Phenobarbital is a long-acting sedative that decreases the functions performed by the central nervous system (CNS). As a barbiturate, phenobarbital has major potential for misuse. Treatment for phenobarbital can be complex because of the mentally and physically addictive qualities of the drug.
Barbiturates can be seriously dangerous because it doesn’t take a lot to overdose on them. In 2011, there were 18,282 emergency room visits due to the non-medical use of barbiturates, according to SAMHSA. And according to a study done by the University of Texas, barbiturates are the top three most abused prescription class of drugs in the U.S.
Though similar to others in its class, Phenobarbital has been shown helpful in treating prescription barbiturates addiction due to its long-acting nature. It has also shown to be helpful in treating benzodiazepines addictions.
What is Phenobarbital?
Commonly referred to as “feenies,” Phenobarbital comes in tablet, pill, or liquid form. It can be ingested orally or intravenously into a large muscle. This sedative is used as a mild sedative and to induce coma. It has also been used as a hypnotic, anaesthetics, and anticonvulsants.
Phenobarbital is a sedative-hypnogenic. It can have a major influence on the mind. Some people may experience:
- Mild euphoria
- Lack of inhibition
- Relief from anxiety and sleeplessness
Some serious side effects can occur when the drug in misuse, though. Chronic administration of phenobarbital in large doses increases the risk for misuse in the future. Phenobarbital may be habit-forming because its effects are similar to that of alcohol and can last up to 12 hours.
Even those taking phenobarbital as prescribed may eventually build up a tolerance to the effects of the drug. This is where addiction starts, when larger doses than prescribed are taken. Someone who may be struggling with addiction or dependence may need help to stop.
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Signs And Symptoms Of Phenobarbital Addiction
About nine percent of adolescents (under 12) have reported using barbiturates, like phenobarbital, recreationally. Common signs phenobarbital addiction may include:
- Inexplicable changes in mood
- Trying to doctor “hop” to get more of the drug
- Erratic behavior like stealing or forging prescriptions
- Intense urges for the drug
- Isolating oneself socially
Abusing phenobarbital causes a sort of brain fog to set it in. This dulls the senses and can often look similar to alcohol intoxication. Some physical signs and symptoms of phenobarbital addiction include:
- Slurred speech
- Blisters and lesions on the skin
- Double vision
- Wide pupils
- Trouble with coordination
- Altered consciousness or behavior
One of these symptoms may not always be an indication of abuse however. Because this medicine is often hard to stabilize doses. These symptoms will appear when an individual ceases misusing the drug.
But, when the above symptoms happen along with hallucinations and/or delirium then that is cause for concern. The person exhibiting these behaviors should seek medical treatment right away.
There are also mental signs and symptoms to look out for if you think that your loved one may be abusing phenobarbital. These can include:
- Memory loss/blackout episodes
- Smaller attention span
- Depressive episodes
- Appearing to be easily agitated
- Different interpersonal behaviors, like increased likelihood to start arguments or be isolated
- Negative changes in social life at work or school
Dangers Of Phenobarbital Abuse
It is a common misconception that prescription pills are not as dangerous as street drugs because they are intended for medical purposes. This is not always the case when they are abused. When taken in excess phenobarbital can cause coma and death.
Like other barbiturates, phenobarbital has a narrow therapeutic index. Meaning that a theraputic size dose and a potentially toxic size dose can be very similar amounts. Typically any amount over one gram is considered to be too much.
Phenobarbital is especially dangerous when mixed with other substances that depress the CNS as well such as alcohol or pain killers. When mixed, the effects of both substances can be amplified and the level of phenobarbital in the blood can start to be considered toxic.
It is possible to overdose on as little as two grams of phenobarbital. The effects of overdose may include:
- Shallow respiration
- Clammy skin
- Dilated pupils
- Weak and rapid pulse
- Coma and possibly death
Withdrawal typically begins within 8 to 12 hours of the last dose. The symptoms that typically occur first may include:
- Mass amounts of anxiety
- Excessive sweating
- Shortness of breath
- Rapid heart beat
- Muscle twitching or tremors
- Distorted visual perception
- Nausea and vomiting
Misuse and abuse of phenobarbital can lead to intoxication or a withdrawal syndrome, both of which have potential to be fatal. Barbiturates interfere with the neurotransmitters that make-up the communication network of the brain. Suddenly stopping large doses of phenobarbital can overwhelm the brain with nerve impulses. Which can result in frightening hallucinations and life-threatening seizures.
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Medically-Supervised Phenobarbital Detoxification
Sedative withdrawal syndrome can be avoided by tapering down the dose of sedative over several weeks. It is essential to detox under the supervision of a qualified medical professional or in a rehabilitation setting, due to the potential life-threatening withdrawal symptoms of phenobarbital. It is very possible for a person to feel depressed after stopping the use of phenobarbital. Addiction specialist can provide the type of treatment when these types of co-occurring medical problems happen.
The best treatment type will depend on the severity of the addiction, however, with the potential toxic withdrawal symptoms phenobarbital can have it is wise to seek medical supervision for the initial detox from the drug. This ensures the safety of the individual seeking treatment.
Complete detox from phenobarbital can take anywhere from one to several weeks, depending on the length and dose amount taken. Once detox phase is over, the physical urges for the drug will subside. Different treatment facilities prescribe different types of therapies that will complement the detoxification process. It is common for people who suffer from drug addiction to be malnourished in some way. In this case, a medically-supervised detox could help by providing nutritional therapy.
Treatment For Phenobarbital Addiction
Rehab programs can approach addiction from multiple angles and use a wide array of treatment types. After a safe detox in an inpatient facility it is possible to enter into a residential program or support group that will meet regularly to keep the focus on healing and not relapse.
It is very common for the psychological urges/cravings for phenobarbital to be much stronger than the physical urges for it. This is why continuing to treatment after detox is so important. This is when the addicted individual is given the space and assistance to figure out the root-cause of their addiction.
In treatment people learn to recognize situations that may trigger drug cravings or a potential relapse. They learn how to deal with peer pressure around deciding whether or not to take the drugs, and to use coping skills in real life.
An aftercare plan may be a good fit for phenobarbital addiction treatment. It is possible to join a support group like a 12-step program, to create and maintain a support network to get you through tempting situations.