Often such abuse begins with the legal (prescription) use of a barbiturate or other sedative-hypnotic as a sleeping pill. The user, finding that the pill also produces a pleasant arid very relaxed state if taken during the day, turns to illegal sources of supply to maintain a growing dependence on the drug.
In the 1950s a group of sedatives called benzodiazepines were developed to treat anxiety. These include diazepam, trade-named Valium, and chlordiazepoxide, trade-named Librium. They are often referred to as antianxiety drugs or minor tranquilizers (the “major tranquilizers” were the phenothiazenes, such as thorazine, now referred to as antipsychotic drugs rather than as tranquilizers). As antianxiety drugs, the minor tranquilizers (benzodiazepines) seem superior to barbiturates in several respects:
First, they reduce anxiety without making the person drowsy; sets end, they act at very low dosages and are less likely to produce addiction; and third, they have less of an effect on respiratory centers, reducing the risk of a fatal overdose. In part, they have these unique properties because they act on CNS sites that are unaffected by barbiturates, although they also do affect some of the same sites that both barbiturates and alcohol affect (indeed excessive use can lead to markedly similar patterns of intoxication).
Identification of receptor sites for benzodiazepines has led to speculation that our bodies may produce substances that are chemically similar to the minor tranquilizers providing a natural way of controlling anxiety (see the Highlight on endogenous benzodiazepines). The wide and enthusiastic prescription of Librium and Valium that began in the 1950s, however, has now been sharply curtailed as their addictive properties and potential for abuse have become more apparent. Nevertheless they remain the most widely used antianxiety drugs.
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