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About Barbiturate Abuse

Barbiturates are a class of central nervous system depressant medications. They are considered controlled substances in the U.S. as the potential for barbiturate abuse and dependence is comparatively high. Barbiturates are also one of only three drug categories with potentially fatal withdrawal side effects. Alcohol and Benzodiazepines are 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 has been prescribed barbiturates and begins taking a higher dose than prescribed, or a person buys this medication illegally online or off the street.

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 which was popular in the 1960s. Benzodiazepines have largely supplanted barbiturates now for controlling anxiety as they have fewer side effects.

But both are roughly equal in addictive potential and danger they present in withdrawal. Like benzodiazepines, barbiturates increase the activity of gamma-aminobutyric acid (GABA) in the brain. These days barbiturates are more commonly used to control seizures or in hospital settings, although butalbital combined with acetaminophen is still prescribed as a migraine headache medicine.

Barbiturates Mechanism of Action

Barbiturates increase 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 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 know 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 taking it for an extended period 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 US

  • 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 several ways. One of the most common occurs when someone has been prescribed a barbiturate and takes more than they are supposed to. While doctors are much wiser about 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. In the 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.

We Can Help

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 now effective non-narcotic medications for anxiety. Combined with non-pharmacological interventions and wellness practices, it is possible to manage most anxiety effectively without using a controlled substance.

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, contact us.


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