the opium poppy. It comes in the form of a white powder, or as a sticky, blackish substance. Some of its consumers mix it with cocaine (speedball), resulting in a mixture that has led to the death of many people over the last decades. In the latter case, the route of consumption is by injection, although heroin is also administered by smoking and snorting, which accelerates its access to the nervous system and the time it takes to take effect on it (by adhering to the opioid receptors).

In its beginnings, this drug was synthesized to replace morphine for military use, since many soldiers returned home (after the first great war) suffering from a harmful chemical dependency to it. It was also sold for the innocent purpose of treating the common cough and diarrhea. Eventually, however, was withdrawn from the market for safety reasons; although its use spread unstoppably as an illegal practice, especially unstoppably, especially in the 1960s.

Its consumption produces a relevant dry mouth (xerostomia), flushing, heaviness in the arms/legs, nausea, diffuse dermal itching, cognitive slowing, deep drowsiness and vomiting. Unbearable joint pain, flu-like symptoms, uncontrollable diarrhea, tremor, and desperate search for the substance may occur when use ceases. The effects of withdrawal can sometimes be quite severe, forcing the articulation of damage control treatments with partial agonists (methadone).

As time goes on, if use does not cease, complications of enormous importance can arise. The most relevant are damage to the structure of the nasal cavities (in the case of the inhaled route), insomnia in any of its phases, pericarditis (infection of the tissue covering the heart), alterations in the sexual sphere, chronic constipation, problems in emotional life (especially depression) and a degradation of renal and hepatic functions. Social ostracism is also very common, which aggravates the problem and makes it difficult to reintegrate into society..

In other cases, as a result of improper use of syringes and the utensils used for intravenous administration, the heroin user may contract a chronic infection (HIV, hepatitis, etc.); this represents an additional health problem for which independent therapeutic solutions must be offered. Finally, there is a relevant risk of overdose, derived from the synergistic effects of its combination with other depressants, or by its use in an unusual or infrequent space (due to conditioned tolerance).

Bibliographic references:

• Barerah, S. (2018). Forms of Drug Abuse and Their Effects. Alcoholism and Drug Abuse Weekly, 1. pp. 13 - 19.
• Dassanayake, T., Michie, P., Jones, A., Carter, G., Mallard, T and Whyte, I. (2012). Cognitive Impairment in Patients Clinically Recovered From Central Nervous System Depressant Drug Overdose. Journal of clinical psychopharmacology, 32, 503-510.