Sedative Drug Addiction, Misuse, and Rehab Treatment

What are Sedatives?

In 2020, 343,000 people aged 12 or older started misusing prescription sedatives, also known as central nervous system (CNS) depressants.^3,4

Sedative misuse occurs when people take their medicine in a way other than as prescribed, give their medicine to someone else, or take it for recreational purposes.⁴ Some common prescription sedatives include:^1,4

• Benzodiazepines, such as alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), and chlordiazepoxide (Librium).
• Barbiturates, such as butalbital (Fiorinal or Fioricet), pentobarbital (Nembutal), and phenobarbital (Luminal).
• Medications for insomnia—sometimes called “Z-drugs” (non-benzodiazepines)—such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta).

Each of these sedative medications works in your brain by increasing the activity of GABA (gamma-aminobutyric acid), similar to the way alcohol affects the brain.⁴ GABA is an inhibitory neurotransmitter, meaning that it slows down certain cognitive functions.⁴ That’s why you feel drowsy or calm when you take these CNS depressants.⁴ However, just like alcohol, that calming feeling can also produce somewhat of a high.⁴

Sedatives fall under schedules II, III, and IV, according to the Controlled Substances Act.⁵ That means that sedatives have accepted and valuable medical uses but may cause physiological or psychological dependence.

Sedative Side Effects

Besides the intended use, sedatives can cause several unintended side effects, especially when sedatives are taken with other medications or in ways other than prescribed. Side effects vary depending on the sedative but may include:^4,5

• Slurred speech.
• Concentration issues.
• Confusion.
• Headache.
• Lightheadedness.
• Abnormal coordination.
• Memory impairment.
• Decreased blood pressure.
• Slowed breathing.
• Hallucinations.
• Irritability.
• Disturbing dreams.
• Paranoia.
• Mild euphoria.

Are Sedatives Addictive?

The use and misuse of sedatives can lead to problem use and addiction in some instances. Long-term use of sedatives may cause individuals to develop a tolerance to the drug. Tolerance means that the individual requires a higher dose and/or more frequent use of the sedative to get the desired or same effect.⁴

Addiction refers to the compulsive, uncontrollable use of a substance despite all of the harm that it causes. Addiction may entail not only physiological changes (such as tolerance and dependence) but several harmful behavioral changes adversely impacting every aspect of an individual’s life. Addiction development is accompanied by functional changes within the brain that can impact an individual’s drive, motivation, thought processes, and behaviors—so much so that drug use becomes prioritized over all else. Repeated substance use itself influences the development of addiction, but so do genetic, psychosocial, and environmental factors.⁴

Symptoms of Sedative Addiction

If you are worried that you or a loved one might have a sedative addiction, consult your doctor. Only a licensed practitioner can make a sedative use disorder diagnosis. Clinicians use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (5^th edition) to diagnose a sedative use disorder. These symptoms include:⁷

• Using more of a sedative than you intended or for longer than intended.
• Developing a tolerance to your sedative.
• Experiencing withdrawal symptoms when sedative use stops or drastically decreases.
• Having cravings or urges to use a sedative.
• Being unable to cut down or stop using a sedative.
• Using sedatives even in dangerous situations.
• Continuing to use sedatives despite the relational problems they cause.
• Spending an increasing amount of time getting, using, and recovering from sedative use.
• Neglecting responsibilities at school, work, or home because of your sedative use.
• Giving up things you used to enjoy or want because of sedative use.
• Continuing to use sedatives despite mental or physical health problems.

Sedative Withdrawal

Chronic or frequent use of sedatives can lead to physical dependence—more so with benzodiazepines and barbiturates than with Z-drugs.¹

Dependence is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.

Sedative withdrawal symptoms may include:¹

• Tremors.
• Anxiety.
• Hypersensitive reflexes.
• Elevated blood pressure, heart rate, and body temperature.
• Sweating.
• Hallucinations.
• Seizures.
• Disorientation or delirium.
• Cravings.
• Insomnia.
• Nausea and vomiting.

The dose of sedatives taken, the duration of time used, your age, and comorbid medical and mental health problems can impact the severity of withdrawal symptoms. In rare cases, sedative withdrawal symptoms can lead to death.¹

Studies suggest that up to 20% of individuals experiencing withdrawal will develop severe symptoms or additional complications if left untreated.¹ Therefore, it is advised that if you’re ready to decrease or stop the use of sedatives, you do so under the supervision of a doctor.¹

Sedative Addiction Treatment and Rehab

Treatment for sedative addiction looks different for everyone and depends on the severity of your sedative use disorder and other factors, such as co-occurring mental health disorders. Your personalized treatment plan may include:⁸

• Detoxification. Detox or withdrawal management involves a process that allows the body to cleanse itself from a substance. To safely detox from sedatives, you need to slowly decrease your dose over several days. Detoxing in a treatment center or under the supervision of a healthcare provider not only keeps you safe but also helps you stay as comfortable as possible.
• Inpatient care. Inpatient rehab refers to 24/7 treatment conducted either at a hospital or residential center, where you live during treatment. Addiction therapy usually includes group and individual counseling, behavioral therapy sessions, and scheduled recreational activities. With around-the-clock care, there is often more medical support to help with co-occurring mental health disorders, other medical conditions, and more. If you begin treatment at an inpatient facility, you may then transition to an outpatient program.
• Outpatient care. Outpatient programs can vary significantly, depending on the type of services offered. Partial hospitalization programs (PHPs), for instance, require 6-8 hours of treatment per day throughout the week. By comparison, intensive outpatient programs (IOPs) typically involve fewer hours and days of onsite treatment than PHPs each week. And finally, traditional outpatient treatment consists of weekly or fewer appointments and offers the greatest flexibility so you can still go to work or attend school.
• Aftercare or recovery supports. Ongoing care provides a collection of services that support you after formal rehab ends. These services may include sober living housing, 12-Step groups such as SMART Recovery, one-on-one or group counseling, and recovery coaching. Aftercare programs may also help you find a job or take other necessary steps to get back on your feet after treatment.

Throughout each step of treatment, your healthcare providers may use various therapies and/or medications to help you recover. Common interventions include:^1,8

• Detoxification medications. To ensure your safety during detox, your doctor prescribes tapering doses of a sedative (sometimes different than the one you were taking). This allows your body to slowly get used to functioning without a sedative.
• Cognitive-behavioral Therapy (CBT). CBT focuses on using your thought processes to change your behaviors. It is one of the most well-researched, evidence-based therapies effectively utilized for substance use disorders.
• Contingency management (CM). CM recognizes that changing behavior involves both learning new ones and eliminating old ones. CM gives positive rewards—like money vouchers or movie tickets—for every drug-free urine test. The longer you remain sedative free, the greater the rewards. Once your body and mind adapt to living without sedatives, you no longer need the rewards to stay substance free.
• Motivational enhancement therapy (MET). MET uses a counseling technique called motivational interviewing to help you resolve any uncertainties you have about taking the next step. By reflecting on what you say and asking guiding questions, the counselor or therapist can often help you find motivation for change by developing self-awareness.
• 12-Step facilitation therapy (TSF). Available to help you better understand and engage with a 12-Step program—such as Narcotics Anonymous—after recovery, TSFs focus on 3 key ideas: acceptance, surrender, and continued involvement in a 12-Step program. By starting TSF during your formal treatment, you are better prepared to feel supported and maintain abstinence in a 12-Step program afterward.

Whatever your individual needs may be in treatment, there is a program and people who are willing to help you.

Most insurance plans cover at least a portion of substance use disorder treatment. For those who cannot afford treatment or don’t have insurance, many rehabs offer a sliding scale payment plan (based on your income) or free treatment for those who qualify.

Don’t wait. Begin your journey to a healthier, sedative-free life today.