About Barbiturate Abuse

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What is Barbiturate Abuse?

Barbiturates are a class of central nervous system depressant medications. They are considered a controlled substance in the U.S. The potential for barbiturate abuse and dependence is comparatively high. Barbiturates are also one of only three categories of drugs which have potentially fatal withdrawal side effects. Alcohol and Benzodiazepines being the other two. 

All three carry a serious risk of fatal seizures in withdrawal if a person stops taking them abruptly without proper medical supervision.  Barbiturate abuse typically begins in one of two ways. Either someone is prescribed barbiturates and begins taking a higher dose than they were prescribed or a person buys this medication illegally online or off the street and barbiturate abuse ensues that way.

Barbiturate Abuse is Less Common Today

Barbiturates have fallen out of favor somewhat in recent decades. Before the advent and growth in popularity of benzodiazepines, they were the “go to” prescription sedative. It is said that the “mother’s little helper” The Rolling Stones referred to in the eponymous tune was the barbiturate meprobamate, sold under the brand name Miltown that was popular in the 1960s. Benzodiazepines have largely supplanted barbiturates now for controlling anxiety has they have fewer unwanted side effects. 

But both are roughly equal in addictive potential and in the danger they present in withdrawal. Like benzodiazepines, barbiturates increase the activity of gamma aminobutyric acid (GABA) in the brain. Barbiturate abuse is much less common today than it was in prior to the 1980s when benzodiazepines began eclipsing them in popularity, especially for treating anxiety. These days barbiturates are more commonly used to control seizures or in hospital settings, although butalbital combined with acetaminophen is prescribed as a migraine headache medicine currently.

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Barbiturate Withdrawal Can Be Fatal

Barbiturates are one of only three categories of drugs which have potentially fatal withdrawal symptoms. The other two being alcohol and benzodiazepines. It is absolutely essential than you NEVER attempt to detox yourself off of barbiturates or stop taking them abruptly without medical supervision. There is a very real potential for seizures in withdrawal and they can be deadly. A barbiturate detox or taper must always be done under a doctor’s supervision.

Some Risk Potential Factors for Seizure in Barbiturate Withdrawal are:

  • Poor overall physical health
  • Advanced age (over 65 years old)
  • Regular alcohol consumption or alcoholism
  • Previous history of seizures (for any reason)
  • Long-term use of barbiturates (5+ years)
  • Taking certain other medications along with barbiturates.
  • Taking more than prescribed or more than a typical prescription dose.

Barbiturates Mechanism of Action

Barbiturates increasing the production of the neurotransmitter gamma aminobutyric acid (GABA). GABA creates a sense of calm and relaxation. As a result the effect of GABA eases anxiety and stress and helps us sleep. It also protects the brain. Increases in GABA seem to alleviate seizures and high blood pressure. The brain needs GABA to function properly. The problem is that barbiturates increase the production of GABA to the point that it can be dangerous if they are abused or if the user abruptly stops taking them.

Someone actively engaged in barbiturate abuse or even regular use should be aware that quitting cold turkey is extremely dangerous. Barbiturates are one of the few classes of drugs which have potentially fatal withdrawal symptoms. The others are alcohol and benzodiazepines. Quitting a barbiturate abruptly without medical supervision after you have taken it for an extended period of time can result in deadly seizures. This must never be taken lightly. If you or anyone you know ever stops taking barbiturates suddenly after regular use, seek immediate medical attention at a hospital or drug detox. No exceptions.

BARBITURATES PRESCRIBED IN THE U.S.:

  • Amobarbital (Amytal Sodium, Tuinal)
  • Butalbital (Fioricet, Firotal)
  • Butobarbital (Butisol Sodium)
  • Phenobarbital (Luminal)
  • Pentobarbital (Nembutal Sodium)
  • Secobarbital (Seconal)

How Does Barbiturate Abuse Occur?

Barbiturate abuse can happen in a number of ways. One of the most common occurs when someone has been prescribed a barbiturate and they take more than they are supposed to. While doctors are a lot wiser concerning the risk of barbiturate abuse now than in the past, it still happens. Through no fault of the patient, they can become dependent on barbiturates after taking them regularly for a period of time. Once they are dependent, it is difficult or even dangerous to stop. Best case scenario, they will experience agitation, anxiety and insomnia. Worst case, fatal seizures in withdrawal. This is why it is imperative that no one ever abruptly stops taking a drug in this class without medical supervision in a controlled setting where detox meds are available and a nurse or doctor are present. This means an inpatient medical detox or hospital. The higher the dose and/or longer a person has taken it, the greater the risk. People with a history of seizures or seniors need to be especially careful.  

Barbiturate Addiction in Illicit Use

Although relatively rare these days, barbiturate abuse does happen when people take these drugs recreationally of course. There is a reason they are considered a controlled substance by the DEA. There is a high potential for abuse with these drugs and the withdrawal symptoms are extraordinarily dangerous without proper supervision. Regardless of why someone engages in barbiturate abuse though, the important thing is that they get the help they need to overcome it. 

The best course of action is a safe, medical detox under a doctor’s supervision followed by addiction treatment to provide the behavioral health support needed to help mitigate relapse. People with anxiety disorders should also know that there are effective non-narcotic medications for anxiety now. Combined with non-pharmacological interventions and wellness practices, it is entirely possible to manage most anxiety effectively without the use of a controlled substance. 

We Can Help

If you believe you or someone you love needs help with barbiturate abuse or addiction to any other drug or you just have questions about treatment, give The Sylvia Brafman Mental Health Center a call at (954) 758-4174

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