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What Are Barbiturates?

What Are Barbiturates?

Barbiturates are synthetic drugs used in medicine to depress the central nervous system (CNS). Barbiturates’ effects range from mild sedation to coma, with their indications ranging from sedatives (depressants), hypnotics, anticonvulsants, or as part of anesthesia. Some barbiturates are also used to relieve anxiety or tension before surgery. At fairly low doses, barbiturates may make someone seem drunk or intoxicated. Barbiturates are addictive. Individuals who take them become physically dependent on them. Stopping them (withdrawal) can be life-threatening. Tolerance to the mood-altering effects of barbiturates develops rapidly with repeated use. But, tolerance to the lethal effects develops more slowly, and the risk of severe poisoning increases with continued use.

Barbiturates were first introduced for medical use in the 1900s, and today, few substances are in medical use. Barbiturates used to be regularly prescribed to treat depression, insomnia, and anxiety. According to the National Institute of Health (NIH) [1], Barbiturates are drugs that cause sleepiness and relaxation. A barbiturate overdose happens when someone takes more than the average or recommended amount of this medicine. This can be by accident or on purpose. A barbiturates overdose is life-threatening.

Therefore, the use of this drugs as hypnotics or sedatives to relieve daytime restlessness or insomnia caused by everyday stresses is no longer recommended. As a result of these potentially life-threatening side effects, the use of barbiturates for these purposes has been replaced with safer medications.

What Are Barbiturates
There is no direct antidote for barbiturates intoxication. An antidote is a medicine that reverses the effects of another medicine or drug.

Nowadays, barbiturates are typically only used to treat serious and extreme cases of insomnia. These drugs are also used to help control seizures in epilepsy, as well as an adjunct to anesthesia in some cases. According to the US Drug Enforcement Agency (DEA) [2], barbiturates are Schedule II, III, and IV depressants under the Controlled Substances Act.

What do barbiturates do?

Like sleeping pills, barbiturates are “downers”. They work by making your nervous system and the brain less active. This makes the individual feel calm. Barbiturates can affect judgment and memory. Barbiturates can also make individuals feel angry, depressed, very tired and cause mood swings. Because they’re stronger than most sleeping pills, they are more dangerous when abused. Individuals can develop tolerance to this drug, so they start using it more and more. Using them regularly and for a long time can muscle weakness, cause liver damage, and bone pain.

Combining two types of any drug is never a good idea. It’s very dangerous to take Barbiturates with heroin or alcohol. Barbiturates, alcohol, and heroin all make the nervous system and the brain less active. The nervous system controls breathing, so if someone combines drugs, they are more likely to stop breathing and die.

Examples of Barbiturates

Amobarbital

Normally referred to as “sodium amytal,” this barbiturate earned its notoriety as a truth serum since it proved effective when given to a person during interrogation. While it doesn’t compel people to tell the truth, amobarbital can slow the central nervous system to make concentration more difficult. The theory was that someone asked a question while under the influence of amobarbital would be less likely to think of a false answer, which requires more focus than simply telling the truth.

Butalbital

This short-acting barbiturate is often used to treat headaches, migraine, often in combination with aspirin, acetaminophen, and caffeine. It was sold under the brand names Fioricet and Fiorinal. It’s also been used as an anesthetic and as a sedative.

Phenobarbital

This barbiturate was used to treat seizures in young children due to its effectiveness as an anticonvulsant. It also has been used to treat drug withdrawal (particularly from other barbiturates), anxiety, and a sleep aid.

Secobarbital

Sold in the U.S. as Seconal, beginning in 1934, this drug was a widely-prescribed sleep aid. It’s the most-used drug in doctor-assisted suicides in the U.S.

Pentobarbital

Used as an anesthetic in animals, these barbiturates formerly used to treat convulsions and seizures has the dubious distinction of being one of the preferred drugs used for state executions in the U.S.

Barbiturate Street Names

Barbiturates are frequently referred to by many different names. Some names that are used to refer to specific barbituates are: 

  • Amobarbital: Blue heavens, Blue velvet, Blue devils, Downers
  • Pentobarbital: Abbots, Nembies, Yellow jackets, , Mexican yellows
  • Phenobarbital: Goof balls, Purple hearts
  • Secobarbital: Red birds, Reds, Red devils, Lilly, F-40s, Pinks, Pink ladies, Seggy
  • Tuinal: Rainbows, Reds and blues, Tooies, Double trouble, Gorilla pills, F-66s

Other common street names for barbiturates are:

  • Blue Bullets
  • Blue Birds
  • Blue Angels
  • Blue Tips
  • Blue Dolls
  • Green Frog
  • Green Dragons
  • Marshmallow Reds
  • Pink Ladies
  • Red Bullets
  • Rainbows
  • Strawberries

Effects of Barbiturates

Barbiturates slow down the central nervous system (brain and spinal cord) in a similar way to alcohol and, depending on how fast they produce effects and the duration of those effects, they may be classed as ultra-short-, short-, intermediate-, or long-acting.

In the case of long-acting barbital and phenobarbital, their effects may last for up to 1 day. Usually, these long-acting barbiturates are used in conjunction with other medications to prevent convulsions in epilepsy.

The effects of intermediate-acting barbiturates, like butabarbital sodium, last between six and twelve hours, and these are used to treat people suffering from insomnia. Pentobarbital is an example of a short-acting barbiturate that is also used to help someone suffering from insomnia fall asleep.

The ultra-short acting barbiturate of thiamylal is administered as an injection to cause unconsciousness in patients who are about to undergo surgery. Gaseous anesthetics are then used to maintain the patient’s unconsciousness throughout the surgical procedure.

Small doses of barbiturates can make individuals feel uninhibited, relaxed, mildly euphoric, free of anxiety, and sleepy. Larger doses can cause anxiety, hostility, body ataxia, paranoia, slurred speech, and suicidal thoughts. The risk of falling over or having an accident is also increased as the dose of barbiturates increases.

With prolonged use, tolerance can quickly develop. To this end, tolerance happens when larger doses than the original dose are needed to produce the same effects. This can increase the risk of overdose, signs of which include rapid and weak pulse, shallow breathing, dilated pupils, clammy skin, coma, and even death as a result of the severe depression of both the respiratory and the central nervous system [3].

What Are Barbiturates
According to the National Institute of Health [4], about 1 in 10 people who overdose on barbiturates or a mixture that contains barbiturates will die. They usually die from heart and lung problems.

Barbiturates Side Effects

When used as a short-term medication, barbiturates can effectively relieve symptoms of anxiety and insomnia, provide pre-surgical sedation, and act as anticonvulsants for those with seizure disorders. Like most drugs, barbiturates have side effect profiles. Chronic abuse of these drugs can produce a number of dangerous effects, such as:
:

  • Insomnia
  • An increased sensitivity to sound
  • An increased sensitivity to pain
  • Increased perspiration
  • Irritability
  • Hallucinations or psychosis (rare)
  • Paranoia
  • Memory and attention impairments
  • Emotional instability
  • Suicidal ideation
  • Incoordination and impaired balance
  • Slurred speech
  • Stupor

At high doses or in barbiturates overdose situations, it can result in coma, significant brain and other organ damage, or death due to respiratory suppression [5].

Common Types of Barbiturates

Phenobarbital

It is one of the most well-known and commonly used barbiturates still in use today. The purpose of Phenobarbital is for the maintenance of insomnia, seizures, and anxiety.

The side effects of Phenobarbital are:

  • Drowsiness and Dizziness
  • Nausea and Vomiting
  • Irritability and Aggression
  • Headaches and a “hangover” effect
  • Confusion
  • Loss of motor control and coordination

Secobarbital

This barbiturates is more commonly known by its street name, “Pink Ladies”, and in the medical setting is most commonly used for anesthesia in humans and euthanasia in pets. It is a very common medication in presurgical sedation but has very high addiction rates when used recreationally.

Secobarbital is not an anti-anxiety medication, as it is reported to develop a tolerance in as little as two weeks. Outside of the surgery setting, it is generally used in hospitals or detox facilities on a short-term basis only, to treat people with insomnia who are already addicted to barbiturates. Other than that, it is one of the most common drugs used in a “death with dignity” situation. This just demonstrates how potentially harmful this drug can be when abused.

The side effects of secobarbital are:

  • Sleepwalking
  • Drowsines
  •  Dizziness
  • Headaches and Nightmares
  • Restlessness and Agitation
  • Nausea, Vomiting, Constipation, and Diarrhea
  • Hallucinations, difficulty breathing, and swelling of the face, lips, tongue, and extremities

Amobarbital

Commonly known as Amytal, this medication is used pre-surgery to calm anxiety, as a sleep aid, or as an anticonvulsant. Individuals taking Amytal for any reason are adviced not to take any other sedative medications, not to drink, alcohol, and to only take other medications after speaking with a doctor. This barbiturate has also been revealed to lower the effectiveness of birth control contraceptives in women.

The side effects of Amobarbital are:

  • Low mood and thoughts of suicide
  • Irritability and aggression
  • Intense mood swings
  • Fatigue and Dizziness
  • Infection from the injection site

Pentobarbital

With the brand name Nembutal, Pentobarbital was originally manufactured in the 1930s as a sleep aid. In low doses, as a medication, it can also help reduce anxiety, control seizures, and is commonly used in the surgery room.

Pentobarbital works by binding to the nerve receptors in the brain that are in control of relaxation. Because of this, people either taking or abusing Nembutal can often experience complications with their heart rate, blood pressure, and breathing, which forms a very dangerous condition if someone combines them with other drugs.

Nembutal is another barbiturate that is commonly used as an “end-of-life” medication and is primarily only legal in countries where euthanasia is a legal practice. In the United States and Europe, it is one of the most common drugs used in the euthanasia of animals.

The side effects of Nembutal in humans are:

  • Slurred speech
  • Poor motor control and loss of coordination
  • Mood Swings
  • Slowed Thinking and trouble concentrating

In many countries, getting most of these barbiturates can be extremely difficult, but there are still hundreds of cases of overdoses every year due to barbiturate abuse.

If you are taking a prescribed amount of a barbiturate for sleep, anxiety, or epilepsy, it is absolutely crucial that you speak with a medical provider before taking or experimenting with other medications or drugs. It is also highly suggested that the user does not drink alcohol.

Another common side effect of these barbiturates is that they reduce the effectiveness of female birth control contraceptive methods. It is highly recommended for women who are not ready to get pregnant, to use an additional form of contraception such as a condom.

Barbiturate Abuse Causes 

Barbiturates are common drugs of abuse; as a result, many medical professionals prefer to prescribe benzodiazepines. While benzos are still drugs of abuse, they have slightly fewer abuse risks than barbiturates.

Individuals who abuse barbiturates tend to choose short-acting or intermediate pills, such as Amytal and Seconal. Such specific drugs typically produce effects within 15-40 minutes, and it can take up to six hours for effects to diminish. Long-acting barbiturates can bring effects that last up to two days, but abuse rates for these types of barbiturates are lower.

The most common method of abuse is oral ingestion in pill form, but some who abuse the drugs have been known to inject the substance in liquid form to speed up delivery to the system. Barbiturates abuse is usually motivated by a desire to reduce anxiety, mitigate the effects of other drugs, and lessen a person’s inhibitions. 

What Are Barbiturates
Barbiturate overdose is a dire situation that can result in death. Therefore, it should be treated as such by anyone who witnesses it.

Misuse of barbiturates usually arises from attempts to self-medicate. Unfortunately, misuse can frequently lead to abuse and possibly addiction, as it’s always a slippery slope when dealing with addictive substances.

Barbiturate use is a major addiction problem for a lot of people. Most individuals who take these medicines for pain syndromes or seizure disorders do not abuse them. Still, those who do usually begin by using medicine that was prescribed for them or other family members.

Most barbiturates overdose involve a combination of drugs, often alcohol and barbiturates, or opiates such as heroin, oxycodone, or fentanyl, and barbiturates.

Those who use such combinations tend to be:

  • New users who do not know these combinations can lead to coma or death
  • Experienced users who use them on purpose to alter their consciousness

Barbiturate Abuse Symptoms

Symptoms of barbiturate intoxication and overdose include:

  • Altered level of consciousness
  • Difficulty in thinking
  • Drowsiness or coma
  • Faulty judgment
  • Lack of coordination
  • Shallow breathing
  • Slow, slurred speech
  • Sluggishness
  • Staggering

Excessive and long-term use of barbiturates, such as phenobarbital, may produce the following chronic symptoms:

  • Changes in alertness
  • Decreased functioning
  • Irritability
  • Memory loss

Barbiturate Overdose

Barbiturates have a low therapeutic index—meaning that there’s a relatively thin line between the dose needed to achieve therapeutic effects and one that will result in harmful consequences. Overdose can be a hazardous side effect of barbiturate abuse, especially when polydrug use is involved with substances like heroin and alcohol.

If a barbiturate overdose is suspected, it is important to contact medical professionals instantly by calling 911. Upon arrival, experts will take and monitor an individual’s vital signs and screen them for substances. Overdose can result in severe injury due to reduced motor function and the possible results of a fall. Such injuries can include head injuries as well as neck injuries, which can have long-term health effects on a person.

Kidney injury and muscle damage are also possible due to a lack of awareness of surroundings and the possibility for an individual to lay on a hard surface for a prolonged period. Aspiration of the lungs is also possible, and the most extreme cases can result in coma and death.

Withdrawal Symptoms

Since physical dependence and tolerance can develop with the continued use of barbiturates, withdrawal from regular use can lead to various problems including:

  • Irritability
  • Faintness
  • Anxiety
  • Nausea
  • Insomnia
  • Convulsions

In cases where an individual withdraws from regular use of very high doses of this drugs, symptoms can be more severe and might include:

  • Low blood pressure
  • Hallucinations
  • Delirium
  • Seizures

Abrupt withdrawal from the regular use of high doses of barbiturates can be life-threatening. For people who have become addicted to these drugs, it is crucial that they seek the care of trained rehabilitation professionals to help them withdraw safely and effectively from these drugs.

Treatment for Addiction

There is no home treatment for barbiturate addiction. If you believe someone has taken barbiturates inappropriately, take them to the hospital for evaluation by a doctor, or consult an addiction specialist.

Withdrawing from barbiturates can be severe and potentially fatal, and should not be done alone. The help of a medically-supervised withdrawal management program will both ease the more uncomfortable symptoms and ensure safety from the more severe and possibly life-threatening symptoms. Medically supervised detox can also boost the chance of a successful recovery from barbiturate dependence and addiction.

The detoxification program for barbiturates normally uses a tapering program such that the clients are given subsequent decreasing doses of either a long-acting barbiturate or benzodiazepine. This incremental process allows the body to adapt to lower levels of barbiturates and slowly normalize its functioning without experiencing the severe effects of withdrawal.

Other medicines may also be employed to control specific symptoms that the tapering process does not effectively address. Medication-assisted treatment (MAT) may prolong the withdrawal process; however, it also decreases the symptoms and effectively eliminates the possibility for any risky symptoms, such as seizures. A medically assisted detox program will be administered under the supervision of an addiction medicine physician or a psychiatrist that specializes in addiction.

Find the Right Addiction Treatment at We Level Up NJ

What are barbiturates, and why are you or your loved one got addicted to it? What help is available, and is it safe? To answer all your questions, contact us today at We Level Up NJ Treatment Facility. We provide utmost care with doctors and medical staff available 24/7 for life-changing and lasting recovery. We provide an enhanced opportunity to return to a fulfilling and productive life. 

What are barbiturates
Treatment begins with recognizing there is a problem. Once you decide you want to do something about your drug use, the next step is to get help and support.

Sources:

[1] [4] NIH – https://medlineplus.gov/ency/article/000951.htm

[2] DEA – https://www.dea.gov/sites/default/files/2020-06/Barbiturates-2020_0.pdf

[3] NIDA – https://www.drugabuse.gov/publications/drugfacts/prescription-cns-depressants

[5] NCBI – https://www.ncbi.nlm.nih.gov/books/NBK499875/