Sedative-hypnotic Use Research Articles

Encouraging Trends in the Use of Sedative-Hypnotics

Encouraging Trends in the Use of Sedative-Hypnotics

The phenomenological structure of drug-induced ego states. II. Barbiturates and sedative-hypnotics: phenomenology and implications.

Empirically derived descriptions of experiential states, induced by heavy, chronic consumption of drugs, provide valuable information for treatment personnel as well as for scientists studying drug abuse or pharmacology. A 7-year program of research has studied persons committed to heavy, long-term use of several prominent substances of abuse. This report results from that research and provides a phenomenological description of the psychological state induced by heavy, chronic use of barbiturates and sedative-hypnotics. Interview, Q-sort and semantic differential data indicate the barbiturate state is intensely unpleasant: a state in which users lose desired characteristics, take on undesired characteristics, engage in self-destructive acts, and emerge in worse condition than before entering it. Explaining why people choose to enter such a state is difficult. Several theoretical alternatives for doing so are considered. Psychotherapy with these individuals must deal with the theme of abandonment/rejection that permeates their lives and with the diffuse hostility, expectations of failure and defeat, self-destructive tendencies, and feelings of hopelessness that they display. Suggestions are presented for treatment of individual cases.

Restricting Amphetamines

AMPHETAMINE abuse is a major component of the drug-abuse problem in the United States. Two 1977 National Institute of Drug Abuse studies showed that anorectic stimulant and sedative-hypnotic use taken together ranked first in prevalence in rural areas, and second only to use of opiates in urban areas, as the primary drug problem at the time of admission to treatment units in eight states; next to marijuana, amphetamines were the class of drugs most commonly used by a large sample of For editorial comment see p 1346. veterans and nonveterans, with a clear relationship between amphetamine use and adjustment problems in the sample.^1,2 In 1975 prescriptions numbering 25.4 million were written for amphetamines and related anorectic drugs. Manufacturers' sales totaled $84.6 million and retail sales totaled $170 million. The production of diet pills reached a total of 12 billion pills in 1971, most of them Schedule II substances.³

Anxiety and depression associated with caffeinism among psychiatric inpatients.

Among 83 hospitalized adult psychiatric patients, 22% reported being high caffeine consumers (750 mg or more per day); these patients scored significantly greater on the State-Trait Anxiety Index and the Beck Depression Scale than moderate and low consumers. High consumers described significantly more clinical symptoms, felt that their physical health was not as good, and reported greater use of sedative-hypnotics and minor tranquilizers. Since caffeine modifies catecholamine levels, inhibits phosphodiesterase breakdown of cyclic AMP, and sensitizes receptor sites, association of caffeinism with both anxiety and depressive symptoms is possible.

Adolescent drug using groups in Chicago parks

In a northern Chicago neighborhood, observational and interview data were collected at parks, school lots, and beaches where adolescents congregate to buy, sell, and use nonopiate drugs. These sites were geographically distinct from areas where heroin is regularly distributed. Users at each area generally resided in the immediate neighborhood, were well known to one another, were predominantly male, displayed similar socioeconomic, religious and ethnic backgrounds, and had attended the same grade schools and high schools. These sites were relatively stable during the summer months, although visitors occasionally changed locations in response to police harassment. Attendance fluctuated with weather and time of day. Drug use was generally confined to the daily use of marihuana and weekend use of alcohol and sedative-hypnotics, but availability seemed to determine the type and frequency of drug use to a greater extent than drug perference. This study suggests the potential of a fieldwork model for prevention and intervention activities prior to the onset of more intense and diversified drug use.

A retrospective analysis of analgesics and sedative-hypnotics in hospitalized obstetrical and gynecological patients.

In a retrospective analysis, the dose per patient day (DPPD) of controlled analgesics and sedative-hypnotics dispensed to inpatients at a women's hospital in the United States were studied from October 1974 through September 1975. Obstetric patients received as many analgesics (1.872 DPPD) as did gynecologic patients (1.945 DPPD). Percodan and meperidine were the most frequently dispensed oral and parenteral analgesics (0.673 and 0.526 DPPD) respectively. Obstetric patients received greater quantities of sedative-hypnotics (0.453 DPPD) than did gynecologic patients (0.311 DPPD). Secobarbital and pentobarbital were the most frequently dispensed oral and parenteral sedative-hypnotics (0.161 and 0.015 DPPD), respectively. A decline in the use of barbiturates was observed toward the end of the study year, with a corresponding increase in the use of the non-barbiturate sedative-hypnotics. It is recommended that intrapartum administration of analgesics and sedatives be carefully evaluated in view of their possible depressant effects on the fetus/newborn.

Adjunctive drug use by methadone patients.

Clinical impressions, reinforced by reports in both professional journals and the lay press, suggested that use and abuse of minor tranquilizers and sedative-hypnotics was extensive among patients in our drug treatment clinics and required some change in our policies. We surveyed a randomly selected national sample of methadone program physicians and found they shared our assumptions concerning the use of these drugs. A pilot program of urine screening for the presence of adjunctive drugs was completed, and we found the incidence of use to be below expected levels, except for opiates and alcohol. These results suggest we should reconsider plans to alter clinic policies concerning the regulation of these substances. A rigorous examination of serum and/or urine in a national research program to determine both the incidence of adjunctive drug use by clients in drug treatment programs and correlations of such data with national surveys would be an expensive undertaking, but would provide a more rational basis for policy making at both local and national levels.