Barbiturate Addiction: Signs, Symptoms, Risks, and Treatment Resources

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    Barbiturates are drugs with a sedative-hypnotic effect, meaning they cause both relaxation and sleepiness. Historically, barbiturates were used as anesthesia and for the treatment of a variety of conditions such as seizures, anxiety, intracranial hypertension, insomnia, and more. Due to their high potential for abuse and the emergence of safer options, barbiturate availability is more limited today.

    What are Barbiturates?

    Barbiturates are a class of central nervous system depressants derived from barbituric acid. They work by reducing neurotransmitter activity in the brain[1]. Barbiturates are currently used to induce anesthesia and treat extreme cases of insomnia, certain forms of epilepsy, and tension headaches (in combination with caffeine and acetaminophen). They are classified as Schedule II, III, and IV depressants under the Controlled Substances Act. 

    Abuse of barbiturates was prevalent in the 1970s but declined significantly when benzodiazepines were introduced as a safer alternative. However, the risk of barbiturate overdose has not been completely eradicated, with 32,000 people over the age of 12 having reported misuse of barbiturates in 2018[2]. Common alternative names for barbiturates include Barbs, Block Busters, Christmas Trees, Goof Balls, Pinks, Red Devils, Reds & Blues, and Yellow Jackets[3]


    Side Effects of Barbiturates

    Barbiturates increase the activity of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter of the central nervous system. This leads to reduced neuronal activity, creating effects ranging from mild sedation to coma. Improper usage of barbiturates has severe implications, and therefore it must be taken carefully. 

    Potential side effects of barbiturates when taken as prescribed include:

    • Confusion
    • Headache
    • Dizziness
    • Drowsiness
    • Impaired memory
    • Irritability
    • Low blood pressure
    • Nausea and vomiting 
    • Reduced self-control
    • Vertigo
    • Trouble breathing

    How are Barbiturates Taken?

    Barbiturates are most commonly consumed in the form of pills and tablets. They may also be administered as a liquid injection or sometimes rectally for pediatric patients. There are ultrashort, short, intermediate, and long-acting kinds of barbiturates. Barbiturates are a prescription-only drug.

    Barbiturate Quick Reference 

    Drug Category Commercial & Street Names DEA Schedule Administration
    amobarbital Amytal® Schedule II Injectable or Oral
    butalbital Capacet® , Fioricet® Schedule III Oral
    methohexital Brevital® Schedule IV Injectable
    pentobarbital Nembutal® Schedule II Injectable or Oral
    phenobarbital Generic Schedule IV Injectable or Oral
    primidone Mysoline® N/A* Oral
    secobarbital Seconal® Schedule II Oral

    *primidone is not a controlled substance according to the DEA, but is metabolized into phenobarbital in the body

    Learn About Other Substances

    • Benzos
    • Sleeping Pills
    • Adderall®

    Statistics on Barbiturate Use, Misuse, and Addiction

    According to the 2018 National Survey on Drug Use and Health, 405,000 people reported any use of barbiturates in the past year[2]. The same survey found that 52,000 people reported misusing barbiturates in 2017, and 32,000 people reported this in 2018. 

    Prior to the introduction of benzodiazepines in the 1970s, barbiturates were the most commonly prescribed treatment for seizures and anxiety disorders in the US. Barbiturate prescriptions have dramatically decreased since then, and the reduced availability has helped curb abuse in recent years. Barbiturates are known to have a high potential for physical dependence after only a short time of use. 


    Effects of Barbiturate Abuse

    As a central nervous system depressant, the effects of barbiturates abuse can look similar to alcohol abuse. In addition to the physical symptoms, those who misuse barbiturates may display risky behaviors, avoid responsibilities such as work and school, isolate themselves from loved ones, and lose interest in hobbies they once enjoyed.

    Can You Overdose on Barbiturates?

    Barbiturates are highly addictive, and the body can build a tolerance quickly, meaning the user will need to take a higher dose to achieve the same effects. This, combined with the fact that barbiturates are often mixed with other legal or illicit drugs that inflate their effects, makes overdose a serious concern. 

    Signs and Symptoms of Barbiturate Overdose

    A barbiturate overdose should be treated as a medical emergency as it is extremely dangerous.

    Barbiturate overdose symptoms include:

    • Incoordination or staggering
    • Impaired judgment
    • Slurred speech or other speech impediments
    • Slowed or shallow breathing
    • Increased heart rate
    • Decreased blood pressure
    • Reduced urine output 
    • Weak and rapid pulse
    • Clammy skin
    • Dilated pupils 
    • Coma and death
    What to do if you suspect someone is overdosing on barbiturates:

    If you suspect someone is suffering from barbiturate poisoning, treatment must be administered quickly. There is no antidote for overdose, but prompt treatment often results in positive outcomes for those who are otherwise healthy. 

    Dangers of Long-Term Barbiturates Use

    Barbiturates come with a high risk for physical and psychological dependence with prolonged use. Those who take barbiturates even just for two weeks can develop a need for its relaxing and euphoric effects. One can build up their tolerance of the drug after two weeks, causing them to need a higher dose to feel the same effects. 

    Mixing Barbiturates with Other Drugs

    Barbiturate abuse is most common among young adults who often use the drug to counteract the side effects of other stimulants such as cocaine and methamphetamines. Mixing barbiturates with other drugs can lead to potentially severe outcomes when taken inappropriately.


    Barbiturate Addiction and Abuse

    Barbiturate abuse today is less common than it was in the 1960s and 1970s when it was a commonly prescribed medication for an array of medical conditions. However, when it’s used, there is a high risk of addiction. Any form of misuse can lead to physical dependence, tolerance (leading to further abuse), intense withdrawal symptoms, and overdose.

    Are Barbiturates Addictive?

    Yes, barbiturates are an addictive drug with a high risk for abuse. They are often misused to reduce anxiety and inhibitions or treat unwanted side effects of other illicit drugs[4]. Barbiturate addiction is a serious condition as it can easily lead to a lethal overdose.

    Signs of Addiction to Barbiturates

    The most telling sign of an addiction to barbiturates is experiencing physical withdrawal symptoms when usage has stopped. However, there are many behavioral and social signs that one has become dependent on barbiturates, including mood swings, attempting to gain more prescriptions than are needed, isolation from family and friends, loss of interest, perpetual drowsiness, new financial obstacles, and relationship issues. 


    Barbiturate Withdrawal

    It doesn’t take long after stopping the drug for withdrawal symptoms to set in. In as soon as 8-12 hours after the last dose, one can experience the following symptoms:

    • Nausea 
    • Vomiting
    • Restlessness
    • Insomnia
    • Muscle cramps
    • Fatigue
    • Anxiety
    • Tremors
    • Seizures
    • Hallucinations

    Barbiturate Withdrawal Management and Addiction Treatment 

    Barbiturates treatment often involves severe withdrawal symptoms in those who have misused the drug or taken them for a prolonged period of time. It is possible to safely overcome barbiturate dependence, though, in a reputable detox facility or rehab center. 

    The first step is detoxing. This is the process of ridding the body of the drug. Typically, this is done gradually to lessen the severity of withdrawal symptoms. Because withdrawal can cause life-threatening symptoms like seizures, it’s recommended to get help from professionals. This is especially true if the patient has been taking a high dose. 

    Withdrawal symptoms peak around the 72-hour mark, which is when the risk is highest for severe symptoms like seizures. Other dangerous withdrawal symptoms are psychosis, aggression, and self-inflicted injury. The withdrawal period can last for up to a week. 

    Detox is often followed by participation in a Partial Care rehabilitation program, from intensive to standard outpatient. Aftercare is another component often involved in the rehabilitation process to ensure long-term recovery. 

    The cost of treatment varies depending on the program and the individual’s needs. However, insurance often makes it possible to seek the professional help one needs regardless of their financial situation. 

    Therapies Used in Barbiturate Addiction Treatment

    There are a wide range of potentially useful therapies for barbiturates treatment, and it’s largely dependent on the individual and their circumstances. Some include Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), Dialectical Behavior Therapy (DBT), and Trauma-focused approaches.

    Drugs Used in Barbiturate Addiction Treatment or Withdrawal Management

    Suspending barbiturate use suddenly is risky; therefore, it’s common to gradually reduce dosage or use a low dose of phenobarbital to ease a patient off heavy barbiturate intake. Withdrawal symptoms can also be managed with the help of other medications, such as sleep aids and anti-nausea substances, to help ease the discomfort.

    Frequently Asked Questions

    Why are Barbiturates rarely prescribed anymore?
    What kinds of Barbiturates are most prevalent today?
    What are the long-term implications of prolonged Baributrate usage?

    Are you or a loved one struggling with Barbiturate usage?

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