Barbituromaniya – abuse of medicines on the basis of barbituric acid. Can result from long reception of the medicines prescribed by the doctor (for example, at chronic sleeplessness) or the uncontrollable use for the purpose of euphoria development. The state after reception of barbiturates reminds alcoholic intoxication, HELL and a pulse urezheniye is followed by a rastormozhennost, increase in mood, an incoordination, decrease. At overdose violations of consciousness and death as a result of oppression of the respiratory center are possible.
Barbituromaniya – dependence on medicines from group of barbiturates. Earlier such medicines often wrote out for fight against sleeplessness. Now the scope of these medicines was significantly reduced that caused decrease in prevalence of a barbituromaniya. In risk group of development of a barbituromaniya people who on medical indications need to accept means on the basis of barbituric acid belong. Besides, the barbituromaniya is quite often observed at patients with alcoholism and drug addiction.
Distinctive feature of a barbituromaniya is the wide variation of a time span from the moment of the first reception of medicine until dependence emergence (of several years at the use on medical indications up to several weeks or months at uncontrolled reception). At a barbituromaniye bystry development of a psychoorganic syndrome is noted, a frequent recurrence is observed. The forecast is adverse. Treatment of a barbituromaniya is performed by experts in the field of narcology.
Barbiturates and development of a barbituromaniya
Barbiturates – medicines on the basis of barbituric acid: barbamit, barbital, phenobarbital, etaminal-sodium, barbital-sodium etc. In this group also belongs once popular among addicts , now entered in the list of narcotic substances and withdrawn from the use. Earlier barbiturates were widely used as hypnotic drugs and demulcents, however in the subsequent at overdose and possible development of a barbituromaniya scope of these medicines was significantly reduced because of dangerous effects.
As well as benzodiazepines, means from group of barbiturates interact with certain receptors of a brain. Decrease in excitability of nervous system and delay of transfer of nervous impulses is result of this interaction. Barbiturates have the calming, somnolent and anticonvulsive effect, promote relaxation of muscles, reduce the level of alarm and fear. At reception of moderate doses of medicines there is a state reminding alcoholic intoxication.
At regular reception of barbiturates on medical indications (now, generally as anticonvulsive means) the barbituromaniya develops slowly, usually – within several years. Abuse is stimulated with two factors: obsessivny (not narkomanichesky) dependence and casual detection of euphoric effects of medicine. Over time euphoria becomes the main internal incentive for acceptance of medicine, and appointment of the doctor is considered as "good reason", a justification to the actions.
Essentially other situation is observed among the people abusing drugs or alcohol. They begin to use barbiturates for achievement of euphoria at once, quite often using them in combination with other psychoactive agents that leads to development of polydrug addiction. Physical dependence in similar cases often develops within several months after the first reception. Bystry increase in a dose is characteristic of this type of a barbituromaniya. There is a high danger of overdose.
At reception of barbiturates the stirred-up inconsiderate behavior, senseless activity and improvement of mood which can be replaced by rage, anger or irritation is observed. Aggression attacks are possible. In general symptoms of barbituric euphoria remind a picture of alcoholic intoxication. The static ataxy and expressed an incoordination of movements is noted. Expansion of pupils, falling HELL, decrease in temperature and reduction of heart rate comes to light. 1-3 hours later after reception of barbiturates the patient falls asleep, and after awakening feels sluggish and weak. At overdose there are violations of consciousness up to a coma, at paralysis of the respiratory center there comes death.
At constant reception tolerance to barbiturates increases. The medicine dose necessary for achievement of euphoria increases several times. At the patients suffering from a barbituromaniya change of symptoms of intoxication is observed. Expressiveness of euphoria decreases. After the use of medicine there is a rage and irritability. Tendency to aggressive behavior is noted: to the conflicts, fights, destruction of property. An incoordination of movements become less expressed over time. The aggression combination to preservation of ability is good to own the body do sick with a barbituromaniya dangerous to other people.
Over time there are symptoms of chronic intoxication. The patients suffering from a barbituromaniya become scattered. They suffer from differences of mood, experience difficulties in attempt to concentrate attention. At a barbituromaniye memory violations often come to light, fiksatsionny amnesia – loss of ability to remember just taken place events (for example that the patient ate for lunch where he went that did and whom met a few hours ago etc. is especially widespread).
From the patient can look barbituromaniy as the indecisive person who is not quite realizing where he is and that happens to him. He badly understands explanations and instructions of people around, poorly is guided in the changing situation. The sense of his answers is not clear, the speech is muffled, gait is not strong. All this can make a deceptive impression of helplessness and inoffensiveness. However the mood of the patients suffering from a barbituromaniya can change very quickly. Their reactions are unpredictable. Sudden irascibility and attacks of aggression is possible (including physical).
At survey of patients with a chronic barbituromaniya neurologic frustration come to light: atactic change of gait, trembling of hands, dizartriya, gipomimiya, illegibility and illegibility of handwriting. Tendinous reflexes decrease. In hard cases against the background of the progressing violations of memory, lack of criticism to own state, intellectual decrease and violations of the speech patients with a barbituromaniya have a clinical picture reminding pseudo-paralysis.
At cancellation of medicine at the patients suffering from a barbituromaniya the heavy abstinence syndrome develops. The increasing weakness and increased fatigue is noted. Paresteziya are possible. For 2-3 day sleep disorders and the expressed uneasiness in combination with convulsive twitchings of muscles develop. In the subsequent to the forefront there is an adynamy in combination with violations from digestive tract (belly-aches, nausea and vomiting). In 4-5 days the generalized attacks reminding attacks at epilepsy can develop. In intervals between generalized attacks clonic spasms without consciousness loss are possible. At some patients with a barbituromaniya sharp psychotic frustration on type a deliriya or hallucinosis are observed.
Treatment and the forecast at a barbituromaniye
Sick with a barbituromaniya hospitalize in a narcological hospital. Unlike other types of dependence, psychoactive agent is cancelled not in one stage, and gradually, reducing a dose within 1-2 weeks. The sharp termination of administration of drugs is contraindicated because of high danger of development of psychoses and epileptiformny attacks. After complete cessation of reception of barbiturates carry out dezintoksikatsionny actions. At a barbituromaniye apply psychotropic drugs, coding with use of gipnosuggestivny techniques to fight against a pathological inclination and various psychotherapeutic methods. After an extract all patients suffering from a barbituromaniya have to be observed within 5 years at the narcologist.
The forecast at a barbituromaniye adverse. At the use of barbiturates there is a high risk of development of dangerous complications. Deadly overdoses, suicide attempts, accidents and criminal incidents are possible. A frequent recurrence is celebrated. Intellectual decrease in combination with a psychoorganic syndrome is reduced by chances of full social rehabilitation of patients with a barbituromaniya and increase probability of failures. The possibility of successful treatment increases at intellectual safety and active desire of patients to get rid of dependence.