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.
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.
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:
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.
(June 2018) Everything You Need to Know About Barbiturates. Medical News Today. from https://www.medicalnewstoday.com/articles/310066.php
(January 2015) Barbiturates Drug Profile. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). from http://www.emcdda.europa.eu/publications/drug-profiles/barbiturates
(March 2018) What are Prescription CNS Depressants? National Institute on Drug Abuse (NIDA). from https://www.drugabuse.gov/publications/drugfacts/prescription-cns-depressants
(April 2017) Amytal Sodium. Valeant Pharmaceuticals. from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=a2523317-e071-4e04-9d9f-9053286e0ce2&type=display
(December 2016) Nembutal Sodium. Oak Pharmaceuticals, Inc. from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=5c380ab0-4386-48b6-80ab-ca594b23bc74&type=display
(April 2018) Seconal Sodium. Valeant Pharmaceuticals North America LLC. from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=d892a312-12ba-4d32-a840-2c0ff3dc1d58&type=display
Mephobarbital. U.S. National Library of Medicine (NLM). from https://pubchem.ncbi.nlm.nih.gov/compound/Mephobarbital%23section=Synonyms
(August 2015) Butisol Sodium. U.S. National Library of Medicine (NLM). from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7883bbc0-0874-11dc-a818-0002a5d5c51b
(May 2019) Phenobarbital. U.S. National Library of Medicine (NLM). from https://medlineplus.gov/druginfo/meds/a682007.html
(January 2019) Barbiturate Toxicity. StatPearls Publishing. from https://www.ncbi.nlm.nih.gov/books/NBK499875/