Key Points

  • Barbiturates are a group of chemicals that reduce activity in the central nervous system (CNS).
  • They have been in use since the 19th century but have fallen out of favor as safer alternatives are available for many conditions.
  • Barbiturates have many unwanted side effects, and an overdose can be fatal.
  • Even at the correct dose, someone can fall victim to barbiturate poisoning as these drugs interact unpredictably with substances like opioids and alcohol.
  • Barbiturate overdose requires immediate treatment to avoid serious long-term health problems or death.

Barbiturates have been around since the mid-19th century, with their clinical use becoming widespread in the early 20th century. Today, it’s rare to be prescribed barbiturates by your doctor unless you have a particular condition that will only respond to these powerful central nervous system (CNS) depressants. [1] However, the use of barbiturates as a recreational drug is on the rise — with potentially lethal consequences.

Because barbiturates are highly addictive and toxic, their use is not recommended without careful medical supervision. As a street drug, barbiturates contribute to overdose deaths and long-term health problems, including severe kidney damage. [2] Understanding the signs and symptoms of barbiturate poisoning could help save someone’s life.

Primary Uses of Barbiturates

Barbiturate use is not as popular as it once was, as there are safer alternatives that provide the desired effect in many cases. Barbiturates are highly addictive even after only short-term use, often causing the individual to develop both a physical and psychological dependence on the substance. This class of drugs is also highly toxic, with many potentially unpleasant side effects and interactions. [2]

Your healthcare provider will usually look at alternatives to barbiturates due to the potential drug toxicity and side effects associated with this group of medications. The most common alternatives to barbiturates are benzodiazepines. Both types of drugs impact gamma-aminobutyric acid (GABA) receptors in the brain, reducing activity and sensitivity in the CNS. However, benzodiazepines are safer, less addictive, and less prone to misuse. [3]

Common Barbiturates

In some medical situations, a healthcare provider may decide that barbiturates are the best choice. Here are some of the most common barbiturates still prescribed by medical professionals:

There are around 2,500 different barbiturate compounds, but only 15 are in use by medical professionals today. [3]

How Barbiturates Work

Barbiturate drugs cause CNS depression, or the reduction of activity across the central nervous system. All currently used barbiturates are based on the foundational formula of barbituric acid, first used to induce sleep in dogs. Further development led to using barbiturates as a general anesthetic for humans. The drug interacts with GABA receptors in the brain, depressing the CNS and causing drowsiness, sedation, and sleep. [8]

Recreational Use of Barbiturates

While the medical use of barbiturates is declining, recreational use is increasing. [2] Some people actively seek out barbiturate intoxication because they enjoy the feelings these drugs produce. As a CNS depressant, barbiturates produce similar effects to alcohol — relaxation, reduced inhibitions, and euphoria. Individuals may take more of their prescription drugs than they’re supposed to or purchase barbiturates illegally. [2]

Barbiturates are problematic because they can lead to physical dependence (addiction) and are potentially lethal if someone takes too much. [9]

What Are the Symptoms of Barbiturate Poisoning?

When it comes to the use of barbiturates, toxicity can be a concern. While the toxicology of barbiturates is relatively straightforward when used on their own, barbiturates can interact negatively with other substances. The combination of opioids and barbiturates, for example, can drastically lower activity in the CNS and cause serious health issues. [9]

It’s very common to see situations where someone may be offered recreational drugs, alcohol, and caffeine (for example, energy drinks) in a short space of time. Night clubs and other social situations may bring these substances together, making them easily available. Both barbiturates and alcohol reduce inhibition and impact judgment. [2] Someone who may usually never consider taking a “street drug” may make this decision due to cognitive impairment caused by alcohol or other medications.

Barbiturate poisoning signs include: [2]

  • Poor concentration
  • Lack of judgment
  • Impaired speech and motor function control
  • Staggering or jerky movements
  • Sluggish, slow movements
  • Low temperature (hypothermia)
  • Slow or shallow breathing

Acute barbiturate poisoning leads to respiratory problems, unconsciousness, and death.

Person with barbiturate poisoning lying in hospital bed with heart monitor in focus.

 

Treating Barbiturate Poisoning

Barbiturate poisoning or overdose is life-threatening and needs immediate treatment, including emergency medicine, to try and remove as much of the toxic substance as possible. Activated charcoal is one potential treatment for barbiturate poisoning. The charcoal decreases the elimination half-life of long-lasting barbiturates such as phenobarbital. In other words, charcoal can help your body eliminate the substance from your body faster. [9]

Naloxone may also be prescribed if the individual took opioids as well as barbiturates. An opioid overdose can also be fatal, but importantly, opioids increase the CNS depression effect of barbiturates. Counteracting the opioid effect can help increase the chances of a positive outcome after a barbiturate overdose. [9]

Emergency teams will take blood samples and check for several factors that could impact how the barbiturate poisoning is handled. They will normally check if the individual is pregnant, where applicable, to ensure that the treatment provided doesn’t negatively impact the unborn child unduly. Medical professionals will also check the individual’s renal (kidney) function. One of the major problems with barbiturate overdose is that it can permanently damage the kidneys. Hemodialysis – manual filtration of the blood – is a possible treatment where the kidneys have been impacted. [9]

Always let the attending medical team know if you have any medical condition or are taking any medications or substances. That information could drastically change the treatment options and potentially save your life.

Barbiturate Side Effects

Even when taken at a non-toxic dose, barbiturates can cause undesirable side effects. These include but are not limited to: [2]

  • Lowered blood pressure
  • Reduced heart rate
  • Mood swings and mental health problems
  • Gastrointestinal problems
  • Nausea or vomiting
  • Dizziness
  • Confusion
  • Headaches
  • Vertigo

If you take barbiturates while pregnant, it’s possible that your baby will be born addicted to the drugs and need immediate medical treatment. As barbiturates can cause long-term kidney problems as well as other serious complications, this is very dangerous for the child. [2]

In situations where you have to take barbiturates, make sure you confirm the exact dose and how to take it with your prescribing healthcare provider. Find out how often you should take the drug and if you should take it with food or not. You should always let your doctor know if you are taking other medications or substances. Even a single glass of wine on a night could dramatically alter the effect that barbiturates have on your body and brain. [2]

How to Stop Taking Barbiturates

If you take barbiturates at the advice of a physician, only stop taking your medication with their advice. Barbiturate withdrawal can be unpleasant and should not be undergone without medical supervision. Even individuals who only take barbiturates for a few weeks may experience disturbing hallucinations, seizures and convulsions, or a high fever. [2]

Taking barbiturates recreationally means you won’t automatically have help on hand when you decide to stop using these drugs. It’s important to seek out support, though, as overcoming addiction on your own can be daunting. Without the right support, such as medications to reduce the impact of nausea or fever, you may be tempted to relapse and take the substance again. Consider contacting a trusted treatment center with professionals who can help you stop taking barbiturates safely and with minimal discomfort.

Substance abuse is challenging to overcome, but you are not alone. If you or a loved one needs support with withdrawal, detoxification, or barbiturate addiction treatment, Southeast Addiction Center can help. Our expert team provides a compassionate, non-judgmental environment with the highest level of care and support. As well as detox services, you’ll gain access to talking therapies, group support, and a holistic approach to overall wellness. Making the decision to stop taking barbiturates is a big step, and you should be proud of yourself. Let us help you get your life back on track today — contact us to learn more about recovery from barbiturate misuse.