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Barbiturate Withdrawal

Based on what we know today, it may sound a bit next level to think of alcohol and opium being used as medications to assist with sleep. The drastic measures quickly displayed their ineffectiveness, and other means were sought to treat everyday ailments like sleep disorders and anxiety. 

Today, nearly 50 million citizens in the United States suffer from more than 80 different kinds of sleep disorders. In addition, another 20 to 30 million have intermittent sleep problems each year. Despite their decline in popularity and usage, barbiturates were one of the first types of medications used strictly for sleep.

The history of barbiturates reaches back to 1864 when Adolf von Bayer created malonylurea. In the early 20th century, it started its journey as the first barbiturate. The substance was introduced to the market in 1904 by Farbwerke Fr Bayer and Co. Barbiturates are known as closed-chain ureic compounds, whose nucleus is malonylurea. Although the drug was initially synthesized in 1864, the formula was not perfected until 1879 by the chemist Edouard Grimaux.

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Once the drug was perfected, there were more than 2,500 variations created to help with anxiety, sleep disorders, and seizures. After many years of use, it wasn’t until 1912 that doctors recognized the first case of dependence on the medicine. Physicians began to report delirium and withdrawal symptoms at alarming rates after abrupt cessation.

Despite its addictive traits, barbiturates were hugely popular in the 1960s and 1970s. You may not hear much about them today, but the sedative-hypnotic drugs are known by their calming effects that soothe and overactive nervous system.

Barbiturates like allobarbital, phenobarbital, and barbital depress our central nervous system, which produces a calming effect. Unfortunately, because the drugs are so addictive, high doses can have terrible consequences. Benzodiazepines slowly replaced barbiturates to treat these disorders, and newer medications known as Z-Drugs have found their way into the market as well.

Despite the drug losing popularity and accessibility over the years, they are still available on the black market and sought by recreational users. Those who are not prescribed barbiturates by doctors do not understand how addictive these drugs are. It’s not necessarily the high that can be deadly, but the withdrawal symptoms are often fatal if left untreated by a medical professional.

What Are the Barbiturate Withdrawal Symptoms?

If someone is misusing barbiturate drugs, it will increase the odds that they’ll develop dependence or addiction. It will make stopping the medication even more difficult due to the uncomfortable withdrawal symptoms that you will experience. If you find that you are unable to stop using barbiturates, you must immediately seek help from addiction specialists. They will refer you to medical detoxification, where you will have support from a caring and supporting staff. The stable environment will allow you to cope with the symptoms easier.

The most common barbiturate withdrawal symptoms may include:

  • Nausea
  • High fever
  • Anxiety
  • Vomiting
  • Restlessness
  • Insomnia
  • Exhaustion
  • Aggression

Other more severe symptoms can include:

The Stages in the Barbiturate Withdrawal Timeline

Withdrawal syndrome is going to affect everyone differently and will vary from one situation to another. Some of the factors that contribute to this include:

  • Age
  • The last dose of the barbiturate drug
  • How long you used barbiturates
  • Frequency of use
  • The half-life of the barbiturate
  • Metabolism
  • How the barbiturate was consumed
  • Polydrug use
  • History of addiction
  • Tolerance
  • Support network
  • Dietary habits

In most cases, people can get through barbiturate withdrawals in one or two weeks. Heavy users, however, may experience the symptoms for three to four weeks. Mild users will get through the process much faster.

A general barbiturate withdrawal timeline consists of:

Days 1-3: You will start to experience withdrawal effects within the first or second day of the process. You are likely to experience nausea, anxiety, and vomiting. Sleep will become difficult to achieve, and you’ll feel tired or agitated. These symptoms should peak around days two or three, and you must place yourself in the care of medical professionals to monitor you for more severe symptoms.

Days 4-7: Around day five, you should start to feel better. Physically, your body has released most of the toxins that have built up from barbiturates. The body is now able to balance itself out, which will help you experience some relief. You will still experience cravings, issues with sleep, anxiety, and mood swings. Continued support throughout detox is key.

Week 2 and Beyond: Someone that is severely addicted to barbiturates will still experience symptoms during week two. You may even have a craving for the drug. Continued support is necessary to avoid a relapse.

Why Should I Detox?

The detox process is often unpredictable, and doing so under the supervision of specialists will allow you to mitigate those risks. If you try to stop using by yourself, you are at a higher risk of death. When someone attempts to stop all at once, it can become severe enough that someone succumbs to their symptoms.

There is no other option for barbiturate withdrawal other than getting professional help in a medical detox facility.

What Is the Next Treatment Step?

Once the barbiturates have exited your system, you must consider the next step of your journey. Detox alone is not enough to overcome addiction, and entering into a program will allow you to see where you are with your addiction. You will also go through a psychological evaluation to determine if you have a mental health condition that is contributing to your drug use.

Once a specialist determines you are ready to move on, you will have the option to further your treatment at an addiction center. Detox will not provide you with the tools to overcome addiction – it is simply a step in the right direction. To address the underlying causes of addiction, you need to go to a residential or outpatient facility. You will benefit significantly by learning more about the disease.

Sources

Sarrecchia, C., Sordillo, P., Conte, G., & Rocchi, G. (1998). Barbiturate withdrawal syndrome: A case associated with the abuse of a headache medication. from https://www.ncbi.nlm.nih.gov/pubmed/10349206

López-Muñoz, F., Ucha-Udabe, R., & Alamo, C. (2005, December). The history of barbiturates a century after their clinical introduction. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424120/

The State of SleepHealth in America. (n.d.). from https://www.sleephealth.org/sleep-health/the-state-of-sleephealth-in-america/

(n.d.). Delirium tremens: MedlinePlus Medical Encyclopedia. from https://medlineplus.gov/ency/article/000766.htm

National Institute on Drug Abuse. (n.d.). 8: Medical detoxification. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

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