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Saturday, October 31, 2020

Barbiturates: Uses, Health Benefits, Side Effects, and Risks

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For about a century and a half, barbiturates have been known and used. But around the 1900s, they become so popular and widely used for its calming effects on the nerves, which helps to induce sleep and control anxiety.

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Barbiturates are sedatives that have calming effects on the user by reducing the nerve activities, which results in the muscle relaxing. Heart rates, blood pressure, and breathing reduces as one of the effects of these substances.

Barbiturates work by increasing gamma-aminobutyric acid (GABA), which is a chemical present in the brain and function by creating a calming effect in the brain. When the activity of GABA is increased, the more sedated the brain becomes, and the calmer the nerves are, following all other benefits of barbiturates use when used correctly.

These substances produce a range of effects, showing off symptoms from mild calmness to death. Barbiturates are effective as anticonvulsants, thus used to treat seizures.

Barbiturates have the potential of addiction and dependence as well as the potential of tolerance that can result in overdose and then death. This is why they have been grossly replaced by safer medications such as benzodiazepines and nonbenzodiazepines.

This is because they pose a much lower risk of dependence, addiction, and overdose. They also overcome one of the biggest challenges of barbiturates use, and that is; the lack of a reversal drug or antidote in the case of a barbiturate overdose.

Despite all these risks, barbiturates are still in use today, that is for several reasons:

  • They are used in general anesthesia.
  • They are still used to treat seizures, and so they are applied in the treatment of epilepsy.
  • They are used in the treatment of severe headaches such as; acute migraines and acute tension headaches.
  • They are used in assisted suicide, and so on.

What conditions are Barbiturates prescribed for?

Even though they are widely misused and are illegal in some countries, barbiturates are one of the oldest classes of medications used in the treatment of seizures, throbbing headaches, sleep disorders such as insomnia,

In our world today, barbiturates are seldom used. This is because; it is now understood that they are most likely to make one develop drug tolerance and substance dependence, which can, in turn, lead to one overdosing, and ultimately lead to death.

It is advised never to stop using barbiturates abruptly after a long term use because it can cause withdrawal syndrome, which will be very severe and can lead to death.

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What drugs interact with barbiturates?

Caution should be applied when using the combination of barbiturates with some other medications. This is because they fasten the metabolization of these substances, causing a reduction in their effectiveness.

Examples of these medications include:

  • Ranolazine (Ranexa)
  • Atazanavir (Reyataz)
  • Telaprevir (Incivek)
  • Ritonavir (Norvir)
  • Boceprevir (Victrelis)
  • Voriconazole (Vfend)
  • Lurasidone (Latuda)

Combining the use of barbiturates along with other medications that are central nervous system depressants should be done with caution.

This is because it can cause; lethargy, excessive sedation, and in worst cases, coma may occur and following death. These medications include;

  • Diazepam (Valium)
  • Zaleplon (Sonata)
  • Clonazepam (Klonopin)
  • Zolpidem (Ambien)
  • Alprazolam (Xanax)

Why are barbiturates prescribed?

Barbiturates

These days, these substances are administered for the following:

  • Traumatic brain injury (TBI)
  • Insomnia
  • Tension headaches
  • Anxiety and sedation relating to surgery
  • Anesthesia
  • seizures

Barbiturates are rarely used for the above reasons, and they are only used when other medications are not available. They are also used when doctors have tried using other drugs without any desired effects.

Forms of barbiturates

Barbiturates come in liquid, and injectable, pills (tablet, and capsule) form. They also come in several different combinations and strengths.

Barbiturates are highly controlled by the drug regulatory system in most countries, and they should be well-managed in countries that are yet to have policies controlling these substances use to avoid the potential of having them misused.

These substances are categorized into five drug schedules, with the use of Roman numerals to indicate the schedule (Schedule I to Schedule V.) The schedule number shows the potential of the drug being misused and also indicating the substance’s accepted medical use.

For instance, Drugs in the category – Schedule I have not recently been accepted for medical use, and it has a high likelihood of being misused. In contrast, Schedule V drugs have a low probability of being abused. Thus it has high acceptance for medical use.

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Risks of taking barbiturates

Even though barbiturates were widely used in the ancient days to treat certain health conditions, they were not entirely safe to use without the supervision of the physician.

There are some factors that can increase one’s risk of suffering from the side effects of these substances and overdose. The factors include; Age, gender, underlying health conditions, and any other medications you’re taking.

In addition to this, barbiturates can double the calming effects of other medications taken with them. The medications include:

  • Pain killers, specifically opioids like hydrocodone and morphine.
  • Medications used in managing allergies like antihistamines.
  • Alcohol
  • Drugs used to induce sleep and manage anxiety like benzodiazepines, and other medications that have relaxing effects can cause drowsiness.

These days, this class of medications is rarely used because newer and safer drugs are being used instead. The risks of barbiturates are not to be compared with their benefits because the risks are far greater than the benefits.

Nevertheless, proper supervision should be adopted when using barbiturates to avoid severe side effects.

Pregnancy risk

Although barbiturates can be used during pregnancy for specific treatment when other medications that are considered safe are not available. There are severe risks associated with long term use of barbiturates.

Studies have confirmed the relationship between long-term use of barbiturate during pregnancy and congenital disabilities. The babies are also at risk with the complications associated with growth and development when exposed to barbiturates use for a long time during pregnancy.

Some babies suffer withdrawal symptoms because longterm use of barbiturates by the mothers during pregnancy can cause the baby to develop drug dependence on barbiturates after birth.

According to a study conducted on baby rats, it was confirmed that even the least exposure to barbiturates in newborn rats could hinder healthy brain development gravely. Specifically, pentobarbital affects memory, learning, and other vital functions.

It is not yet confirmed that barbiturates can be found in the breast milk of nursing mothers, but it is undoubtedly ruled out not to be used by nursing mothers to avoid the possible event of having the baby affected by barbiturates use.

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Withdrawal symptoms

Quitting barbiturates is all-around difficult because it may lead to death if stopped abruptly. The severity of the withdrawal symptoms depends on the individual’s wholistic health, other underlying conditions affecting their health and other medications being administered.

It is recommended that one talks to a health specialist (doctor) before stopping the intake of these substances, that is, if you have been using these drugs for a while.

Some withdrawal symptoms of barbiturates include:

  • Nausea
  • Vomiting
  • Stomach cramps
  • Depression
  • Anxiety
  • Restlessness
  • Difficulty in concentration, and focus
  • Difficulty with sleep
  • Tremors
  • Seizures
  • Delirium
  • Hallucinations
  • Increased body temperature
  • Heart problems

Severe signs of withdrawal may need one to be monitored under professional care in the hospital for many days until the substance is out of one’s body, and one’s body has recovered fully.

Legal issues surrounding barbiturates?

Barbiturates are still available for legal uses in the hospital for anesthesia, traumatic brain injury, sedation, seizures, and other select cases.

Doctors can prescribe barbiturates to help relieve headaches and induce sleep. However, this should only apply if other medications are not available or did not work when administered.

However, they are still gotten through illegal access and misused. Because the substances are obtained through Illegal means are used without any professional supervision.

This has caused several deaths following overdose. Usually, self-treatment is dangerous, more so, self-administration of drugs like barbiturates. The danger of barbiturates uses doubles when they are combined with opioids, alcohol, benzodiazepines like diazepam, or other substances.

Because they are relatively less costly, barbiturates are still in use in several countries today, and this contributes to the reason why it is very much available.

They can be found in the veterinary sources and research laboratories, strictly for research purposes. Illegally buying these kinds of medications online come with far higher risk because the substances may be adultered (in order to make more profit for the seller) or expired.

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It is illegal to purchase or administer barbiturates without a physician’s prescription and professional supervision. There are penalties at the federal and state level against the illicit trade or use of the drugs.

Signs of overdose

If you or someone you know uses barbiturates, and you or the person starts showing the following signs, then you or the person has had an overdose.

  • Confusion
  • Turning blue
  • Drop in body temperature
  • Trouble with coordination and balance
  • Trouble speaking
  • Extreme drowsiness
  • Slow breathing
  • Very slow heart rate
  • Severe weakness or tiredness

No drug nor substance can reverse the effects of barbiturates overdose when treating barbiturates overdose.

However, activated charcoal can be used to remove the excess quantity of the content from the body before the body can begin to normalize. Other measures are applied as well, which includes maintaining the airway and breathing.

How do barbiturates compare to benzodiazepines?

In our world today, the use of benzodiazepines such as; Valium (diazepam) and Xanax (alprazolam) have been adopted in the replacement of barbiturates in the treatment of anxiety and sleep disorders such as insomnia.

This is because they are known for having fewer side effects when they are being prescribed for home use, unlike barbiturates. Although benzodiazepines function in a similar way barbiturates work; by triggering the increase of GABA (a neurotransmitter) activity in the brain, thus creating a calming effect that relaxes.

Nevertheless, if they are combined with barbiturates, they increase the risks of overdose.

Benzodiazepines, when used for a very long time, can lead to dependency, and one can form it as a habit to always use them, coupled with the fact that they have almost the same side effects and risks as barbiturates when misused.

Thus, they should only be used only for a short period.

Conclusion

Barbiturates became known from the early 1900s to 1970s as medications used to treat insomnia, anxiety, and seizures. In the late 70s, doctors quit the use of barbiturates for medical reasons when the record of overdoses and misuse skyrocketed.

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In our world today, medications considered relatively much safer than barbiturates are being used instead of barbiturates. That did not stop barbiturates from being misused in our world today, even with the knowledge of the risks accompanying the misuse of this medication.

Barbiturate misuse can be associated with severe risks such as overdose and death. These risks have significantly increased, especially when they are consumed with other substances that have psychological effects.

These substances include benzodiazepines, opioids alcohol, or other medications. The consumption of barbiturates needs to be monitored strictly, clearly because of the severe risks accompanying their consumption, which could be an overdose.

This type of drug should never be used without a doctor’s prescription or outside your doctor’s knowledge and direction.

Are you or someone you know addicted to barbiturates? If yes, how were you about to manage the addiction? Do you mind sharing tips about the steps you followed to avoid being affected by the drugs? Kindly do so in the comments below.

Disclaimer: This article is purely informative & educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

Oluwafemi Michael
Oluwafemi Michael is an online Mental Health Therapist, Advocate for Mental Health Awareness, a programmer, and also a content creator from Edo state, Akoko-Edo LG.
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