Barbiturates are sedatives derived from barbituric acid and were once used to treat anxiety, epilepsy, insomnia, and seizure disorders. People who abuse them do so for their relaxing, euphoric effects. They also are popularly used to counter the effects of stimulant drugs, such as cocaine and methamphetamine, for a “come down” period.
The risks associated with excessive barbiturate abuse are usually underestimated today as the drugs’ dangers were more widely known in the 1970s, according to WebMD. However, it is easy to become addicted to these prescription medications and a dependence on them can be fatal. A number of celebrities have died from barbiturate overdose. Among them are Marilyn Monroe, Judy Garland, Edie Sedgwick, and Jimi Hendrix.
The drugs’ ability to kill is not lost on some modern-day users. According to WebMD, barbiturates are commonly used in suicide attempts, and the U.S. National Library of Medicine reports that about 1 in 10 people who overdose on barbiturates or a mixture that contains barbiturates will die.
What is a Barbiturate?
Barbiturates are sedative-hypnotics that relax the body and produce calming effects for people struggling with anxiety, insomnia, and other conditions. These medications, which are derived from barbituric acid, depress the central nervous system, which can mildly sedate users or put them into a coma, depending on the dose taken. To date, there have been 2,500-plus barbiturates that were made during the 20th century. Only 50, however, have been put onto the market, and about 12 are used today. Barbiturates are Schedule II, III, and IV depressants under the Controlled Substances Act.
In the 1960s and 1970s, they were once widely prescribed to help people manage anxiety, epilepsy, insomnia, and seizure disorders. They have since been replaced by other drugs, such as benzodiazepines, which are considered a safer to use because they lessen the chance that users will overdose. They are still used to induce anesthesia in surgery to relieve anxiety and tension patients may feel. They are also used to control seizures. Teenagers are found to be drawn to barbiturates because their effects are similar to alcohol. While barbiturates can be obtained legally only through a doctor’s prescription, some teens may use and abuse medications prescribed to older relatives, such as their parents or grandparents, or they may buy them from a street drug dealer. This class of medications includes:
- Amobarbital (Amytal)
- Butisol (Butabarbital sodium)
- Mephobarbital (Mebaral)
- Pentobarbital (Nembutal)
- Phenobarbital (Luminal)
- Secobarbital (Seconal)
- Butalbital (Fiorinal, Fioricet)
How Do Barbiturates Affect the Brain?
Barbiturates can be taken in tablet or capsule form while others can be taken in an oral liquid or injection form. Like benzodiazepines, barbiturates slow the processes of the body’s central nervous system and stimulate the brain neurotransmitter gamma-aminobutyric acid, or GABA. Barbiturates also slow down one’s heart rate and breathing, and increase drowsiness and relaxation. The psychoactive effects of these drugs are similar to that of alcohol intoxication or benzodiazepine tranquilizers such as Valium and Xanax.
Not All Barbiturates are the Same
While barbiturates make up a class of medications, their effects have different time lengths and therefore affect the body differently. How long or short those effects are determine how they are classified. They generally fall into four categories, which are ultra short-acting, short-acting, intermediate-acting, and long-acting.
Ultra short-acting barbiturates produce effects within one minute after intravenous use. Short-acting and intermediate-acting barbiturates take effect between 15-40 minutes and can last up to six hours. And long-acting ones can take effect in an hour and last up to 12 hours.
Street names for barbiturates depend on the particular drug being used. Downers, barbs, dolls, Christmas trees, pinks, reds and blues, goof balls, yellow jackets, and sleepers are all slang terms for these sedative-hypnotic drugs.
Why are Barbiturates Abused?
People who abuse barbiturates may have trouble falling asleep or staying asleep or they may feel a great deal of stress and need a release. Euphoria, relaxation, pleasurable feelings, and a sense of well-being are experienced when barbiturates are used in a manner not intended. Barbiturate abuse may involve crushing the pills into powder form either to sniff it or inject in intravenously after adding the powder to a liquid. Or, they may increase the drug’s effects by taking more than what’s prescribed.
People who are looking to relieve stress and anxiety may turn to barbiturates for some relief. The medication’s sedative effects have been described as akin to alcohol intoxication. Others use them to counteract the effects of stimulant drugs, such as cocaine and methamphetamines, and the “come down” from those drugs.
Barbiturate Addiction: How Dangerous is it?
The addictive nature of barbiturates as well as how little it takes for the drugs to be lethal make them dangerous to one’s health and life. These sedatives can stay in the body long after they are ingested, so this is why it’s very easy for people to overdose on the drugs and fall into a coma they’ll never wake from. Some barbiturate users increase their risks of addiction and overdose when they use the drugs with alcohol, opioids, and benzodiazepines at the same time.
Respiratory failure, hypothermia (abnormally low body temperature), lethargy, low blood pressure, and loss of coordination can all result from combining barbiturates with alcohol. Any of these symptoms indicate that brain activity has decreased. Having two depressants in one’s system at the same time can overwhelm the brain, which can cause it to shut down completely.
According to the U.S. National Library of Medicine, people who are new to barbiturates generally are among the group of people who use alcohol and barbiturates concurrently. There also are experienced users in this population who are aware of the effects that result from mixing these two substances. It is harder to treat this set of barbiturate users, reports the NLM.
The library reports that overdose can bring about these complications:
- Head injury and concussion from falls when intoxicated
- Miscarriage in pregnant women or damage to the developing baby in the womb
- Neck and spinal injury and paralysis from falls when intoxicated
- Pneumonia from depressed gag reflex and aspiration (fluid or food down the bronchial tubes into the lungs)
- Severe muscle damage from lying on a hard surface while unconscious, which can cause permanent injury to the kidneys
Signs of Barbiturate Addiction
Habitual use of barbiturates can bring on mental and physical changes. A large barbiturate dose can make people appear high-spirited, talkative, and uninhibited in addition to the feeling of euphoria. Other signs and symptoms of barbiturate intoxication or addiction include:
- Shallow breathing
- Slow, slurred speech
- Chronic fatigue
- Memory loss
- Poor judgment
- Mood swings
- Motor control problems
- Physical coordination problems, such as clumsiness
- Unclear thinking, thinking difficulties
- Reduced emotional reactions
- Impotence (men)
- Irregularities in menstrual cycle (women)
A person may exhibit emotional changes and exhibit behavior illustrating that there may be increased sensitivity to pain and/or sound. Addiction is also behavioral, so if the following is noticed from a person who is taking barbiturates, then it is possible the person is in active addiction and needs help.
Barbiturate Addiction May Bring on These Behavioral Changes:
- Strong, seemingly unbearable drug cravings
- Constantly thinking about a barbiturate(s)
- Taking the drug outside of what is prescribed
- Not using the drug in the manner it was intended
- Experiencing withdrawal symptoms 24-48 hours after the drug is last taken
- Taking the drug to avoid withdrawal symptoms
- Hiding barbiturate use from family, friends, colleagues
- Isolation from others; strained relationships
- Inability to stop using drugs despite repeated attempts to quit
- Feeling like you can’t function without the drug
- Mixing a barbiturate with alcohol or benzodiazepines (polysubstance abuse)
- Using the drug despite the negative consequences that result from doing so, such as job loss
Chronic barbiturate users who want to quit their use must take care to go about this process gradually. There may be an urge to quit the drugs abruptly, a popular practice known as “going cold turkey.” But that’s not recommended as it can result in uncomfortable withdrawal symptoms that can lead a person to go back to using just to make those symptoms stop. With that relapse comes the possibility of overdosing, which can lead to death. A sudden break in long-term barbiturate use can cause hallucinations, seizures, convulsions, fever, vomiting, and suicidal thoughts.
How Does Addiction Treatment Work?
Barbiturate overdose is life-threatening, so a medical evaluation is advised before addiction treatment is started.
Many factors affect how long the process is for treating a barbiturate addiction. Much depends on the individual, including the person’s history of barbiturate use. Longtime users are advised to enter a drug rehab program and get professional help that can point the way to recovery.
Other factors that can affect the recovery process include:
- Age, sex, health, medical history, and lifestyle
- Your weight and body fat percentage
- How often barbiturates are consumed
- Barbiturate tolerance
- The manner in which barbiturates are used (snorted, injected);
- If barbiturates have been used with other drugs and substances, such as benzodiazepines, opioids, or alcohol (polysubstance abuse)
The barbiturate addiction treatment process typically starts with a medical detox. This medically monitored process involves around-the-clock care to ensure all traces of barbiturates and other drugs and toxins are safely removed from the system. During this process, clients are kept safe and comfortable as they are given medicines and other care to ease withdrawal symptoms and make them manageable. Medical professionals may use a tapering method to wean clients slowly off barbiturates.
Detox is the first step in drug rehabilitation treatment. This process alone is not enough to stop someone from abusing barbiturates again.
An evaluation will help determine how far along a person is in barbiturate addiction and whether the person has a co-occurring disorder, which means a mental health disorder is present, such as depression, anxiety, Post-traumatic stress disorder (PTSD), and bipolar disorder, along with their substance use disorder. Both conditions must be addressed at the same time to give the person the best chance at recovery, so finding a treatment program that can do that is recommended. If you or someone you know is facing this situation, Maryland House Detox can help with these needs. Call us at 855-928-0596.
Once the detox process has been completed and an evaluation has taken place, clients are presented with options for a treatment program. These options include residential treatment, intensive outpatient treatment, and partial hospitalization programs. In all of these programs, recovering barbiturate users can address their addiction and begin to heal on all levels—mentally, physically, emotionally, and perhaps spiritually. These treatment programs can be tailored to an individual’s needs and preferences.
Treatment also can be customized according to the needs and preferences of the person. It can include 12-step fellowship programs (Alcoholics Anonymous and Narcotics Anonymous, for example), motivational therapy, trauma therapy, holistic therapies such as yoga and acupuncture, and individual counseling and group counseling sessions.
Aftercare services can help people recovering from barbiturate addiction by giving them the tools and guidance to focus on their recovery goals and reduce their chances of relapse. There are many opportunities out there that can help one achieve this goal, including follow-up medical care and ongoing therapies to help manage post-acute withdrawal symptoms, known as PAWS, which often happens long after dependence on the drug has passed. Barbiturate-related PAWS include anxiety, cognitive impairment, irritability, and depression.
- In 2013, barbiturates were found to be responsible for almost 400 deaths.
- Each year, doctors give out about 19 million barbiturate prescriptions.
- 8% of all barbiturates in the U.S. are created illegally.