Detox from Depressants

Depressants are substances that slow down signals sent across your central nervous system (CNS). You may have heard depressants referred to as “downers,” but despite these names, the drug does not necessarily depress you. Depressants include a wide range of substances, including alcohol, some inhalants, and various prescription medications.¹ Choosing to detox from depressants can be difficult, confusing, and involve much anxiety. However, the benefits that detox can have on your mental and bodily processes are substantial.

In this article:

• What Depressants Do
• Withdrawal from Depressants
• How to Detox from Depressants
• Treatment After Detox from Depressants

What Depressants Do

Typically, depressants induce a drowsy and calming effect.² This sedation makes the drug helpful in treating anxiety and sleep disorders.³

Calming occurs as the depressant acts on neurotransmitters in the brain.² It is known that most depressants increase the activity of the gamma-aminobutyric acid (GABA) neurotransmitters.² These chemicals are responsible for slowing brain activity. Notably, depressants increase activity at the receptor sites of GABA.³

Depressants include a wide range of substances, and many of them are prescribed medications for sleep or anxiety. These substances include:^1,2,4

• Alcohol
• Barbiturates (e.g., phenobarbital)
• Benzodiazepines (e.g., alprazolam, clonazepam)
• Cannabis
• GHB
• Ketamine
• Opioids (e.g., heroin, morphine, codeine, fentanyl)
• Sedative hypnotics (e.g., zolpidem, eszopiclone)
• Tranquilizers
• Tricyclic antidepressants (e.g., amitriptyline)

Effects of Depressants

As depressants impede messages sent across your CNS, your ability to respond to your surroundings effectively, as well as your coordination and concentration, may falter.¹ Effects from the general use and misuse of depressants may include:^1,2

• Light-headedness
• Headaches
• Experiencing increased confusion
• Poor concentration
• Dizziness
• Sleepiness
• Slurred speech
• Dry mouth
• Nausea or vomiting
• Lowered blood pressure
• Slowed breathing
• Decreased movement and memory abilities
• Periods of unconsciousness

Notably, depressants also cause an increased level of impulsivity and impairment in several psychomotor and cognitive functions.⁴ When taken in large doses, depressants can lead to overdose and life-threatening consequences.¹

Withdrawal from Depressants

Given that depressants work by slowing down the brain, when you stop taking them, you may experience a rebound effect.³ This rebound effect, also known as withdrawal, can result in seizures and other detriments to your health.

Side Effects and Symptoms of Depressant Withdrawal

For some, when they stop taking depressants, they will experience withdrawal symptoms. Symptoms can range from mild to severe to life-threatening. Symptoms can begin as soon as 6-8 hours after last use (e.g., alcohol) or days (e.g., benzodiazepines).

These symptoms can include:²

• Agitation
• Anxiety
• Body aches
• Coma
• Confusion
• Cravings or a strong desire to use
• Decreased appetite
• Delirium Tremens
• Depressed mood
• Diarrhea
• Fatigue
• Hallucinations
• Headaches
• Increased blood pressure
• Increased heart rate
• Increased internal temperature
• Insomnia
• Irritability
• Mood swings
• Nausea
• Restlessness
• Running nose and eyes
• Seizures
• Sweating
• Tremors and shakiness
• Vomiting
• Weight loss

Individuals who are dependent on a depressant should not attempt to stop taking the substance on their own.² Withdrawal symptoms for depressants can be severe and sometimes life-threatening.²

How to Detox from Depressants

There are several evidence-based approaches to treating substance use disorders. Detox is the first step of treatment. Detox refers to the process in which the body is cleared of substances.⁵ Finding the right form of detox is important, as services are designed to help the body manage the symptoms of withdrawal. Withdrawing from substances, especially depressants, can have severe physical, physiological, and psychological effects.⁵

Professional Help to Detox from Depressants

When you undergo any detox from depressants, you should be supervised by a medical professional.² Your medical provider will examine your risk for serious withdrawal symptoms and provide a recommendation for a specific level of care. Providers will take into account many things, such as:

• Your history of use
• Your frequency and amount of use
• Your use of more than one substance
• Your history of past and existing medical conditions
• Your history of and current mental health condition

For several depressant substances, especially benzodiazepines, detox can include a gradual taper off the depressant.² When you seek detox from depressants, your medical provider will work with you to develop a plan and timeline. A benzodiazepine taper varies but could be:⁶

• Switching your benzodiazepine to a longer half-life alternative
• Reducing your initial dose by 25%-30%, then reducing that dose by 5%-10% each week
• Reducing your dose by 25% each week
• Reducing your dose by 10%-25% each week
• A prolonged taper (i.e., greater than six months)

For other depressant substances, you may be given medications to manage the withdrawal process (e.g., alcohol). Some medications used to treat the withdrawal symptoms of alcohol include:⁷

• Acetaminophen
• Anti-emetics
• Anti-diarrheal
• Gabapentin
• Clonidine
• Benzodiazepines

It is common for individuals who misuse one depressant to misuse other forms of depressants or to use multiple depressants together.² For example, some people may use benzodiazepines and alcohol, or alcohol and opioids. The use of multiple depressants significantly increases your risk for overdose. When using multiple substances, always speak with your provider about the detox process for all the substances you are using.

Detox services should also include counseling, which will help you through the detoxification process.² If you are unable to secure counseling services while completing the detox process, treatment should immediately follow it.²

Settings to Detox from Depressants

Both detox and counseling can be performed either on an inpatient or outpatient basis.² You may benefit from finding agencies that offer detox and treatment services as a whole package. Detoxification services can be provided in numerous settings, but not all settings are right for your specific needs. These settings include the folowing:⁸

• Social Detoxification: This is accomplished with a support network of friends and family. It is ideal for individuals who do not need medical supervision, are at low risk of serious withdrawal, and have zero to mild withdrawal symptoms.
• Ambulatory Detoxification Without Extended Onsite Monitoring: This includes some medical oversight, such as going to a physician’s office. It is intended for persons with mild withdrawal symptoms.
• Ambulatory Detoxification with Extended Onsite Monitoring: Here, you attend monitoring services for a few hours each day with medical oversight. This is meant for clients who experience mild to moderate withdrawal symptoms.
• Clinically Managed Residential Detoxification: This involves 24-hour supervision. It focuses on treating withdrawal symptoms, involves peer support, and is ideal for moderate withdrawal symptoms.
• Medically Monitored Inpatient Detoxification: This also involves 24-hour supervision but prioritizes maintaining medical stability. It is needed for those who are at risk for severe withdrawal symptoms.
• Medically Managed Intensive Inpatient Detoxification: This requires 24-hour medical care for severe and life-threatening withdrawal symptoms (e.g., psychiatrist hospital inpatient center).

Treatment After Detox from Depressants

Once you complete depressants detox, it’s pertinent that you transition into a depressants addiction treatment program where you will receive a myriad of therapies and treatment modalities to help you obtain and maintain sobriety in the long run.

Follow-up Care

Follow up addiction treatment can include:⁵

• Relapse prevention medications
• Behavioral therapy
• Combination of both therapy and medication
• Long-term residential treatment
• Short-term residential treatment
• Outpatient treatment programs
• Individualized drug counseling
• Group counseling
• Support groups (e.g., Narcotics Anonymous, Alcoholics Anonymous)

Behavioral Therapies

One type of therapy that has been shown to be effective in helping people stop using benzodiazepines, a common depressant, is cognitive-behavioral therapy (CBT).² This type of therapy focuses on changing your thinking and expectations. Cognitive-behavioral therapy also aims to change behaviors.²

Additionally, behavioral therapies help motivate people to make changes. These types of therapies can also help with:⁵

• Providing strategies to deal with cravings and stress
• Teaching ways to prevent relapse and avoid continued use of substances
• Coping with relapse
• Improving communication
• Improving relationships
• Improving parenting skills
• Improving family dynamics

Furthermore, behavioral therapies help clients modify their attitudes and behaviors related to drug use and help increase general life skills.⁵ Evidence has shown the following behavioral therapies are effective in the treatment of substance use disorders in adults:⁵

• Cognitive-Behavioral Therapy
• Contingency Management Interventions/Motivational Incentives
• Community Reinforcement Approach Plus Vouchers
• Motivational Enhancement Therapy
• 12-Step Facilitation Therapy
• Family Behavior Therapy

In addition to the improvement of general life skills, behavioral therapies can provide numerous incentives for people to remain abstinent.⁵ Specifically, as an example, many contingency management interventions are developed to give participants a monetary incentive after they produce a negative urine drug screen. Treatment for substance use disorders may also include social support groups (e.g., Alcoholics Anonymous).

If you think you may have a substance use disorder and you’re interested in detox and/or treatment, call 800-996-6135(Who Answers?) today.

Resources

1. Australian Government, Department of Health. (2021). Types of drugs.
2. National Institute on Drug Abuse. (2018). Prescription CNS depressants drug facts.
3. National Institute on Drug Abuse. (2020). What classes of prescription drugs are commonly misused?
4. Dassanayake, T. L., Michie, P. T., Jones, A., Carter, G., Mallard, T., & Whyte, I. (2012). Cognitive impairment in patients clinically recovered from central nervous system depressant drug overdose. Journal of Clinical Psychopharmacology, 32(4), 503-510.
5. National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (Third edition).
6. National Center for PTSD. (2015). Effective treatments for PTSD: Helping patients taper from benzodiazepines.
7. Bergeron-Parent, C. (2020). Alcohol withdrawal in my office…Yes! Family Doctor: A Journal of the New York State Academy of Family Physicians, 8(3), 52-55.
8. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment.