A barbiturate is a type of medication that is known for its relaxing and sedating properties. Most popular in the 1960s and 1970s, barbiturates were the go-to drug for people with anxiety, sleep problems, and seizure disorders. However, barbiturates were also widely abused for their sedative effects and for recreational purposes. Late celebrities such as Elvis Presley and Judy Garland, for example, were known to have overdosed on these substances.

While modern use of barbiturates has declined and been replaced by less harmful medications like benzodiazepines, these substances are still misused. Some studies indicate that barbiturate abuse may even be on the rise, particularly among teenagers and young adults.

Due to the way these drugs induce strong feelings of relaxation and sedation, they pose a high risk for abuse. Barbiturates are known to be highly addictive both physically and psychologically, especially when they are taken in high doses or with other substances.

However, treatment is available for individuals who become addicted to barbiturates. Before going into the kinds of treatment that are available for this type of addiction, this article will provide an outline of what barbiturates are and what the long-term effects are.

What are Barbiturates?

Spilled bottle of prescription pills

Barbiturates — also known as sedative-hypnotics — are a class of drugs that depress the central nervous system. Popularized in the 1960s and 1970s, these drugs affect the GABA system in the brain by acting on receptors and neurotransmitters that influence stress and relaxation.

Due to their euphoric and sedating effects, barbiturates were often abused and taken recreationally. However, their high risk for misuse led to increased restrictions with the introduction of the Federal Comprehensive Drug Abuse and Control Act in 1970. After that, barbiturates were labeled as Schedule II-IV controlled substance.

In recent years, barbiturates have been replaced by benzodiazepines, which work in a similar way but are considered less addictive and safer when taken at high doses. Barbiturates are less frequently prescribed by doctors except for conditions such as:

  • Seizures
  • Increased pressure in the skull
  • Severe head trauma
  • Convulsions
  • As an anesthetic
  • Migraine headaches
  • Alcohol and benzodiazepine withdrawal
  • Sleep disorders (but less frequently)
  • Jaundice

Types of Barbiturates

There are many types of barbiturates, and they vary depending on how long their effects last. For example, some long-acting barbiturates can last for up to 2 days while very short-acting ones only last for a few minutes. The most well-known types of barbiturates are amobarbital, pentobarbital, Tuinal, secobarbital, and phenobarbital, but there are a few others as outlined below.

Amobarbital

Amobarbital is an intermediate-acting barbiturate that was first synthesized in Germany in 1923. It usually comes as a white crystalline powder and produces sedative-hypnotic qualities. Street names for amobarbital include Downers, Blue Heavens, Blue Velvet, and Blue Devils.

Pentobarbital

Pentobarbital is a short-acting barbiturate typically used as an emergency treatment for seizures, insomnia, and to put individuals to sleep before surgery. On the street, this drug is known as Nembies, Yellow Jackets, Abbots, and Mexican Yellows.

Tuinal

Tuinal is a combination of secobarbital and amobarbital, which are both short- and intermediate-acting barbiturates. This combination is often used to treat insomnia by helping a person fall asleep quickly and stay asleep through the night. Originally manufactured as brightly colored half-reddish and half-turquoise capsules, tuinal is also known as Rainbows, Reds And Blues, Tooies, Double Trouble, Gorilla Pills, and F-66s.

Secobarbital

Secobarbital is a short-acting barbiturate that was patented in 1934 in the U.S. Possessing anesthetic, anticonvulsant, anxiolytic, sedative, and hypnotic properties, this drug is also known on the street as Reds, Red Birds, Seggy, Red Devils, Lilly, F-40s, Pinks, and Pink Ladies.

Phenobarbital

Phenobarbital is one of the most long-acting barbiturates and lasts for up to 10 to 12 hours. This medication is mainly used to treat seizures and anxiety, and to prevent withdrawal symptoms from other barbiturates. On the street, phenobarbital is also called Purple Hearts or Goof Balls.

Mephobarbital

Mephobarbital is a long-acting barbiturate which is primarily used as an anticonvsulant. It is also used as a sedative and anxiolytic.

Butabarbital

Butabarbital is an intermediate-acting barbiturate, making it useful as a treatment for severe insomnia, anxiety, and to help calm individuals before surgery. However, butabarbital is particularly dangerous when mixed with alcohol so it is rarely prescribed.

Aprobarbital

Apropbarbital is an intermediate-acting barbiturate that was invented in the 1920s. It is primarily used to treat insomnia due to its sedative, hypnotic, and anticonvulsant properties.

How are Barbiturates Abused?

Despite its decline in usage and prescription rates, some studies suggest that barbiturate abuse has been rising over the last ten years. This is mainly among young adults who obtain the drugs to counteract the effects of other recreational stimulant drugs such as cocaine and methamphetamines. Barbiturates are also commonly used in suicide attempts due to their toxicity and sedative effects.

Like other drugs, barbiturates are often misused or abused when they are taken inappropriately or without a prescription. Also, young adults are known to obtain barbiturates without a prescription and to use multiple substances simultaneously (known as poly-drug use).

Are Barbiturates Addictive?

Barbiturates are considered a highly addictive drug, which is why they have been largely replaced by benzodiazepines. Like most other substances that depress the central nervous system, individuals can become addicted to the relaxing and euphoric qualities of barbiturates.

As the body builds up a tolerance, people also start to abuse the drug by consuming it more often and in higher quantities. This not only becomes habit-forming, but it can also lead to uncomfortable withdrawal symptoms. Another danger with barbiturates is fatal overdoses, especially as they are known to be more toxic when taken in high quantities.

Barbiturates, like all substances, can also be psychologically addictive. People who become dependent on the effects of barbiturates may need these substances to feel normal. Individuals with anxiety may be especially prone to addiction as they can become used to the high levels of relaxation that barbiturates provide. This can prompt an attachment that can be difficult to break. Therefore, treatment can be effective for helping individuals wean off the drug while dealing with the underlying causes of their addiction.

Statistics and Facts About Barbiturate Abuse

Below are some statistics and general facts surrounding barbiturate abuse in the U.S.:

  • Before the 1970s, barbiturates were the main type of treatment for seizures and anxiety disorders.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2018, roughly 405,000 Americans aged 12 and above were using barbiturates — 32,000 of which were misusing them.
  • Women and elderly individuals are more likely to be prescribed barbiturates.
  • According to the National Institute on Drug Abuse (NIDA), approximately 50% of high school seniors in 2013 reported abusing prescription medications — 5% of which involved sedatives.
  • Most cases of barbiturate use among young adults or adolescents are obtained illegally or from someone else who has a prescription.
  • Veterinarians sometimes use barbiturates to put animals to sleep.
  • The drug known as “truth serum” is a barbiturate called sodium pentothal. It is also used as a lethal injection in state executions.

History of Barbiturates

Barbiturates date back to 1864, when a German chemist named Adolf von Bayer first synthesized barbituric acid. However, it wasn’t seen as providing any medical value until 1903, when scientists discovered that it was effective at putting dogs to sleep. After that, Bayer marketed it under the name Veronal — and it was named as such because it reminded one of the scientists of Verona, a peaceful Italian city.

Following its discovery as a sedative-hypnotic, barbiturates were the primary way to treat anxiety, insomnia, and seizure disorders from the 1900s until the 1960s. As its popularity grew, barbiturates evolved into recreational drugs that were soon being abused to reduce inhibitions and minimize the unwanted side effects of other illicit drugs.

After the introduction of the Federal Comprehensive Drug Abuse and Control Act of 1970, barbiturates were less readily available and were soon replaced by their modern counterpart, benzodiazepines. However, doctors still occasionally prescribe barbiturates for certain conditions, and they are also becoming increasingly abused by teenagers and young adults for recreational purposes. Luckily, though, barbiturate addiction is far less common than other addictions in modern times.

Physical and Neurological Effects of Barbiturates

Barbiturates affect the central nervous system, resulting in various physical and neurological effects. Some of the most common are:

  • Drowsiness
  • Feelings of euphoria
  • Altered mental state
  • Staggering
  • Sluggishness
  • Mood changes

Barbiturate Combinations

Glass of alcohol, syringe and pills on table

Barbiturates are commonly abused with other substances, especially when they’re taken recreationally. Below are the effects and consequences of these combinations.

Alcohol

Alcohol and barbiturates are both nervous system depressants, which means combining these substances enhances sedation. Alcohol can also greatly impair your judgment, as well as mask the effects of the barbiturates, and this can lead to overdoses, respiratory failure, over-sedation, coma, and death.

Stimulants

Many people abuse barbiturates as a way to “come down” from the stimulating effects of illicit drugs such as amphetamines and cocaine. While it may seem safe to mix stimulants and barbiturates, the two drugs can mask the effects of the other, leading to an overdose. Another risk of mixing these two substances is that they can negatively affect respiration. While barbiturates slow down breathing, stimulants demand increased oxygen, leading to respiratory complications.

Negative Health Consequences

When taken in high doses and for long periods, barbiturates can lead to serious health consequences. These include:

  • Increased sensitivity to sound
  • Increased sensitivity to pain
  • Changes in blood pressure
  • Breathing difficulties
  • Increased risk of developing bronchitis and pneumonia
  • Irregular menstrual cycles in women
  • Sexual dysfunction
  • Increased risk of kidney failure
  • Respiratory depression
  • Overdose
  • Death
  • Anxiety, restlessness, or panic
  • Impaired mental functioning
  • Emotional instability
  • Loss of short- or long-term memory
  • Insomnia
  • Hallucinations
  • Depression

Overdose

It’s also important to be aware of the signs and symptoms of a barbiturate overdose which include:

  • Shallow breathing
  • Clammy skin
  • Dilated pupils
  • Weak and rapid pulse
  • Respiratory failure
  • Coma
  • Hyperthermia
  • Circulatory failure

Signs & Symptoms of Barbiturate Abuse

People who are addicted to barbiturates can begin to exhibit the following signs of abuse.

Physical Signs of Abuse

  • Altered or decreased consciousness
  • Coordination problems and muscle weakness
  • Clouded thinking
  • Lack of balance/vertigo
  • Nausea
  • Slurring of speech
  • Slow heart rate
  • Decreased urine output

Behavioral Signs of Abuse

Barbiturate addiction can also lead to behavioral signs. While some of these are specific to other substances, they include:

  • Sudden mood swings or behavioral changes
  • Taking barbiturates without a prescription
  • Running out of prescriptions early or faking symptoms to get a prescription
  • “Doctor shopping” to acquire multiple prescriptions at once
  • Hiding or lying about barbiturate use
  • Isolating from family and friends
  • Loss of interest in activities or hobbies
  • Appearing chronically drowsy
  • Acting suspiciously
  • Engaging in “poly-substance use” (abusing multiple substances at once)
  • Ongoing or new debts, job losses, or financial problems
  • Relationship issues

Barbiturate Withdrawal Symptoms


Chronic barbiturate abuse can create tolerance and subsequent withdrawal symptoms. Individuals can experience withdrawal effects as soon as 8 to 12 hours after their last dose. Some of the most common symptoms include:

  • Abdominal cramps
  • Nausea
  • Vomiting
  • Restlessness
  • Insomnia
  • Fatigue
  • Anxiety
  • Tremors
  • Seizures
  • Delirium
  • Hallucinations

Treatment for Barbiturate Addiction


Female doctor comforting male patient

If you are addicted to barbiturates, help is readily available. Below are some common forms of substance abuse treatment that can also be effective for drugs like barbiturates. These therapies are often most effective when combined with other treatments and are accessible through a doctor or rehab facility. You may also want to enroll in an inpatient or outpatient option, depending on your needs.

Dual Diagnosis

Dual diagnosis programs are designed to treat co-occurring addiction and mental health conditions. These programs can be highly beneficial if you struggle with issues such as anxiety or clinical depression. Rehab facilities that provide dual diagnosis are often led by psychiatrists or other mental health experts who are qualified to diagnose and treat underlying mental health disorders. Enrolling in a dual diagnosis program allows you to address your conditions while safely detoxing from barbiturates.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is the gold standard treatment for many addictions and mental health conditions. This type of therapy helps individuals identify and re-frame negative thinking patterns while also fostering a stronger sense of self-worth. CBT also provides a framework for dealing with stress, addiction triggers, cravings, and how to deal with situations that encourage drug use.

The Matrix Model

The Matrix Model is an evidence-based approach that consists of a mixture of behavioral therapy, counseling, 12-Step support, family education, and more. Individuals who receive this type of treatment learn about addiction and relapse, while developing a stronger sense of self-esteem and self-worth. This therapy involves a close working relationship between the patient and the therapist and has shown to be effective for many types of addictions.

Motivational Interventions

Motivational Interventions such as motivational interviewing (MI) consist of counseling techniques for addiction. Based mainly on a reward system, these techniques help individuals deal with cravings and remain abstinent by teaching them it is possible to achieve sobriety using self-control. Motivational interventions also usually involve the use of rewards or incentives.

Support Groups

Support groups are another fundamental and effective way to treat addictions and substance abuse. Well-known groups like Alcoholics Anonymous (A.A.), Narcotics Anonymous (N.A.), and 12-Step programs can provide support, guidance, and encouragement, especially as individuals transition into a life free of substances. These groups are known for helping people to reduce the risk of relapses.

Wellness & Holistic Activities

As part of therapy and rehab, wellness and holistic therapies can also be highly beneficial. This includes activities such as yoga, massage therapy, music and art therapy, fitness, and social outings. These activities and therapies are great for encouraging calmness, emotional expression, and teaching skills about health and nutrition.

Stopping On Your Own

Barbiturate withdrawal can be especially dangerous, so stopping on your own is not recommended. Medical detox centers are the best way to safely wean yourself off these drugs, as doctors and clinical staff can keep you safe and comfortable. They can also provide you with other medications to help minimize the barbiturate withdrawal effects.

Resources

If you or a loved one are struggling with barbiturate abuse or addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Dryden-Edwards, R. (n.d.). Barbiturate Abuse. Emedicinehealth.com.  https://www.emedicinehealth.com/barbiturate_abuse/article_em.htm#what_are_barbiturates.

Medical News Today. (2018). Everything you need to know about barbiturates. Medicalnewstoday.com. https://www.medicalnewstoday.com/articles/310066.

Sarrechia, C., Sordillo, P., Conte, G., and Rocchi, G. (1998). Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication. Ann Ital Med Int. 13(4), 237-9. https://pubmed.ncbi.nlm.nih.gov/10349206.

WebMD. (n.d.). Barbiturate Abuse. WebMD.com. https://www.webmd.com/mental-health/addiction/barbiturate-abuse#1.

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

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