Sedative Drugs

The term ‘sedatives’ refers to a group of drugs that decrease the activity in the brain. The Royal College of Anaesthetists describes sedation as ‘when drugs are given to help you feel more relaxed.’ Sedatives can be administered in various medical settings, such as during surgical procedures or medical interventions, to help patients feel more at ease and to manage anxiety. Additionally, sedatives are often prescribed for non-medical purposes to address issues like insomnia or generalised anxiety.

Whilst sedatives are frequently used in the medical sphere, they are not without risk. One of these risks is the development of dependency or sedative addiction. As there is a whole range of sedative substances, the risk of addiction varies from drug to drug.

Names for sedatives

Sedatives’ refer to a whole range of substances acting in varying ways.
These types of drugs are frequently known by other names, including:

  • Calmatives
  • Depressants
  • ‘Downers’
  • Narcotics
  • ‘Sleepers’
  • Soporifics
  • Tranquillisers or ‘Tranks’

What do sedatives do?

The type of sedative you take will alter their effect on your body. Generally, Sedatives are used in two key ways;

  1. as long-term symptom management
  2. in short-term instances

Sedative as long-term symptom management

The key areas of sedative use from a medical perspective are to treat:

  • Anxiety and panic disorders
  • Muscle contractions
  • Seizures
  • Sleep disorders
  • Psychosis

In these cases, sedatives are typically used as preventive measures – meaning that sedatives are taken in order to manage pre existing symptoms in the longer term. If you are struggling with anxiety, sleep or seizures, then sedative treatment will likely come in the form of a prescription medication that you take regularly.
However, there are times when sedatives can be used on a more short-term, or urgent basis.

Short-term sedative use

Types of sedation
Sedation is commonly used during a medical procedure, such as during an operation. In these cases, sedatives are typically administered intravenously or through a mask.
There are three different levels of sedation; a medical team will select the most appropriate level. These three levels are:

  1. Minimal sedation
  2. Moderate sedation
  3. Deep sedation

Minimal sedation (known as ‘anxiolysis’) is the shallowest type of sedation.

During minimal sedation, you will:

  • be awake, present and aware
  • be able to speak as usual
  • feel more relaxed than usual
  • have some memory of what happened during sedation
  • not experience changes to your breathing

Moderate sedation (or conscious sedation) is when slightly more of a sedative is administered.

This type of sedation is characterised by:

  • being awake but feeling very tired
  • being able to speak as usual
  • feeling very relaxed
  • having some memory of what happened during sedation
  • no changes to breathing

Deep Sedation is the name for the strongest type of sedation.

During deep sedation, you will:

  • sleep throughout the majority
  • be unable to speak or react as normal
  • be very unlikely to remember what happened during sedation
  • potentially experiencing a slowing in your breathing

Sedation is different to general anaesthetic. With general anaesthetic, you lose consciousness. The Royal College of Anaesthetists describes ‘deep sedation’ as a middle ground between shallower sedation and anaesthetic effects.

Sedatives as restraint

Sedatives can also be used as a kind of ‘pharmacological restraint.’ These are used in instances when a ‘patient compromises his or her own safety, and that can cause serious or physical or mental injuries, or compromises the safety of others.’
This can happen when an individual is experiencing intense psychological stress, and staying awake may cause more risk than temporarily losing consciousness. Examples of this may be:

  • following a car accident or other physical trauma
  • if patients are experiencing ‘delirium’
  • in instances of very severe pain
  • in instances of very severe anxiety or ‘agitation’

Sedatives: How they work

Sedatives are central nervous system depressants. This means that they reduce the activity in our brains.

The central nervous system (sometimes shortened to CNS) comprises the brain and the spinal cord. The CNS regulates ‘responses, sensation, movement, emotions, communication, thought processing and memory.’ This means that the majority of our more complex processes are achieved through the mechanisms of the CNS.

Whilst the CNS is responsible for all of these functions, they only sometimes run perfectly smoothly. Issues within the central nervous system can occur. These can result in complications associated with the spine and the brain, including neurological and psychiatric conditions.

Sedatives work by inhibiting abnormal processes in the central nervous system. This works by slowing the activity in the brain to more typical levels.

Types of sedatives

Within the overarching umbrella of sedatives, there are several different subgroups. These include:

Each type of sedative has a slightly different ‘mechanism of action’ – or way of acting on the brain. These mean they each treat slightly different disorders (and have different side effects).

Barbiturates are ‘sedative-hypnotic medications.’ 

They are multifaceted drugs that have a range of applications, including:

  • inducing coma
  • managing anxiety prior to medical procedures 
  • managing seizures
  • treating neonatal abstinence syndrome
  • treating insomnia and sleep deprivation 

Barbiturates work by enhancing the action of GABA. Gaba is a neurotransmitter – a naturally occurring chemical in the brain. The job of GABA is to inhibit function. There are some instances where the brain can act too fast. For instance, seizures are caused by high levels of electrical activity in the brain, and anxiety can be related to increased neuron firing. GABA is a natural mechanism to control this. 

But for some people, GABA levels are low. This is where drugs like barbiturates come in, as they can enhance the action of GABA in a targeted effort to reduce brain activity.

Benzodiazepines (also known as benzos) are also sedative-hypnotic medicines. They are primarily used as:

  • anxiolytics (to treat anxiety)
  • anticonvulsants (to treat seizures)
  • and to control involuntary muscle movements 

Like barbiturates, benzodiazepines also work by interacting with GABA to slow down activity in the brain. Benzodiazepines achieve this by increasing the opportunities for GABA to ‘dock’ into the receptors in the brain. This helps the brain uptake GABA more regularly to reduce brain activity more consistently. 

Benzodiazepines are also available on the illicit drug market. They are used to manage health conditions, as well as for recreational purposes. Purchasing benzodiazepines outside of the legal channels is not recommended due to the increased health risks associated with non-regulated substances. 


Hypnotics are a branch of sedatives dedicated to sleep. This means they are used for various sleep issues, including insomnia. There is a wide range of hypnotics that will each achieve different effects. 

Some of these medicines are short-term, whilst others are prescribed to treat sleep disorders for a longer period. Hypnotics can also be fast or slow-release. This means that some are more fast-acting than others. 

Other methods of managing sleep issues are typically recommended before the use of hypnotics. This is due to the high risk of addiction associated with some hypnotic substances. 

Sedative addiction: Key statistics

A research team writing for The British Journal of Psychiatry found that:

  • 7.7% of 1500 (116) respondents reported misusing benzodiazepines or other ‘Z’ drugs.’
  • 15% said they engaged in sedative misuse more than once a week.
  • 55.2% of these respondents reported accessing sedative medications through clinical professionals.
  • 39.7% said they accessed them from family and friends, with the rest of the group accessing sedatives directly through illegal channels
  • In 2017/18, 1 million adults in England were prescribed sleeping medications. That sits at around 2% of the population.

The survey also asked why people use these drugs.

  • 66.4% said they did so to help them to sleep
  • 37.1% said they did so to help cope with stress
  • 31.0% said the did to get high

Why are sedatives addictive?

The numbers suggest a high percentage of individuals are being prescribed – or are otherwise using –sedatives. But why is the risk of doing so considerably high?

The desirability of depressant drugs

Sedatives are depressants. This means that they belong to the same category of drugs as alcohol, another very addictive substance. Depressants act by slowing down the nervous system, which decreases our ability to respond and concentrate as normal.

When taken for reasons related to anxiety or stress, this can provide a pleasant break from the incapacitating nature of chronic worry. Sedatives can, therefore, become a kind of medication for mental health issues. They can act to ‘numb’ discomfort and allow us to forget difficult thoughts, feelings or situations. After initial use, this leads to the potential seeking of sedative drugs to feel temporary relief from pain, stress or sadness. Physicians know this as ‘chemical coping.’

But as we take more of them, our tolerance begins to build. That means that more sedatives are needed to create the same depressive effect.


As tolerance builds, dependency begins to develop. Dependency occurs when we feel that we rely on something. This can be physical or psychological; for example, someone with difficulties sleeping may feel that they are dependent on sedatives to have a good night’s rest.

Psychological dependency occurs when a fear of the drug’s absence develops. Heavy users may find that they feel low, depressed or even suicidal in the absence of sedatives. This leads to repeat use, as the high achieved from misuse can act to alleviate these difficult effects. However, in the long term, repeat use can increase the intensity of these feelings.

How serious are sedative addictions?

Sedative addictions can be particularly difficult to break out of because the withdrawal effects associated with the substances typically tend to mimic the symptoms that led to the use of sedative drugs in the first instance.

Relapse of symptoms 

As the central nervous system begins to function without the depressant effects of sedatives, relapses in anxiety, pain and seizures can occur. This can then lead to a feeling that sedatives are ‘needed’, as though they are the only treatment that can aid these symptoms. This can then lead to a deeper dependency forming.

Polydrug use

Sedatives are typically used alongside alcohol. This type of polydrug use is especially dangerous and can be linked to an increased mortality rate. This is because alcohol is also a depressant. The use of multiple depressants can significantly impair the functioning of the central nervous system, making it difficult to maintain essential function such as breathing.


Another element that feeds into the risky nature of sedative addiction is that it typically occurs under the radar. Because sedatives can be accessed in legal ways, some of the stereotypical behaviours associated with addiction (such as rapid changes in social circles, deception and evidence of engaging with dealers) are either reduced or not present. 

This means that addiction may exist under the surface for prescription users, who can continue to access their medications without fear of being ‘found out.’ 

Signs of sedative addiction

There are many ways that a sedative addiction can impact our everyday lives. Potential signs of sedative abuse specifically are:

  • Periods of uncharacteristically low levels of anxiety
  • Appearing relaxed, careless or nonchalant
  • Feeling dizzy and disoriented
  • Dulled senses
  • Drowsiness and lethargy
  • Reduced heart rate
  • Reduced coordination and spatial awareness
  • Changes to speech, including slowed speech pattern and slurring
  • Difficulty focusing or retaining new information
  • Experiencing blackouts or gaps in memory

It is possible for sedatives to cause an increase in some psychological difficulties in some individuals. This can include instances of:

  • Heightened anxiety
  • Panic attacks
  • Nightmares and disturbed sleep
  • Appearing aggressive

Long-term sedative use can usher in a range of health complications. These complications – alongside other indicators of addiction – can be potential signs of sedative abuse:

  • Development (or exacerbation of depression)
  • Liver failure
  • Long term issues with memory
  • Suicidal ideation

Overdose risk

Sedative overdose (either intentional or accidental) is not uncommon. A sedative overdose can cause:

  • Loss of consciousness
  • Difficulty breathing
  • Lack of balance and coordination
  • Changes to speech
  • Coma

If you believe someone is experiencing a sedative overdose, the best course of action is to contact emergency services by calling 999.

Treating sedative addiction

There are several steps involved in treating any addiction. These steps are:

  • Identification of addiction
  • Physical treatment (Such as detox)
  • Psychological treatment
  • Aftercare

Identifying addiction

To identify a sedative addiction, you can refer to the specific signs of sedative abuse above. However, more general signs of addiction may be present that can help you identify that an issue with substances is present. These include:

  • social withdrawal
  • changeable mood
  • changes in sleeping schedules
  • changes in appetite and weight loss
  • conflict in relationships
  • difficulties with work or school
  • lack of attention to personal care
  • lack of attention to surroundings
  • appearing ‘distant’
  • financial issues
  • being unwell with frequent headaches, colds, aches and pains


Physical treatment

Treatment for physically addictive drugs tends to begin with a detox. Detoxes are the first step as they are a powerful method of interrupting the addiction cycle. A detox addresses cravings and dependency, giving your body the time to adjust to functioning without substances present.

Detoxing from sedatives can be difficult, as there are some withdrawal symptoms associated with the process. These can include heightened anxiety, shaking, feeling anxious and irritable, an increase in blood pressure and difficulty sleeping. This is sometimes known as sedative withdrawal syndrome.

It is important to note that withdrawal should be conducted with the knowledge and assistance of medical professionals who can oversee the process to ensure you are as safe and comfortable as possible.

Psychological treatment

After cravings have been quelled, you may find yourself with more clarity. This can be a very positive state in which to begin therapy and start assessing the role addiction has played in your life.

For some people, medication is helpful during this stage. This can help with dual diagnoses such as anxiety, bipolar and psychotic disorders. These conditions are commonly experienced in individuals who develop sedative addictions as they are mental health conditions that can be treated with depressant medicines.

Outside of pharmacological support, there are psychotherapies available to begin unravelling difficult thoughts, feelings and memories with the support of industry professionals.

Modes of therapy you may access include:


Addiction treatment typically wraps up with aftercare. Aftercare is a longer term type of support that aims to help you maintain sobriety after formal treatment ends. Aftercare can take place in the early stages after treatment, as a way of helping you readjust to life outside of rehab. It can also be a longer term arrangement for those who feel it would help them stay on the right path away from the grip of sedative addiction.

What comes next?

If you feel you are ready to confront your sedative addiction, take the first step by contacting your GP or local addiction specialist. Embark on the path to recovery, reclaiming mastery over your life and breaking free from the grips of sedative addiction.

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