Phenobarbital is a long-acting barbiturate used to treat seizures, anxiety, and withdrawal symptoms in those suffering from a drug or substance dependence problem. It may also be prescribed to treat other conditions.
Barbiturates like phenobarbital are highly habit-forming and very dangerous to mix with many drugs and substances. For these reasons, barbiturates are not as commonly prescribed as they once were.
Benzodiazepines and other medications have risen in popularity as safer alternatives for many of the conditions once treated by barbiturates. However, phenobarbital and other barbiturates are still prescribed and used in hospital settings. Many doctors consider phenobarbital to be safe and effective when used as directed.
Phenobarbital is the oldest epilepsy medication still on the market. Today, it is mostly prescribed as a seizure medication rather than for anxiety or sleeping problems.
Phenobarbital and barbiturates are still sold on the illicit street market as well.
Many users of phenobarbital — whether they began using the drug as they were prescribed or recreationally — become dependent. The road to recovery can be a long and difficult one, especially because the withdrawal symptoms from phenobarbital can be extremely uncomfortable and even dangerous and life-threatening.
As a barbiturate, phenobarbital works as a depressant in the central nervous system, slowing activity in the brain.
Most commonly, phenobarbital is taken as a tablet. It may also be ingested as a liquid elixir or injected.
Taken as a tablet or in liquid form, the drug will begin to take effect in about 30 to 60 minutes, and it will last from five to 12 hours.
The half-life of phenobarbital is around 80 hours in adults, and 110 hours in children.
Phenobarbital is excreted through urine after being metabolized in the liver.
It can be detected by a urine drug test for up to 15 days after a dose, resulting in testing positive for barbiturates.
Barbiturates, including phenobarbital, are highly addictive and habit-forming.
This is one reason their use has been in decline as safer drugs have entered the market.
Users develop a tolerance to the drug, which increases the risk of abuse. Users may need to take higher and higher doses to achieve the desired effect.
This makes the drug very addictive, and it also increases the likelihood of an overdose, as users take higher doses over time.
Phenobarbital is a serious medication with a wide range of side effects, which include:
If an individual is experiencing severe side effects after taking phenobarbital — whether they’ve taken the drug recreationally or as prescribed — they should seek medical attention immediately.
If someone takes phenobarbital and begins to show signs of a serious reaction, emergency care should be sought out immediately. The following may be signs of an allergic reaction or overdose:
In addition to dependency problems and possible allergic reactions, phenobarbital has other potential dangers.
Whether an individual uses phenobarbital recreationally or as a prescription medication, they will likely exhibit symptoms of use, which may include:
Symptoms that appear to be worsening may signal that a person is falling deeper into phenobarbital addiction.
Increased use and phenobarbital abuse may be indicated if an individual:
Phenobarbital withdrawal can be severe and even life-threatening. Often compared to alcohol withdrawal, but perhaps more dangerous, phenobarbital withdrawal should only be attempted under medical care.
Seizures are very common during acute barbiturate withdrawal and can be fatal.”
Because of the dangers involved, a medical professional will often gradually reduce a user’s phenobarbital dosage very slowly. This is safer and less unpleasant for the individual.
In addition to seizures and convulsions, withdrawal symptoms may include the following:
Users may also experience extreme confusion during withdrawal from phenobarbital. This confusion is similar to what is often experienced by individuals who are dependent on alcohol during detox. It is called delirium tremens (DTs). Symptoms of this include:
If untreated, this extreme withdrawal sickness can lead to high fever, heart failure, and death.
Withdrawal symptoms may be more severe for those who have taken phenobarbital long term as well as for those who have developed a high tolerance and are, therefore, accustomed to a higher dose.
The initial phase of phenobarbital treatment will be medical detox. This should be done in a treatment center with trained medical professionals.
These professionals will create a strategy for withdrawal, usually weaning an individual off phenobarbital at a slow and steady level to avoid the most dangerous and uncomfortable side effects of detox.
Most individuals will feel relief from the physical effects of withdrawal within 14 days.
After physical withdrawal, an individual still has to overcome their psychological addiction to phenobarbital. This is why a comprehensive treatment program is necessary for true recovery.
When choosing a treatment center, it’s important to look for a facility with medical staff trained in barbiturate withdrawal so that they can provide relief during the extremely difficult detox process.
However, it’s just as important to choose a program that offers support for psychological dependency as well. Most individuals with a substance use disorder (SUD) have underlying issues that drove them to addiction in the first place. They may have been self-medicating to treat their own depression, anxiety, or trauma.
Without addressing these concerns, they will likely be triggered to return to barbiturate use, or another substance, after detox.
Choosing a treatment center that offers a full range of therapy services is the best way to ensure that an individual is ready to reenter society. Options like cognitive behavioral therapy (CBT) will help an individual to identify triggers in their everyday life that may have led them to drug use before. It will also help them to develop new habits and better coping skills.
Although less popular now than in the 20th century, barbiturates like phenobarbital are still used recreationally and to treat conditions like epilepsy.
While safe when used as prescribed, particularly in a medical setting, these drugs have many side effects and are highly habit-forming, with a high potential for abuse and overdose. Because withdrawal effects can be severe and even life-threatening, users should never attempt to quit on their own or to quit abruptly.
Instead, they should seek out a medical facility that can offer a safe withdrawal strategy as well as intensive therapy, allowing for full recovery.
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