All barbiturates are very addictive, which is largely why they aren’t commonly used anymore. Amobarbital (Amytal) has the shortest duration of action among barbiturates, which makes it one of the most addictive.
Once widely prescribed as sedatives, anticonvulsants, anesthetics, and sleep aids, barbiturates are prescribed sparingly today.
These drugs are considered to have more risk than reward much of the time. Their therapeutic nature is often overshadowed by their potential for dependence and fatal overdose.
Even when taken as directed for medical reasons, regular use can quickly lead to tolerance and physical dependence. Once dependence on a barbiturate is established, the withdrawal symptoms when the drug processes out of the body can be life-threatening, making it hard to stop taking them and increasing the rate of addiction.
All barbiturates are considered to be highly addictive. Recreational use of a barbiturate increases the odds for addiction, and the method of use can play a role in how quickly it develops.
Other factors involved in the addictive potential of barbiturates include how quickly the drug starts working and how long it stays effective in the system. Amobarbital works quickly and wears off faster than phenobarbital, for example, which can make it more addictive.
The Addictive Nature Of Barbiturates
Barbiturate drugs are central nervous system depressants that lower body temperature, blood pressure, and heart rate. They act as sedatives which are effective in controlling seizures, and as anesthetics and sleep aids.
The therapeutic index of barbiturates is often considered to be much smaller than the risk, however. It’s relatively easy for an overdose of barbiturates to occur, and it can be fatal.
Barbiturates are classified as very habit-forming. Tolerance can form with regular, and even short-term, use.
Tolerance means that it will take more of the drug to keep working the same way, causing you to feel the need to increase the dosage or take it more often. Over time, physical and psychological dependence usually develops.
Dependence can bring on severe withdrawal symptoms when the drug wears off. These symptoms can even be life-threatening. Seizures, fever, extreme confusion, agitation, insomnia, anxiety, depression, and delusions can all occur during withdrawal
These significant withdrawal symptoms make it hard to stop taking a barbiturate. This compounds the risk of addiction and often leads to compulsive use.
Rankings Of Addictive Potential Of Barbiturates
Again, all barbiturates are addictive.
Personal biology, genetics, and, environmental factors like stress levels can all influence the rate of addiction. The way you take a drug can also make it more or less likely that you will struggle with addiction.
Recreational drug use is always more hazardous than taking a drug as directed for medical purposes. Injection use, snorting or smoking drugs all raise the odds for addiction, as these methods send the drugs into the bloodstream faster than ingesting them can.
Another factor that can be involved in how addictive a particular drug can be is how quickly the drug starts working and how long it stays active in the body. Drugs that work fast and wear off fast are often considered more addictive, as you will need to take higher doses more often to keep them active and working in your bloodstream.
The following barbiturates are ranked based on how addictive they are, but again, they all carry a high risk for addiction:
- Amobarbital (Amytal): This barbiturate has the fastest onset and shortest duration of action. It is used to treat sleep disorders. It starts working quickly and wears off in about six to eight hours.
- Pentobarbital (Nembutal): This short-acting barbiturate can start working within minutes and has a half-life of between 15 and 40 hours. It is prescribed as an anticonvulsant and a sedative.
- Secobarbital (Seconal): a sedative-hypnotic barbiturate with a half-life of between 15 and 40 hours that can start working within ten to 15 minutes and remain active for about three to four hours as a short-acting medication.
- Mephobarbital (Mebaral, Prominal): This is considered an intermediate-acting barbiturate, primarily prescribed as an anticonvulsant that usually starts working within 30 to 60 minutes after taking it. Mephobarbital keeps working for 10 to 16 hours.
- Butabarbital (Butisol): This intermediate-acting barbiturate is prescribed as a sedative or a hypnotic. It usually begins working within an hour and stays effective for about six to eight hours. Butabarbital has a half-life of around 100 hours.
- Butalbital (Fortabs, Fiorinal Ascomp, Esgic, Fioricet): Butalbital is typically administered as a combination medication containing acetaminophen and caffeine or aspirin and caffeine. It is a barbiturate prescribed to reduce muscle tension when other medications are not working. Butalbital is an intermediate-acting barbiturate with a half-life of around 35 hours.
- Phenobarbital (Luminol): This is one of the earliest used barbiturates with the latest onset of action and the longest duration of action. Phenobarbital is generally used as an anticonvulsant. It usually takes at least an hour to start working, and it can then remain active for 10 to 12 hours. It has a half-life of between 53 and 118 hours.
Barbiturates are usually considered to do more potential harm than good. They are generally reserved for use only when extremely necessary, and other medications are not effective.
When barbiturates are used, they are only used for a short period of time, which can reduce their effectiveness. They are so habit-forming and can so easily lead to an addiction that this is often necessary.
Barbiturates can also be toxic in relatively low doses. Sedative-hypnotic medications are one of the top five leading drugs involved in fatal overdoses in the United States, with pentobarbital topping the list. In fact, the barbiturate sodium thiopental is used in lethal injections.
If you have been taking a barbiturate for any length of time, you will need to detox from it slowly through a medical detox program. The drug will usually need to be weaned off in a controlled manner. The dosage may be tapered over a few days or even weeks to ensure that the withdrawal symptoms are safely managed.
After detox, a specialized addiction treatment program is recommended. The program may use medications, behavioral therapies, group and individual counseling, life skills training, educational programs, relapse prevention tools, and support groups as part of a comprehensive plan to support recovery.