Barbiturate Addiction: Signs, Symptoms, Risks, and Treatment Resources


Amanda Stevens, BS

Medical Review by:

Dr. Po Chang Hsu MD, MS

Updated On: Jan 13, 2024
Last Medical Reviewer On: April 21, 2024
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    Barbiturates are a class of drugs that depress the central nervous system (CNS); however, they are similar but a distinct class of sedatives to benzodiazepines. Their anticonvulsant and hypnotic qualities make them an ideal drug for epileptic and preoperative surgical patients.

    Tight regulations are responsible for a relatively low level of addiction compared to other drugs. Nevertheless, barbiturates are still dangerous because the difference between the therapeutic dose and the fatal dose is tiny.

    Key Points

    • Barbiturates are a class of sedative medications commonly prescribed for treating epilepsy (seizure disorder) and preoperative anxiety.
    • Serious side effects include hypotension, coma, and respiratory depression.
    • Someone who has overdosed on barbiturates might seem drunk or intoxicated with slurred speech, impaired coordination, glassy eyes, altered consciousness, extreme fatigue, and coma.
    • Long-term barbiturate use has been associated with depression, loss of appetite, achiness, and rarely liver damage.
    • Treatment for barbiturate abuse includes medical detox, inpatient treatment, and long-term aftercare interventions.

    What are Barbiturates?

    While barbiturates were historically prescribed for conditions such as epilepsy and anxiety, their use has significantly declined due to the high risk of dependence and overdose, coupled with the development of safer alternatives like benzodiazepines. They act on the CNS (central nervous system) similarly to the inhibitory transmitter GABA.

    Barbiturates cause sleepiness and a hypnotic state conducive to general anesthesia before surgery. Historically, they were also commonly prescribed for insomnia but have now been largely replaced by benzodiazepines, which have a lower risk of overdose and an available antidote to reverse toxicity.[1][2]

    Due to stringent regulations, barbiturates are less commonly found on the streets in countries like the United States, Australia, and Canada, making unauthorized access and misuse less prevalent compared to other substances.

    However, there are still available barbiturates like Pentobarbital, which is widely used as a euthanasia agent by veterinarians. Until it was discontinued in 2011, Thiopental (another barbiturate) was widely used by veterinarians for euthanasia and by executioners as one drug in the lethal injection cocktail given to inmates condemned to die.[3]

    In countries like Mexico, which don’t tightly regulate who veterinarians can sell barbiturates to, it is less difficult to purchase them. In the US, barbiturates are classified as a Schedule II-IV controlled substance.

    Side Effects of Barbiturates

    Serious side effects of barbiturates include hypotension, coma, and respiratory depression.[4] Allergic reactions and skin rashes can occur, which may be associated with mild liver injury in some cases.[5]

    If barbiturates are administered intravenously, blood pressure will be reduced, and the heart rate will increase. Respiratory depression may occur.

    How are Barbiturates Taken?

    There are three methods of administration:

    • Intramuscular
    • Intravenous
    • Orally

    Legal barbiturates are most commonly administered intravenously. They are fast-acting and classified according to short-acting (lasting 2-4 hours) to long-acting (6+ hours).

    Illicit use of barbiturates may involve oral administration, sometimes being mixed with liquids like whiskey to mask their taste. This situation is extremely dangerous, and a fatal dose of barbiturates can easily be misjudged as safe.

    Barbiturates Quick Reference

    Drug Category Commercial & Street Names DEA Schedule Administration
    Sedative- Hypnotic Commercial Names: Phenobarbital, Methohexital, Butalbital, Pentobarbital, Primidone, and Amobarbital. Street Names: Barbs, Downers, Christmas trees, Blue heavens, Blues, Goof balls, Blockbusters, Pinks, Rainbows, Reds, Red devils, Reds and blues, Sekkies, Sleepers, and Yellow jackets. Schedule II-IV Intramuscular Intravenous Orally

    Learn About Specific Barbiturates

    Barbiturates are a sedative-hypnotic class of medications. They are all produced in laboratories under very controlled conditions. They generally have no cutting agents. They are all controlled substances, though some have more accepted uses than others. The most common barbiturates are:

    • Phenobarbital
    • Methohexital
    • Butalbital
    • Pentobarbital
    • Primidone
    • Amobarbital

    Statistics on Barbiturate Use, Misuse, and Addiction

    Fewer barbiturates appear on the black market than in the past, so their rate of use and misuse is lower than other drugs. According to the Substance Abuse and Mental Health Services Association, around 405,000 Americans 12 or older used barbiturates in 2018; in the same year, 32,000 people reported misusing them.[6][7]

    There is emerging research that shows barbiturates are increasing in popularity as a form of assisted suicide.[8]

    Substance Use Disorder Treatment by Substance

    Effects of Barbiturate Abuse

    Can You Overdose on Barbiturates?

    Yes. Too much barbiturates will depress your breathing and stall your heart. Oxygenated blood isn’t reaching your brain if your heart isn’t pumping. And, if your brain doesn’t get oxygenated blood, you will die.

    Signs and Symptoms of Barbiturate Overdose

    Someone who has overdosed on barbiturates might seem drunk or intoxicated:[9]

    • Slurred speech
    • Impaired coordination
    • Altered consciousness
    • Extreme fatigue
    • Coma

    What to do if you suspect someone is overdosing on Barbiturates:

    If you suspect someone is overdosing on barbiturates, call emergency services immediately. Prioritize ensuring the person’s airway is clear if they are unconscious and monitor their breathing. If necessary, begin CPR if they are not breathing until emergency responders arrive.

    Death could occur if they are unconscious while vomiting and begin to choke (just like people who overdose on alcohol). Begin CPR if they’re unconscious and not breathing until emergency workers arrive.

    Dangers of Long-Term Barbiturate Use

    Long-term barbiturate use has been associated with depression, loss of appetite, achiness, and in rare cases, liver damage.[10]

    Abrupt cessation of barbiturates can lead to severe withdrawal symptoms. If possible, a more gradual approach is recommended to reduce dependency.

    Mixing Barbiturates with Other Drugs

    Barbiturates are sometimes mixed with alcohol or even opiates like heroin or fentanyl. It cannot be stressed enough how dangerous this is. It can intensify the effects of the other drugs.

    Barbiturate Addiction and Abuse

    According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), addiction to barbiturates is clinically referred to as a “Sedative, Hypnotic, and Anxiolytic Use Disorder.”

    A diagnosis requires at least 2 of the following criteria. The disorder is mild if 2-3 criteria are met, moderate if 4-5 are present, and severe with 6-7 or more:

    • Too much barbiturate use or for too long.
    • Unable to control barbiturate use.
    • Increasing mental energy expended to find barbiturates.
    • Craving
    • Recurrent barbiturate use, which significantly disrupts personal responsibilities.
    • Relationship problems caused by barbiturate use.
    • Discontinuing hobbies as a result of barbiturate use.
    • Use despite dangerous environments (e.g., used needles nearby)
    • Use despite physical and mental degeneration.
    • Need more and more barbiturates to achieve the same effect.
    • Not using barbiturates is painful.

    Are Barbiturates Addictive?

    Though barbiturates do not bind with opioid receptors, they can still be highly addictive. Users may develop a dependency, using them to alleviate symptoms such as insomnia or seizures. So yes, barbiturates are addictive.

    How addictive a barbiturate is to an individual depends on how often they are taken and what dependencies the user has psychologically formed with them. One of the primary dangers of barbiturates is their narrow therapeutic index, meaning the effective dose is very close to the lethal dose, increasing the risk of overdose.

    Whether or not you are addicted, if you are self-administering outside the counsel of a medical professional, it is very easy to give yourself a fatal dose.

    Signs of Addiction to Barbiturates

    Signs of addiction to barbiturates could include trouble sleeping, inability to stay awake, reclusive behavior, neglect of responsibilities, interpersonal problems, increasing tolerance, and, although less commonly, frequent urinary tract infections.

    Cutting Agents Used for Barbiturates

    Cutting agents are rarely found in barbiturates.

    Barbiturates Addiction Treatment

    Although barbiturates are physically addictive and withdrawal can be severe, treatment can be complex and must address both physical dependency and psychological factors. In many cases, detox and inpatient alone could take a few weeks to 3 months to truly address substance and related mental health concerns.

    Outpatient programs, 12-step programs, and aftercare could extend that time even longer. It will take however long you need to achieve your wellness goals. There is no price too high or time too long that is not worth being in control of your own life.

    Barbiturate Addiction Treatment Levels of Care

    We will meet you wherever you are. Here at Paramount Wellness, we have four different options for barbiturate addiction treatment. Wherever you are in your journey to recovery, we can help you. Whether you need immediate help with detox or you need community support in outpatient care, we’ve got you covered:

    Therapies Used in Barbiturate Addiction Treatment

    You are unique. You are a person; what works for you might not work for anyone else. At Paramount Wellness, we offer many different kinds of barbiturate addiction therapy that are as unique as you are:

    Barbiturate Addiction and Mental Health

    Since barbiturates are physically addictive and can exacerbate or coexist with mental health disorders, integrated treatment addressing both issues is often necessary. If you’re depressed, you might want to take barbiturates so you can go to sleep and forget about what concerns you.

    If you’re anxious, you might feel like you can’t get to sleep without barbiturates. Either way, your mental health will suffer if you abuse barbiturates. Taking barbiturates will not address the root cause of your mental disorder. You might need dual diagnosis treatment to address all concerns.

    Co-Occurring Disorders

    Co-occurring disorders like mental disorders are common in patients who also exhibit a substance use disorder. It’s a negative feedback cycle that’s difficult to escape. If that sounds like you, Dual Diagnosis treatment may be the solution you need.

    Your treatment team should assess your disorders and develop a coordinated intervention plan that addresses them concurrently, as integrated treatment is crucial for effective recovery in dual-diagnosis cases. It’s powerful because dual diagnosis acknowledges that your disorders may feed into each other. To avoid the sobriety/addiction trigger/relapse cycle, your substance abuse will be examined alongside your mental health.

    Your treatment team will work with you to come up with a plan that takes into account what you can manage with your co-occurring disorders today but also your potential for growth in the future.

    How to Find Barbiturate Addiction Treatment in Connecticut

    Don’t get overwhelmed by the prospect of searching for the right treatment provider in Connecticut. There are resources available right here that can help you find the right provider.

    If any of your friends work in healthcare, ask them which treatment centers they see the most success with addiction referrals. Word of mouth is a good metric of quality.

    You can also contact your insurance company to see if there are any specifically approved providers and/or treatment modalities. Finding help through SAMHSA’s “Behavioral Health Services Locator” tool is a great free resource.[10]

    However you identify prospective treatment centers, it is imperative to read reviews online. See what past clients say. If you’re still interested, call them to schedule a discovery session to see if they fit you.


    Frequently Asked Questions

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