Barbiturates Treatment and Addressing Overdose Symptoms and Risk

Medically Reviewed By

Dr. Po-Chang Hsu

Dr. Po-Chang Hsu

On April 15, 2024

Written By

Amanda Stevens

Amanda Stevens, B.S.

On November 15, 2023

Reading Time: 5 minutes

Barbiturates are prescription drugs that belong to a class known as depressants. Depressant drugs force the nervous system to slow down and relax. This is helpful for those who suffer from insomnia or anxiety. But when misused, they can be highly addictive and lead to an overdose.

What Are Barbiturates?

Barbiturates are made from barbituric acid and effectively suppress the nervous system. This makes them beneficial for treating anxiety, sleep disorders, migraines, and seizures.

Though barbiturates have dropped in popularity in recent years in favor of benzodiazepines, these drugs are among the top five substances that cause the most overdose deaths in the United States.[1] Barbiturates have a high potential for dependence and abuse, especially when used improperly.

There are several types of barbiturates, and they range between Schedule II, III, and IV drugs. They’re also known as several street names, including barbs, yellow jackets, and reds.

Side Effects of Amobarbital (Amytal®)

Amobarbital has been around for a hundred years, and it is traditionally used to treat anxiety. However, this barbiturate treatment is occasionally used as a sedative to make people drowsy before surgery. It can also cause several undesirable side effects.

Some of the side effects include the following:

  • Rash
  • Swelling
  • Itching
  • Tightness in the chest
  • Difficulty breathing
  • Swelling and blisters

Taking too much of this drug may require barbiturate poisoning treatment.

Side Effects of Butabarbital (Butisol®)

This medication is often prescribed to those who suffer from sleep disorders like insomnia. However, it also can be administered as a sedative before surgeries. Unfortunately, this medication can negatively affect your mental state.

You may experience paranoia and depression or have suicidal thoughts. Some people may also experience difficulty concentrating or remembering things and have slow reflexes.

Side Effects of Phenobarbital (Luminal®)

This drug is often prescribed to those who suffer from seizures and is also used to help some patients through alcohol withdrawal symptoms. When using this medication, you may experience the following:

  • Dry eyes
  • Constipation
  • Nausea and vomiting
  • Dizziness

How Are Barbiturates Taken?

Many barbiturates are taken as oral pills or tablets. The medication slowly gets dispersed through your body as your stomach breaks it down over many hours. Some barbiturates require IV administration, especially when being used for surgery. This induces an instant effect. Barbiturates are misused on the street. People may crush the pills and snort them for a fast feeling of euphoria. Others may inject the drug, take too many pills at once, or chew them before swallowing.

Barbiturates Quick Reference Chart

Drug Category Commercial & Street Names DEA Schedule Administration
Amobarbital Amytal®, barbs, goofballs Schedule II Oral, IV, rectal
Butabarbital Butisol®, sleepers, blockbusters Schedule III Oral tablet, IV
Phenobarbital Donnatal®, downers Schedule IV Oral tablet, liquid elixir

Statistics on Barbiturate Use, Misuse, and Addiction

Over 107,600 people died from drug overdoses in 2021, a 15% increase over the previous year.[2] An overdose is a serious health risk, even if it isn’t fatal. Severe overdoses can cause permanent damage to your brain and internal organs.

Sedative-hypnotic drugs are one of the common causes of death by overdose, ranking at number five. Among those deaths, barbiturates are the most commonly present substance.[3]

Barbiturates have a high potential for addiction, and it is possible to develop a tolerance. This can compel some to take increasing doses to experience the same feeling of euphoria.

Effects of Barbiturate Abuse

When people abuse barbiturates, they may feel a deep sense of calmness and euphoria. But some people may experience dizziness, fatigue, nausea, and stomach pain, while others may faint. Fainting can be dangerous as you can easily hit your head and cause other serious injuries.

Can You Overdose on Barbiturates?

It is easy to overdose on barbiturates when you take too many, take them with other substances, or otherwise misuse them. While not all overdoses are fatal, many of them can be by accident. A person may attempt to misuse the drug for the first time and not realize that the dose they took was more than they could handle.

Signs and Symptoms of Barbiturate Overdose

Barbiturates overdose symptoms include the following:

  • Nausea and vomiting
  • Confusion
  • Dizziness
  • Loss of consciousness
  • Low heart rate
  • Low respiration
  • Seizures
  • Death

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

Because of the fatal nature of overdoses, call for medical help right away. The longer you wait, the more at risk the patient will be. The faster they can receive treatment, the better.

Dangers of Long-Term Barbiturate Use

The long-term use of these drugs can lead to chronic health problems. Liver damage is a primary concern as this is how the drug is metabolized. Some may develop persistent breathing problems or pneumonia. Others may have memory loss, sexual dysfunction, and mood changes. It is also possible to sustain heart and kidney damage.

Mixing Barbiturates with Other Drugs

Barbiturates should not be mixed with other depressant drugs, including alcohol and other sedative-hypnotics, as this can significantly increase the risk of severe respiratory depression, unconsciousness, or cardiac complications. Mixing barbiturates with other drugs can increase the risk of severe adverse effects such as respiratory depression, which can lead to overdose or death. In some cases, interactions with other drugs, like stimulants, can also lead to seizures.

Barbiturate Addiction and Abuse

As of 2021, 4.9 million people misused sedative medications within the last 12 months.[4] Many people misuse these medications because they want to achieve a euphoric experience or instant anxiety relief. Others may think that misusing these drugs enhances other substances, which can be life-threatening.

Barbiturate addiction is more likely when a person misuses their prescriptions and may require professional intervention.

Signs of Addiction to Barbiturates

If you experience intense cravings or withdrawal symptoms when you don’t take your barbiturates, you may have an unhealthy dependence. You may also experience tremors, watery eyes, headaches, irritation, and mood swings. You may try to get several prescriptions from several doctors so you don’t run out of barbiturates. You may also find yourself misusing them in different ways.

Barbiturates Addiction and Mental Health

While barbiturates can help treat anxiety, this property might become weaker over time as you develop a tolerance. You may require larger quantities to get the same anxiety relief. Depression may also result from long-term barbiturate use, along with paranoia and mood changes.

Barbiturates Addiction Treatment

Substance use disorder treatments will vary depending on the severity of the disorder and any unique needs. In most cases, a detox placement program may be beneficial to allow a safe space for harmful toxins to be removed from the body while beginning other treatment interventions.

Short-term intensive treatment begins once the desired level of stability is reached, usually after a few days or a week. Partial hospitalization programs offer an inpatient level of care with the flexibility of an outpatient program.

The next level of care is an intensive outpatient program that takes place a few days a week to continue addiction treatment, payroll therapy, and peer support. The final level of treatment is an outpatient program that operates on a regularly scheduled, as-needed basis.  This progression represents a full continuum of treatment and supports personal autonomy and lasting sobriety.

Therapies Used in Barbiturate Addiction Treatment

Psychotherapy and behavioral health interventions offer individualized holistic treatment. By understanding how and why substance use disorders have developed, patients can prevent future relapse and promote a healthy, sustainable lifestyle.

  • Cognitive Behavioral Therapy (CBT)
  • Art therapy
  • Group therapy
  • Mindfulness
  • Holistic therapy

Dual Diagnosis for Co-Occurring Disorders

Most people have been prescribed barbiturates because of anxiety, insomnia, or seizure disorders. Due to the presence of mental health conditions in addition to substance use, a holistic and custom treatment plan must be developed. This strategy offers the most comprehensive approach to recovery and supports lasting abstinence.

Barbiturate Withdrawal Management Treatment

Being in the early stages of detox and withdrawal from barbiturates can be challenging. You may experience increased sleep disruption and other uncomfortable symptoms. Evidence-based treatment for the symptoms includes medical detox, medication-assisted treatment, and mental health therapy.

Treatments Used in Barbiturate Withdrawal Management

Unfortunately, there are not many drugs that are recommended to help with barbiturate withdrawal management. Some providers may offer OTC options like Tylenol to help reduce discomfort during the process.

Frequently Asked Questions

How Addictive Are Barbiturates?

Barbiturates have a high potential for addiction, leading many doctors to prescribe them less frequently. Instead, benzodiazepines are often preferred as they also manage similar conditions like anxiety and insomnia but generally have a lower risk of addiction compared to barbiturates.

It is also more likely to develop an addiction when you misuse the medication by snorting it, injecting it, or taking too many pills at once. Misuse also involves mixing the substance with other drugs.

What Are the Complications of Taking Barbiturates?

Barbiturates can cause numerous side effects. Short-term effects include fatigue and drowsiness. Long-term use can lead to dependency and may disrupt normal sleep architecture, which might affect daily functioning and the ability to manage responsibilities. You may feel that you can’t function if you don’t take them throughout the day. It may be difficult for you to face important responsibilities in your life, such as work or relationships. 

Barbiturates can also cause damage to your internal organs when you take them for a long time. This may result in permanent health consequences such as breathing problems, liver and kidney damage, or heart damage.

Are Barbiturates and Benzodiazepines the Same?

Though benzodiazepines and barbiturates both act as central nervous system depressants, they differ in chemical structure and mechanism of action. Benzodiazepines, which are more commonly prescribed today, are generally considered to have a lower risk of addiction and overdose compared to barbiturates.

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Sources

[1] Suddock JT, Cain MD. Barbiturate Toxicity. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499875/ on May 22, 2023.

[2] Centers for Disease Control and Prevention. (2022, May 11). U.S. overdose deaths in 2021 increased half as much as in 2020 – but are still up 15%. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/202205.htm on May 22, 2023.

[3]MD;, S. J. K. (n.d.). Barbiturate toxicity. National Center for Biotechnology Information. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29763050/ on May 22, 2023.

[4] NIDA. 2023, February 13. What is the scope of prescription drug misuse in the United States?. Retrieved from https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse on May 22, 2023.