Barbiturates were once the go-to drug for rest and relaxation, especially because of how quickly the potent sedatives helped people calm down or fall asleep. They offered a sure path to relief for people who struggled with anxiety or anxiety-related disorders and needed a break. But these calming properties also made the drugs popular on the recreational drug scenes of the 1960s and 1970s, leading several people, including celebrities such as Judy Garland, Jimi Hendrix, and Marilyn Monroe, to die after overdosing on them.
The old class of medications, first developed in 1864, are dangerous because the difference between a therapeutic dose and a fatal one is slim.
It gets harder to tell when chronic barbiturate users become tolerant and use higher amounts of the addictive substance for their desired outcome, only to be met with an untimely death because the dose was too much.
Barbiturates aren’t as common today because other drugs that have been deemed safer to use have pushed them out of the limelight. According to Medical News Today, the side effects of these drugs are less severe and less likely to lead to accidental overdoses.
While times have changed, barbiturates may have been pushed out but are still around enough to raise concern about their use. According to the Global Barbiturate Drug Market Research Report 2019, “North America is expected to account for the largest share of the global market from 2018 to 2025, due to [the] highest percentage of insomnia-affected patients.”
Not all of these medications will fall into the right hands. Some may even find their way into the possession of U.S. teenagers, a population that in recent years has shown interest in these medications.
The National Institute on Drug Abuse reports that in 2013, about 50 percent of high-school seniors reported abusing prescription medications and that nearly 5 percent of these admitted to having access to or abusing sedatives. Some of these teens surveyed gain access to barbiturates that were prescribed to their parents or grandparents; some get them from street drug dealers.
Barbiturates are labeled Schedule II, III, and IV depressants under the Controlled Substances Act. The manufacturing and distribution of the medications are under strict government control in the U.S. To be clear, any use of barbiturates outside of a clinical setting is illegal. Only medical professionals can prescribe these medications. Still, some people will find a way to use them illegally.
How Barbiturates Work
Barbiturates are medications derived from barbituric acid. More than 2,500 of them have been made since the 1900s, but only about 50 of them actually made it to the market for human use. Today, even that number has dwindled as about 12 are used today for medical purposes in a clinical setting.
Historically, barbiturates have been used to treat anxiety, epilepsy, insomnia, and seizure disorders, and they were in widespread use in the 1960s and 1970s. In modern times, they have been largely phased out in favor of benzodiazepines, which the medical community considers safer medications to use to treat these conditions. Barbiturates, however, haven’t completely been abandoned. They are still used to relieve patients’ anxiety and tension and to control seizures.
Barbiturates that are commonly used include:
- Amytal (amobarbital)
- Brevital (methohexital)
- Mysoline (primidone)
- Seconal (secobarbital)
- Nembutal (pentobarbital)
- Luminal (phenobarbital)
Barbiturates are designed to slow down the body’s central nervous system. They stimulate the brain’s gamma-Aminobutyric acid (GABA) neurotransmitter, reducing the heart rate, slowing breathing, and increasing drowsiness and relaxation. People who take these drugs can expect effects that are similar to those of alcohol intoxication or potent benzodiazepine tranquilizers such as Xanax and Valium.
Barbiturates come in various forms. Some can be taken as tablets or capsules while others come in oral liquid or injection form. Some people who abuse them will crush up the pills into a powder and add the powdered substance to a liquid so they can inject it intravenously. Effects can last between four and 16 hours depending on dosage and type of barbiturate is taken.
Why Do People Abuse Barbiturates?
People who abuse barbiturates do so for various reasons. Some enjoy the euphoria, relaxation, and feelings of well-being they get from using the substance while others use them to “come down” from a high after using stimulant drugs, such as cocaine and methamphetamines. Others use barbiturates with other drugs, such as heroin or oxycodone. Alcohol is also used along with these drugs, a very deadly combination. Two depressant substances only increase the effects of the other, and this can bring all sorts of complications, from respiratory failure and low blood pressure to decreased brain function.
Suddenly going off these drugs is not recommended, as doing so could result in death. That still does not stop people from attempting to go cold turkey. There is a safer way to end drug dependence and addiction.
What Are Barbiturate Withdrawal Symptoms?
Longtime or frequent users are vulnerable to developing a strong addiction to these medications. The longer use takes place, the more physically and psychologically dependent users will become, and this dependence can turn into an addiction that makes it highly challenging to stop using. Going off a drug that has been used in a high amount or for an extended period typically jump-starts an uncomfortable period of symptoms known as withdrawal for users. Withdrawal happens as the body attempts to adjust to not having a drug’s presence in its system.
Uncomfortable withdrawal symptoms that occur when use has stopped is a sure sign that dependence and/or addiction are underway.
Common barbiturate withdrawal symptoms include:
- Increased Anxiety
- Nausea, vomiting
- Difficulty sleeping
There are withdrawal symptoms that are more serious in nature, which are:
- Circulatory failure
- Suicidal thoughts
If you or someone you know is experiencing any of these symptoms after stopping barbiturate use, seek immediate medical attention at a medical facility or licensed addiction treatment facility.
What Are The Stages In The Barbiturate Withdrawal Timeline?
The timeline and stages of barbiturate withdrawal can be challenging to predict.
Various factors influence how long the period lasts for each person, including:
- The drug’s half-life (how long it takes it to leave the body)
- The specific barbiturate used
- The drug’s dosage
- Length of time on the drug
- Age, physiology
- Whether or not there is a co-occurring mental illness
- Whether or not other drugs have been used with the barbiturate
- Tolerance levels
Those who are recovering from barbiturate use are strongly advised to consult with a physician for specifics about their situation. Users can expect for withdrawal to take place over at least two weeks. However, once the worst of it has cleared, there may be post-acute withdrawal symptoms to contend with, which can linger for weeks, months, or even years after substance use has stopped. After-care treatment can help people manage these symptoms.
A General Timeline May Look Something Like The Following:
Barbiturate users who are in the early stages of withdrawal may experience a rapid pulse, nausea and vomiting, sleep issues, and mood swings. Symptoms may peak by the third day. They also may notice that some symptoms may intensify, such as fatigue, insomnia, anxiety, excessive sweating, and delirium. The risk for seizures is also high during this initial period, so it is advised to have medical professionals on board who can monitor these first few days.
Psychological and physical symptoms should lessen in intensity by the fifth day. Users may still experience emotional issues, such as sadness or anxiety. Cravings may linger though they may not be as strong as before. Sleep difficulties, mood swings, fatigue, and irritability are also other symptoms users may grapple with.
Physical withdrawal symptoms usually subside by the first week, and users report feeling normal. Some emotional symptoms may linger on through the next couple of weeks, but overall, the body should start to stabilize. As mentioned previously, aftercare is recommended to manage lingering symptoms.
Why Should I Detox?
Withdrawal from barbiturate use can become harrowing for users who are attempting to end their dependence on these addictive medications. However, no matter how discomforting this period is, users are encouraged to go about managing their withdrawal symptoms gradually and under the care of medical professionals who can monitor them and address any complications that may arise.
The proper way to end barbiturate use is to start with medical detox, which is typically the first step on the road to long-lasting recovery and sobriety. Detox ensures that recovering barbiturate users in withdrawal are kept safe as they manage their symptoms during a rough period that for many, is the first step of ending drug use. Attempting to go this rough period alone puts one at risk of having a relapse and overdosing, which could lead to death.
Many people commonly abstain from their drug of choice only to later pick up the substance again to satisfy hard-to-ignore cravings. Unfortunately, they are at higher risk of overdose, even if they go back to using their usual dose because their tolerance was lowered during the time they were not using. This is another reason it is highly recommended that users enter a facility and avoid trying to get through withdrawal symptoms on their own.
What Is The Next Treatment Step?
Barbiturate users who are ready to end their dependence are advised to enter a reputable addiction treatment facility or detox center which helps people safely navigate the withdrawal period. During detox, medical professionals may opt to taper the client’s dosage gradually as the body gets used to not having the barbiturate of choice in its system. Recovering users are kept as comfortable as possible during this process. They can improve knowing they are in good hands of people who can help them get through a rough withdrawal period.
During the medical detox period, clients are also assessed to determine their general health and well-being and if they have any mental health disorders that need to be addressed. If the assessment finds evidence of a dual diagnosis, when a mental health disorder is present as well as a substance use disorder, that will be taken into account as medical, and addiction care professionals work to determine the best treatment for the person who needs care.
Barbiturate Addiction Treatment
Detox is just the first step of a long road to recovery from substance abuse. It is rarely recommended that a person complete detox only and not enroll in a treatment program that can help them gain the tools they need to overcome their addiction on a holistic level that treats their mind, body, and spirit. There are various treatment options available that fall along a continuum of care.
People in recovery who complete more steps in the continuum increase their chances of a full recovery from substance abuse. The most effective facilities are the ones that create treatment plans that address each person’s specific needs that are unique to their situation. After detox, many people either enter a residential treatment program or receive treatment on an outpatient basis.
Residential Barbiturate Addiction Treatment
Inpatient or residential treatment programs can run from a month to up to 90 days or longer if needed. Clients who receive treatment in this structured, monitored environment live on-site full-time and have 24/7 access to medical staff and supervision. This setting allows for little to no distractions as one concentrates on recovering from their substance use. Various therapies are utilized to give them the right tools and strategies to understand their addiction and healthily cope with life after using, which involves stress, triggers, and the possibility of relapse.
Understanding and preparing for relapse is an important part of this recovery process. The National Institute on Drug Abuse writes that addiction relapse rates range from 40 to 60 percent, which is similar to relapse rates for other chronic illnesses such as diabetes, hypertension, and asthma. Fortunately, relapse is preventable with the right guidance in place.
Outpatient Barbiturate Addiction Treatment
People who have a mild case of barbiturate dependence or are early in their recovery may find an outpatient program effective. Outpatient programs also may attract interest from recovering users who feel like a relapse is near or if they need more support to achieve their sobriety goals. This program offers flexibility schedule-wise and affordability, making recovery a more realistic option.
Clients have more control over their treatment schedules and the hours at which they receive their treatment. They also can live at home during their treatment, which is of the same quality as they would get from an inpatient residential facility.
Outpatient clients are responsible for attending therapy sessions and keeping their lives free of distractions and situations that could derail their recovery.