What Are Barbiturates?
Barbiturates are a group of drugs known as sedative-hypnotics. They can make you sleepy and less anxious. They’re typically used to treat problems like seizure disorders, insomnia, and some types of anxiety. Barbiturates can also be used as part of surgical anesthesia to help you relax.
Barbiturate side effects
Barbiturates can cause several side effects. The most common ones include:
- Feeling clumsy or unsteady
- Dizziness, lightheadedness
- Drowsiness
- Feeling like you have a hangover
You could also experience:
- Anxiety or nervousness
- Constipation
- Irritability
- Nausea and vomiting
- Nightmares
- Difficulty sleeping
If you experience any of these serious side effects, contact your doctor as soon as possible:
- Confusion
- Depression
- Excitement, but more than is normal
- Hallucinations
- Unusual bleeding or bruising
- Excessive fatigue or weakness
Contact your doctor immediately, go to a local urgent care or emergency department, or call 911 if you have any of these side effects:
- Wheezing
- Tightness in your chest
- Chest pain
- Skin rash or hives
- Swelling on your face, including your eyelids or lips
Other serious side effects that need immediate attention include:
- Bleeding sores on your lips
- Ulcers (sores) or painful white spots in your mouth
- Fever
- Muscle or joint pain
- Changes in your skin: red, thickened, or scaly
- Sore throat
- Fever
Barbiturate Misuse Overview
Barbiturates were first used in medicine in the early 1900s, but they became popular in the 1960s and 1970s as doctors began prescribing them for anxiety, insomnia, and seizure disorders. As people learned that barbiturates could change their mood, many began using them as recreational drugs. They found the drugs reduced their inhibitions, decreased anxiety, and helped get rid of unwanted side effects of illicit drugs.
Barbiturate use and their abuse dropped dramatically since the 1970s for two main reasons. First, the U.S. government developed stricter guidelines for when and how barbiturates were used. This meant there were fewer reasons for doctors to give them to their patients. Second, a safer group of sedative-hypnotics called benzodiazepines began replacing barbiturates, except in a few specific indications. Since doctors prescribed fewer barbiturates, they became harder to get illegally. Unfortunately, barbiturate misuse among teenagers may be on the rise again, particularly phenobarbital, compared with the early 1990s. That said, addiction to barbiturates is still uncommon today.
Types of Barbiturates
There are many different barbiturates. The biggest difference between the barbiturates is how long their effects last. Some last only a few hours, some much longer.
The drugs can be injected into the veins or muscles, but they are usually taken in pill form. The street names of commonly misused barbiturates describe the desired effect of the drug or the color and markings on the actual pill.
The greatest danger to misusing barbiturates is that you can become dependent on them. If taken daily for longer than about one month, the brain develops a need for it. This can cause severe symptoms if you stop taking it.
They are also easy to overdose on.
Amobarbital
Amobarbital is a sedative and hypnotic. It’s used to treat insomnia, but only for short-term use because its effect stops after a couple of weeks. Amobarbital is an intermediate-acting drug, starting to work in 45 to 60 minutes and lasting up to eight hours. On the street, these pills are called downers, blue heavens, blue velvets, and blue devils.
Pentobarbital
Pentobarbital is a hypnotic medication used to treat seizures. It’s a short-acting drug, starting to have an effect in 10 to 15 minutes, but only lasting three to four hours. On the street these pills are called nembies, yellow jackets, abbots, and Mexican yellows.
Phenobarbital
Phenobarbital is used to reduce anxiety and control seizures. If someone is dependent on a different type of barbiturate, their doctor might prescribe phenobarbital to help ease withdrawal symptoms. This barbiturate is a long-acting drug, taking about an hour to start working and then lasting up to 12 hours. On the street, these pills are called purple hearts and goof balls.
Secobarbital
Secobarbital is used most often to treat insomnia, but it’s also used to help reduce anxiety before you have surgery. Secobarbital is another short-acting drug. On the street, these pills are called reds, red birds, red devils, lilly, F-40s, pinks, pink ladies, and seggy.
Secobarbital and amobarbital (Tuinal)
Tuinal is a barbiturate that’s no longer made in the U.S. The pharmaceutical company stopped producing it in 2001. It was two drugs in one: secobarbital and amobarbital. Since it’s a combination of these two drugs, it can start taking effect after only 15 minutes or so, but it can last as long as 8 hours. On the street, these pills are called rainbows, reds and blues, tooies, double trouble, gorilla pills, and F-66s.
Barbiturate Misuse Causes
Although prescriptions for barbiturates have dropped since the 1970s, high school surveys suggest that the number of people using it on the street is rising. The barbiturates counteract the excitement and alertness obtained from stimulant drugs like cocaine and methamphetamines.
Those who choose to use the drug recreationally today might be too young to remember the death and dangerous effects barbiturates caused in the 1970s, so they may underestimate their risks. Barbiturates are also commonly used in suicide attempts.
Barbiturate Misuse Symptoms
In general, barbiturates are relaxants, much like alcohol. Their effects are very similar, and when combined can be lethal. Pain medicines, sleeping pills, and antihistamines also cause symptoms similar to those of barbiturates.
It’s important to understand that the difference between the dose that causes drowsiness and one that causes death may be small. In the medical profession, this difference is called a narrow therapeutic index. It’s the small difference between the amount of the drug that is helpful (therapeutic) and what can harm you (toxicity). This is why barbiturates are so dangerous and why they’re not often prescribed today.
- In small doses, the person who misuses barbiturates may feel drowsy, disinhibited, and intoxicated.
- In higher doses, the user may stagger as if drunk, develop slurred speech, and be confused.
- At even higher doses, the person might become unconscious (coma) and may stop breathing. Death is possible.
Signs of an overdose include:
- Slowed breathing
- Increased heart rate
- Drop in blood pressure
- Drop in body temperature
- Coma
Symptoms of withdrawal
Symptoms of withdrawal after you stop taking barbiturates include tremors, difficulty sleeping, agitation, and hallucinations. These symptoms can become worse, resulting in life-threatening symptoms, including high body temperature and seizures.
Newborns exposed to barbiturates during the pregnancy may be born addicted and may have withdrawal symptoms.
When to Seek Medical Care
Someone who has taken a barbiturate and has symptoms of side effects or an overdose must be cared for in an emergency room. If you believe someone has taken barbiturates inappropriately, take them to the hospital. Barbiturates can act very quickly, so while someone may only be drowsy or seem intoxicated, more serious symptoms can develop quickly and unpredictably. Learn more about the consequences of untreated substance abuse.
- If the person is drowsy or you are unable to rouse them (if they seem to be in a coma), call 911.
- Bring any leftover pills, pill bottles, or other medicines the person may have taken to the hospital.
Exams and Tests
Once a person who has taken barbiturates arrives in the emergency department, the staff has to determine if the problem is the barbiturates or if the symptoms are being caused by something else, like a different type of drug, head injury, stroke, infection, or shock. This means taking a urine test and blood tests. Usually, someone will start an intravenous (IV) and do an electrocardiogram (EKG) to look at the heart rhythm. Other tests depend on the specific situation.
Barbiturate Misuse Treatment: Self-Care at Home
There is no home treatment for barbiturate misuse. If you believe someone has taken barbiturates inappropriately, take them to the hospital.
Barbiturates have a narrow therapeutic index and can cause coma or death if taken inappropriately. This is especially true in children and older people.
Barbiturate Misuse Medical Treatment
The treatment of barbiturate abuse or overdose is generally supportive, meaning that the staff works to make sure the person doesn’t get worse. The amount of support required depends on the person’s symptoms.
- If the person is drowsy but awake and can swallow and can breathe without difficulty, the treatment may be just to watch closely.
- If the person is not breathing, a breathing machine (ventilator) will help the person breathe until the drugs have worn off and they can breathe on their own again.
- Liquid activated charcoal may be pumped into their stomach to bind to any drugs still in the stomach. If the person is able, they’ll drink it. If they can’t, a tube will be placed through the nose or mouth.
- Most people are observed in the emergency department for a number of hours. If needed, they might be admitted to the hospital for more monitoring and treatment. Other treatments depend on the specific situation.
Next Steps After Barbiturate Misuse
Someone who is addicted to barbiturates needs prolonged therapy to prevent dangerous withdrawal symptoms. They are typically treated with decreasing doses of barbiturates (called detoxification) until they are drug-free.
Outlook After Barbiturate Misuse
Most people survive after misusing barbiturates if they go to the hospital and get the care they need. That said, some people who have overdosed will die despite intensive emergency care.
A person’s outcome depends on a number of factors, including:
- If they took other drugs as well
- How quickly the person received medical attention
- Which barbiturate the person abused
Takeaways
Barbiturate misuse isn’t as common today as it was in the 1970s because they aren’t commonly used anymore. But they are still out there, and some people use them to get a high or to counteract the effect of other illicit drugs. It’s very easy to overdose on barbiturates and to become dependent on them.
Barbiturate Misuse FAQs
What is barbiturate abuse?
Barbiturate abuse is using the drug when it’s not prescribed for you.
How do barbiturates make you feel?
Barbiturates can make you feel relaxed, sleepy, or high.
What are barbiturate drugs used for?
Barbiturates are generally used to treat seizures, anxiety, and insomnia.
Which street drugs are barbiturates?
Many street drugs are barbiturates, such as downers, yellow jackets, red birds, and rainbows.
