Barbiturates are a kind of depressant or sedative drug. They are an old class of drug used to relax the body and help people sleep.

These drugs were first developed in the late 19th century. Use of barbiturates as a recreational drug then became popular in the 1960s and 1970s, leading to abuse in some cases.

Use and abuse have declined greatly in recent years, however. This decline is mainly due to the development of newer, safer drug alternatives.

Barbiturates carry a risk of psychological and physical addiction. 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.

Fast facts on barbiturates

Here are some key points about barbiturates.

  • Barbiturates were first developed in 1864 and became a popular sleeping pill.
  • Between the 1920s and the mid-1950s, barbiturates were practically the only drugs used as sedatives and hypnotics.
  • 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.

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).

As a medication, they reduce muscle spasms, relieve anxiety, prevent seizures, and induce sleep.

As a recreational drug, they produce effects similar to those of alcohol:

  • relaxation and euphoria
  • reduced inhibition
  • slurred speech
  • loss of coordination
  • impaired judgment
  • confusion

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 4 to 16 hours.

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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
  • severe trauma to the skull
  • some types of convulsions

Barbiturates can also be used as a form of anesthetic.

Off-label uses include treatment for:

However, they are not a popular drug because of the risk of poor outcomes and adverse effects.

Today, it is rare to use them for sleep disorders.

Phenobarbital is most likely to be used for treating seizures. The World Health Organization (WHO) list it as a first-line treatment for epilepsy for adults and children in the developing world, because of its low cost and proven effectiveness.

Barbiturates are available in pill, liquid, rectal, and injectable forms.

Legal status

In the late 1950s and 1960s, there was an increase in reports of barbiturate overdoses and dependence problems, and physicians stopped prescribing them. Eventually, barbiturates were scheduled as controlled drugs.

Barbiturates are now scheduled II, III, and IV drugs in the United States, depending on their form and use.

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

Medical-use barbiturates are available under many names, including:

  • Phenobarbital
  • Butabarbital (Butisol)
  • Seconal
  • Nembutal
  • Butabital (in Fioricet, not a controlled substance)
  • Primidone (not a controlled substance)

Thiopental (Pendothal) is no longer on the market because of ethical issues relating to lethal injection for capital punishment.

Barbiturates street names

There are various street names for barbiturates, including:

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Barbiturates have a wide variety of commercial and street names.
  • barbs
  • downers
  • Christmas trees
  • blue heavens
  • blues
  • goof balls
  • blockbusters
  • pinks
  • rainbows
  • reds
  • red devils
  • sekkies
  • sleepers
  • double trouble
  • yellow jackets

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
  • headache
  • vomiting
  • confusion
  • problems with remembering things
  • respiratory arrest and death

A major problem 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.

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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
  • drowsiness
  • shallow breathing
  • kidney failure
  • coma
  • death

Overdose is more likely to be seen in developing countries, where low cost has led to barbiturates 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 who frequently use barbiturates may reach a constant state that is similar to a drunken daze.

The effects and dangers of barbiturate use increase greatly if they are taken with alcohol.

As a person uses barbiturates 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.

Withdrawal symptoms

Suddenly stopping use of barbiturate drugs can quickly lead to withdrawal symptoms. These symptoms may include:

  • restlessness
  • anxiety
  • insomnia
  • stomach cramping
  • nausea
  • vomiting
  • thoughts of suicide
  • hallucinations

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. Up to 66 percent of people may experience delirium for several days.

The confusion is similar to that seen during alcohol withdrawal, known as delirium tremens (DTs). 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 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.