dg-chapter 7 section 1 text

CHAPTER

8 Barbiturates

Did You Know That…  Generally, sleepwalking cannot occur during the dreaming phase of sleep because the motor system is paralyzed.  You go through several 90-minute sleep cycles nightly.  You dream more just before you awaken.  “Short sleepers” are often active, ambitious, and conformist, while “long sleepers” are often shy, passive, and sexually inhibited.  Dreaming may help you store the day’s experiences away in memory.  Nightmares frequently occur a day or so after you’ve stopped taking sleeping pills.  It is in REM sleep that anxiety nightmares take place.  Barbiturates are the number one drug used in chemically induced suicides.  Barbiturates were used extensively during World War I and II as truth serum.  More than 50 tons of Meprobamate is distributed annually in the United States under its generic name, and brand names such as Miltown and Equanil.  A real "Mickey Finn" was a powerful laxative sometimes surreptitiously employed by bartenders to rid their establishments of unruly or belligerent customers.  Marilyn Monroe died from an overdose of barbiturates, as did George Sander, Jean Seberg and Pier Angeli (Judy from Rebel Without a Cause).  Judy Garland also died from (accidental) barbiturate overdose.  Jimi Hendrix’s death resulted from a barbiturate overdose and vomit inhalation  Edie Sedgwick died in 1971 of barbiturate overdose. His death was said to be accidental/suicidal.

Introduction ____________________________________

Barbiturates were first introduced for medical use in the early 1900s. More than 2,500 barbiturates have been synthesized and at the height of their popularity, about 50 were marketed for human use. Today, about a dozen are in medical use. Barbiturates produce a wide spectrum of central nervous system depression, from mild sedation to coma and have been used as sedatives, hypnotics, anesthetics and anticonvulsants. The primary differences among many of these products are how fast they produce an effect and how long those effects last. Barbiturates are classified as ultrashort, short, intermediate, and long acting.

CRITICAL POINT: The hustle and bustle of everyday life creates stress in many people. To reduce stress, some people turn to drugs to bring back a feeling of calm. Alcohol is one drug people use to deal with stress; another class of drugs is called the "barbiturates." These drugs act to depress the central nervous system and are often called sleeping pills.

The ultra short acting barbiturates produce anesthesia within about one minute after intravenous administration. Those in current medical use are the Schedule IV drug Methohexital (Brevital) and the Schedule III drugs Thiamyl (Surital) and Thiopental (Pentothal). Barbiturate abusers prefer the Schedule II short acting and intermediate acting barbiturates that include Amobarbital (Amyta), pentobarbital (Nembutal), Secobarbital (Seconal) and Tuinal (an Amobarbital/Secobarbital combination product). After oral administration, the onset of action is from 15 to 40 minutes and the effects last up to six hours.

These drugs are primarily used for insomnia and preoperative sedation. Veterinarians use pentobarbital for anesthesia and euthanasia.

CRITICAL POINT: Barbiturates produce a wide spectrum of central nervous system depression, from mild sedation to coma and have been used as sedatives, hypnotics, anesthetics and anticonvulsants.

Long acting barbiturates include Phenobarbital (Luminal) and Mephobarbital (Mebaral), both of which are in Schedule IV. Effects of these drugs are realized in about one hour and last for about 12 hours and are used primarily for daytime sedation and the treatment of seizure disorders.

Sometimes two or more barbiturates are combined in a single tablet or capsule. Perhaps the most well known of these combinations is Tuinal, which consists of Amobarbital ∞ DRUGS in Perspective ∞ and Secobarbital in equal proportions. __________________________________________________________________ CRITICAL POINT: There are three classifications of barbiturates as ultrashort, short, intermediate, and long acting.

Barbiturates: Central nervous system depressants. These drugs are seldom abused because of their potential for addiction, and their thin margin of safety.

Barbiturates were very popular in the first half of the 20th century. In moderate amounts, these drugs produce a state of intoxication that is remarkably similar to alcohol intoxication.

Symptoms include slurred speech, loss of motor coordination and impaired judgment. Depending on the dose, frequency and duration of use one can rapidly develop tolerance, physical dependence, and psychological dependence on barbiturates. With the development of tolerance, the margin of safety between the effective dose and the

Delta Sleep: The deepest state of sleep

Benzodiazepines: The most popular and safest central nervous system depressants on the market today

REM (Rapid Eye Movement) Sleep: The dream state of sleep. This happens when you are sleep and you begin to dream. During this process you have a lot of eye movements and brain activity occurring while you are sleep.

Alpha Waves: These are waves in the brain, alpha waves were the first waves discovered in the brain. This mostly happens when someone is relaxed or effortless when they are awake.

Narcolepsy: A sleeping disorder that causes spontaneous and uncontrolled sleeping episodes.

Rainbows: Tuinal capsul, a barbiturate.

Goofballs: A barbiturate laced with a stimulant such as cocaine or amphetamines.

lethal dose becomes very narrow. That is, in order to obtain the same level of intoxication, the tolerant abuser may raise his or her dose to a level that may result in a coma or death. Although many individuals have taken barbiturates therapeutically without harm, concern about the addiction potential (withdrawal symptoms can include tonic clonic or grand mal seizures potentially leading to permanent disability or even death) of barbiturates and the ever increasing number of fatalities associated with them led to the development of alternative medications, namely benzodiazepines. Today, fewer than 10 percent of all sedative/hypnotic prescriptions in the United States are for barbiturates.

Barbiturates and Sleeping Patterns _____________________________________________________________________________________________

This is going to be fun, interesting and extremely informative. I guarantee you, meaning I am relatively sure. Okay! I am sure. You are going to love this section. First of all, brace yourself because I am going to start off by telling you a little about myself. Hey! I am all about self promotion. You’ve read this far and haven’t figured that out yet? Shut up and just listen. When I was a little boy, a couple of years ago…okay, a lot of years ago…I was in bed asleep with my little teddy bear. Everything was cool. I hadn’t been asleep for more than an hour when all of a sudden I heard this terrifying scream. It was unlike any scream I had ever heard before. When I opened my eyes, this large ape like creature was hovering over me. His face was only inches from mine and he was staring straight into my eyes. His nose was broad and his mouth was abnormally huge. Large fangs protruded from his gaping mouth. The expression on his face was twisted with a sardonic smile and a vile odor oozed from his mouth. Before I could move, his hand clutched my throat and his mouth covered my mouth and nose. I felt my heart stop! Then, I found myself choking for air. I started fighting for my life, kicking and punching at the beast. It possessed awesome strength though, well beyond any human that I had ever encountered. I thought I was going to die.

The next thing I knew I was running through the house. My heart was pounding wildly and I was gasping for air. The beast was still at my throat trying to choke the life out of me. I could still smell that odor, that vile stinking odor. In my haste to escape the beast, I ran smack dab into the The incubus bathroom door. Mercifully, the impact knocked me unconscious for God knows how long.

When I finally gained consciousness and opened my eyes, the beast was gone. For the next ten minutes I just sat there looking around the room, trying to get my thoughts together. It was the incubus. It was the second time that I had fought the incubus. My first incubus attack occurred when I was only 11 years old. To this day, the incubus is the most frightening thing that has ever happened to me.

CRITICAL POINT: An incubus (from the Latin, incubo, or nightmare; plural incubi) is a demon in male form supposed to lie upon sleepers, especially women, in order to have sexual intercourse with

them, according to a number of mythological and the succubus.

legendary traditions. Its female counterpart is

Chances are you haven’t had an incubus attack. If you ever do, you will never forget it. It’s absolutely horrifying. Fortunately, an incubus attack occurs in only one person in several thousand. In case you didn’t know, the incubus is a nightmare. Incubus nightmares are not just any nightmare. They are physiologically unique. Usually, dreaming occurs during rapid eye movement sleep (REM). It is in REM sleep that anxiety nightmares take place. You may have experienced such nightmares in which someone is chasing you or you find yourself falling off a cliff or building. Anxiety nightmares are quite common. Actually, most people experience anxiety nightmares some time during their life. During REM sleep, your vital signs (heart rate, pulse and respiration) are fairly low, but rather consistent. When you experience an anxiety nightmare, your vital signs increase significantly and you generally wake up breathing like a racehorse and sweating like a mule. It is not a real fun experience. Generally though, you are not somnambulistic during this time. In other words, you don’t sleep walk during your dreams. You may mumble or even talk in your sleep, but you won’t scream. And even though you feel like your heart is coming out of your chest, there is little change in your physiological responses during your nightmare…indicating that it is the psychological content of your dream, someone chasing you or contemplating a frightening scene, that is responsible for your nightmare. As bad as an anxiety nightmare is, it can’t hold a candle to an incubus nightmare.

An incubus attack occurs when your vital signs are even lower than they are in REM sleep. It occurs during delta or deep sleep, when your vital centers are extremely low. Furthermore, just before an incubus attack, your vital signs slow down even more.

In actual fact, physiologically you approach a state close to death. Your pulse becomes extremely low and abnormal as does your respiration and motor activity. At this point, various centers of the brain “panic” and respond as if you were on the verge of death. In response, your cardiopulmonary functions immediately skyrocket. You are catapulted from deep sleep to consciousness. Your heart rate and respiration are near maximum capacity.

You feel like you are going to have a heart attack and you can barely catch your breath. And this will really scared you. Most incubus attacks contain hallucinations similar to the one I experienced…with a large beast lying on your chest, sucking the life out of you!

Sleepwalking, which cannot occur during REM sleep because the motor system is paralyzed, is a common part of an incubus attack. Initially, you feel paralyzed…probably from sheer terror…within seconds though, you can stumble to your feet and haul ass in order to get away from the beast. That is the way it was for me and the way it is for most people who experience the incubus. Also, as eerie as it is, almost every incubus nightmare begins with a scream…your own scream. Interestingly, most times the individual doesn’t even realize he is the one who is screaming. Take my word for it…the whole affair is right out of a Halloween horror movie.

CRITICAL POINT: According to the United States Department of Health and Human Services in the year 2010, approximately 64 million Americans regularly suffer from insomnia each year.

Insomnia is 41% more common in women than in men.

After my first episode with the incubus, I developed a case of insomnia that plagued me for close to a year. The experience was so horrifying that I was actually afraid to fall asleep for fear that the incubus would return. Although my second incubus attack was just as terrifying as the first, I experienced only mild difficulty sleeping for a week after the attack. I guess knowing that the incubus was no more than a dream and knowing how to deal with sleeping difficulties helped me to alleviate any long range problems that might have developed. However, the incubus did stimulate my desire to learn more about dreams and sleep. Consequently, I embarked on an extensive investigation into the field of somnus. What I discovered was not only fascinating, but it gave me a clear insight as to how drugs can affect sleep.

The Sleeping Cycle ______________________________________________________________

You know what is really weird? The guys in the sleep labs with their white clinical smocks and clipboards don’t know why we sleep. They don’t even know what sleep is. They can tell us that sleep is necessary for our bodies to recover from a day’s activity. You really ∞ DRUGS in Perspective ∞ needed to hear that from an expert. __________________________________________________________________ These same researchers are also Different Brain Waves. convinced that there is a strong link between sleeping and dreaming. In fact, they think dreaming may be the most important part of the sleep cycle.

During consciousness, billions of brain cells fire separately.

Interestingly, the sleep cycle seems to have several distinct stages.

When you first lie down, your brain is probably emitting beta Awake with your eyes closed and thinking. rhythms, which means it is still engaged in active thought. As you start to drift off into light sleep, several things happen. Your body Falling asleep, your brain activitiy goes from Alpha to Beta state. temperature drops, muscles relax, breathing slows down becoming irregular and last but not least, your brain slips into a peaceful alpha brain wave state. This means the brain’s electrical output has slowed to a wave pattern which cycles about 10 to 12 Sleeping. Your brain cells fire gently in unison. times per second. After close to an hour of this alpha stage, the brain slows even further to delta rhythms and you arrive at deep sleep, but you only get to stay there for about 20 minutes.

Something else is waiting…REM sleep. As mentioned, Delta sleep… deep state (slow wave) sleep.

REM is short for rapid eye movement.

The lab guys use a lot of fancy language. Even if they don’t know what sleep is, they sound impressive.

REM sleep... the dream state of sleep. Your brain is as active as when you’re awake.

Well, it’s during REM sleep that you dream. REM sleep only lasts

a few minutes, 8 to 15, and even though your eyes may dart about under their lids, the rest of the body is essentially paralyzed! Therefore, when someone thrashes around in their sleep, it’s not because they are dreaming. Each cycle of the sleep stages takes about 90 minutes and is usually repeated about five times in a normal eight hours of sleep. Although the need for sleep isn’t officially clear, it’s obvious that the lack of sleep has profound effects on our mental and physical performance. As a matter of fact, sleep deprivation has been a basic tool for brainwashing.

CRITICAL POINT: Although older people tend to sleep just as much as they did when they were younger, the elderly don’t get as quality sleep, meaning that they often suffer from fatigue and daytime drowsiness. The main reason for this is that older people don’t get as much REM sleep, the deepest, most restorative sleep phase.

Researchers say most of us can go up to 40 hours without sleep before we begin to show ill effects. Typical symptoms of deprivation might include irritability, impulsiveness, lethargy, confusion and irrational ideation. This sounds like any normal morning before the first cup of coffee to me. Well, after 100 sleepless hours, things become much worse. Symptoms now mimic a psychotic break: delusions of persecution and many times, extreme hostility. Now, if the subject is allowed to sleep, the sleep cycle will not simply resume its normal pattern. Instead, there is usually a rebound effect for the deep sleep stage. That is, you will experience more deep sleep at the expense of REM sleep, which might mean that deep sleep at that time is more important. One thing remains clear. Whatever sleep is, it is important…extremely important.