ADDICTION TO BARBITURATES AND THE BARBITURATE ABSTINENCE SYNDROME

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Abstract
Chronic intoxication with barbiturates is a true addiction. The same phenomena observed in addiction to narcotics are also present in chronic barbiturate intoxication[long dash]tolerance, emotional dependence and physical dependence. The symptoms and signs of maintained chronic barbiturate intoxication include impairment of mental ability, confusion, regression, emotional instability, nystagmus, dysarthria, adiadokokinesis, tremor, hypotonia, ataxia in gait and station and depression of the superficial abdominal reflexes. A characteristic train of symptoms follows abrupt withdrawal of barbiturates from chronically intoxicated persons. The barbiturate abstinence syndrome is characterized by diminution of signs of intoxication which is followed by weakness, tremor, insomnia, great anxiety, anorexia, nausea and vomiting, rapid wt. loss, elevation of pulse and respiratory rates, increase in blood pressure, difficulty in making cardiovascular adjustments on standing, convulsions of grand mal type and the development of a psychosis. The delirium observed in the withdrawal of barbiturates resembles alcoholic delirium tremens and is characterized by anxiety, agitation, fever, insomnia, confusion, disorientation chiefly in place and time but not in person, delusions, and auditory and visual hallucinations. Recovery from chronic barbiturate intoxication and the barbiturate abstinence syndrome is complete so far as can be detd. by clinical means and by psychometric testing. Abrupt withdrawal of barbiturates from addicted persons is contraindicated. The only method of withdrawal which is known to be safe involves careful, slow reduction of the dosage of barbiturates.

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