Phenazepam as a narcotic - effect on the body

1. General information
2. Historical facts
3. Effect on the body
4. How to recognize a drug addict
5. Tests for Phenazepam
6. How long does it stay in the body?
7. How long do drug addicts live?
8. Analogs
9. How to speed up elimination at home
10. Detoxification in hospital
11. Perdose
    How to recognize and what to do
12. Rehabilitation
13. Coding
14. Why you can’t undergo rehabilitation at home or on an outpatient basis
15. Resocialization and work with codependents
16. How to quit on your own

Attention! Drug use causes irreparable harm to health and poses a danger to life!

General information

The drug phenazepam is a typical tranquilizer. It is used to normalize sleep, combat anxiety, and relieve convulsive syndrome in epilepsy. Fenozepam is available in injection form or in tablets. All central effects of the drug are achieved through stimulation of benzodiazepine receptors.

The effect of the drug extends to the reticular formation, nonspecific centers of the thalamus and the amygdala complex. The muscle relaxant effect is based on the ability to block spinal reflexes. The tranquilizer is well absorbed through the gastrointestinal tract, after which it is metabolized in the liver and excreted by the kidneys.

Phenazepam is available without a prescription. Doctors sometimes prescribe it to improve sleep, relieve anxiety during performances or in extreme situations. The first aid kit always contains Phenazepam in injection form to relieve seizures in epilepsy or damage to the central nervous system.

All drugs from the benzoidazepine group cause sleep lasting up to 6-8 hours. But the longer the sleep, the stronger the drowsiness, fatigue and depression will be during the next day after taking the drug.

Taken from: Pharmacology, tenth edition by D.A. Kharkevich

The drug is not considered a drug, but addiction can develop from it. In addition, with each subsequent dose, to achieve the desired effect, it is necessary to increase the dose. If you increase the dosage without consulting a doctor, this will lead to acute drug poisoning with possible death.

Release form of Phenazepam

The drug is available in the form of tablets and injections for intramuscular and intravenous administration.

The drug was recognized as dangerous and began to be sold by prescription only recently, so it can still be found in home medicine cabinets as a remedy for insomnia. For practically healthy people (with anxiety, sleep problems, nervous tension, lower back pain) it is no longer prescribed, choosing drugs with a milder effect. Phenazepam is now used only for severe mental disorders and for the relief of seizures during epileptic seizures.

Historical facts

The drug was invented in the 1970s. The developers who received the state order for the new medicine were the scientific directors of the departments of pharmacology from the Odessa Institute of Physics and Chemistry. After successful research and launch of the drug on the market, the group of voters received the USSR State Prize.

The peak use of the drug came at the end of the 80s, when facts of abuse of barbiturates were published and proven. Phenazepam and its analogues have become alternative drugs with similar effects but fewer adverse reactions.

Indications and contraindications for taking Phenazepam

The drug is prescribed for the treatment of phobias, panic attacks, hypochondria, depression or severe excitability. It is allowed to prescribe medicine to patients over 18 years of age. If you take it without a doctor's indication, then addiction develops.

Phenazepam is contraindicated in cases of pathology of the cardiovascular system, during pregnancy and lactation, in shock or mental illness. The drug is prescribed with caution to patients who have a predisposition to drug dependence.

Effect on the body

After the drug binds to benzodiazepine receptors and the reticular formation, the patient becomes calm and anxiety is eliminated. Then drowsiness appears, smoothly turning into sleep. In addition, the effect of the drug on limbic structures, reflex connections and the thalamus leads to the fact that the drug has the following effects:

• reduces feelings of fear;
• relieves irritability;
• increases emotional lability;
• reduces the manifestation of phobias;
• relieves alcohol and drug withdrawal syndrome;
• relieves muscle spasms;
• prevents nervous tics.

But you should be careful when using Phenazepam. It has a pronounced toxic effect on the liver and heart. If this tranquilizer is abused, the following disorders may occur:

• increased drowsiness, feeling tired;
• nausea and vomiting;
• dizziness;
• fast fatiguability;
• hematopoietic disorders (leukopenia, thrombopenia);
• urinary retention or incontinence;
• epileptic seizures;
• visual impairment;
• depression;
• constipation or diarrhea;
• increased activity of liver enzymes, jaundice;
• dysmenorrhea;
• hallucinations.

To achieve a narcotic effect, Phenazepam is not used in isolation. More often it is combined with other drugs to enhance the result. When the pharmaceutical dose is increased by 2-4 times, the patient's condition becomes the same as with alcohol intoxication or an overdose of barbiturates. But the negative effects and disruption of internal organs are tens of times stronger.

At the moment, benzodiazepanes are the most adequate means to combat insomnia, which is caused by emotional tension, stress, anxiety and worry.

Taken from: Pharmacology, tenth edition by D.A. Kharkevich

What are the consequences of using Phenazepam with alcohol?

Phenazepam can be used as a complex treatment for alcoholism to relieve withdrawal symptoms. A prerequisite for successful treatment is complete abstinence from drinking alcohol. If a person does not follow the doctor’s recommendations and continues to drink alcohol, the following consequences are possible:

• confusion;
• slowing down the respiratory rate;
• development of bradycardia;
• dyspnea;
• feeling of lack of air;
• decreased blood pressure;
• pronounced tremor;
• drowsiness;
• speech disorders;
• lack of coordination of movements;
• very tired.

In the presence of concomitant pathologies and due to an overdose of Phenazepam, the joint use of alcoholic beverages can lead to death.

Alcohol consumption also increases the likelihood and severity of side effects:

• memory and intelligence impairment;
• psychomotor agitation;
• attacks of anger and aggression, increased irritability;
• hallucinations;
• suicidal thoughts;
• severe insomnia;
• severe headaches;
• uncontrollable vomiting;
• liver damage;
• damage to the urinary system.

How to recognize a drug addict

As with any addiction, a drug addict can be in two states: the effects of the drug and the state of withdrawal. In the first case, the patient will be sleepy, lethargic, and answer questions slowly. A person can sleep for a long time. Drug addicts under the influence of Phenazepam react inadequately to external stimuli, they have an increased pain threshold, impaired breathing and a slow heartbeat.

The picture resembles intoxication with alcohol, but there is no smell or bottles of alcohol. But near such a drug addict you can find various packages of medicines and empty packages of pills.

In the case of withdrawal, the opposite is true. The peculiarity of taking tranquilizers is that they cannot be abruptly stopped. If a drug addict runs out of a new dose of medication, he will suffer from insomnia and his general condition will be anxious. Nervous tics will appear, the addict will move into the aggressive phase. When searching for a dose, such a person can deceive those closest to him, sometimes even hit them.

It is difficult to reliably recognize that a person is dependent on tranquilizers. Therefore, the best way to determine drug addiction is testing. Only in this way can you either confirm or eliminate your suspicions.

Tests for Phenazepam

You can check for the presence of benzodiazepines in the body using a conventional rapid test. The cost of these tests is from 40 to 100 rubles. Urine is tested at home; blood testing is carried out only in laboratories.

Please note that the effect of phenazepam is similar to other narcotic substances, therefore, in parallel with the test for benzodiazepines, a rapid test is carried out using a tablet for 10 drugs. This allows you to quickly check traces of narcotic substances and, if necessary, request laboratory confirmation.

Laboratory confirmation must be done if a person committed an offense under the influence of a drug. The results of rapid tests have no legal force.

To study biomaterials of a drug addict, methods of enzyme immunoassay, gas chromatography-mass spectrometry or gas-liquid spectrometry are used. These methods are written down in the relevant decrees, and can be used in court as a confirmed diagnostic method.

Phenazepam is quickly eliminated from the body through the kidneys, so it is important to know how much time has passed since the last use of the drug.

Please note that there is no specific test for Phenazepam. There is a test for benzodiazepines. If the patient took any drug from the benzodiazepine group (including Phenazepam), the result will be positive.

How long does it stay in the body?

The rate of elimination from the body depends on the ability of the liver to process the components of the drug. On average, tranquilizers are eliminated in 3-5 days. But the exact period depends on both the period of use and the age of the addict.

It is necessary to consider whether it was taken together with other drugs or alcohol. All this slows down the functioning of internal organs and leads to a slower elimination of the drug from the body.

Phenazepam is excreted through the kidneys, so the best method is to test your urine. Metabolites of the drug can be found in urine within 3-4 days. In the blood - 12-18 hours. There are no other data on hair or saliva testing for Phenazepam.

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Adverse reactions

Phenazepam may cause side effects. They occur more often at the beginning of treatment and can take the form of:

• fatigue;
• drowsiness;
• dizziness;
• impaired ability to concentrate;
• unsteady gait;
• slower reactions;
• confusion;
• depressed.

It may also cause side effects on the hematopoietic, digestive and genitourinary systems. Consequently, a person may encounter:

• anemia;
• thrombocytopenia;
• leukopenia;
• dry mouth;
• heartburn;
• decreased appetite;
• stool abnormalities;
• jaundice;
• urinary incontinence/urinary retention;
• decreased libido.

Sudden withdrawal increases the excitability of the central nervous system, which leads to irritability, nervousness, smooth muscle spasms, insomnia, tremor, and depression.

How long do drug addicts live?

Life expectancy with tranquilizer abuse reaches 3-4 years. But the higher the dose and the more often it is taken, the fewer years the addict has to live. In pharmaceutical doses, the drug does not affect internal organs and the nervous system. If you systematically exceed the permissible limit, irreversible changes will occur in the cerebral cortex. Liver cirrhosis with chronic liver failure may develop.

Phenazepam damages the kidneys, causing chronic kidney disease (CKD or kidney failure). When decompensation occurs in the functioning of the kidneys and liver, a person dies, even if assistance is started.

Analogs

In terms of their effect on the body, barbiturates are analogues of benzodiazepines. They act similarly on the central nervous system and have the same effect on internal organs.

In terms of chemical composition, all drugs from the benzodiazepine group are analogues of Phenazepam, for example:

• Fezanef;
• Phenorelaxan;
• Elzepam;
• Gidazepam;
• Clobazam;
• Lorazepam.

Among drugs, opiates cause similar effects. They also inhibit processes in the central nervous system, but the mechanism for the development of these effects is different.

You're still not allowed to drive

When prescribing a course of therapy with an anti-anxiety drug to a patient, doctors warn him that he should not take Phenazepam while driving, as well as about the restriction period after the end of treatment..

• After a single dose of axiolytic, you are allowed to start driving no earlier than 24 hours later. It is known that exactly this period is necessary for the removal of the active substance, so after taking Phenazepam you can start driving after 24 hours.
• A course of taking Phenazepam allows you to start driving no earlier than three days after the last dose of the medicine.

A person whose work is directly related to increased risk when driving should remember that any psychotropic or axiolytic drug acts on response mechanisms.

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How to speed up elimination at home

Breeding at home can be hazardous to health. During the rapid release of the drug and its metabolites, rebound syndrome may occur. This means that all inhibitory effects that the drug had will be suppressed by antagonistic mediators. That is, if Phenazepam relaxes the muscles, then if it is abruptly discontinued, cramps may begin. The same applies to sleep and other functions that are affected by tranquilizers.

It is better to limit withdrawal at home to 3-4 procedures and carry it out only in case of an overdose caused by a desire to get drug intoxicated or during a suicide attempt. In other cases, if there are no symptoms of overdose, there is no need to accelerate the elimination of the drug.

Algorithm of actions:

• Rinse the stomach. You can do this by drinking plenty of water, up to two liters of water, and then mechanically induce vomiting (press the root of the tongue with two fingers). This procedure must be repeated 2-3 times. They are effective in the first hour and a half after taking the tablets.
• Take sorbents. It is recommended to take one tablet of activated carbon per 10 kilograms of body weight. You can do more, there will be no harm from the sorbents.
• Drink plenty of fluids to speed up kidney function. This technique is called forced diuresis. Due to heavy drinking, the fluid that is excreted by the kidneys will “pull back” some of the drug metabolites.

If after these procedures lethargy remains and the person is inhibited, you can brew him strong coffee. Caffeine stimulates the nervous system and “unblocks” some of the nerve synapses that inhibit the reaction.

It is better to speed up the elimination of the drug in a hospital setting. Then it is possible to monitor the patient’s general condition and carry out specific therapy with antidotes. In addition, in cases of life-threatening symptoms, emergency medical care can be provided.

Detoxification in hospital

In the hospital, first of all, gastric lavage is performed using a siphon. In this way, you can cleanse the entire stomach without artificially stimulating the vomiting center. After gastric lavage, sorbents (activated carbon, Smecta, white carbon) may be prescribed.

Instead of drinking plenty of fluids in the hospital, infusion therapy with 5% glucose and saline is carried out. This helps remove drug toxins from the liver and kidneys. This way, cleansing occurs faster and symptoms of poisoning or overdose disappear.

The next step is to prescribe specific antidotes to benzodiazepines. These are the following:

• Mesocarb;
• Flumazenil.

Both drugs must be calculated correctly. If the dosage is incorrect, it can only make things worse.

If possible, in a hospital or special rehabilitation clinics, the blood is purified using an “artificial kidney” device, and the patient is sent for hemodialysis. All methods are based on hardware blood purification; they are relevant for detoxification. Although there is evidence that in case of an overdose of Phenazepam, hemodialysis is ineffective.

It has been established that among all drugs from the benzoidazepine group, Phenazepam is one of the best anxiolytics.

Taken from the scientific article: “The effectiveness of phenazepam as part of complex therapy in patients with anxiety-depressive syndromes.” Authors: M.E. Statsenko, O.E. Sporova, O.A. Talker.

Addiction treatment

Treatment for benzodiazepine addiction follows standard regimens. However, the approach to patients is always individual - each clinical case has its own characteristics. Treatment begins with the safe removal of all psychotropic substances, supporting the person until complete resocialization.

Detoxification

The largest number of hospitalizations occur in cases of phenazepam poisoning. Addicts also seek help during withdrawal periods. Detoxification is carried out using the following methods:

• Gastric and intestinal lavage followed by administration of sorbents.
• Controlled administration of a benzodiazepine receptor antagonist, Flumazenil.
• Droppers with antitoxic solutions, glucose, electrolytes.
• Cardiotonic drugs to support cardiac activity.
• Oxygen therapy.
• Symptomatic treatment.

The effectiveness of extracorporeal blood purification (hemodialysis) has not yet been proven. In the hospital, all manifestations of “withdrawal” are painlessly relieved.

Patients with mild illness can receive care at home (anonymously), but further treatment is still required.

Rehabilitation and resocialization

After restoration of the impaired functions of internal organs, treatment is started aimed at preventing relapses. It includes individually selected psychotherapeutic techniques. With the help of a doctor, a person finds the origins of his addiction, normalizes his emotional background, and learns to deal with life’s failures.

An important part of rehabilitation is helping codependent family members. Often relatives suffer no less than the patient, which negatively affects their health. The psychotherapist helps restore normal relationships between loved ones, which increases the patient’s chances of a successful outcome.

After treatment, it is difficult for patients to return back to a society that rejects drug addicts in every possible way. Regular consultations with a doctor help solve current problems without causing a breakdown. If necessary, social services help with studying or getting a job.

Overdose

An overdose of Phenazepam most often occurs for three reasons: an overdose when increasing the dose on your own, when trying to get drug intoxicated, and when attempting suicide.

An overdose always occurs. This is due to the fact that with each subsequent dose of the drug, receptor insensitivity to its active substances occurs. This process is called the development of tolerance. That is, with each subsequent reception the severity of the effects is less, and they end faster.

If help is not provided in time, a person may die from respiratory failure or cardiac arrest.

How to recognize and what to do

In case of an overdose of any drug from the group of tranquilizers, the following symptoms will immediately appear:

• depression and confusion;
• decreased blood pressure;
• slowing and stopping of the heart;
• slowing and stopping breathing;
• nystagmus;
• convulsions or tremors of the limbs;
• decreased response to tendon reflexes.

With such symptoms, a coma develops, and the person dies without treatment. The main help is gastric lavage, taking sorbents and intravenous administration of a specific antidote: flumazenil.

If necessary, artificial respiration and chest compressions must be performed before the ambulance arrives. You need to press on the chest at intervals of 2 times in 1 second. You need to inhale air into the person’s mouth or nose every 30 presses.

Rehabilitation

Considering that physical dependence on Phenazepam practically does not develop, the main task of rehabilitation is the psychological restoration of the individual, programming a new style of behavior, the patient’s adaptation to society and working with codependent people.

In complex addiction therapy, the location where rehabilitation is carried out plays a role. As a rule, at home or with friends, any attempts to quit end with taking the same drugs or other drugs with a similar effect.

Antidepressive therapy is sometimes added to the rehabilitation complex. With the right dosage, this is a good technique that allows you to get rid of the consequences of depletion of your own mediators.

Coding

Coding doesn't work with dependencies. More than 1000 studies have shown that this method has no evidence base and its use is not rational. Therefore, we can conclude that specialists engage in coding solely for personal gain. The best method of treatment is the correct rehabilitation complex. Coding, hypnosis and similar methods do not work.

Why not at home or on an outpatient basis?

With abrupt withdrawal of Phenazepam, rebound syndrome occurs. This means that without the drug, all the processes that were inhibited by the drug will become 3-4 times more intense. This leads to convulsions and even loss of consciousness. Therefore, you need to quit gradually, under the control of tests and after consultation with a specialist.

In an outpatient setting, it is very difficult to monitor whether the patient is complying with the rehabilitation program. At home, there are no barriers or incentives that force you to stop using drugs. In addition, home conditions mean constant contact with possible active drug addicts. If communication is not stopped, the person will not leave on his own.

Another disadvantage of home rehabilitation is the presence of constant conflicts with family members. Conflict situations become reasons for relapse or even switching to harder drugs.

The only option for outpatient treatment is when a person has been using for 1-2 months and the dependence is mild.

Working with codependents and resocialization

Resocialization is a person’s path to a new social life. Without restoration of the social role, a breakdown may occur. Addicted addicts need constant communication, work for distraction and emotional return from friends, colleagues, and family members. This way a person will realize that he has something to live for and limit himself from drugs.

If this is not done, after a short period of time a breakdown may occur due to melancholy or depression. These are frequent cases, and they are dangerous because after the next breakdown it becomes increasingly difficult to achieve remission in addiction.

In order to minimize disruptions, they work with codependent people, that is, loved ones and family members. During such work, codependent people learn how to correctly shape their behavior and how to help the patient quit drug use forever.

Only close people have constant contact with the addict. They should play the role of psychologists with whom the patient can share his experiences without keeping anything to himself. This minimizes the risk of disruption and restores harmonious relationships between family members. Therefore, without working with codependents, rehabilitation is considered incomplete.

How to quit on your own

You really have to want it. If I quit, then immediately without such excuses: starting Monday, tomorrow, the last time, I’ll quit. In the case of drugs, the reservations do not apply. You need to be prepared for withdrawal, during which there will be a strong desire to use the drug, and without use, depression and even suicidal thoughts may appear.

It is necessary to limit contact with anyone who is an active drug addict, even if they are taking other substances or medications. Such people are a constant temptation to relapse. You cannot change one drug for another because you will end up dependent on two drugs.

It is necessary to monitor health indicators, liver and kidney function. Your attending physician will tell you about the regularity of liver tests and creatinine clearance. In any case, treating addiction on your own is difficult and dangerous. If possible, it is always better to consult with specialists in the field of addiction.

First aid

If a person takes Phenazepam with alcohol, then you need to immediately call an ambulance, because it is impossible to predict the consequences for the body and psychological state of a person. Before the doctor arrives:

• do a gastric lavage: give the person who consumed at least 6 glasses of water with soda, induce vomiting.
• give a sorbent: polysorb, smecta, polyphepan or activated carbon will do, this will prevent loss of consciousness;
• monitor the condition: do not leave the person alone; if he has lost consciousness, then lay him on his side and fix his tongue so that he does not swallow it during attacks of vomiting.