“Downer” and “upper” drugs are casual terms that refer to how different substances act on the central nervous system (CNS). In short, downers are depressants and uppers are stimulants. Downers commonly include sedatives and tranquilizers, such as benzodiazepines and barbiturates. Uppers include drugs like amphetamine, methamphetamine, and cocaine.
In addition to sedatives, many other substances have depressant effects, such as alcohol, opioids, and muscle relaxers. Anecdotally, many people report using downers to diminish the undesirable effects of stimulants, and conversely, a person might use an upper to reduce sedation. At first glance, it appears that this approach could be a reasonable way to mitigate the adverse effects of these substances. Unfortunately, it also increases the risk of severe health complications and overdose.
What Are Downers?
As the name implies, downers depress the CNS and can reduce heart rate, lower blood pressure, and cause sedation and impair cognition. Examples of prescription downers include sedative/hypnotics such as Ambien and Lunesta, as well as benzodiazepines such as Ativan, Klonopin, Valium, and Xanax, among others.
Side effects of depressants may include the following:
- Sedation
- Muscle relaxation
- Dizziness
- Drowsiness
- Trembling
- Reduced inhibitions
- Impaired coordination
- Impaired memory
- Fatigue
- Lethargy
Different types of downers can affect various processes in the body. For this reason, they are usually classified into three subgroups: alcohol, opioids, and sedatives/hypnotics.
Depressants that are prescribed for anxiety, panic, or sleep disorders are generally referred to as sedatives or tranquilizers. Opioids can be found in both prescription and illegal forms (e.g., oxycodone and heroin, respectively.) Opioids are technically classified as painkillers but can also have potent depressant effects. Finally, alcohol is legal to drink in the U.S. for those over 21 years of age and is readily available in most areas of the country.
CNS Depression
An overdose of depressants can occur when a person consumes excessive amounts of drugs or alcohol, and it can cause profound CNS depression that is potentially life-threatening. Symptoms of a depressant overdose include the following:
- Slurred speech
- Impaired cognition
- Impaired vision
- Impaired motor skills
- Slowed, labored, or stopped breathing
- Respiratory arrest
- Unresponsiveness
- Coma and death
Alcohol, hypnotic/sedatives, sleep aids, painkillers, and other downers can cause profound CNS depression, especially when multiple substances are used in combination.
What Are Uppers?
Uppers or stimulants work on the CNS to increase activity, heart rate, blood pressure, and boost energy levels. They also increase the production of dopamine and adrenaline, two chemical messengers responsible for feelings of reward and well-being. Uppers can also improve alertness and focus, reduce appetite, and extend wakefulness.
In addition to drugs such as cocaine and meth, which are usually found in illicit form, prescription stimulants commonly misused include Adderall, Concerta, and Ritalin. These are medications most often used to treat ADHD and sometimes narcolepsy. MDMA (Ecstasy) is also a type of stimulant, but it is sometimes placed in its own category due to its potential to induce hallucinations and alter sensory perceptions.
Side effects of stimulants may include the following:
- Dizziness
- Sweating
- Insomnia
- Hypersomnia
- Headache
- Chest pains
- Muscle tension
- Jaw clenching
- Tremors
- Heart palpitations
Mixing two stimulants can also be risky, as the effects of all substances in a person’s system are amplified. A life-threatening overdose may occur that can include aggression, dehydration, hypertension, hyperthermia, heart failure, and seizures. Overdose can occur even in a first-time user, depending on the amount of drug ingested in one episode.
Risks of Combining Depressants and Stimulants
As noted, many people will use downer drugs to mitigate undesired effects related to upper drugs or vice versa. They may also be seeking to experience a particular type of high such as that produced by a combination of a potent stimulant and depressant. This cocktail is traditionally cocaine and heroin, otherwise known as a speedball.
Combining cocaine, amphetamine, or methamphetamine with opioids such as heroin, however, is extremely risky. Indeed, this combination was the reported cause of death for many famous actors, such as John Belushi, River Phoenix, and Chris Farley, among others.
Unfortunately, dangerous drug interactions can also occur unintentionally for those who take other medications for depression, anxiety, pain, or ADHD. An adverse reaction is especially likely if an individual consumes alcohol while using these drugs. Sometimes people use uppers and downers together, unaware of the dangers of using them in conjunction.
Health Risks
In addition to potentially lethal overdoses, the upper-downer combination has been associated with several other serious health risks, including the following:
1) The combined effects of these opposite-acting substances can result in minimization of the symptoms of either, thus creating the illusion that the individual is not as intoxicated as they really are. Stimulant effects can motivate a user to continue partying and engaging in substance use longer while underestimating their level of intoxication. Uppers can dull warning signs that profound CNS depression is happening, while downers might mask a perilously accelerated heart rate.
As a result, a person may use more of a stimulant substance than initially intended, especially if it is combined with alcohol consumption. The body’s default response to heavy alcohol intake is to induce unconsciousness. Because stimulants can prevent this from occurring, a person might be able to consume more alcohol than they otherwise could without passing out. If other depressants are added into the mix, the person faces the risk of slipping into a coma and death.
2) Combining cocaine and alcohol is particularly dangerous. Alcohol changes how the body metabolizes cocaine, and this results in the development of a chemical byproduct. Also known as cocaethylene, this metabolite is more toxic than either cocaine or alcohol on their own and remains in the body longer. As a result, the liver and heart are placed under undue, prolonged stress, and death can occur just a few hours after using alcohol with cocaine.
3) Stimulants cause dehydration, and this can be made worse by drinking alcohol. When a person is not well-hydrated, he or she may encounter dizziness, disorientation, diarrhea, and vomiting. If dehydration persists, vital organs can be damaged, and death can occur.
4) The counteraction of using opioids and stimulants in combination can result in heart problems, heart failure, and death.
Getting Help for Polydrug Use and Addiction
A significant risk of using downer and upper drugs in combination is that an individual can become addicted to multiple drugs at the same time. A person with an addiction to one substance may turn to the abuse of another in an attempt to manage the symptoms of the original addiction. However, this approach almost never works, and instead, can force a person into a self-perpetuating cycle of substance abuse, making each addiction more dangerous and intense than it would be on its own.
If addiction to one or more substances develops, professional treatment offers the most effective path to recovery. You should never try to discontinue the use of any of these drugs suddenly or “cold turkey.” Depending on the drugs of abuse, you could encounter significant pain and discomfort, and, in some instances, withdrawal can even be life-threatening.
Importantly, rehab centers, such as Midwood Addiction Treatment, can provide medical and psychological support during withdrawal and can ensure that clients are as safe and comfortable as possible. Following detox, clients are urged to continue intensive treatment that includes behavioral therapy, counseling, and group support.
Please do not continue to make the risky decision to continue using upper and downer drugs—the dangers of doing so may be far greater than any perceived benefits. If you suspect that you or someone you love are struggling with addiction, we can help. Call us today and start the path to a new life without the use of drugs or alcohol!