Barbiturates are prescription sedatives that have taken a back seat to benzodiazepines for treating anxiety and insomnia. Even though these drugs are not prescribed frequently, they are still available and therefore represent a potential drug of abuse. When someone either accidentally or intentionally overdoses on barbiturates, it constitutes a medical emergency that requires immediate intervention.
Barbiturate overdose treatment involves multiple actions to attempt to minimize the drug’s effect on body systems. Medical personnel will administer various emergency measures to prevent potentially deadly barbiturate poisoning. Once barbiturate overdose treatment is successfully completed, the individual will transition to an addiction recovery program.
Someone who has developed a chemical dependency on barbiturates will need to undergo a supervised medical detox and withdrawal program prior to beginning addiction treatment. It is never advisable to attempt to stop taking the drug suddenly, as serious withdrawal symptoms can suddenly emerge. A medical detox team will gradually reduce the dosing of the drug until the individual has safely completed detoxification.
Treatment for the barbiturate addiction or dependency will involve multiple therapeutic interventions that are designed to help the individual establish new healthy thought patterns and lifestyle habits, resulting in a sustained recovery.
What Are Barbiturates?
Barbiturates, including phenobarbital, Seconal, Amytal, and butalbital, are a class of sedative-hypnotic drugs intended for the treatment of seizure disorder, preoperative anxiety, and insomnia. Because of the mild euphoric effects, as well as the relaxation properties of these drugs, barbiturates are illicitly abused recreationally. In fact, the 2018 SAMSHA survey reported that more than 32,000 Americans over the age of 12 had admitted misusing barbiturates.
Barbiturates, a chemical derivative of barbituric acid, work by acting on the central nervous system as a depressant, causing a sedated effect. Because of the drugs addictive properties and toxicity in the event of an overdose, most physicians now prescribe benzodiazepines for treating individuals struggling with anxiety or insomnia. However, barbiturates are still commonly prescribed for epilepsy, general anesthesia, acute migraines, and other purposes. These drugs are not recommended for use by a pregnant woman or in individuals over the age of 65. In addition, individuals with severe respiratory disease or kidney disease should avoid barbiturates.
How Are Barbiturates Misused?
As with any drug that is capable of altering brain chemistry through the central nervous system, barbiturates are highly addictive. When used on a regular basis, the body will become more tolerant to its effects, leading the individual to need higher or more frequent dosing to achieve the desired effect.
The short-acting barbiturates are the most recreationally abused form of the drug, as these provide the desired sense of euphoria and relaxation. These drugs include Amytal, Nembutal, Seconal, and Tuinal. Barbiturates are often consumed with alcohol, which only amplifies the dangerous sedative effects that can result in toxic poisoning. Barbiturates may also be combines with the use of heroin and prescription opioids.
What Are the Signs of a Barbiturate Overdose?
Even someone who was prescribed a barbiturate for a legitimate medical condition is vulnerable to toxicity building up in the system. When someone has ingested more of the drug than the body can safely metabolize, it results in overdose. Initially, the individual may appear to be intoxicated due to alcohol, as those are the initial symptoms of a barbiturate overdose. Signs and symptoms of a barbiturate overdose include:
- Shallow breathing, or even breathing that has stopped
- Altered level of consciousness
- Cognitive disruption
- Appearing uncoordinated
- Low blood pressure
- Slurred speech
- Skin rash
- Faint pulse
- Possible kidney failure
- Heart failure
If an overdose is suspected it is imperative that 911 be called immediately.
Emergency Barbiturate Overdose Treatment
Obtaining timely emergency medical interventions for barbiturate overdose treatment is paramount, as one in ten individuals will die from the overdose. The medical personnel will conduct the following actions:
- Determine that the individual’s airway is not blocked
- Order blood and urine tests
- Conduct a chest x-ray
- Conduct an electrocardiogram (ECG)
- Introduce respiratory support, such as intubation or oxygen treatment
- Begin intravenous fluids
- Provide activated charcoal through the mouth or nose to the stomach
- Stomach washing
A dose of 1gram of barbiturates can cause toxic poisoning, and dosage of 2-10 grams can cause death.
When the Overdose is a Suicide Attempt
Barbiturates are powerful sedatives, making them desirable for individuals seeking to end their life. In fact, barbiturates are used for euthanasia and death penalty convictions to induce death. If a loved one has developed the symptoms of depression and has barbiturates in their possession it is essential that the drugs be taken from them. Be aware of the symptoms of depression and the red flags that can indicate suicide risk.
Warning signs of suicide might include:
- Seeming despondent, hopeless, despairing
- Change in eating habits
- Losing interest in activities usually enjoyed
- Appearing anxious or agitated
- Withdrawing from friends and family
- Increased substance abuse
- Sleep disturbances
- Expressing feelings of being overwhelmed
- Expressing guilt or shame, feeling humiliated
- Seeking information or items for suicide plan
- Increased risk-taking behavior
- Excessive fatigue
- Says he or she is a burden to others
- Makes a will, puts affairs in order
- Giving away prized possessions
- Saying goodbye to loved ones
- Talk of death or suicide
Someone who has attempted suicide will benefit from psychiatric intervention after the barbiturate overdose treatment has been completed.
Comprehensive Addiction Treatment for Barbiturate Use Disorder
Treatment for the barbiturate addiction or dependence will involve a full spectrum of therapeutic interventions that work together as an integrated approach to recovery. Treatment can be obtained at either an outpatient or inpatient program, with pros and cons for each.
- Outpatient rehab allows the individual to remain at home while undergoing treatment. There are different levels of outpatient intensity, with the intensive outpatient program being the most often requested. An IOP involves 9 hours a week of recovery programming and lasts for an average of three months. Outpatient rehab offers more flexibility and is available at a lower cost when compared to residential treatment. However, outpatient treatment is best reserved for those individuals with a mild to moderate substance use disorder.
- Residential rehab is the higher standard of care for addiction treatment. The programs involve the client residing at the treatment center for an extended stay of 1-6 months where they will receive intensive treatment and 24-hour support. Inpatient programs provide treatment for individuals with moderate to severe barbiturate addiction or dependence, as well as dual diagnosis treatment.
Treatment elements for barbiturate recovery include:
Medically supervised detox and withdrawal: Barbiturate detox and withdrawal is potentially dangerous, with risks surpassing those involved with alcohol or benzodiazepine detox. Therefore, a barbiturate detox effort should always be medically supervised, as potentially serious withdrawal symptoms can suddenly emerge. Detoxification is conducted under the supervision of a doctor who will prepare a detox plan for the individual. The first phase is to switch the individual to a benzodiazepine, and then followed by a scheduled tapering process to wean the individual off of the benzo. Withdrawal symptoms are carefully monitored, and medical interventions are provided to help minimize discomfort.
Individual psychotherapy: Therapy is an essential core element for treating the barbiturate addiction and any co-occurring mental health conditions, such as depression. The therapist will guide the individual to examine any potential underlying psychological issues and then help them resolve them. Some of the evidence-based psychotherapies used in addiction treatment include:
- Cognitive behavioral therapy
- Dialectical behavior therapy
- Contingency management
- Motivational enhancement therapy
All of these psychotherapies target behavioral changes, as well as shifting thought patterns away from negative, irrational thoughts to more affirming, productive thoughts.
Group counseling. Group therapy supports peer interaction through opportunities to share personal trials and experiences. Meeting with others who can relate to addiction or chemical dependence can provide a source for sharing and mutual accountability.
Medication management. To date there is no medication available that targets barbiturate addiction. However, if the individual is struggling with a co-occurring mental health disorder, the doctor can prescribe medications for help manage the symptoms.
Relapse Prevention: Individuals create a detailed relapse prevention strategy by identifying specific triggers or situations that could lead to barbiturate relapse, and then create an actionable response plan for when cravings or other triggers threaten sobriety.
Complementary activities: Addiction treatment now includes such adjunctive measures as recreational therapy, nutritional counseling, and holistic methods for promoting relaxations, such as yoga class, art therapy, massage, and meditation.
Continuing care services: Following completion of the treatment program, continuing care activities that help reinforce recovery are strongly advised. These might include staying for a few months in sober living housing, joining a 12-step community, and continuing outpatient therapy.
Individuals who have experienced a barbiturate overdose can reform their lives through comprehensive addiction treatment interventions.
Ken Seeley Communities Provides Barbiturate Addiction Treatment
Ken Seeley Communities is a comprehensive addiction and dual diagnosis treatment center in Palm Springs, California. Ken Seeley was an intervention specialist who was featured on the hit A&E series, Intervention, as well as an invited guest on several networks to talk about his effective intervention techniques. Ken Seeley founded Ken Seeley Communities with the intention of serving individuals seeking effective treatment for addiction recovery.
Ken Seeley Communities provides all aspects of barbiturate addiction treatment, including interventions, outpatient rehab, residential rehab, dual diagnosis treatment, sober living housing, and continuing care services. Our focus is on early intervention and comprehensive treatment, all within the context of a compassionate and respectful treatment environment. For more details about our intervention services and barbiturate recovery programs, please contact Ken Seeley Communities today at (877) 744-0502.