Barbiturates were first introduced for medical use in the early 1900s. More than 2,500 barbiturates have been synthesized, and at the height of their popularity, about 50 were marketed for human use. Today, about a dozen are in medical use. Barbiturates produce a wide spectrum of central nervous system depression, from mild sedation to coma, and have been used as sedatives, hypnotics, anesthetics, and anticonvulsants. The primary differences among many of these products are how fast they produce an effect and how long those effects last. Barbiturates are classified as ultrashort, short, intermediate, and long-acting.
The ultrashort-acting barbiturates produce anesthesia within about one minute after intravenous administration. Those in current medical use are the Schedule IV drug methohexital (BrevitalÂ®), and the Schedule III drugs thiamyl (SuritalÂ®) and thiopental (PentothalÂ®). Barbiturate abusers prefer the Schedule II short-acting and intermediate-acting barbiturates that include amobarbital (AmytaÂ®), pentobarbital (NembutalÂ®), secobarbital (SeconalÂ®), and Tuinal (an amobarbital/secobarbital combination product). Other short and intermediate-acting barbiturates are in Schedule III and include butalbital (FiorinaÂ®), butabarbital (ButisolÂ®), talbutal (LotusateÂ®), and aprobarbital (AlurateÂ®). After oral administration, the onset of action is from 15 to 40 minutes, and the effects last up to six hours. These drugs are primarily used for insomnia and preoperative sedation. Veterinarians use pentobarbital for anesthesia and euthanasia.
Long-acting barbiturates include phenobarbital (LuminalÂ®) and mephobarbital (MebaralÂ®), both of which are in Schedule IV. Effects of these drugs are realized in about one hour and last for about 12 hours, and are used primarily for daytime sedation and the treatment of seizure disorders.
Acknowledging the problem of addiction is the first step on the road to recovery. This first step is the most important and once you have admitted there is a problem and that you or your loved one needs help you will need to find the type of support and recovery that is right for your situation. A common approach is to have an assessment done by a licensed chemical dependency counselor, who will then come up with a treatment plan for you. This plan may include, detox, inpatient treatment followed by outpatient and aftercare treatment and a plan for the future. This is extremely general and your situation will require plans to confront your specific problems. Alcoholism and drug addiction often mask other psychological or physiological problems which will need to be dealt with to ensure long term success. Read on to find out more about some of these treatments and to get a general idea of what is involved in each step along the way.
Drugs such as heroin, Prescription Opiate Based Painkillers (Morphine, Oxycontin, Oxycodone, Vicodin) and alcohol can create a condition in the body known as “physical addiction”. Excessive use of these drugs over time creates a state in which your body has an actual physical need for the drug. When stopped abruptly intense physical urges occur which make it very difficult to quit using the drug. In the case of alcohol, these withdrawal symptoms can be so serious that it is essential that you have medical care during this period. In the case of opiates such as heroin the physical symptoms create such discomfort that medical help is strongly suggested to decrease discomfort and increase your success in getting through detox. Generally a patient is admitted into a 3-7 day detox program at a hospital or medical detox facility in your area prior to further treatment. At this facility a doctor will examine you and you will undergo treatment specific to your drug of abuse. This treatment may include the use of certain prescription drugs to ease symptoms, the use of Buprenorphine for opiates or benzodiazepines for alcohol.
Residential Addiction Treatment
The most successful treatment for addiction continues to be precluded by a length of time at an inpatient residential treatment center. An inpatient treatment program allows a patient to be immersed in treatment for a length of time. This time can vary but is most often 7 – 35 days. In this process the addict is surrounded by other people going through the same problems. There is also 24 hour access to chemical dependency counselors. In residential facilities the addict is given the unique opportunity to completely focus on their recovery. These facilities usually offer many types of programs to aid in the individual’s recovery. An additional benefit to being at a residential treatment facility is that the underlying problems, either physical or psychological can be diagnosed during sobriety and dealt with appropriately. The residential facility can then recommend further treatment such as dual diagnosis, anger management, trauma counseling, or medical treatment for physical disabilities. Treating these underlying problems is a key to long term success.
Outpatient Addiction Treatment
Outpatient treatment is an umbrella term which describes any number of methods which do not include being admitted to a facility. Outpatient treatment is a good choice for an individual’s first recovery experience or as an extension of treatment once an individual is released from and inpatient program. Outpatient treatment often is a group therapy situation where an individual comes to their group from once a day to once a month. The group is used as the addict’s support system as well as the counselor who runs the group. Outpatient therapy is most successful when done for the long term and in conjunction with participation in twelve step groups such as Alcoholics or Narcotics Anonymous.
Alcohol or drug abuse is sometimes easy to spot. However in most situations substance abuse is difficult to notice. The abuse of substances is a disease which presents itself through a variety of physiological and psychological symptoms. Part of the disease of addiction is the fact that the alcoholic or addict goes to great lengths to disguise their illness. The addict realizes the consequences of their behavior and in an effort to minimize their behavior’s negative effect on their life they will develop elaborate rituals, deceptions and manipulations to be able to continue using. Though an individual may not exhibit stereotypical symptoms they may still be suffering from a serious addiction.
If you suspect that a family member, friend, co worker or other loved one is in a sate of addiction to drugs or alcohol there are some signs and symptoms which you can look for over time to help you determine if your suspicions are correct. Different drugs and alcohol have slightly different physical symptoms of abuse, however the baseline signs of addiction are common to all addictions. Read on for some symptoms to look for if you are trying to determine if you need to take further action to help your loved one.
Psychological signs of addiction
- Reclusive behavior, long periods spent alone or isolated from others.
- Extended unexplained absences
- Lying or stealing
- Involvement in the law, arrests or jail time
- Deteriorating personal relationships
- Obvious intoxication, slurred speech, odor of drugs or alcohol
- Changes in behavior or attitude
- Decrease in work or school performance.
Physiological signs of drug abuse
Physical symptoms of alcohol or drug abuse are outward signs which can be observed in the physical reactions of an individual while under the influence of drugs or alcohol or shortly after as the effects are wearing off. These symptoms are more specific to the chemical being used and may also be caused by other environmental influences such as prescription drugs, normal social drinking, tiredness or stress and other factors. The key is to look for these symptoms in combination or recurring over time. These factors may not be indicative alcoholism or addiction, this is best determined by a professional. One or more of these symptoms is a good sign of a problem and should prompt further action and questioning.
- Dehydrating Effect
- Decrease in the time it takes to fall asleep
- Loss of muscular coordination
- Slowed reaction time
- Slurred speech
- Reduction in some social inhibitions
- Exaggerates current emotional state
- Rapid talking, loud speech and burst of excessive laughter
- Sleepy or stuporous in the later stages
- Losing track of conversation and loss of memory
- Red eyes or dry eyes
- Odor similar to burnt rope on clothing or breath
- Time distortion, tendency to overestimate time intervals
- Use or possession of paraphernalia including roach clip, packs of rolling papers, pipes or bongs
Stimulants (cocaine, amphetamines, methamphetamines)
- Dilated pupils (when large amounts are taken)
- Dry mouth and nose
- Excessive activity, difficulty sitting still, lack of interest in food or sleep
- Irritable, argumentative, nervous
- Talkative, but conversation often lacks continuity; changes subjects rapidly
- Runny nose, cold or chronic sinus/nasal problems, nose bleeds
- Use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws
Depressants (barbiturates, benzodiazepines)
- Similar symptoms as alcohol without the characteristic odor of alcohol on the breath or body
- Lack of facial expression or animation
- Flat affect
- Flaccid appearance
- Slurred speech
Narcotics (heroin, codeine, morphine, Vicodin)
- Drowsiness, lethargy, random sleep “nodding out”
- Constricted pupils
- Scars (tracks) on inner arms or other parts of body, from needle injections
- Use or possession of paraphernalia, including syringes, bent spoons, bottle caps, eye droppers, rubber tubing, cotton and needles
- Slurred speech
Dissociative Anesthetics (PCP)
- Unpredictable mood swings
- Disorientation; agitation and violence if exposed to excessive sensory stimulation
- Fear, terror
- Rigid muscles
- Deadened sensory perception (may experience severe injuries while appearing not to notice)
- Pupils may appear dilated
- Floating pupils, appear to follow a moving object
- Comatose (unresponsive) if large amount consumed; eyes may be open or closed