Concurrent Alcohol and Phenobarbital Abuse
The Problem of Alcohol and Phenobarbital Abuse
The dangers of addiction and overdose are greatly increased when phenobarbital is combined with alcohol.
Phenobarbital (trade name: Luminal) is a prescription barbiturate that is used primarily as an anticonvulsant to treat patients with seizures. Phenobarbital has been used to treat many different types of seizures for over 100 years. It is also used occasionally for insomnia and anxiety and to treat withdrawal symptoms caused by other drugs such as alcohol.
Like all barbiturates, phenobarbital can produce physical dependence and addiction in some people, and the dangers of addiction and overdose are greatly increased when phenobarbital is combined with alcohol. As a barbiturate, Luminal produces sedative effects, including;
Because of its potential for abuse, phenobarbital is classified as a Schedule IV controlled substance by the Drug Enforcement Agency (DEA).
Phenobarbital, like other barbiturates, can produce tolerance and dependence in individuals who take it excessively or for a long period of time. Combining Luminal with alcohol is likely to significantly increase these risks.
Alcohol and Phenobarbital Abuse question 1
Alcohol and Phenobarbital Abuse question 2
Signs and Symptoms
The combination of phenobarbital and alcohol intensifies each drug's sedative, euphoric effects. Unusual behavior may be an outward indicator that someone is under the influence of Luminal and alcohol. The side effects of both of these substances are similar and include:
Phenobarbital, Alcohol, and GABA
Phenobarbital increases the action of GABA receptors in the brain. These neurotransmitter receptors are targeted by many sedative drugs, and their activation elicits the drowsy, relaxed feelings most sedatives produce in users.
Alcohol also activates GABA receptors in the brain, so when Luminal and alcohol are used together, they reinforce each other's effects. Their central nervous system (CNS) depressant effects are intensified and felt more quickly.
- Loss of coordination.
- Syncope / loss of consciousness.
*In rare cases, phenobarbital can also cause symptoms including:
- Slowed breathing or difficulty breathing.
- Rash or blistering of the skin.
- Swelling of the eyes, lips, or cheeks.
Alcohol and Phenobarbital Abuse question 3
Alcohol and Phenobarbital Abuse question 4
Effects of Alcohol and Phenobarbital Abuse
Phenobarbital is a "long-acting" barbiturate, which increases the potential danger for dependence and overdose because the drug's effects will continue for a longer period of time than other barbiturates.
Alcohol greatly increases the danger of a lethal overdose because it enhances the effects of Luminal, which can reduce breathing and brain activity to dangerously low levels.
Development of Addiction
If an individual takes Luminal for a long period of time, especially at higher doses than recommended and with alcohol, they will typically begin to develop dependence on these substances and experience negative consequences to their health and their life. Addiction to phenobarbital and alcohol can cause:
- Changes in alertness.
- Significant impairment of driving ability.
- Memory loss.
- Drug-seeking behavior, such visiting multiple different doctors to get Luminal.
- Suicidal ideation.
- Anxiety when unable to obtain/use the substances.
Alcohol and Phenobarbital Abuse question 5
Alcohol and Phenobarbital Abuse Treatment
Withdrawal symptoms, ranging from merely uncomfortable to life-threatening, have long been known for people dependent on both alcohol and phenobarbital. Serious withdrawal symptoms are similar for both substances, as well as their combination, and may include:
- Anxiety and panic attacks.
It is highly recommended that withdrawal from Luminal and alcohol be conducted under the supervision of trained medical staff at an inpatient medical or drug rehabilitation facility. The detox process from alcohol can result in seizures and can actually be deadly for long-term alcohol abusers. Supervised medical detox can ensure your safety during withdrawal and may administer certain medications to make the experience more comfortable.
In addition to ensuring the safety and health of addicted individuals during withdrawal, counseling staff at these facilities can recommend sources of assistance and options available to help users confront their disease and recover from addiction. General types of recovery services include:
- Inpatient and residential treatment facilities that can provide full-time care, supervision, and support.
- Intensive outpatient programs that offer assistance and support, while also allowing you to remain at home and fulfill work and family obligations.
- Peer recovery organizations including SMART Recovery, LifeRing Secular Recovery, or 12-step groups, where people who share the disease of addiction offer their experience and mutual support in recovery.
Alcohol and Phenobarbital Abuse question 6
These are some important statistics showing the extent of phenobarbital abuse, both alone and with alcohol:
- According to the National Survey on Drug Use and Health and Health (NSDUH), nearly 850,000 people in the U.S. over the age of 12 have used phenobarbital for non-medical reasons at some point in their lives.
- The National Institutes of Health (NIH) reports that overdosing on barbiturates like phenobarbital, either alone or combined with alcohol, results in death for about 1 in 10 people.
- A recent study in New York City revealed that 2% of overdose suicides in elderly persons were due to barbiturates.
Teen Alcohol and Phenobarbital Abuse
Although rates of phenobarbital abuse peaked in the 1960s and 1970s and has since declined due to increased legal controls and a trend toward the medical use of non-barbiturate sedatives, a gradual increase in the abuse of this drug has been documented in high school seniors over the last decade.
Among younger users, phenobarbital is known by the following slang terms:
- Purple hearts.
Although it is unclear why teen abuse of this drug is rising, young people may be attracted by the fact that by combining Luminal and alcohol, strong effects can be felt using smaller amounts of each substance.
It is also possible that the lack of negative media coverage of phenobarbital compared to other prescription drugs, such as oxycodone or codeine, makes this drug seem less dangerous. Unfortunately, by combining Luminal with alcohol, taking even a small amount more than the suggested dose can be lethal.
Education is the best way to prevent abuse, so it's extremely important to talk to your teen about the risks of abusing prescription drugs and combining any drug with alcohol.
Resources, Articles, and More Information
Check out the following articles for more information on alcohol and phenobarbital abuse and recovery:
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- 2013 Tables: Illicit Drug Use - 1.47 to 1.92 (PE), SAMHSA, CBHSQ. (n.d.). Retrieved September 5, 2015 from http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect1peTabs47to92-2013.htm
- Phenobarbital: MedlinePlus Drug Information. (n.d.). Retrieved September 5, 2015, from https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682007.html
- Barbiturate Toxicity. (n.d.). Retrieved September 5, 2015, from http://emedicine.medscape.com/article/813155-overview#showall
- Alcohol use disorder. (n.d.). Retrieved September 5, 2015, from http://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/basics/definition/con-20020866?reDate=04112015