Substance Misuse in Pregnancy - NHS Lothian

anxiety related problems and can interact with other CNS depressant
drugs and CNS stimulant drugs.
Effects of commonly used drugs
Benzodiazepine drugs, such as diazepam (Valium®) and temazepam, are
commonly called ‘minor tranquillisers’ or ‘sleeping tablets’ (hypnotics) and
are CNS depressant drugs. They are easily available on the black market
and are in widespread use. People can become dependent on
benzodiazepines in a very short period of time if they are used
continuously (ISDD 1999). Sudden withdrawal from benzodiazepines can
result in severe anxiety symptoms, hallucinations and seizures (similar to
alcohol dependency withdrawal symptoms).
Opioid drugs are CNS depressant drugs that have an analgesic (‘pain
killer’) effect. They include:
• opiates… derived from the opium poppy e.g. morphine and codeine, and
their
• synthetic analogues… e.g. methadone (‘meth’), diamorphine (‘heroin’),
dihydrocodeine (DF118 or ‘difs’), dipipanone (Diconal®), pethidine.
Opioids produce a range of physical effects apart from analgesia. They
depress nervous system activity, including reflex functions such as
coughing, respiration and heart rate. They also depress bowel activity,
resulting in constipation. At higher doses sedation results and the user
becomes drowsy and contented. Excessive doses produce stupor and coma.
Tolerance and physical dependence develops with regular continued use.
The physiological effects of long-term opiate use are rarely serious in
themselves. They include respiratory complaints, constipation and
menstrual irregularity (ISDD 1999).
Opioid intoxication… ‘gouching’ is the colloquial term used in Lothian to
describe being intoxicated or ‘stoned’ on opiate drugs (i.e. the person
takes a dose which is above their tolerance level). An intoxicated person
may be unresponsive, have pinpoint pupils, respiratory depression (shallow
and infrequent breathing), a weak and rapid pulse, and they may appear
pale and have cold extremities.
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