What Are Barbiturates?

Barbiturates are sedative/hypnotic (sleep-inducing) medications that are used to treat diseases like seizure disorders, surgery related anxiety, insomnia, psychiatric conditions, alcohol withdrawal and increased intracranial pressure (ICP). They’re also used to help induce anesthesia. In some U.S. states they act as active components in lethal injections for the execution of the death penalty.

Barbiturates have lost medical favor since the 1970s due to their elevated toxicity and addictive properties. This has led to the discontinuation of several types and their replacement with safer medications.

Barbiturates in Clinical Practice

Barbiturates were introduced in the early 1900s as medication for insomnia, anxiety, anesthesia and multiple psychiatric conditions.

In the late 1940s the FDA didn’t require clinical trials to evaluate medication safety. Increasing reports of barbiturates’ toxicities escalated to a level that led some clinicians to investigate their health risks.

Research found that by 1950 about 25% of all acute poisonings in the United States that ended in hospital emergencies involved barbiturates.

Investigators found that barbiturates presented a major risk of intoxication due to their life threatening withdrawal symptoms, dangerous side effects with alcohol and other depressants, addictive potential and widespread prescription.

Barbiturates: Health Effects

Barbiturates cause the following adverse health effects:

• Sedation
• Movement difficulties
• Involuntary muscle movements (ataxia)
• Confusion
• Slurred speech or incapacity to speak
• Shallow breathing
• Low blood pressure 
• Weak heart function 
• Reduce heart muscle strength
• Slow digestion that may lead to a bowel blockage
• Decrease in body temperature (due to the brain’s temperature control being disrupted)

Barbiturates’ effects on the brain are far reaching. Barbiturates and benzodiazepines inhibit (slow down) the nervous system. Both types of medication reduce neurons’ activity by binding to and activating GABA (a calming neurotransmitter). However barbiturates’ sedative effects are more profound.

The pharmacological actions of benzodiazepines are dependent on available GABA in the brain. They do not directly increase GABA production, so their actions are somewhat limited by this.

Barbiturates are capable of inhibiting neurons without GABA so they may depress a person’s central nervous system to dangerously low levels which can lead to breathing difficulties, comas or even death.

Barbiturates are the 15th most common drug involved in fatal toxicities due to drug use. Their clinical use is extremely limited so these numbers point to illicit consumption methods.

Barbiturate Abuse

Sedative drugs like barbiturates are not opioids but they are misused and abused in similar ways as them. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 4.7 million Americans misuse prescription sedatives every year.

Why do people abuse barbiturates? When a person consumes even exceptionally low doses of barbiturates they may feel intoxicated or drunk, experience mild euphoria, lose their inhibitions or report feeling calmer. People who use opioids sometimes seek barbiturates to combat withdrawal symptoms.

However, these effects also may cause memory loss, difficulties walking, erratic decision making, aggressiveness, paranoia and even a heightened suicide risk.

A dangerous aspect of barbiturate abuse is that individuals tend to mix them with other substances that depress the central nervous system such as fentanyl, alcohol, heroin or oxycodone. These combinations multiply a person’s risk of barbiturate overdose as the additive inhibitory effects can result in breathing difficulties, coma and death.

Barbiturates’ Addictive Potential

People can develop tolerance to the mood altering properties of sedatives like barbiturates because with repeated use these drugs are eliminated faster by the body. This means they may require increasingly larger dosages to obtain the desired effects.

Habitual consumption of barbiturates can modify a person’s brain structure and functional properties which leads them to struggle with self control and could lead them toaddiction.

Is Phenobarbital a Barbiturate?

Phenobarbital is a barbiturate. It is approved by the FDA as an antiepileptic drug (to treat seizures) but as the oldest anticonvulsant medication with many known toxic side effects it’s often the second or third medication of choice employed by clinicians. It’s also utilized in brain surgery and for traumatic brain accidents.

Its use as a sleep-inducing agent and anti anxiety medication has declined sharply because its many side effects and addictive potential outweigh its benefits.

Phenobarbital has also been employed as an aid in alcohol withdrawal to prevent seizures but benzodiazepines may be a safer choice.

Phenobarbital is only available via prescription. Individuals who misuse this drug typically obtain it from friends or family. Phenobarbital is a DEA class IV controlled substance and should not be prescribed to a person with a history of substance abuse as it’s highly addictive and has a long legacy of being a drug commonly employed in suicide attempts.

Abusing substances like phenobarbital comes at a heavy price. Its repeated use can change brain function and structure. Long term intake may cause memory problems, issues with concentrating and paying attention, depression, changes in thinking and behavior, aggressiveness, loss of appetite, physical pain and movement difficulties.

Phenobarbital side effects include:

• Confusion
• Drowsiness
• Thinking abnormalities
• Restlessness
• Nightmares
• Mental agitation
• Involuntary movements
• Hallucinations
• Breathing impairment or cessation
• Low blood pressure and heart rate
• Fainting
• Nausea and vomiting

People who use phenobarbital should never stop taking it abruptly. They put themselves at risk of life threatening withdrawal symptoms like impaired breathing and dangerously low blood pressure that could escalate to a coma and even death. Always seek medical guidance to taper off your use of phenobarbital.

Is Pentobarbital a Barbiturate?

Pentobarbital (Nembutal) is a barbiturate approved by the FDA for seizure management, anesthesia and sedation.

Despite its approved uses pentobarbital is generally considered a second or third line treatment alternative for non responsive patients as it has a high potential for toxic side effects and it’s one of the most abused barbiturates.

Pentobarbital is classified as a DEA Schedule II substance due to its elevated addiction risk and harmful side effects. When a person consumes pentobarbital then they may rapidly develop tolerance and need more to achieve the effects they seek. This exposes them to physical dependence and overdosing.

As with other barbiturates pentobarbital carries a double threat to misusers. Consuming it poses a risk of addiction and overdose and stopping its use suddenly can increase the chance of life threatening respiratory and neurological withdrawal symptoms.

Pentobarbital adverse reactions include:

• Sedation
• Confusion
• Agitation
• Hallucinations
• Insomnia
• Labored breathing
• Low heart rate and blood pressure that may cause cardiac arrest
• Fainting
• Headache
• Liver damage
• Total loss of brain function
• Coma

If you have a pentobarbital prescription or misuse it then do not stop abruptly. Seek medical guidance to discontinue safely as quitting cold turkey may lead to withdrawal symptoms that could threaten your life.

Other Examples of Barbiturates

Thiopental

Thiopental is an ultra short acting barbiturate. This means its fast effects facilitate anesthesia. This rapid onset of action is the reason why very few people abuse thiopental. Like other barbiturates this medication slows brain activity. Its adverse effects accumulate as more is used.

Lower doses induce sedation while larger doses are used in general anesthesia and high doses lead to coma and death. As a result of these characteristics thiopental has been used in several states in the U.S. as part of lethal injection protocols.

Butalbital

Butalbital is a barbiturate used in combination therapy with acetaminophen and caffeine to treat tension headaches.

People who use butalbital to relieve headaches report withdrawal symptoms consistent with the use of other barbiturates. They also experience a 100% increase in the risk of misusing their headache medication compared to traditional prescriptions.

Methohexital

Methohexital is a barbiturate prescribed for short term sedation in outpatient surgery procedures and to control seizures.

It’s used only in a hospital setting. This is because a person’s vital signs must be watched continuously due to an elevated risk of heart and respiratory complications that could necessitate resuscitation.

Other Barbiturates

Primidone is prescribed for seizure disorders depending on underlying conditions and response to other medications.

Amobarbital (Amytal) is a sedative with limited clinical use due to its serious side effects.

Secobarbital is a sedative used for anxiety before surgery and for short term management of insomnia. It’s one of the most commonly misused barbiturates.

Can You Overdose on Barbiturates?

One out of 10 people who overdose due to barbiturate consumption die. This primarily occurs from respiratory or heart complications according to the National Library of Medicine.

All substances that depress the central nervous system reduce brain cell activity but they do so on distinct levels. Antihistamines or beer are less potent while benzodiazepines and opioids are much stronger. Barbiturates are among the most powerful substances inhibiting brain activity.

Why does this matter?

If brain cells reach a dangerously low level of activity then a person can stop breathing and die due to lack of oxygen. This is the main reason why people overdose on barbiturates.

The more barbiturates a person takes the more tolerance they develop to the drug’s effects so they will consume more. The larger the doses they take the more their nervous system is inhibited and the harder it is for them to breathe.

Barbiturate overdose symptoms are life threatening. Please consult medical help if you experience:

• Central nervous system depression
• Low body temperature
• Reduced breathing capacity
• Elevated heart rate
• Low blood pressure
• Decreased urine production

Combining barbiturates with substances like alcohol, opioids, benzodiazepines, marijuana, allergy medications and kratom can worsen the risk of dangerous side effects like respiratory depression and heart complications.

Risk factors for barbiturate overdose include asthma, severe allergies, pulmonary diseases and heart failure.

The sudden discontinuation of barbiturates can lead to severe withdrawal symptoms. This happens because the brain has adapted to the use of these substances that suppress its activity. Extreme neurotransmitter stimulation may happen when suddenly stopped. This can result in seizures, coma and death.

What Are the Treatment Options for Addiction to Barbiturates?

Detox

Detox is a medical process delivered in specialized facilities to aid individuals in safely managing withdrawal symptoms following the cessation of barbiturate consumption.

Clinicians watch the process round the clock to provide a safe and comfortable experience. Medications are also used when necessary to minimize discomfort and reduce cravings.

Inpatient

The use of inpatient treatment modalities can be beneficial for individuals who wish to focus full time on the recovery process.

As part of the program you will meet other people in recovery and explore addiction causes in depth. Throughout your stay your care team will help you rebuild your life, address past trauma and set up healthy habits for long term sobriety.

Outpatient

Depending on your situation outpatient programs may allow you to attend barbiturate recovery treatment part time. With these programs you receive evidence based treatment while living at home or working part time.

Clinical staff at some facilities can prescribe medication to help you manage cravings and withdrawal symptoms if necessary. Outpatient treatment provides group and individual therapy, life skills workshops and the power of a community of peers invested in recovery.

Aftercare

Abstinence from barbiturates is a life long journey. Aftercare programs help individuals design a roadmap after treatment to remain sober and accomplish personal goals. Here you can access long term mental health support, life skills training and a community to remain accountable and win the recovery battle one day at a time.

Resources

If you experience side effects after consuming barbiturates then you can call 911 or the Poison Help hotline (1-800-222-1222) to access emergency help.

If you believe you may be addicted to barbiturates then help exists. For example the Substance Abuse and Mental Health Administration (SAMHSA) provides a National Helpline that’s available 24/7 at 1.800.662.HELP for mental health and addiction support.

You can also check out our website to find rehab centers near you in the US. At Rehab.com we’ll help you find a suitable facility based on your values, lifestyle and insurance so you can begin the next chapter in your life free of barbiturates.

Narcotics Anonymous is an organization that assists individuals recover from substance abuse disorders. Its website offers a local meeting finder and hotlines to find local rehab support.

You can also ask your pharmacist, doctor or another trusted healthcare professional for guidance in accessing services to combat barbiturate addiction in your community.

You put your life in danger every time you misuse barbiturates. Treatment is available and recovery is possible with professional help. Do not risk your future. Seek help today.