Barbiturbation: the effects of barbiturate abuse, dependence treatment
Barbituromania is a form of dependence caused by drugs - derivatives of barbituric acid, related to hypnotics.As a percentage of barbiturism, by the number of people who consume these substances is much lower than opium, hashish addiction. The peculiarity of the action of barbiturates consists in severe, malignant destruction of personality.
Addiction to barbituric sleeping pills is a disease of civilization.Deprivation of a man of the usual dose of these drugs can give: delirium;Epileptiform seizure, marked neurological disorders with speech and coordination disorders, severe tremor in the body. A large number of people who abuse the barbituric group of drugs develop severe disabilities.The number of patients suffering from this type of dependence is steadily growing.Table of contents:
Barbiturates include :
- Barbitan sodium;
- Standard sodium;
How barbiturates work on humans
Among the drugs of this group, drug addicts choose the fastest.It is they who are characterized by the euphorizing effect of the receiving person.Drug effect is caused by exceeding the average single dose in two to three times.
Please note: the application also uses a psychic phenomenon - if a person tunes to sleep, he will get drowsy.If euphorization is expected, then it is.
Another note - the excitement of barbiturates occurs in a rested person who does not need a dream.A similar effect is also in healthy people who decide to resort to barbiturates for unplanned sleep.
Features of the narcotic effect:
- when taken in the form of tablets - "arrival"( 1 phase of narcotic intoxication - absent), immediately comes the 2nd phase - "drag".The exception - beginners.They can appear briefly the phenomenon of "arrival" - euphoric dizziness, languor in the body and darkening in the eyes;
- with intravenous administration is characterized by a bright manifestation of both the 1st and 2nd phases;
- in people who abuse alcohol, or against the background of drinking alcohol by an ordinary person, the phase of euphoria is expressed strongly, and lasts for a long time.
Manifestation of pathophysiological-narcotic effect on the body:
- When examined, the patient has sharply dilated pupils;
- Reddening of the skin and mucous membranes, marked sweating.
- The speech is broken, the coordination of movements is reminiscent of that in alcoholic intoxication( which often causes errors in assessing the condition).
The first phase of barbiturial intoxication
When injected, comes immediately, "on the needle."It flows according to principle of anesthesia , patients describe it as a "blow to the head", but the sensations are pleasant .In the mind there are all kinds of colorful visions, luminous points, divergent circles, etc.In this case, the patient can not maintain the vertical position of the trunk.There is a kind of "self-shutdown".The duration of this state lasts only a few seconds.
The initial state is changed by the onset of unreasonable cheerfulness, activity, non-purposeful activity with a reduced understanding of .Distraction and absent-mindedness, change of emotions( from gaiety to anger), increased conflict and friendliness, all this is combined in the patient during the action of this phase.
Body temperature decreases, pressure drops, the pulse becomes less frequent.Drawing attention to the redness of the skin and sweating, dilated pupils.The condition lasts 2-3 hours.
Gradually the activity fades and the next stage of barbituric intoxication comes.
Deep and heavy sleep.It is almost impossible to wake a patient. The arterial pressure remains low, the heartbeat is slow, the muscles feel dull, the skin is pale.If the patient falls asleep in the day, this medication will last 3-4 hours.At night, there may be problems with sleep.
The fourth phase of the action of barbiturates
After awakening, a person feels a pronounced weakness, weakness, barbiturate "stupor", reduced ability to concentrate .When examined - a violation of reflex reactions, the functions of the eye muscles.There may be a headache, nausea and even vomiting.There is thirst and aversion to food.If at this moment take 150-200 ml of hot water, then a new intoxication may occur.
Please note: these manifestations are typical for the use of double and triple single doses of barbiturates.
Overdose is accompanied by a rapid 1st phase, 2nd - or absent altogether, or flows for several minutes.Rapidly developing:
- sharp drop in blood pressure;
- weak and frequent pulse;
- pathological respiratory( Chain-Stokes);
- pallor and cyanosis of the skin;
- marked decrease in body temperature;
- paralysis of the respiratory center and death.
Overdose requires immediate assistance.
Development of barbituromania
Addiction to barbiturates develops in people with neurotic disorders, in affective-unstable psychopaths, alcoholics .It is they who in high doses take this group of medicines, including in the daytime.Dependence in this group of patients is formed very quickly.Slower barbituromania develops in "primary" patients who do not have the described problems.
Sometimes for a predilection it is enough 4-5 weeks, in more "protracted" cases - 3-4 months.
Note: you can start talking about addiction if the person taking barbiturates does it in the daytime.
Mental dependence is different from alcohol and otic.In the case of taking barbiturates, it is rather the nature of a conditioned reflex, ritual action, a pathological habit.
The destruction of the personality comes very quickly.In the formation of all the painful manifestations of dependence on barbiturates, the toxic component comes first.
The stages of barbiturbation:
The first stage.This period is characterized by a clear manifestation of the euphoric effect, but with the still preserved sleeping pills .The dose of the medicine taken is increased from the standard schedule - 1 tablet at night, up to 4-5 per day( with the motivation "to fall asleep").In fact, patients are in high spirits, developed euphoria, appetite, desire to move, communicate and talk a lot.At stage 1 there is still a pronounced sedative effect in the 3 phase of intoxication, which indicates a physiological( as yet) effect of taking medications.A night's sleep, though heavy, but comes.The next days the patient, without taking the usual dose, feels broken and tired.The adopted dose "corrects" the physical and mental state.
Patients at this stage often combine barbiturates with alcohol.This "mixture" has a mutual potentiating effect.After such excesses, tolerance increases.Ordinary doses of tablets no longer exert the same effect, an increase in their number is required.
Drug acquisition becomes systemic.Gradually, mental dependence grows.
This stage lasts from several weeks to several years.An average of 3-4 months.
Second stage. It is determined by the formation of physical dependence. The dose of the drug is stabilized.A new increase is not required.The first phase of intoxication is going away.The effect of enhancing the effect is achieved by taking a hot bath, or drinking warm water.Excitability is reduced, patients behave more calmly.The need for constant narcotization is very high.Developing sensitivity, affective outbursts, anger.The patient develops serious problems with sleep, which only comes in the morning at dawn, accompanied by nightmares.Sleep patient can, only by taking an increased dose of barbiturates, which can cause overdose, coma.
Note: deprivation of the usual dose is characterized by severe abstinence, which is characterized by severe psychosis and epileptiform seizures.
Completely absent protective gag reflex.Gradually, the dose of is lost.Patients may take the amount of the drug 15-20 times higher than the average therapeutic value.A dose above 2.5 grams of barbiturates often causes death from an overdose.
At this stage, the severe is formed :
- In the first phase of , the pupils are significantly dilated, the patient is shivering, profuse sweating, complete lack of appetite, chills, muscle weakness.The patient absolutely can not fall asleep.
- In the second phase, developing day after day, cavities of calves arise, muscle tension, trembling in the body, increased blood pressure, increased heart rate.The patient is irritated by all sounds and light stimuli.
- The third phase of - comes on the 3rd day of abstinence.Characteristic signs - pain in the stomach, large joints.Develops vomiting, severe diarrhea.
- The fourth phase of is determined by the end of 3 days.Apogee of withdrawal.Patients experience severe mental stress.On the 4th-5th day of giving up drugs, there are epi-seizures, delusional psychoses that can last for 1-2 months.
The duration of the abstinence syndrome is up to 4-5 weeks.The most difficult are the first 10-14 days of .After passing this critical "point" the state begins to gradually normalize.
Third stage. With barbituric dependence develops rarely.The ability to feel euphoria completely disappears.Therefore, patients begin to resort to combinations of barbiturates with neuroleptics, alcohol.Polytoxicomania forms.The manifestation of chronic barbiturate intoxication develops.
Consequences of barbiturbation
Patients with dirty-earthy color, edematous.Trophic changes lead to the appearance on the skin of multiple pustular rashes.Appearance of patients - faded. Dull eyes, hair.Developed toxic hepatitis and cirrhosis of the liver in the end.There are dystrophic changes in the heart muscle.
The examination reveals a tongue with a brown coating, a bad smell from the mouth.Against the background of encephalopathy, the mental capacity of barbiturans suffers, severe chronic depression is formed.
Neurologic manifestations are particularly plural and diverse.All problems lead to disability of patients.
Diagnosis of barbituromania
Severe manifestation and course of this disease requires a serious diagnosis, including a thorough clinical and psychopathological examination, a survey. The laboratory-instrumental part of the survey consists of the assignment of clinical blood tests, especially its biochemical indices.Patients need: electroencephalography, computed tomography, MRI of the head.
Features of Barbiturate Dependence Treatment
Patients can be effectively treated only in specialized drug clinics.
Important: all preparations of the barbituric series are canceled gradually, unlike the treatment of other types of drug addictions.
This need is dictated by the special danger of developing psychoses and epileptic seizures.The dose decreases smoothly, during 1-2 weeks of treatment.
After complete cancellation, the following is carried out:
- massive detoxification;
- restorative therapy with massive doses of vitamins, drugs of the metabolic series, hepatoprotectors;Heart and antioxidant drugs;
- long-term appointment of nootropics that restore the brain;
- tranquilizers and antidepressants that stabilize the psyche.
All patients undergo long-term psychotherapy, which includes many methods.With a favorable course of treatment, an encoding is done at the end.After the entire treatment cycle, patients are referred to rehabilitation centers.
The outcome of the disease is rarely favorable.Mortality in barbitur drug addiction can be called one of the highest among patients who consume the remaining drug groups . Also, among consumers of barbiturates there is the highest percentage of suicides.According to some data, 60-80 times in relation to the corresponding age group.
Remissions are few and rarely long.
Alexander Lotin, medical reviewer