Barbiturates: What it is, Types, Uses, Side Effects & Abuse

As a street drug, barbiturates were largely replaced by other substances during the 1970s, especially by PCP. An overdose of barbiturates can result in coma and even death due to severe depression of the central nervous and respiratory systems. Ultrashort-acting barbiturates, such as thiopental sodium and thiamylal, are used intravenously to induce unconsciousness smoothly and rapidly in patients about to undergo surgery, after which gaseous anesthetics are used to maintain the unconscious state. Short-acting barbiturates, such as pentobarbital and secobarbital, are used to overcome difficulty in falling asleep.

To better understand the degree of misuse, it helps to consider data from the 2023 National Survey on Drug Use and Health (NSDUH), which categorizes barbiturates as prescription sedatives. This pattern of misuse can quickly lead to tolerance and, ultimately, to physical dependence and addiction . People sometimes take barbiturates outside of prescribed guidelines, either in higher doses or for more extended periods, in search of their sedating or euphoric effects. What’s more, pregnant or breastfeeding women face additional risks, as barbiturates can disrupt fetal development and can pass through breast milk to children .

How Are Barbiturates Different from Benzodiazepines?

You also shouldn’t have a problem with barbiturate dependence if you take your medication as your healthcare provider instructs. Combining benzodiazepines and barbiturates can be very dangerous, so you should never combine them unless a doctor prescribes them this way. For the most part, healthcare providers often prescribe benzodiazepines before trying a barbiturate. You should go to the emergency room if you have the symptoms of a barbiturate overdose, which can look similar to alcohol intoxication. Most barbiturates aren’t for long-term use, so you might need to see your healthcare provider for follow-up. However, barbiturates are still proven medications for treating many conditions.

Ultra-short-acting barbiturates like thiopental are used for anesthesia, while long-acting ones such as phenobarbital are prescribed for seizure disorders and insomnia. According to the National Institute on Drug Abuse (2023), the risk of overdose with barbiturates is much higher, even with slight deviations from the prescribed dose, due to their profound suppression of the central nervous system. This fundamental difference in action makes barbiturates more potent and less selective than benzodiazepines. Barbiturates are different from benzodiazepines through their action mechanism, safety profile, and dependence risks. The dose-dependent nature of barbiturates makes them highly potent, with effects ranging from mild sedation to complete CNS shutdown, depending on the amount administered. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), barbiturate misuse has significantly declined over the years, with less than 0.2% of U.S. adults reporting non-medical use in the past year​.

• A key reason why healthcare providers don’t prescribe barbiturates as often now is the risk of misusing them.
• You should go to the emergency room if you have the symptoms of a barbiturate overdose, which can look similar to alcohol intoxication.
• Given the connection between these drugs and drug addiction, barbiturates are only applied for medical use as a last resort when other treatments fail.
• This fundamental difference in action makes barbiturates more potent and less selective than benzodiazepines.
• We do everything in our power to help you succeed in breaking the cycle of addiction, and know that with the right kind of help, everyone is capable of healing.

Slang terms for barbiturates include barbs, barbies, bluebirds, dolls, wallbangers, yellows, downers, goofballs, sleepers, ‘reds & blues’, and tooties. Short-acting and intermediate-acting barbiturates are usually prescribed as sedatives and sleeping pills. People who use substances tend to prefer short-acting and intermediate-acting barbiturates.

What Are Barbiturates?

Experts divide these medications into groups depending on the timing of their effectiveness. Others can last for hours or even days, which is one reason healthcare providers still prescribe them to prevent seizures. That’s useful during short medical procedures. Some of these medications are only effective for a very brief time. They can also serve as backup when the first-line medications don’t work.

Carolina Center for Recovery is lucky to have some of the most qualified and experienced addiction specialists in the country. We pride ourselves on carefully selecting men and women who are not only thoroughly informed and knowledgeable about addiction, but also those who have personally experienced the trials and blessings of recovery themselves. Throughout treatment, clients experience the warmth and compassion of an entire staff that cares deeply about their success. Clients at Carolina Center for Recovery will undergo a personalized journey through one of our highly effective treatment programs. At Carolina Center for Recovery and affiliates, we aim to provide readers with the most accurate and updated healthcare information possible. In North Carolina, rehab programs provide structured environments where individuals access both medical support and counseling, fostering long-term recovery and relapse prevention.

Which drugs are barbiturates?

Barbiturates have a narrower therapeutic window, meaning the body becomes more reliant on the drug, and the brain’s compensatory mechanisms are significantly disrupted when use stops. Barbiturates are abused by oral ingestion, intravenous use, and recreational mixing with alcohol or other substances. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), opioid addiction is more prevalent, with approximately 2.1 million people in the U.S. struggling with opioid use disorder.

Once hailed as miracle treatments, these medications found their way into countless medicine cabinets and emergency rooms. Barbiturates are sedative-hypnotic medications known for their powerful ability to ease pain, induce sleep, and calm intense anxiety. The use and availability of barbiturates in the United States declined steeply following the federal Comprehensive Drug Abuse Prevention and Control Act of 1970.

More on Substance Abuse and Addiction

• Tuinal is a barbiturate that’s no longer made in the U.S.
• This Cys-loop receptor superfamily of ion channels includes the neuronal nACh receptor channel, the 5-HT3 receptor channel, and the glycine receptor channel.
• Drug Enforcement Administration (DEA) now classifies various barbiturates as Schedule II, III, or IV controlled substances, based on their medical value and potential for abuse.
• Abusing barbiturates can result in dangerous consequences, as depressing the CNS can cause automatic body functions, such as your breathing or heartbeat, to stop.
• The signs of barbiturate misuse and abuse include drowsiness, slurred speech, impaired coordination, mood swings, and frequent cravings for the drug.

With the proper support and a personalized plan, recovery from barbiturate addiction is within reach. Even a slight increase in dose can have devastating consequences, especially when barbiturates are combined with other depressants like alcohol . As such, heightened doses of barbiturates can cause respiratory distress, which can be life-threatening. Several barbiturates now carry risk-related boxed warnings, the FDA’s strongest safety alert. Their fast-acting, calming effects made them a mainstay in hospital settings, helping patients relax or sleep when rest was desperately needed . Working to increase the neurotransmitter gamma-aminobutyric acid (GABA), barbiturates intensify the brain’s natural ability to dampen nerve activity.

If someone is dependent on a different type of barbiturate, their doctor might prescribe phenobarbital to help ease withdrawal symptoms. The biggest difference between the barbiturates is how long their effects last. That said, addiction to barbiturates is still uncommon today. Second, a safer group of sedative-hypnotics called benzodiazepines began replacing barbiturates, except in a few specific indications.

Keeping these medications secure

As a result, people over the age of 65 are at higher risk of experiencing the harmful effects of barbiturates, including drug dependence and accidental overdose. Because withdrawal from barbiturates can be unpredictable, medical supervision is essential for anyone attempting to stop these medications. The barbiturates have largely been replaced as sedatives by the benzodiazepines and other minor tranquilizers, which have fewer unfavourable side effects and less abuse potential. Yes, there are safer alternatives to barbiturates for medical use including benzodiazepines and non-sedative medications for conditions such as epilepsy and insomnia. The symptoms of barbiturate withdrawal include anxiety, seizures, tremors, insomnia, and hallucinations.

Common side effects

But they are still out there, and some people use them to get a high or to counteract the effect of other illicit drugs. Most people survive after misusing barbiturates if they go to the hospital and get the care they need. If you believe someone has taken barbiturates inappropriately, take them to the hospital.

It’s the small difference between the amount of the drug that is helpful (therapeutic) and what can harm you (toxicity). In the medical profession, this difference is called a narrow therapeutic index. Their effects are very similar, and when combined can be lethal. Tuinal is a barbiturate that’s no longer made in the U.S. Secobarbital is used most often to treat insomnia, but it’s also used to help reduce anxiety before you have surgery. Phenobarbital is used to reduce anxiety and control seizures.

These issues, combined with the higher margin of safety in benzodiazepines, prompted their widespread replacement of barbiturates in the treatment of anxiety, insomnia, and seizures during the mid-20th century. The Centers for Disease Control and Prevention (CDC) highlights that barbiturates’ narrow therapeutic index makes their side effects particularly dangerous compared to other sedative drugs. Stopping barbiturates cold turkey is not advisable, and medical detox is often necessary to prevent potentially deadly withdrawal symptoms.

These types of barbiturates are used for mental health treatment and other healthcare purposes, including anxiety, insomnia, and seizures. If you notice withdrawal symptoms when you stop taking barbiturate medications, you should talk to your healthcare provider. Barbiturates are also used to alleviate the adverse or withdrawal effects of illicit drug use, in a manner similar to long-acting benzodiazepines such as diazepam and clonazepam. Those who died of a combination of barbiturates and other drugs include Rainer Werner Fassbinder, Dorothy Kilgallen, Malcolm Lowry, Edie Sedgwick, Marilyn Monroe, and Kenneth Williams. Similarly to benzodiazepines, the longer acting barbiturates produce a less severe withdrawal syndrome than short acting and ultra-short acting barbiturates.

Why Are Barbiturates Rarely Prescribed in the US Today?

You are encouraged to report negative side effects of prescription drugs to the FDA. These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. However, in high doses the inhibitory effects of barbiturates can cause drowsiness, while also slowing a person’s breathing and heart rate to dangerous levels. In people with anxiety and other conditions marked by increased neural activity, barbiturates help to calm those processes.

Barbiturate Misuse

They found the drugs reduced their inhibitions, decreased anxiety, and helped get rid of unwanted side effects of illicit drugs. As people learned that barbiturates could change their mood, many began using them Barbiturate Withdrawal Case as recreational drugs. Addiction treatment programs may use intervention techniques like medically assisted detoxification programs to help the person safely adjust to functioning without drugs.