Uppers and downers are slang terms that refer to how a particular substance affects the central nervous system (CNS).

The Drug Enforcement Administration (DEA) refers to uppers and downers as stimulants and depressants respectively, and DEA fact sheets list the most common, which include the following:

  • Uppers include amphetamines, methamphetamine, cocaine, and khat.
  • Pharmaceutical examples include Adderall, Ritalin, and Concerta.
  • Downers include benzodiazepines, barbiturates, GHB, and flunitrazepam.
  • Examples include Xanax, Valium, Rohypnol, Ambien, Lunesta, and Klonopin.

In addition to the primary downer drugs, other substances also have depressant qualities including alcohol, muscle relaxants, and both illicit and prescription opiates. The Illinois Department of Human Services website notes that people often take downers to reduce undesirable effects from stimulant drugs, and an individual might take an upper to come out of a sedate state. Some people think this is a logical way to reduce the negative effects of these drugs, but it actually increases the damage and risks.

Central Nervous System Depression

An overdose can occur when people consume unsafe amounts of drugs and/or alcohol, and it can trigger a potentially fatal CNS depression. According to WebMD, symptoms of a CNS depression include slurred speech, impaired thinking, blurred vision, diminished reflexes, and slowed breathing; and a severe case can result in respiratory failure, coma, and death. Alcohol, antidepressants, hypnotic sedatives, benzodiazepines, sleep aids, pain medication, and other depressant substances can cause a CNS depression especially when such substances are taken together.

However, the Journal of Intensive Care Medicine in 2004 explained how uppers might also contribute in several ways including the following:

  • Downers impair respiratory pump function and suppress the medulla oblongata.
  • Uppers increase the respiratory workload causing respiratory muscle fatigue.
  • Suppressing an overworked respiratory system increases the risk of its failure.
Highlighting the risks of taking multiple substances together, the 2011 Drug Abuse Warning Network (DAWN) report lists several relevant findings including the following:
  • Alcohol is present in 38% of all medical emergencies involving stimulants.
  • 56% of all medical emergencies involved multiple drugs.
  • 53% involved multiple types of prescription medications.
  • 66% of all non-emergency detox requests involved multiple drugs.

Many people will take a depressant to come down from a stimulant high and possibly to fall asleep while others seeking a particular euphoric high might intentionally combine uppers and downers such as shooting a speedball (cocaine and heroin). Dangerous drug mixes can also happen unintentionally with people who take medication for pain, depression, attention-deficit hyperactivity disorder (ADHD), and/or anxiety especially if they drink while on these drugs. A legal yet dangerous combination of uppers and downers is alcohol and energy drinks.

Risks of Mixing Stimulants and Depressants

In addition to potentially fatal overdoses, upper-downer combinations involve several other health risks including the following:

  • The mix minimizes the symptoms of each individual substance creating the illusion that users are more in control than they actually are.
  • The stimulant effects often motivate the user to continue partying for longer periods and to underestimate their intoxication level.
  • Uppers might mask warning signs that a CNS depression is occurring while downers might mask a dangerously rapid heartbeat.
  • The physical fatigue from taking conflicting drugs strains multiple systems in the body.

The Academic Emergency Medicine journal in 2008 did a study on college students who mixed alcohol and energy drinks, and the statistics were alarming. Such drinkers had much higher occurrences of being injured and riding with intoxicated drivers, and their rates doubled for both sexual victimizing and victimhood. Any combination of uppers and downers affects decision-making and cognitive function and can lead to similar risks and consequences.

Addiction to Multiple Drugs

Another risk is becoming addicted to multiple drugs simultaneously. In 2005, The Journal of Clinical Psychiatry noted that benzodiazepines are usually a secondary drug abuse. People typically took the downer to augment the high from another substance or to offset the adverse effects of other drugs. A person addicted to uppers may use downers in an attempt to control the symptoms, but this can result in an addiction to both the stimulant and the depressant.

If an addiction to one or more substances does occur, professional rehabilitation offers the most efficient path to recovery. If an addiction to one or more substances does occur, professional rehabilitation offers the most efficient path to recovery.

Treatment centers customize recovery plans for each patient that generally include a variety of potential services including the following:
  • Safety-focused detox that reduces uncomfortable withdrawal symptoms
  • Tapered dosage reductions for patients with benzodiazepine dependence
  • Integrated care for co-occurring physical and mental health disorders
  • Optional holistic therapies for issues like chronic pain, anxiety, insomnia, and depression
  • Motivational therapies to address apathy and instill personal catalysts for change
  • Behavioral therapies that target maladaptive thought patterns and beliefs
  • Relapse-prevention tools to cope with cues that trigger substance use cravings

Rehab professionals also create aftercare plans to empower the recovery after the primary treatment is complete. In particular recovering addicts are strongly encouraged to engage in local support groups and connect with a recovery sponsor.

Free Addiction Hotline

If you have questions about substance abuse and rehab treatment, our admissions coordinators are available to provide answers. We can discuss rehab centers, warning signs and treatment options, and if you have health insurance, we can check the policy for benefits. Call us at 706-914-2327.

Articles posted here are primarily educational and may not directly reflect the offerings at Black Bear Lodge. For more specific information on programs at Black Bear Lodge, contact us today.