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Depressants include several distinct categories of drugs, each with its own benefits and dangers.

Sedative-Hypnotics

This large category of depressants comprises alcohol, "sleeping pills," and certain tranquilizers. In low doses these drugs promote relaxation and restfulness (sedation), especially in the daytime. Larger doses, especially at night, induce sleep (the word hypnosis comes from the name of the Greek god of sleep). "Sedative-hyp-notic" refers to this double action.

Alcohol (Ethyl Alcohol, Ethanol)

Alcohol is the most popular psychoactive drug in the world, used every day by many millions of people. Probably, it is also the oldest drug known to human beings, because it is easy to discover that fruits and juices, left to stand in a warm place, soon ferment into alcoholic mixtures. Alcohol is so commonplace and its effects, both good and bad, are so well known that they need little description. Anyone who has felt the pleasant stimulation of a glass of wine knows the beneficial side of this drug. Anyone who has interacted with a drunk person knows how powerful and unpleasant alcohol can be in overdose. Anyone who has lived with an alcoholic can attest to the horrors of alcohol addiction.

Production of ethyl alcohol depends upon yeast, which feeds on sugar, making alcohol and carbon dioxide as by-products. Yeasts are simple, one-celled forms of life found everywhere — in the air and on the skins of many fruits, especially grapes. To grow and multiply, yeast cells need water, sugar, and warmth. They keep on growing until they use up all the sugar or until the rising concentration of alcohol kills them. Alcohol is a poison as well as a drug; in high enough doses it kills living things, including the yeasts that make it.

Natural sources of sugar available to primitive people were fruit and honey, both of which can be made into wine with a maximum alcohol content of about 12 percent. Starch is also a potential source of alcohol, but it must be converted to sugar by enzymes before yeast can digest it. There are enzymes in saliva that can accomplish this, and one of the earliest kinds of beer was made by Indians in tropical America who learned to chew corn to a pulp, spit it into clay pots, mix it with water, and let it ferment. Sprouting grains also produce usable enzymes; in standard beer-making, sprouted barley (malt) is used to convert the starch of

61 Depressants

grains to sugar so that yeast can grow and produce alcohol. The alcohol content of beer is usually less than half that of wine. Beer is also more nutritious than wTine because it has a lot of calories in the form of carbohydrates.

Distilled alcohol is a relatively new product, dating back only a few hundred years. Brandy was the first distilled liquor made; it was obtained by heating wine and then cooling and condensing the vapors in another container. This process increases the alcohol content dramatically: from 12 percent up to 40 or 50 percent. The original idea of distillers was to concentrate wine to a smaller volume to make it easier to ship it in barrels overseas. At the end of the voyage the brandy was to be diluted with water back to an alcohol content of 12 percent. What happened, of course, wras that when people got their hands on what was in the barrels, no one waited to add water. Suddenly a new and powerful form of alcohol flooded the world.

Our society now manufactures and consumes many distilled liquors. Scotch and bourbon whiskeys are made from beerlike preparations of grain. Rum is distilled from fermented molasses;

In these famous drawings the English artist William Hogarth (1697-1764) portrayed the different consequences of regular use of fermented and distilled alcoholic beverages. The residents of Beer Street are happy, healthy, and productive, maintaining an orderly neighborhood. In Gin Lane there is disorder, chaos, and death. Among other calamities: a man has hanged himself, a skeletal man is near death from malnutrition, and a drunken woman lets her helpless child fall to its doom. (The Boston Athenaeum

From Chocolate to Morphine 62

I like alcohol. It is a powerful drug and, God knows, for some people a hellish one, but if used carefully it can give great pleasure. After a long, hard day, the splendid warm glow that strong drink provides is one of my favorite feelings; it starts in the pit of my stomach, then spreads to my limbs and brain. I know that alcohol is a depressant, but it acts and feels like a gentle relaxant — of the spirit as well as of the physical body. Just notice the increased vivacity and noise level at a cocktail party after a drink has been served to see how alcohol can put people at ease emotionally.

— sixty-two-year-old man, psychoanalyst gin and vodka arc just diluted ethyl alcohol (gin has flavor added), also usually distilled from grain. Because of their much higher alcohol content, these hard liquors are stronger and more intoxicating than fermented drinks.

From earliest times, people probably used beer and wine much as we use them today: as social and recreational drugs, to dispel worry and anxiety, to feel high, and as a change from the dull routines of work. Our early ancestors probably also noticed that the effects of alcohol were variable and dose-related, and that some people became dependent on it.

Alcohol is absorbed very quickly from the digestive system, enters the bloodstream, and reaches the bram, where it causes its effects on mood and behavior. The body has to work hard to eliminate alcohol; it burns some of it as fuel and excretes some unchanged in the breath and urine. The burden of metabolizing alcohol falls especially on the liver.

The effects of alcohol are directly related to how much of it is in the blood at any time. Low concentrations, particularly at the beginning of drinking, cause alertness, good moods, feelings of energy, warmth, and confidence, and the dissipation of anxiety and inhibition. Most people find these changes pleasant.

It is important to note, however, that some of the sensations — especially the sense of confidence — produced by low doses of alcohol may be false. Unlike stimulants, alcohol and other depressants slow the functioning of the nervous system, including reflexes, reaction time, and efficiency of muscular response. Though people often feel they are performing better after a few drinks, scientific tests show otherwise. This is one source of danger in using depressant drugs to feel good: the false sense of confidence can lead people to take unwarranted risks, such as driving cars in conditions that favor disaster.

Similarly, the sense of warmth produced by drinking is deceptive. It is due to increased blood flow to the skin, which allows more heat to radiate to the outside of the body. In fact, inner body temperature is dropping even as the sensation of warmth increases, so that people inadequately dressed for cold weather who drink in order to feel warm may fall victim to hypothermia.

Another example of the deceptive nature of alcohol is its sexual effect. Many people who drink to enhance sex claim that alcohol increases desire, removes inhibitions, and promotes relaxation. In men, however, its depression of the nervous system can prevent erection and drastically interfere with sexual performance. Writers as far back as Shakespeare have noted this property

63 Depressants of alcohol. In Act II, Scene 3, of Macbeth, the following exchange occurs between Macduff and a porter in Macbeth's castle:

Macduff: What three things does drink especially provoke? Porter: Marry, sir, nose painting, sleep, and urine. Lechcry, sir, it provokes, and unprovokes; it provokes the desire, but it takes away the performance.

People who drink should be aware that their subjective impressions while under the influence of alcohol may not correspond to reality.

Further, it is clear that, as with any psychoactive drug, the pleasant feelings alcohol can provide depend as much on set and setting as on pharmacological action. The same amount of wine that makes someone pleasantly high at a party may make a depressed person in a lonely room even more depressed.

Concentration of alcohol in the bloodstream is determined by several factors: first, by the concentration of alcohol in the drink; second, by the rate of drinking; third, by the presence or absence of food in the stomach; and fourth, by the rate at which the body can metabolize and eliminate alcohol.

The stronger the drink, the faster the blood alcohol level will rise and the sooner a person will get drunk. Gulping down cocktails and drinking wine like water are good ways to speed through the more pleasant, early effects of alcohol intoxication and go right to the less desirable ones.

Food in the stomach, especially milk, slows down absorption of alcohol into the blood. Therefore, drinking on an empty stomach can result in faster and more intense drunkenness. Eating before and during drinking moderates the intensity of alcohol's effects.

Finally, some people metabolize alcohol more rapidly than others and so can handle larger doses. This may be genetically determined; if so, some people could inherit a tendency to become alcoholic. People who drink alcohol regularly metabolize it faster than people who do not, and won't be affected by doses that nondrinkers would certainly feel. This is tolerance, and it develops quickly to alcohol and other sedative-hypnotics. Alcoholics show very high tolerance to the drug; they can even survive doses of alcohol that would kill nondrinkers. Other people may have lower than normal abilities to metabolize alcohol. Some Japanese, for example, have an inborn biochemical quirk that causes them to get drunk on doses of wine or liquor that would hardly affect most Americans or Europeans.

"I Keep forgetting. Is alcohol a depressant or a stimulant?"

(Copyright© 1980 Los Angeles Times Syndicate. Reprinted with permission!

From Chocolate to Morphine 64

LESS THAN .10%

Dry and decent.

Dclighfful and devilish.

Dry and decent.

Dclighfful and devilish.

Delinquent and disorderly.

MOKE THAN .50%

\

Doied ond deserted

Dead drunk.

OfGtfIS Of INTOXICATION

THe perceniogei ¡ndicoted show the concentration of okohol in the blood, brain, ond other organs.

Um ctftMM toft bmJ #rt from • r«r" *«"l Ba«rn

From Effects of Alcoholic Drinks, Tobacco, Sedatives, Narcotics by Thurman B. Rice, M.D., and Rolla N. Harger, Ph.D. (Chicago: Wheeler Publishing Co., 1952]

As alcohol increases in the bloodstream, it depresses more and more of the nervous system, producing the familiar symptoms of drunkenness: slurred speech, incoordination, inscnsitivity to pain, and inappropriate behavior. People become drunk in very different ways, depending on their personalities, their mood at the time, and the social setting. Some people become boisterous and obnoxious; others become overly friendly, confiding the most intimate details of their lives to perfect strangers. Some people get belligerent, even violent, while others become gloomy, tearful, and self-pitying.

Drunkenness is a serious problem throughout the world, accounting for many accidents, acts of violence, iniuries, and deaths. Many traffic accidents are directly related to alcohol in-, toxication, as are many murders. It isn't uncommon for drunk people to kill friends or relatives and have no memory of the incidents the next day, a consequence of alcohol's depressant effect on parts of the brain responsible for reason, thought, and memory.

Most people who get drunk eventually fall into stuporous sleep. When they wake up they are hung over, with such symptoms as sour stomach, headache, weakness, shakiness, depression, and inability to concentrate, work, or think clearly. These symptoms reflect the toxic effects of alcohol on the body and are very uncomfortable. Alcohol is strongly diuretic — that is, it increases the flow of urine, causing the body to lose water. A night of hard drinking can result in serious dehydration if lost water is not replaced, and this condition may contribute to the discomfort of the next day's hangover.

Because additional alcohol ("the hair of the dog that bit you") makes a hung-over person feel better in the short run, excessive drinking can lead to further drinking and start people on the path to dependence.

Dependence on alcohol is a true addiction, marked by extreme craving for the drug, tolerance, and withdrawal. The craving for alcohol among alcoholics is legendary and has been the subject of many books and films.* Recovered alcoholics tell frightening stories of the lengths to which they went to obtain their drug when deprived, and of squandering all of their money on drink. Withdrawal from alcohol is a major medical crisis. Some of its worst forms, such as delirium tremens (the D.T.'s), can be fatal and are more serious than withdrawal from narcotics.

*Scc pages 90-91.

65 Depressants

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Conquering Fear In The 21th Century

Conquering Fear In The 21th Century

The Ultimate Guide To Overcoming Fear And Getting Breakthroughs. Fear is without doubt among the strongest and most influential emotional responses we have, and it may act as both a protective and destructive force depending upon the situation.

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