Before being replaced by benzodiazepines, barbiturates were doctors’ go-to drug for the treatment of insomnia and other sleep disorders as well as generalized anxiety. However, the many dangers and serious health issues associated with barbiturate use, including a significantly high risk of abuse, addiction, and overdose, led to their disuse.
Barbiturates are often thought of as a drug of times gone by as they are associated with the deaths of celebrities such as Judy Garland, Marilyn Monroe, and Jimi Hendrix.
However, while usage of the drug today is typically restricted to hospital settings for pre-surgery sedation, barbiturates can still be obtained illicitly, sometimes as easy as buying them on the internet. In fact, certain barbiturates, such as Amytal, are on the U.S. Drug Enforcement Agency’s list of “most commonly abused drugs.”
So you should not assume that just because barbiturates have fallen out of everyday prescriptive use that they are not still a potential danger when it comes to substance abuse and addiction. The truth is quite the opposite, as it is frighteningly easy to become dependent and eventually overdose on these powerful sedatives.
What Are Barbiturates?
Barbiturates are potent central nervous system depressants that are derived from barbituric acid. They first came into use in the late 1800s and were used not only in the treatment of insomnia and anxiety but also epilepsy, as general anesthesia, a method of euthanasia and capital punishment, and even in some forms as a truth serum.
Barbiturates work in essentially the same way as most central nervous system depressants, binding with the brain’s gamma-aminobutyric acid (GABA) receptors in order to slow down the function of the nervous system. GABA is a brain chemical that naturally inhibits nerve impulses carrying feelings of anxiety and stress to the brain.
What barbiturates do is mimic the natural GABA in the brain in order to activate these receptors and cause them to produce an excess of GABA, flooding the brain and nervous system to create potent feelings of sedation and relaxation.
Signs of Addiction
Being able to recognize the signs of barbiturate abuse before it progresses to dependence and addiction is more difficult than someone might think. For many people, what they think of as substance abuse is actually the loss of control consistent with addiction.
When someone is abusing a substance but not yet fully addicted, there are usually early signs, but they can be hard to catch if you are not looking for them, even if you are the one who is misusing the drug. Often it is only after someone has reached the point of addiction that a pattern of earlier behavior becomes recognizable.
However, there are specific effects of regular abuse that will sometimes stand out and act as signs of a growing barbiturate addiction, such as:
- Slurred speech
- Chronic drowsiness
- Bouts of confusion
- Noticeably impaired coordination
- Frequent, painful headaches
Aside from the effects caused specifically by dependence, as someone becomes increasingly addicted to a substance and begins to lose control, they will usually start exhibiting abnormal behavior consistent with substance use disorders.
Priorities, responsibilities, and relationships become secondary in favor of getting and using the drug, despite any potential negative consequences. As someone’s addiction progresses, the signs of barbiturate addiction will become more apparent.
Examples of these signs and behaviors include:
- Taking larger doses or more often than prescribed
- Doctor shopping for multiple prescriptions
- Forging prescriptions or taking barbiturates without a prescription
- Stealing money or valuables to obtain barbiturates
- Increased tolerance
- Experiencing withdrawal symptoms when not using barbiturates
- Feeling unable to function or perform daily tasks without barbiturates
- Lying about or hiding usage
- Noticeable decline in school or work performance
- Isolating yourself and becoming withdrawn in favor of using barbiturates
- Trying to quit using without success
If you have observed these behaviors in someone you know or are experiencing them yourself, it is indicative of barbiturate addiction. It is vital that you seek out professional addiction treatment to avoid an overdose and put a stop to any further mental or physical harm caused by prolonged abuse.
Similar to benzodiazepines, barbiturates can have unpredictable, potentially life-threatening withdrawal symptoms, so beginning treatment with detox at a medically supervised treatment center is crucial. Attempting to detox on your own puts you at needless risk of dangerous symptoms such as hallucinations, seizures, delirium, and suicidal behavior.
Once you have successfully cleared barbiturates from your system under the careful monitoring of an experienced medical detox team, the next stage in barbiturate addiction treatment is receiving ongoing care in an addiction recovery program.
While detoxing is an essential first step in the recovery process, it is still only the first step, and while it will make you sober, it does nothing to keep you that way. An addiction treatment program gives you the best chance of maintaining long-term sobriety. It provides you with the understanding and tools you need to help you manage your addiction effectively.
Depending on factors such as the severity of your addiction, your current health, and whether or not you have a strong outside support system, barbiturate addiction treatment can be done in either an inpatient or outpatient program.
Generally, you will collaborate with your therapist or clinician to create a treatment plan that is tailored to your specific needs, although it will usually include at least some of these common treatment modalities, including:
- Individual and group therapy
- Stress management
- Medication-assisted treatment
- Behavioral therapy
- Addiction education workshops
- Relapse prevention planning
How Dangerous Are They?
Along with the previously mentioned withdrawal symptoms, continual abuse can have extremely dire consequences, including the development of health issues such as:
- Severe liver damage
- Enlarged blood vessels
- Dangerously low blood pressure
- Hemorrhagic blisters
- Frequent periods of confusion
Perhaps one of the most dangerous aspects of barbiturate addiction is the increased risk of overdose. It is almost too easy to unintentionally overdose, especially when they are mixed with depressants such as alcohol and benzodiazepines.
Unlike opioids and naloxone, there is no direct antidote for a barbiturate overdose. Even if it is successfully treated in time to prevent it from being fatal, the individual in question will still most likely be left with debilitating, often permanent health problems afterward.
The signs of a barbiturate overdose include:
- Loss of coordination
- Slowed reflexes
- Confusion and delirium
Other potentially fatal complications that can happen as a result of a barbiturate overdose include:
- Heart failure
- Kidney failure
- Brain damage
- Pulmonary edema (buildup of fluid in the lungs)
- An estimate of 6.4 million people aged 12 or older misused prescription tranquilizers or sedatives in 2018.
- According to the U.S. National Library of Medicine (NLM), roughly 1 in 10 people who overdose on barbiturates or a mixture of substances including barbiturates will die.
- Approximately, 1.2 million people aged 12 or older misused prescription tranquilizers for the first time in 2018.