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The WHO defines drug abuse as “persistent or sporadic excessive drug use inconsistent with or unrelated to acceptable medical practice.” Barbiturates are the class of drugs which act on the central nervous system and produce depression.

What is barbiturate abuse and its types

These drugs can be broadly classified as “hypnotics and sedatives”. The pharmacological effects of barbiturates scale from mild sedation to anesthesia. These drugs are prescribed to treat insomnia, anxiety, tension and also help in palliating epileptic seizures and hence barbiturates are also termed as “downers”.

Barbiturate abuse is a condition where one consumes barbiturates or its derivatives by evading the advice of the healthcare provider. Non-adherence to the instructions of the health care provider or digression from the prescription is considered to be an offence. Even after having stringent rules, drug abuse still exists in most parts of the globe. Studies have revealed that age and gender are the major contributing factors of drug abuse. These people consume barbiturates either for a long duration or may even consume larger doses of the drug in much shorter intervals. Over a period of time, they tend to get addicted and may hanker for the drug, which may not be required for any therapeutic benefit. However, continuing barbiturates for a longer period may result in serious impairment or distress.

What are the different types of barbiturates?

In the year 1903, barbiturates were initially used for its therapeutic benefit. Since then more than 2,000 derivatives of barbituric acid have been synthesized, out of which, many are still available in the market. The main difference amongst barbiturates is the duration of action. The effect of long-acting barbiturates may last up to two days; however, the effect of short acting and ultra-short acting barbiturates last only for a few minutes or few hours. Barbiturates may be injected into veins or muscles, but usually taken as oral pills.

What are the possible reasons for barbiturate abuse?

More than 2,000 barbituric acid derivatives have been synthesized, out of which more than 60 have proved to be therapeutically beneficial; amongst which, 12-20 are been marketed in various countries throughout the globe. Researchers could not find the exact cause of barbiturate abuse till date. One may start taking barbiturates to get relief from physical or mental stress. Barbiturates tend to have hypnotic/sedative activity, which produces euphoria and the person feels more relaxed and not tensed about any problems. Another major reason of barbiturate abuse is to offset the symptoms of other drugs. However, there are some other causes identified for barbiturate abuse, which are as follows:

  • Teenagers are mostly influenced by barbiturates, who generally enjoy the euphoric effect of the drug and underestimate the future hazards of abuse
  • Increase in the incidence of barbiturate abuse is due to the unavailability of prohibited exhilarating drugs such as methamphetamines, opoid analgesics, cocaine etc; and easy availability of barbiturates in the market. Implementing stringent rules and regulations against the use of narcotic and psychotropic substances may reduce the rate of drug abuse.
  • These drugs are also commonly used by people who are depressed and have the tendency to commit suicide; such people may get addicted to using these drugs

What are the clinical manifestations of barbiturate abuse?

Sedation or euphoria is produced by drugs that cross the blood brain barrier. Barbiturates, alcohol, opioid analgesics and some anti-allergic agents are better examples. Following are the symptoms that result upon abusing barbiturates:

  • A small dosage makes the barbiturates abusers feel drowsy and intoxicated
  • A higher dosage makes the abusers both physically and mentally impaired, as if they are drunk. It develops slurred speech and confused mind
  • If a person has taken high doses and is unable to be aroused (coma), then there is a possibility of stopping the breath involuntarily
  • Barbiturates are addictive. If they are taken regularly for about a month, the brain develops a need for the barbiturate that causes severe symptoms
  • Sudden withdrawal symptoms of barbiturates in abusers include a state of extreme emotional disturbance, sleeplessness and tremors, which can further lead to severe effects such as hallucinations, increase in body temperature and seizures
  • If a pregnant women consume barbiturates, the baby too becomes addicted to the drug and the newborn may have withdrawal symptoms

When to seek medical advice?

Medical advice has to be sought if you note that you are dependent upon barbiturates for relief of your symptoms. If you are taking these medications beyond the prescribed period or above the prescribed limits then you should meet your healthcare provider immediately. Barbiturate abusers tend to take large doses of these medications at times which may lead to severe complications. If you suspect that a person has consumed an overdose of barbiturates, inform the physician or take the abuser to a hospital emergency department for further evaluation by concerned specialist. Soon after taking barbiturates, a person may only be drowsy or seem intoxicated, but more serious symptoms can develop quickly and unpredictably. While taking the abuser to the hospital try to collect any leftover pills, pill bottles, or other medicines that the abuser has consumed, this helps in further evaluation and appropriate treatment.

How is barbiturate abuse diagnosed?

The diagnosis of barbiturate abuse is based on the history of the use of barbiturates by the affected individuals. Additional information about the abuse can be gathered from friends and family members of the affected individuals. Enquiry about the signs and symptoms of abuse is also performed. The pattern of drug use and the dosage commonly consumed can give an idea about the barbiturate abuse. Blood tests and urine tests may be used to detect the presence or levels of these drugs in the body.

How is barbiturate abuse treated?

There are many pharmacological and non-pharmacological modes of treatment that can help the abuser get rid of the above mentioned symptoms. However, the aim of therapy is to stop or control barbiturate abuse. Providing education to the abuser and his caregivers is the major concern of treatment, this also helps in preventing further complications. For the safety of abuser and as a preventionary measure, the physician may ask the abuser not to drive or operate machineries. Initial treatment may require the abuser to be admitted in the hospital to prevent any adverse event when the barbiturate use is stopped completely.

Read More: Barbiturate

Barbiturate abuse treatment may include any of the following measures:

Detoxification: Detoxification procedure is done to flush out the toxic residues of barbiturates present in the patient’s body. During detoxification, medicines are given to help prevent withdrawal symptoms when the person stops taking barbiturates. The affected persons are also educated about the harms of barbiturate abuse and counseled for stress relief and coping with the problems in hand. You may also be advised to avoid places, people or things that remind about barbiturate use.

Medical treatment: The medical treatment in barbiturate abuse is largely symptomatic.

The healthcare provider may give certain medicines to relieve symptoms. These may include medicines to treat anxiety or sleeping problems. The physician may also suggest certain medicines to help control barbiturate abuse and other related problems. The dosage and frequency of the barbiturates may be altered to prevent you from becoming dependent upon these medications.

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