A sedative is a drug that depresses the central nervous system (CNS), which causes

calmness, relaxation, reduction of anxiety, sleepiness, slowed breathing, slurred speech, poor
judgment, and slow, uncertain reflexes. Sedatives may be referred to as tranquilizers, depressants,
anxiolytics, soporifics, sleeping pills, downers, or sedative-hypnotics.
Sedation is widely used by doctors and nurses to dull the anxiety related to painful or
anxiety-provoking procedures. Athough sedatives do not relieve pain in themselves, they can be a
useful adjunct to analgesics in preparing patients for surgery, and are commonly given to patients
before they are anaesthetized, or before other highly uncomfortable and invasive procedures like
cardiac catheterization or MRI. They increase tractability and compliance of children or
troublesome or demanding patients. Patients in intensive care units are almost always sedated
(unless they are unconscious from their condition anyway).
All sedatives can cause physical and psychological dependence when taken regularly over a
period of time, even at therapeutic doses. When dependent users decrease or end use suddenly, they
will exhibit withdrawal symptoms ranging from restlessness, insomnia and anxiety to convulsions
and death. When users become psychologically dependent, they feel as if they need the drug to
function although there is no biological dependence. In both types of dependence, finding and using
the drug becomes the focus in life. Both physical and psychological dependence can be treated.
All sedatives can be abused, but barbiturates are responsible for most of the problems with
sedative abuse due to their widespread "recreational" or non-medical use, as well as overprescribing by medical doctors. People who have difficulty dealing with stress, anxiety or
sleeplessness may overuse or become dependent on sedatives. Heroin users take them either to
supplement their drug or to substitute for it. Stimulant users frequently take sedatives to calm

excessive jitteriness. Others take sedatives recreationally to relax and forget their worries.
Barbiturate overdose is a factor in nearly one-third of all reported drug-related deaths. These
include suicides and accidental drug poisonings. About half of all the people admitted to emergency
rooms in the US as a result of nonmedical use of sedatives have a legitimate prescription for the
drug, but have taken an excessive dose or combined it with alcohol or other drugs. Others get
sedatives from friends who have bona fide prescriptions or by using faked prescriptions.
Sedatives and alcohol are sometimes combined recreationally or carelessly. Since alcohol
also is a strong CNS depressant that slows brain function and depresses respiration, the two
substances reinforce each other and this combination can prove fatal.

Sedatives Commonly Used in the Control of

PainAnodynes, Analgesics.
* OPIUM.
* MORPHINE.
* SALTS OF MORPHINE.
* CODEINE.
* HEROIN.

Physiological Action of Opium and Morphine.

The action of opium, and of morphine and its narcotic salts, is much the same. Opium is
stimulant and narcotic, according to the dose and susceptibility of the patient. Infants and old people
are easily poisoned by the drug, while those addicted to alcohol can take very large doses without
any bad effects; and those accustomed to the drug can take a poisonous dose with impunity. In the
healthy adult a moderate dose of opium stimulates all the nervous functions of the body, raises the
spirits and excites intellectual action; this gives way to a condition of placidity, freedom from care,
and a state of quiet enjoyment. In an hour or less, consciousnes is lost in sleep, which may continue
for eight hours or longer.
On waking there is evidence of disturbance of the functions of the organism, such as nausea,
vomiting, headache, constipation and diminished secretion, except that of the skin. In a dose
sufficient to cause death the period of excitement is short, while the strength of the system rapidly
gives way to drowsiness and apoplectic sleep. There is stertorous breathing, dusky countenance,
slow pulse, nearly total insensibility, only responding slightly to violent agitation, with confusion of

the mind, and an inclination to continue in a comatose state with increasing debility. After a few
hours, six to twelve, acording to the dose and the resisting power of
the patient, the face becomes pale, the pulse from being full and strong becomes weak and thready,
with cold extremities, a cool and clammy skin, a slow gasping respiration; a condition from which it
is impossible to rouse the patient and death soon follows.
The pulse is first slow from stimulation of the vasomotor nerve centers, and becomes rapid
as these become paralyzed. The pupil is first contracted by stimulation of the oculo-motor nerves,
and dilates as death approaches and these become paralyzed. Death results from paralysis of
respiration.
AdministrationOpium may be administered by the mouth, by the rectum or vagina, by the
hypodermic injection of its alkaloids, by application to a portion of the surface of the body after
removal of the cuticle, by inhalation or by insufflation.
The hypodermic use of morphine is demanded and is justifiable where great pain is present.
In these cases the size of the dose must be determined by the circumstances. Its influence is prompt
and satisfactory.
Contra-indicationsIn its primary influence it is a brain and nerve stimulant. It, is,
therefore, contra-indicated where there is an irritated and overstimulated nervous system, with
flushed face, bright eyes with contracted pupils, dry, hot skin, dry, coated tongue and inactivity of
the excretory functions. Administered under these circumstances, it will increase the restlessness
and induce general distress and painful wakefulness.
TherapyIn sudden acute pain, in pain from wounds or injury, or from burns, the contraindications are seldom present, and morphine can be administered usually hypodermically.
ToxicityOpium has been used as much if not more than any other agent for suicidal or
homicidal purposes. It is certainly a desirable agent for suicide if one desires a comfortable and
painless death. It is also acceptable when euthanasia is desired.