Doctor's Notes on Barbiturate Abuse
Barbiturate abuse is the misuse of a barbiturate drug (for example, phenobarbital, secobarbital) by an individual to obtain a high like alcohol intoxication. Such use can lead to addiction. Signs and symptoms are dose-related, and the dose differences between therapeutic and toxic are small and make these drugs dangerous to use without medical supervision. Street names of the drugs include downers, blue heavens, yellow jackets, goof balls, reds, rainbows, and many others. Low overdose symptoms and signs may include the following:
- Depression
- Mood swings
- Drowsy
- Intoxication
- Disinhibition
- Irritability and/or agitation
- Poor concentration
- Sluggishness
- Sleepiness
- Decreased REM sleep
- Dilated pupils
- Impaired judgment
The above may be a prelude to more serious symptoms that may develop (due to moderately high overdoses) such as
- slurring of speech,
- lack of coordination,
- dizziness,
- visual problems, and
- decreased motor control.
Serious life-threatening symptoms due to high overdoses of barbiturates may include the following:
- Hypotension
- Bradycardia
- Confusion
- Inability to urinate
- Slowed brain functions
- Slowed pulse
- Slow breathing
- Respiratory arrest
- Death
Some of the above symptoms may develop with lower doses, as everyone may react differently. Also, barbiturate dependence may develop if the individual takes overdoses daily for about a month. If a person develops dependence, life-threatening symptoms like hallucinations, delusions, high temperatures, seizures, and even death may occur if the patient is not medically cared for during withdrawl.
The cause of barbiturate abuse is overdosing with a barbiturate drug to obtain a high. Individuals with symptoms of barbiturate overdosing should be seen immediately (call 911) as symptoms and signs may rapidly progress. There is no home treatment.
What Is the Treatment for Barbiturate Abuse?
Treatments are supportive and aimed at reducing symptoms and may range from close observation to placing the patient on a breathing machine and treating other symptoms medically. In general, the following treatments are listed for an incident of barbiturate abuse:
- Watch the patient to see if he can swallow, breathe without problems, and is awake but drowsy. The patient should be evaluated by a medical caregiver.
- A breathing machine is used if the patient has difficulty or is unable to breathe until the drug wears off and the person can breathe on his own.
- Liquid activated charcoal may be placed in the stomach by swallowing it or by a tube placed in the nose or mouth.
- Patients are usually admitted to the hospital and observed to determine if additional treatments are needed.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.