Barbiturate Addiction

Barbiturates are some of the oldest modern medications which are still used today. Barbituric acid was first used in the late 1800s and was later synthesized as a medicinal sleep aid. 

The drug has a controversial history. In the mid-20th century, barbiturates, benzodiazepines, and other depressant anti-anxiety sleep aids were marketed to otherwise healthy women, especially mothers. 

In the Golden Age of Hollywood, movie producers would give young actors amphetamines to keep them awake and alert through long hours of shooting. They would later give them barbiturates to counteract the stimulants and help them sleep.

Barbiturates are useful as an anti-anxiety medication and sleep aid, but their addiction potential can cause some adverse side effects, including overdose. 

There have been several high-profile deaths linked to barbiturate use including actress Judy Garland and musician Jimi Hendrix. Long-term barbiturate use can lead to dependence and overdose, but the drug also has abuse potential.

It can cause intoxication, similar to alcohol. Finally, unlike other drugs, it can even be dangerous during withdrawal.

Learn more about barbiturate addiction and why this drug has all but been replaced by alternative sleep aids.

What Are Barbiturates?

Barbiturates are in the class of psychoactive substances known as central nervous system (CNS) depressants, along with benzodiazepines and alcohol. They work by affecting a naturally occurring chemical in the brain called gamma-Aminobutyric acid (GABA).

This chemical is responsible for a number of important functions in the brain, especially controlling excitability in the CNS. This means that GABA slows you down, relaxes your muscles, eases your anxieties, and helps you sleep.

In some cases, people with anxiety disorders or sleep disorders can have a chemical imbalance that creates too much excitability in the brain.

Barbiturates can help by increasing the efficiency of GABA, allowing it to induce sleep and relaxation effectively. 

However, the problem is that the brain quickly adapts to the presence of barbiturates. If you use them regularly for too long, they can make anxiety and sleep problems worse. Your brain may stop producing its inhibitory chemical, relying primarily on barbiturates. Plus, your brain may also start producing excitatory chemicals to counteract the barbiturates and balance brain chemistry.

By the 1960s, the American public grew increasingly aware of the dependence and overdose potential of barbiturates.

Soon, benzodiazepines, another CNS depressant, started to grow in popularity.

By the 1970s, benzodiazepines were the most popular prescription in the world and had all but completely replaced barbiturates. Today, barbiturates are still used, but they are usually only prescribed as an anticonvulsant to help with seizures.

Types of Barbiturates

The following are barbiturates that still retain medical use:

• Amobarbital (Amytal): Branded as Amytal Sodium, this injectable barbiturate medication, once known as “truth serum,” treats insomnia and seizures. It is also utilized to induce sedation in patients. The U.S. Drug Enforcement Agency (DEA) also classifies it as a Schedule II controlled substance, meaning that it carries a high potential for abuse and could lead to severe psychological or physical dependence.
• Butabarbital (Butisol): This medication treats the symptoms of insomnia and is designated as a Schedule III controlled substance by the DEA. This classification means that it is seen as having less addiction potential than Schedule II drugs, but that “abuse may lead to moderate or low physical dependence or high psychological dependence.”
• Pentobarbital (Nembutal): Pentobarbital, which is branded as Nembutal, treats a variety of conditions, including anxiety, insomnia, and nervousness. It is also used on patients before medical procedures or surgery, and it has also been employed to treat epilepsy and seizures. Like amobarbital, it also carries a Schedule II DEA classification.  
• Secobarbital (Seconal): Also, a Schedule II controlled substance, secobarbital is a short-acting drug that treats symptoms of insomnia. It is also administered to patients to sedate them before surgery or medical procedures. 
• Phenobarbital (Donnatal): Relative to barbiturates like amobarbital, pentobarbital, and butabarbital, this drug possesses a low potential for abuse as a Schedule IV substance. Phenobarbital is prescribed to treat epilepsy. 
• Butalbital (Fioricet): This drug carries no DEA designation. Therefore, it is not sanctioned as a substance of abuse. Butalbital is often combined with acetaminophen to treat headaches and pain.
• Primidone (Mysoline): This barbiturate is employed to treat seizure disorders. It is not designated as a controlled substance. 

What Are the Signs of Barbiturate Addiction?

If you’ve been using barbiturates or another CNS depressant, there are a number of physical and psychological symptoms that can tip you off that there might be a pending addiction.

The first sign that your body is getting used to the drug is tolerance. If you are no longer experiencing the same effects of the drug, or if you feel like you need to use more to achieve the same results, it means you are becoming tolerant.

Your brain is producing chemicals to counteract the drug and diminishing its effects.

Signs of Barbiturate Withdrawal

The next sign is physical dependence. If you stop using the drug and start to feel withdrawal symptoms like anxiety, panic, insomnia, tremors, shakiness, aggression, or irritability, it can mean that you’ve become dependent.

Other symptoms associated with barbiturates are hallucinations, thoughts of suicide, and restlessness.

Signs of Barbiturate Addiction

If you are worried about a friend or family member that’s been using barbiturates or any other CNS depressant, there are some observable signs that can point to potential addiction:

• Impaired judgment
• Sedation
• Slurred speech
• Confusion
• Loss of motor function
• Irritability
• Restlessness
• Shakiness
• Isolationism
• Not participating in normal everyday activities
• Sudden problems at work or school
• Hiding or lying about drug use

If you believe that you, or a loved one, might be struggling with barbiturate addiction or dependence, it’s important to call your doctor as soon as possible. Quitting cold turkey can be potentially dangerous. Barbiturate withdrawal symptoms can cause serious medical complications that can sometimes be fatal.

What Is Involved in Barbiturate Addiction Treatment?

Since barbiturate withdrawal symptoms can be potentially life-threatening, treatment usually starts with medical detox. Also called medically managed inpatient service, medical detox represents the highest level of care in addiction treatment. It involves 24 hours of treatment from medical professionals who will help to ease your symptoms as you detox. They will also ensure that you go through detox safely, avoiding any complications. The extra supervision will help keep you from relapsing during drug cravings. Medical detox may also be appropriate if you have other co-occurring medical conditions that need immediate care.

If barbiturate use has turned into an addiction, it may not stop after you go through detox. If you have cravings and compulsions to use barbiturates again, you may need to go through continued addiction treatment. After detox, clinicians can help you find the next level of care that’s appropriate for your needs. There are three major levels of care after detox, including:

• Inpatient treatment
• Partial hospitalization program (PHP)
• Intensive outpatient
• Outpatient services

In addiction treatment, you will help your therapist and clinicians create a personalized treatment plan that addresses your individual needs. The plan may involve a variety of therapies that are designed to address any underlying mental health issues,

How Dangerous Are Barbiturates?

Barbiturates can cause intoxication, drowsiness, sedation, and other symptoms similar to alcohol use. These can be dangerous, especially when used before driving or operating heavy machinery. Side effects may be worse for older people.

As people get older, it becomes harder for the body to process and eliminate barbiturates, which can lead to more intense effects. This can cause accidents, like slip and fall accidents that are especially dangerous for older people.

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Barbiturates can cause fatal overdoses, where the nervous system is suppressed to the point where a person stops breathing. Deadly side effects are more likely to occur if you combine barbiturates with another depressant like alcohol or opioid pain relievers. 

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According to MedlinePlus.gov, the following are symptoms of barbiturate overdose:

• Drowsiness or coma
• Shallow breathing
• Altered level of consciousness
• Lack of coordination
• Slow, slurred speech
• Sluggishness
• Difficulty in thinking
• Faulty judgment
• Staggering

Finally, barbiturates are especially dangerous when you stop them using cold turkey, after developing a chemical dependence. Suddenly stopping barbiturate use can cause nervous system overactivity, which leads to symptoms like seizures and delirium, which can be fatal without medical care.

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Buck, S. (2016, December 22). Old Hollywood forced its first stars to work long hours and take amphetamines in exchange for fame. from https://timeline.com/hollywood-drugs-1930s-6b27a1404552

U.S. Drug Enforcement Agency (DEA). (n.d.). Title 21 Code of Federal Regulations. from https://www.deadiversion.usdoj.gov/21cfr/cfr/1308/1308_12.htm

U.S. Drug Enforcement Agency (DEA). (n.d.). Title 21 Code of Federal Regulations. from https://www.deadiversion.usdoj.gov/21cfr/cfr/1308/1308_13.htm

U.S. Drug Enforcement Agency (DEA). (n.d.). Title 21 Code of Federal Regulations. from https://www.deadiversion.usdoj.gov/21cfr/cfr/1308/1308_14.htm

U.S. Drug Enforcement Agency (DEA). (n.d.). from https://www.deadiversion.usdoj.gov/schedules/

European Monitoring Centre for Drugs and Drug Addiction. (n.d.). Barbiturates drug profile. from http://www.emcdda.europa.eu/publications/drug-profiles/barbiturates

Medical News Today. (2018, June 25). Barbiturates: Uses, side effects, and risks. from https://www.medicalnewstoday.com/articles/310066.php

Health Research Funding. (2014, December 23). 21 Fascinating Barbiturates Statistics. from https://healthresearchfunding.org/21-fascinating-barbiturates-statistics/

MedlinePlus.gov. (n.d.). Barbiturate intoxication and overdose: MedlinePlus Medical Encyclopedia. from https://medlineplus.gov/ency/article/000951.htm