Barbiturates are an old class of drugs used to relax the body and help people sleep.
These drugs were first developed in the late 19th century. Barbiturate abuse then became popular in the 1960s and 1970s.
Use and abuse have declined greatly in recent years, however. This decline is mainly due to the development of newer, safer drug alternatives.
Barbiturates are both psychologically and physically addictive. The risk of a fatal overdose is higher with barbiturates than other drugs as the difference between a safe dose and a deadly one is small.
A class of drugs known as benzodiazepines has largely replaced barbiturates for both medical and recreational use.
Benzodiazepines have less severe side effects and are not as likely to result in accidental overdose as barbiturates. Examples of benzodiazepines include Valium and Ativan.
Here are some key points about barbiturates. More detail and supporting information can be found in the main article.
- Barbiturates were first developed in 1864 and eventually became a popular sleeping pill.
- Between the 1920s and the mid-1950s, barbiturates were practically the only drugs used as sedatives and hypnotics.
- Barbiturates were used during World War II to help American soldiers in the South Pacific tolerate the heat.
- Phenobarbital the most commonly prescribed barbiturate. It was first used as a drug for epilepsy in 1912.
- Older adults are the patients most at risk from barbiturate overdoses.
- There is no antidote to reverse barbiturate poisoning.
- Sodium pentothal is a barbiturate often known as "truth serum." In larger doses, it has been used in lethal injection executions.
- Sudden withdrawal from a barbiturate drug after becoming physically dependent can result in death.
- Vets sometimes use barbiturates to put animals to sleep.
What are barbiturates?
Barbiturates are a group of drugs that have calming effects on the body. They can produce effects similar to those of alcohol, ranging from mild relaxation to an inability to feel pain and loss of consciousness.
The first barbiturates were made in the 1860s by the Bayer laboratories in Germany. Barbiturates increase the activity of a chemical in the brain that helps transmit signals. This chemical is known as gamma amino butyric acid (GABA).
How quickly barbiturates act and how long their effects last can vary. They can be classified as ultra short-, short-, intermediate-, and long-acting. When people take barbiturates by mouth, their effects begin within 30 minutes of swallowing and last from 5 to 6 hours.
Extent of use
One of the main medical uses for barbiturates is to treat seizures.
Barbiturates (mainly phenobarbital) are occasionally used by doctors to treat the following conditions:
- Seizure disorder (epilepsy)
- Increased pressure in the skull
- Alcohol and benzodiazepine poisoning
Barbiturates can also be used as a form of anesthetic.
Phenobarbital is most likely to be used for treating seizures in children younger than 2 years of age. The World Health Organization list it as a first-line recommendation in the developing world. Average doses are between 50 to 100 milligrams.
Barbiturates are available in pill, liquid, rectal, and injectable forms. Their effects last between 4 and 16 hours.
In the late 1950s and 1960s, barbiturate overdoses and dependence problems were reported more, causing physicians to stop prescribing them. This eventually led to the scheduling of barbiturates as controlled drugs.
Presently, barbiturates are nearly nonexistent on the black market. However, although illegal barbiturate use is rare, it remains an extremely dangerous drug to abuse because of the high risk of fatal overdose.
Barbiturates commercial names
- Butabital (in Fioricet, not a controlled substance)
- Primidone (not a controlled substance).
Barbiturates street names
Barbiturates have a wide variety of commercial and street names.
- Christmas trees
- Blue heavens
- Goof balls
- Red devils
- Double trouble
- Yellow jackets
What side effects do barbiturates cause?
When used according to instructions, the most common side effects of barbiturates are drowsiness, relaxation, and feeling sick.
More serious side effects of barbiturate use may include:
- Lack of coordination
- Problems with remembering things
A major problem with barbiturates is that they can cause tolerance and dependence. Tolerance is when a greater amount of a drug is required to get the desired effect. Dependence is when withdrawal symptoms occur if the person stops using the drug.
What are the health risks of using barbiturates?
A barbiturate overdose can affect coordination and make thinking difficult.
Death from overdose is the most significant risk associated with barbiturate use.
Symptoms of an overdose can include:
- Lack of coordination
- Slurred speech
- Difficulty in thinking
- Poor judgment
- Shallow breathing
Despite a fall in barbiturate use, overdoses are more likely to be seen in developing countries. In these countries, the low cost of barbiturates has led to them being used more to control and prevent seizures.
Because of its relaxing effects on many of the body's organs, long-term barbiturate use can lead to breathing problems and pneumonia. Long-term use can also cause sexual dysfunction, delayed reflexes, a short attention span and memory loss.
People that frequently use barbiturates may reach a constant state that is similar to a drunken daze.
The effects and dangers of barbiturate use are greatly increased if they are taken with alcohol.
As barbiturates are used more, the difference between a dose that causes the desired effect and that of a fatal overdose becomes narrower. This makes overdoses more common in long-term use such as for more than 2 weeks.
Suddenly stopping use of barbiturate drugs can quickly lead to withdrawal symptoms. These symptoms may include:
Barbiturate withdrawal can also be fatal. Up to 75 percent of individuals withdrawing from a barbiturate may have one or more seizures, along with confusion and elevated body temperature.
The confusion is similar to the confusion sometimes seen during alcohol withdrawal known as delirium tremens. People who are withdrawing may experience anxiety, disorientation, and visual hallucinations. If untreated, this withdrawal can progress to high fever, heart failure, and eventually death.
Medical care in a hospital is typically needed to treat barbiturate withdrawal.
Barbiturates are sedative prescription medications that produce a wide range of relaxing effects on the body, ranging from mild sedation to coma. These drugs are associated with a high rate of dependency and a small window between effective and fatal doses.
Although they were widely used in the middle of the 20th century, present day barbiturate use is uncommon. Some barbiturates are still made and sometimes prescribed for certain medical conditions. However, most barbiturate use has been replaced by the development of newer, safer, alternative drugs.