Accidents and Deaths Among Young Adults Due to the Illegal Use of the Drug Known As Barbiturates

Accidents and Deaths among Young Adults Due to the Illegal Use of the Drug Known as Barbiturates

A Research Paper Presented to the Faculty and Students of The College of Arts and Sciences

In Partial Fulfilment Of the Course Grammar and Composition II

Submitted by:

Mishel Ablao Raymart Los Banos Ma. Noven Canales Lourelle Mae Ocon Jea Cordova Coleen Joy Pitogo Sherry Lynn Lim Lianting

March 2011

Acknowledgement

Our group would like to acknowledge and thank first and foremost, our Heavenly

Almighty Father for giving us wisdom, knowledge and understanding to fulfil this task with excellence. Without His guidance, this research will not be possible. We are forever grateful to Him.

We would like to thank our mentor and English 12 teacher, Mrs. Liezl Jay

Gantuangco, for teaching us the correct ways of doing a research and instilling the correct attitude towards research which we will need in the coming years. We thank her for her efforts and patience in correcting and guiding our research from the beginning until the end.

We also acknowledge the vast collection of materials and references of the CDU

Library which were very helpful in giving strong primary resources and data for our research. Its services made our research easier to conduct.

Lastly, we acknowledge the efforts done by everyone who contributed to the making of this research, fellow group mates and people who gave information that this study benefited.

Table of Contents Title Page 1

Acknowledgement 2

Introduction 4

Problem Statement 6

Objectives 8

Rationale and Limitation of the Study 9

Discussion 10

Conclusion and Recommendation 15

Definition of Terms 17

Bibliography 19

Curriculum Vitae 20

Introduction

The drug Barbiturate is derived from Barbituric acid. Barbiturates were first used in medicine in the early 1900s and became popular in the 1960s and 1970s as treatment for anxiety, insomnia, or seizure disorders. With the popularity of barbiturates in the medical population, barbiturates as drugs of abuse evolved as well. Barbiturates were abused to reduce anxiety, decrease inhibitions, and treat unwanted effects of illicit drugs. Barbiturates can be extremely dangerous because the correct dose is difficult to predict. Even a slight overdose can cause coma or death. Barbiturates are also addictive and can cause a life-threatening withdrawal syndrome.

Barbiturate use and abuse has declined dramatically since the 1970s, mainly because a safer group of sedative-hypnotics called benzodiazepines are being prescribed. Benzodiazepine use has largely replaced barbiturates in the medical profession, with the exception of a few specific indications. Doctors are prescribing barbiturates less, and the illegal use of barbiturates has also substantially declined,although barbiturate abuse among teenagers may be on the rise compared with the early 1990s. Addiction to barbiturates, however, is uncommon today.

Barbiturates can, in most cases be used either as the free acid or as salts of sodium, calcium, potassium, magnesium, lithium, etc. Codeine- and Dionine-based salts of barbituric acid have been developed. In 1912, Bayer introduced another barbituric acid derivative, phenobarbital, under the trade name Luminal, as a sedative-hypnotic.

In the 1940s, military personnel were given "Goofballs" during WWII in the South

Pacific region to allow soldiers to tolerate the heat and humidity of daily working conditions. Goofballs were distributed to lower the respiratory system and blood pressure to combat the extreme conditions. Many soldiers returned with addictions that caused several months of rehabilitation before being discharged. This led to addiction problems through the 1950s and 1960s.

In the 1950s and 1960s, increasing reports began to be published about barbiturate overdoses and dependence problems, which eventually led to the scheduling of barbiturates as controlled drugs.

In 1970, several barbiturates were designated in the United States as controlled substances with the passage of the American Controlled Substances Act of 1970.

Pentobarbital, secobarbital and amobarbital were designated schedule II drugs, butabarbital schedule III, and barbital and phenobarbital schedule IV.

In 1971, the Convention on Psychotropic Substances was signed in Vienna.

Designed to regulate amphetamines, barbiturates, and other synthetics, the treaty today regulates secobarbital, amobarbital, butalbital, cyclobarbital, and pentobarbital as schedule III, and allobarbital, methylphenobarbital, phenobarbital, and vinylbital as schedule IV scheduled substances.

Problem Statement

Researches from the past have reported that barbiturate drugs can cause death if used without proper supervision. Some may be because of accidental overdose while others are caused by long-term use of drugs or during withdrawal process.

Barbiturates users and addicts may experience short-lived relief from emotional tension accompanied by some of the following reactions: contraction or dilation of the pupils, or no discernible reaction to light; difficulty and slowness in thinking and remembering; drowsiness; difficulty or inability to walk straight; jerky, irregular movements; slurred speech; twitching, trembling hands, shaking; stupefaction; the feeling of living in a fantasy world; belligerency; depression; the possibility of suicidal thoughts and actions; slow reaction time, mentally and physically; garrulity; and silliness.

As mentioned before, the degree of severity of intoxication depends upon the psychological make-up of a person and the kind and quantity of the drug taken. It should be noted that if barbiturates are used in combination with alcohol, the intoxication, that results is more severe than if either is used alone.

In general, barbiturates may cause such side effects as impaired judgment, poor motor coordination, and slurred speech. Some individuals develop a tolerance to barbiturates, and they may also develop a physical dependence and a psychological dependence on these drugs

When used frequently, barbiturates can suppress rapid eye movement (REM) sleep, during which dreaming occurs. When the drug is stopped, REM periods are

6 extended and the person may experience distressing nightmares. This condition is called the REM-sleep rebound effect (also called "rebound dreaming"). In addition, the day after REM-sleep rebound, the individual usually feels irritable and tired

Depending on the length of use and the amount of the drug used, withdrawal symptoms can range from restlessness and anxiety to convulsions and death. The danger of sudden death during barbiturate withdrawal is a major concern.

(http://www.wikipedia.com February 2011)

Objectives

1) How will the people be informed of the consequences of Illegal Use of

Barbiturates?

2) What promotions had to be done to make the people be aware of the prevention

of the deaths caused by drug overdose?

3) How will medical practitioners and other members of the healthcare team further

enhance and update their knowledge on drug information?

Rationale and Limitation of the Study

This study is propelled by the desire in particular to learn and know why young people become involved in barbiturates abuse and what can be done to help prevent it. The limitation of the study is the fact that not much of the cases have been solved or prevented and researchers are still conducting extensive animal research to uncover the underlying action of the stimulants and depressants and try to find out how psychological or physical dependence develops. Many are still searching for new drugs and techniques to treat overuse and dependence on the barbiturates. The study may contribute to the literature that can help resolve these problems to the society.

A Closer Look on the Study

As mentioned before, Barbiturates were synthesized from the Barbituric acid.

They are classified as sedatives, or depressants of the central nervous system (CNS).

These drugs destroy or decrease sensation from mild to total anaesthesia. Its primary dosage form is in pills, because it is commonly prescribed as sleeping pills. It could also be in IV (intravenous) form.

Barbiturates are prescribed to patients who are suffering from epilepsy, high blood pressure, insomnia, anxiety and seizure disorder because they decrease or slow down the nerve activities, which results to emotion control and the feeling of calm.

However, these drugs cannot be taken excessively because it may cause dependence and overdose.

Taken in normally, and supervised doses, the therapeutic effect of this drug can be achieved. Nerve actions, work of the heart muscle and other muscles will be depressed. But in higher doses, effects could be the same with alcohol drunkenness.

(Williams 1974)

Barbiturates are highly dangerous when taken without medical advice and prescription. This is because the therapeutic dose of the drug is very close to its lethal dose. These were used to commit suicide in the past; and can also cause death due to overdose. A barbiturate overdose results when a person takes a larger-than-prescribed dose of barbiturates. Some symptoms of an overdose typically include sluggishness, difficulty in thinking, shallow breathing, unconsciousness, sometimes coma and worse— it can lead to sudden death. (Williams 1974)

Many accidents of barbiturate overdose have been reported to the authorities.

Several factors contribute to this phenomenon. First, the overdose is a result of a failed suicide attempt. Second, the person illegally used the drug or has been taking it longer than it was directed. Third, there were errors on the administration of the drug to the patient.

However, the overdose depends on the type of Barbiturate used. Barbiturates range from short –acting, fast- starting; long-acting, slow- starting. The short- acting ones are usually the most abused. Below is a table of types of barbiturates and their street names.

Varieties of Barbiturates

TRADE NAME PHARMACOLOGICAL SLANG/STREET NAME NAME 1. Seconal (Eli Lilly and Secobarbital sodium Reds, Red Birds, Pinks, Co.) Red Devils, etc. 2. Nembutal (Abbott Pentobarbital sodium Yellows, Yellow Jackets, Laboratories) Nembies, etc.

3. Tuinal (Eli Lilly and A combination of Rainbows, Reds and Blues, Co.) Amobarbital sodium and etc. Secobarbital sodium 4. Amytal (Eli Lilly and Amobarbital sodium Blues, Blue Birds, Blue Co.) Heavens, etc. 5. Phenobarbital Barbs, Slow-downs

(William, 1974)

These drugs are highly addictive. It is because the body can easily build tolerance to this substance. Thus, increase in dose is required to achieve the said effect of the drug. Some experts even think that Barbiturate addiction is harder to cure compared to narcotic dependency since the withdrawal stage of this drug is very critical and dangerous and really needs full-time medical supervision. The withdrawal process of this drug can occur with nausea, convulsions, delirium, and in some cases, sudden death. That is why it is necessary to bring the patient to the hospital during his withdrawal stage.

A lot of young adults in the United States are victims of Barbiturate addiction or overdose. This is because Barbiturates are easy to acquire since it is generally prescribed as sleeping pills. Common reasons for drug abuse are depression, stress, peer pressure/ curiosity and suicide attempts. It is alarming that young adults turn to drugs for the short-relief from anxiety or other stress-related factors.

A barbiturate user is hard to tell compared to other substance abusers because unlike the alcohol, there is no odor of barbiturate that is present. There are no needle marks like in opiate addiction. Only, the barbiturate user may appear to be intoxicated and most manifestations are mental-related.

Once a person is suspected to be a user of barbiturate, it is necessary to take action so that complications can be prevented. Medical attention is highly recommended at this stage. Without a medical professional attending to a barbiturate user, his case might worsen and his body might suffer other complications.

Below are sample cases of Barbiturate addiction, overdose or death due to any of these.

Case 1

A user, 15 years of age, has abusively and addictively taken a large amount of barbiturates due to some personal issues. One issue that he has difficulty in dealing with was the divorce of his parents. He said it helped him relax and feel nothing from pain and it felt like normal and crazy. The drug caused him a low blood pressure and decrease heart rate which almost lead him to cardiovascular collapse.

Case 2

Mary Anissa Jones (March 11, 1958 – August 28, 1976) was an American child actress known for her role as Buffy on the CBS sitcom Family Affair. She died from combined drug intoxication at the age of 18.

Five and a half months later, in the early morning hours of August 28, 1976 after partying all night in the beach town of Oceanside, California with her new boyfriend

Allan (Butch) Koven and others, Jones was found dead in the bedroom of a house belonging to a 14-year-old friend named Helen Hennessey.[3] The coroner's report listed her death as an accidental drug overdose.[6] Cocaine, PCP, Quaaludes and

Seconal Barbiturates were found in her body during an autopsy. The coroner who examined Jones reported she had died from one of the most severe drug overdoses he had ever seen.

Case 3

Dickie Pride (21 October 1941 — 26 March 1969[1] was a British rock and roll singer. On 26 March 1969, Pride was found dead in his bed. He died at the age of 27 due to an overdose of sleeping pills

Case 4

Marilyn Monroe was found dead in the bedroom of her Brentwood home by her psychoanalyst Ralph S. Greenson after he was called by Monroe's housekeeper Eunice

Murray on August 5, 1962. She was 36 years old at the time of her death. Her death was ruled to be "acute barbiturate poisoning" by Dr. Thomas Noguchi of the Los

Angeles County Coroner’s office and listed as "probable suicide".

According to an article in The New York Times, use of sleeping pills in young adults and college-aged students nearly tripled in the past decade. Among the users of sleeping pills, those who age 18-24 years old had the most number of increases from

599 users per 100,000 in 1998 to 1,524 users per 100,000 in 2006.

(http://www.nytimes.com/2009/01/15/health/15sleep.html?_r=1 .March 2011)

This phenomenon is alarming. Sleeping pills prescription must be strictly monitored by physicians and pharmacists should properly dispense these drugs. The medical team should work hand in hand so that cases like these can be prevented. But

the mass should not also abuse the privilege of the effects of these drugs because

abusing substances can cause problems to themselves and the society.

Conclusion and Recommendation

Ergo, we conclude that, individuals abusing barbiturates frequently underestimate the potential danger. Tolerance can build easily due to regular and prolonged use of barbiturates and the user cannot always assess how much the body can handle without overdosing. It is not that barbiturates themselves lead to increased attempts of suicide, but rather, it is the lethal dose of barbiturate which is close to the therapeutic dose. As a result, an overdose of barbiturates in a suicide attempt is more likely to be successful than an overdose of many other drugs.

Based on the findings, the following recommendations were formulated to avoid accidental deaths and overdosing among users. The patient should consult the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage. For physician/pharmacist, factors should be considered like recommending dosage which depends on the type of barbiturate and other factors such as the patient's age and the condition for which the medicine is being taken. Patients should always take barbiturates exactly as directed.

Larger or more frequent doses should never be taken and the drug should not be taken for longer than directed. If the medicine does not seem to be working, even after taking it for several weeks, the patient should not increase the dosage. Instead, the physician who prescribed the medicine should be consulted.

People taking barbiturates should not stop taking them suddenly without first checking with the physician who prescribed the medication. It may be necessary to taper the dose gradually to reduce the chance of withdrawal symptoms. Taking an overdose of barbiturates or combining barbiturates with alcohol or other central nervous system depressants can cause unconsciousness and even death. Anyone who shows signs of an overdose or a reaction to combining barbiturates with alcohol or other drugs should get emergency medical help immediately. If it is necessary to stop taking the drug, the patient should check with the physician for instructions on how to stop. If a user is to remain drug-free, follow-up treatment, usually with psychiatric help and resort to community resources, is vital.

Lifestyle changes such as avoiding people, places, and things related to sedative use should be encouraged. Initial psychosocial treatment should focus on confronting denial, teaching the disease concept of addictions, fostering identification as a recovering person, recognition of the negative consequences of sedative abuse, avoiding situational and intrapsychic cues that stimulate craving and formulation of support plans.

Definition of Terms

 Barbiturates-are drugs that act as central nervous system depressants, and, by

virtue of this, they produce a wide spectrum of effects, from mild sedation to total

anesthesia. They are also effective as anxiolytics, as hypnotics, and as

anticonvulsants. They have addiction potential, both physical and psychological.

Barbiturates are derivatives of barbituric acid.

 Benzodiazepine- is a psychoactive drug whose core chemical structure is the

fusion of a benzene ring and a diazepine ring. Benzodiazepines enhance the

effect of the neurotransmitter gamma-aminobutyric acid (GABA), which results in

sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant,

muscle relaxant and amnesic action.

 Depressants- are psychoactive drugs that temporarily reduce the function or

activity of a specific part of the body or brain. This is widely used throughout the

world as prescription medicines and as illicit substances. Anaesthetics,

sedatives, tranquillizers and alcohol are examples of depressants.

 Dose- a quantity of a medicine or drug taken or recommended to be taken at a

particular time

 Drug- a medicine or other substance which has a physiological effect when

ingested or otherwise introduced into the body

 Sedative or tranquilizer- is a substance that induces sedation by reducing

irritability or excitement. At higher doses it may result in slurred speech,

staggering gait, poor judgment, and slow, uncertain reflexes; a drug with a

soothing, calming effect.

 Withdrawal Symptoms- the unpleasant physical reaction that accompanies the

process of ceasing to take an addictive drug

Bibliography Books

 Williams, John B. Narcotics and Drug Dependence. Glencoe Press,1974.

Websites

 http://www.wikipedia.com

 http://www.facebook.com/l.php?u=http%3A%2F%2Fbooks.google.com.ph%2Fbo oks%3Fid%3DzkgrAAAAYAAJ%26pg%3DPA1%26lpg%3DPA1%26dq%3Dbarbit urates%2Bused%2Bas%2Bsuicide%2Bmedium%26source%3Dbl%26ots%3DrB CCEVz0Tx%26sig%3DisvZ8- T08CY0pYzWbrx0WD9rLwc%26hl%3Dtl%26ei%3Dqi1qTb71NoPZcY_Y7I0M%2 6sa%3DX%26oi%3Dbook_result%26ct%3Dresult%26resnum%3D4%26ved%3D 0CDQQ6AEwAw%23v%3Donepage%26q%3Dbarbiturates%2520used%2520as %2520suicide%2520medium%26f%3Dfalse&h=ccaf6cIDPwc1fSb10kh3N4tnsmA February 27, 2011.

 http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.essayempire.com%2F customessay%2Fdrugs_and_drug_abuse%2Fbarbiturates%2F1491.html&h=ccaf 64tglQ8M_iV7BmUg0EtpHwQ February 27, 2011

Curriculum Vitae

Name: Lourelle Mae D. Ocon

Nickname: Relle, Mae, Lai

City Address: Larrazabal Hall, North Reclamation Area, Mandaue City

Home Address: Poblacion, Talibon, Bohol

Contact number: 09234963607

Age: 17

Sex: Female

Birth date: March 05, 1994

Birth place: Cebu City

Civil status: Single

Citizenship: Filipino

Religion: Roman Catholic

Hobbies: Reading Novels, sleeping

Educational Background

Tertiary: Cebu Doctors’ University

Course & Year: B.S. Pharmacy 1A

Secondary: Blessed Trinity College

Primary: Talibon Central Elementary School

Research Experience: Accidents and Deaths among Young Adults Due to the Drug

Known as Barbiturate

Curriculum Vitae

Name: Sherry Lynn M. Lim Lianting

Nickname: Sherry or Lynn

City Address: 60- 62 Osmena Blvd. Cebu City

Home Address: # 7 Wool Bright Drive, Beverly Hills, Lahug, Cebu City

Contact number: 236-1618

Age: 17

Sex: F

Birth date: February 14, 1994

Birth place: Cebu City

Civil status: Single

Citizenship: Filipino

Religion: Roman Catholic

Hobbies: Watch TV, Chat , Cooking , Playing , Hang out with friends and family

Talents: Leadership, Cooking , Smiling and Negotiating

Educational Background

Tertiary: Cebu Doctor’s University

Course and year: B.S. Pharmacy IA

Secondary: Cebu Eastern College

Primary: Cebu Eastern College

Research Experience: Accidents and Deaths among Young Adults Due to the Drug

Known as Barbiturates

Curriculum Vitae

Name: Mishel Senining Ablao

Nickname: Meesh

City Address: Cebu Doctors' Dormitory, North Reclamation, Mandaue City

Home Address: St. Scholastica Subdivision, Menzi Brgy., Isabela City, Basilan

Contact number: 09266324903, 09283639643, 09333154561

Age: 17

Sex: Female

Birth date: February 15, 1994

Birth place: Calle Visaya Brgy, Isabela City, Basilan

Civil status: Single

Citizenship: Filipino

Religion: Roman Catholic

Hobbies: Surfing the net, eating, listening to music

Talents: Dancing

Educational Background

Tertiary: Cebu Doctors' University

Course and year: B.S. Pharmacy 1A

Secondary: Claret College of Isabela

Primary: Isabela Central Elementary Pilot School

Research Experience: Accidents and Deaths among Young Adults Due to the Drug

Known as Barbiturate

Curriculum Vitae

Name: Ma. Noven E. Canales

Nickname: Nov, Nobiin, Nobinita

City Address: Larrazabal Hall, Cebu Doctors’ University, Mandaue City

Home Address: Cadiz City, Negros Occidental

Contact number: 09398175496

Age: 17

Sex: Female

Birth date: November 8, 1993

Birth place: Cadiz City

Civil status: Single

Citizenship: Filipino

Religion: Christian

Hobbies: Reading is my passion; play my guitar; listen to some music; goof around with friends; Splurge myself on DVD’s; Surf the net; Sing; Sleep and Eat A lot

Talents: Singing, Dancing and Baking

Educational Background

Tertiary: Cebu Doctors' University

Course and year: BS Pharmacy

Secondary: Philippine Normal University

Primary: Philippine Normal University

Research Experience: Accidents and Deaths among Young Adults Due to the Drug

Known as Barbiturate

Curriculum Vitae

Name: Raymart C. Los Baños

Nickname: Ray, Mart, R-mart

City Address: TPI Homes Phase II, Pajac, Lapu-lapu City

Home Address: Johnston Subdivision San Jose Rd. Zamboanga City

Contact num: 09238081529

Age: 17

Sex: Male

Birth date: September 2, 1993

Birth place: Zamboanga City

Civil status: Single

Citizenship: Filipino

Religion: Roman Catholic

Hobbies: Singing, listening to some music, and playing volleyball

Talents: Singing, and dancing

Educational Background

Tertiary: Cebu Doctors' University

Course and year: BS Pharmacy

Secondary : St. Joseph School, Zamboanga City

Elementary: St. Joseph School, Zamboanga City

Research Experience : Accidents and Deaths among Young Adults Due to the Drug

Known as Barbiturate

Curriculum Vitae

Name: Jea A. Cordova

Nickname: Jey, Jyang, Yang, Ya

City Address: Cebu Doctors' Dormitory, North Reclamation, Mandaue City,Cebu City

Home Address: Purok 4, Brgy. San Juan, Surigao City

Contact num: 09334476810

Age: 16

Sex: Female

Birth date: April 14, 1994

Birth place: Surigao City

Civil status: Single

Citizenship: Filipino

Religion: Roman Catholic

Hobbies: Listening to music; Watching movies; Surfing the net

Talents: Dancing

Educational Background

Tertiary: Cebu Doctors' University

Course and year: B.S. Pharmacy 1A

Secondary: Surigao Education Center

Primary: Surigao City Pilot School

Research Experience: Accidents and Deaths among Young Adults Due to the Drug

Known as Barbiturate

Curriculum Vitae

Name: Coleen Joy Chua Pitogo

Nickname: Colz, Coleen, Cookie/Kuki

City Address: Larrazabal Hall, Cebu Doctors’ University, Mandaue City

Home Address: Cypress rd., Villa Angela Subd., Bacolod City

Contact number: 09173636916; 09236042925

Age: 18

Sex: Female

Birth Date: February 24, 1993

Birth Place: Bacolod City

Civil Status: Single

Citizenship: Filipino

Religion: Christian

Hobbies: Reading, Blogging, Listening to music, Watching TV

Talents: Writing, Baking

Educational Background

Tertiary: Cebu Doctors’ University

Course and year: B.S. Pharmacy 1A

Secondary: St. John’s Institute, Bacolod City

Elementary: Trinity Christian School, Bacolod City

Research Experience: Accidents and Deaths among Young Adults Due to the Drug

Known as Barbiturate