Patient Basics: Depressant and Sedative-Hypnotic Drug Misuse (Substance Abuse)

Depressants, also called sedative-hypnotic drugs, slow down the brain. Doctors prescribe them for anxiety, sleep problems and seizures, and they help many people when used as directed for a short time. Taken in higher doses, for longer than planned or with alcohol or opioids, they can lead to dependence, a sedative use disorder or a deadly overdose. If you take one regularly, don’t stop suddenly, because withdrawal can cause seizures.

Key points

• The most common depressants are benzodiazepines, such as alprazolam (Xanax), and sleep medicines such as zolpidem (Ambien).
• Mixing them with alcohol, opioids or other sedating drugs can slow or stop breathing.
• Pills bought outside a pharmacy may be fake and can contain fentanyl.
• Stopping after regular use should be done slowly, with a doctor’s help.
• Treatment works. For free, confidential help any time, call the SAMHSA National Helpline at 1-800-662-4357.

Which drugs are depressants

• Benzodiazepines, used for anxiety, panic attacks, seizures, muscle spasms and alcohol withdrawal: alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), diazepam (Valium) and others
• Sleep medicines often called “Z-drugs”: zolpidem (Ambien), eszopiclone and zaleplon
• Barbiturates, which are now used less often, such as phenobarbital and butalbital (found in some headache pills)
• Other drugs, such as the muscle relaxant carisoprodol and GHB

Alcohol is also a depressant, and it adds to the effects of all of these.

How problems develop

These drugs boost a calming chemical messenger in the brain called GABA. Over weeks of regular use, the brain adjusts:

• Tolerance. The same dose has less effect, so people may take more.
• Physical dependence. The body gets used to the drug, and stopping causes withdrawal. This can happen even when you take the medicine exactly as prescribed.
• Sedative use disorder. Use becomes hard to control and causes harm, but continues. It is a medical condition that can be treated. Doctors may call it sedative, hypnotic or anxiolytic use disorder.

Some people start with a prescription. Others use pills from friends, family or the street, sometimes to come down from stimulants or to boost the effects of alcohol or opioids.

Signs of a problem

• Taking more, or more often, than prescribed
• Running out early, or getting prescriptions from more than one doctor
• Strong cravings, or feeling you can’t get through the day or night without it
• Trying to cut back and not being able to
• Falling behind at work, school or home
• Using it with alcohol or other drugs, or before driving
• Drowsiness, slurred speech, unsteady walking or memory gaps

Health risks

• Overdose. The risk climbs sharply when depressants are mixed with opioids, alcohol or other sedating medicines. Breathing can slow until it stops.
• Fake pills. Pills sold online or on the street that look like Xanax or other medicines may contain fentanyl or stronger sedatives. A single pill can be deadly.
• Accidents and falls. Slowed reaction time raises the risk of car crashes. Older adults are more likely to fall and break a hip, and to become confused.
• Sleep behaviors. Z-drugs can cause sleepwalking, sleep-driving and other activities you don’t remember, sometimes with serious injuries.
• Memory and mood. Long-term use can affect memory and concentration and can worsen depression.
• Pregnancy. Use late in pregnancy can cause breathing problems and withdrawal in the newborn. Talk with your doctor before stopping or changing a medicine.

Withdrawal from depressants

Stopping suddenly after weeks or months of regular use can cause anxiety, trouble sleeping, shakiness, sweating, a racing heart, nausea, and sensitivity to light and sound. Severe withdrawal can cause hallucinations, confusion and seizures, and can be life-threatening. Withdrawal from barbiturates and high doses of benzodiazepines is especially dangerous.

A doctor can help you lower the dose slowly, often over weeks to months. Some people switch to a longer-acting medicine first to make the taper smoother. People who take high doses, have had withdrawal seizures or also use alcohol may need to start in a hospital or detox program.

Treatment

• A supervised taper, at a pace you can manage, with check-ins along the way
• Talk therapy. Cognitive behavioral therapy (CBT) helps people manage cravings, stress and triggers. A version for insomnia (CBT-I) works better than sleeping pills over the long run.
• Other treatment for anxiety or sleep, such as antidepressants that ease anxiety and aren’t habit-forming
• Treatment for other substance use, including medicines for opioid or alcohol use disorder
• Support groups and recovery programs, outpatient or residential

There is no medicine approved to treat sedative use disorder itself, but many people recover with these steps. Setbacks are common. When they happen, your care team can adjust the plan.

Using these medicines safely

• Take the lowest dose for the shortest time, exactly as prescribed.
• Don’t drink alcohol or take opioids, cannabis or other sedating drugs with them unless your doctor approves.
• Don’t drive or use machinery until you know how the medicine affects you.
• Store pills locked up, never share them, and get rid of leftovers at a pharmacy take-back site.
• Older adults should ask whether a safer option exists.

Get emergency help

Call 911 if someone can’t be woken, has slow or shallow breathing, or has blue or gray lips or fingertips. If opioids could be involved, which is often the case with street pills, give naloxone (Narcan) if you have it. It won’t reverse a sedative but can reverse an opioid and does no harm. Lay the person on their side and stay with them. Many states have laws that protect people who call for help during an overdose.

For questions about a possible poisoning, call Poison Help at 1-800-222-1222. If you are thinking about suicide or are in crisis, call or text 988. To find treatment, call the SAMHSA National Helpline at 1-800-662-4357.

Common questions about depressants

What is the difference between a depressant and a sedative?

A depressant is any drug that slows brain activity, and a sedative is a depressant used to calm you. At higher doses, many of the same drugs bring on sleep, and then they are called hypnotics. Benzodiazepines and barbiturates are all depressants, and doctors use them as sedatives or sleep aids depending on the dose.

Are antidepressants depressants?

No. Despite the similar names, antidepressants treat depression and anxiety and don’t slow the brain the way depressants do. Most, such as sertraline, aren’t habit-forming, although stopping them suddenly can cause unpleasant symptoms. Doctors often use them for long-term anxiety instead of benzodiazepines.

How fast can you become dependent on benzodiazepines?

Physical dependence can start after a few weeks of daily use, even at the prescribed dose. That is why doctors usually prescribe them for short periods or only as needed. If you have taken one every day for more than a few weeks, ask your doctor how to taper rather than stopping on your own.

Questions to ask your doctor

• Is this medicine still the right choice for me?
• How long should I take it?
• How can I safely lower my dose or stop?
• Are there other treatments for my anxiety or sleep?
• Should I keep naloxone at home?

Learn more

• Prescription drug misuse (MedlinePlus, U.S. National Library of Medicine)
• Boxed warning to improve safe use of benzodiazepines (U.S. Food and Drug Administration)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.