When some people need to relax or get to sleep or stay asleep, they may take sedatives to help them do that. Sedatives are a class of drugs that relax the central nervous system. Barbiturates fall in this category. They are sleep-inducing medications, and they are used to treat anxiety, epilepsy, insomnia, headaches, and seizure disorders among other conditions.
This older class of medications that was popular in the 1960s and 1970s produces a range of effects—from sedation to anesthesia—and their relaxing, euphoric effects are among the reasons people abuse them. Some users take them to work against the effects of stimulant drugs, such as cocaine and methamphetamine, during a “come down” period.
Because these prescription drugs are older, modern-day users may not know or understand the risks that accompany excessive barbiturate abuse, according to WebMD. However, becoming physically and/or psychologically dependent on barbiturates is dangerous indeed and can be fatal. Barbiturate overdose has claimed its share of lives, including celebrities Judy Garland, Jimi Hendrix, Marilyn Monroe, and Edie Sedgwick.
The drugs’ lethal reputation is known among people who seek to end their own lives. WebMD reports that the sedatives are commonly used in suicide attempts, and, according to the U.S. National Library of Medicine (NLM), 1 in 10 people who overdose on barbiturates or a mixture that contains barbiturates will die.
Barbiturates are sedative-hypnotic medications 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. This mildly sedates users or put them into a coma, depending on how much is taken. More than 2,500 barbiturates were produced during the 20th century. Only 50, however, have been appeared on the market, and about 12 are used today. Barbiturates are Schedule II, III, and IV depressants under the Controlled Substances Act.
Barbiturate medications include:
Physicians once prescribed barbiturates in the 1960s and 1970s to help patients manage their anxiety, epilepsy, insomnia, and seizure disorders. Today, benzodiazepines are used in their place as the medical community regards them safer to use because the chances of users overdosing are lower. Still, the medications are used to induce anesthesia in surgery.
Barbiturates’ alcohol-like effects draw teenagers, who may abuse prescription medications prescribed to older relatives, such as their parents or grandparents. They can also get them on the streets.
Barbiturates can be taken as a tablet or a capsule or they can be taken as an oral liquid. An injection form is also available. Users are advised to review the side effects, dosage, and drug interactions of these medications before taking them.
Like benzodiazepines, barbiturates slow the processes of the body’s central nervous system and stimulate the brain neurotransmitter gamma-aminobutyric acid (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 created equally. Each has its own set effects that last for different times, which means they affect the body differently. How long or short those effects determine how they are classified. They generally fall into four categories. They 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.
Some people turn to barbiturates when they have trouble getting to sleep or staying asleep or they may be looking to relieve stress. When barbiturates are used in a manner not intended, people tend to experience euphoria, relaxation, pleasurable feelings, and a sense of well-being. Barbiturate abuse may involve crushing the pills into powder form so users can inhale it through their noses or inject in intravenously after adding the powder to a liquid. There’s also taking more of the drug than prescribed, which is also a form of abuse.
The addictive nature of barbiturates and 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.
The U.S. National Library of Medicine reports that people who are new to using barbiturates are typically in the population of people who use alcohol and barbiturates at the same time. 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, NLM says.
NLM reports that overdose can bring about these complications:
Habitual barbiturate users may experience physical and psychological changes as a result of their use or overuse. A large barbiturate dose can affect users in noticeable ways, including making them appear high-spirited, talkative, and uninhibited, according to the Global Information Network About Drugs. Other signs and symptoms of barbiturate intoxication include the following:
Emotional changes are common as is 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.
Behavioral changes include:
As much as “going cold turkey” can look and sound appealing to people who want to quit using or abusing barbiturates, it is not the way to go. Chronic barbiturate users who are ready to quit must use caution as they go about the process gradually. Quitting abruptly can result in uncomfortable withdrawal experience that can lead a person to relapse, or return to using, just to ease their discomfort or make it go away. symptoms stop. With that relapse comes the possibility of overdose, which can lead to death. A sudden break in long-term barbiturate use can cause hallucinations, seizures, convulsions, fever, vomiting, and suicidal thoughts.
Barbiturate overdose is life-threatening, so a medical evaluation should take place before addiction recovery treatment begins.
Treating a barbiturate addiction will depend on a number of factors that are unique to each person who goes through it. The person’s medical history, history of barbiturate use, and other factors are considered. Longtime users are advised to enter a drug rehab program and get the professional help that can point the way to recovery.
Other factors that can affect the recovery process include:
Addiction is a chronic, relapsing brain disease for which there is no cure, according to the National Institute on Drug Abuse. It is characterized by compulsive drug-seeking and use despite the harmful consequences that follow, the agency explains. Addiction also causes structural changes in the brain as well as how the brain functions. While not curable, it is treatable, NIDA says.
As with most addiction treatment programs, ending barbiturate use begins with a medical detox when it’s done professionally. This medically monitored process can happen in a hospital, at a private, stand-alone treatment center, or another kind of clinical setting and run three to 10 days or longer if needed. The procedure is beneficial for several reasons. It involves around-the-clock care to ensure all traces of barbiturates and other drugs and toxins are safely removed from the body.
During this process, clients are kept safe and comfortable as they are given medications approved for use by the U.S. Food and Drug Administration and other care to ease withdrawal symptoms and make them manageable. Clients also may be required to undergo a tapering procedure as they are slowly weaned barbiturates.
The detoxification period is the first step in drug rehabilitation treatment. It is not the only step, and it is not the last step. 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 a mental health disorder, such as depression, anxiety, Post-traumatic stress disorder (PTSD), and bipolar disorder is present along with a substance use disorder. If so, this is known as a co-occurring disorder, comorbidity, or dual diagnosis. 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.
Treatment 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 give people in addiction recovery with the tools and guidance to focus on their recovery goals and reduce their chances of relapse. Ongoing therapies are designed to help recovering substance users manage post-acute withdrawal symptoms (PAWS), which often happens long after dependence on the drug has passed. PAWS symptoms related to barbiturate use include anxiety, cognitive impairment, irritability, and depression.
Drug Scheduling. Drug Enforcement Administration. from https://www.dea.gov
López-Muñoz, F, (December, 2005).The history of barbiturates a century after their clinical introduction. US National Library of Medicine . from https://www.ncbi.nlm.nih.gov
(March, 2018).Barbiturate intoxication and overdose. Medline Plus. from https://medlineplus.gov
RxList.(2018, September 24) Barbiturates. WHAT ARE SIDE EFFECTS ASSOCIATED WITH USING BARBITURATES? from https://www.rxlist.com/consumer_barbiturates/drugs-condition.htm
(March, 2017). Barbiturate intoxication and overdose. Global Information Network About Drugs. from http://www.ginad.org
NIDA. (October 2016). “The Science of Drug Abuse and Addiction: The Basics.” The National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics
Substance Abuse and Mental Health Administration.(2019 August) Key Substance Use and Mental Health Indicators in the United States:Results from the 2018 National Survey on Drug Use and Health. Tranquilizer or Sedative Misuse. from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf