We don’t tend to hear much about barbiturates anymore. Because of their high abuse potential, use of these drugs for medical purposes has fallen out of favor, and they are not as common as they used to be in the mid-to-late 20th century, especially considering the advent of a new, similar type of drug, benzodiazepines, that are now used to treat the conditions barbiturates used to treat. Nevertheless, barbiturate abuse is still occurring, and it is an issue of concern because of the high risks of using and abusing these drugs.
The sedative-hypnotic barbiturate drug type was often used to treat anxiety, control seizures, or perform other sedative or similar functions. Before benzodiazepines saturated the market, barbiturates were commonly prescribed drugs. However, their highly addictive nature was quickly discovered, and they have fallen out of favor as anti-anxiety drugs. Nevertheless, they are still medically useful in some circumstances – particularly for treating some types of seizures, including epilepsy – and they are therefore still prescribed sometimes, as Schedule II controlled substances.
List of Addictive Barbiturates
- Amobarbital (Amytal)
- Pentobarbital (Nembutal)
- Secobarbital (Seconal)
Barbiturates are also popular drugs of abuse. The following are the most common, according to WebMD:
Phenobarbital is one of the better-known barbiturates, and it is still used to manage epilepsy and related seizures in various parts of the world. It goes by the street names of purple hearts or goof balls. According to the National Library of Health’s Medline Plus, phenobarbital is also used to treat anxiety, and it can be used as part of the detox and withdrawal recovery process for people who are addicted to other barbiturates. For this reason, it is somewhat easier to find phenobarbital than it is to find other barbiturates.
Phenobarbital is also used as the first line of treatment for canine epilepsy, according to the Ohio State University Veterinary Medical Center. Shown to be effective in 60-80 percent of dogs with epileptic seizures, the drug is not officially approved by the FDA for this use, but it is commonly applied for this purpose.
This drug is considered to be a high addiction risk for youth and young adults, and use should be monitored closely if it is prescribed to treat epilepsy or anxiety in these populations in particular.
2. Amobarbital (Amytal)
According to the Federal Drug Administration’s information on Amytal, as provided through Drugs.com, amobarbital is generally used as a pre-anesthesia relaxant and painkiller before surgery, or as a sleep aid. Amobarbital’s blue pills are referred to on the street as blue heaven, blue velvet, or blue devil. They are also simply called downers.
The challenge of using a barbiturate for sleep is that it does not allow rapid-eye movement sleep – or REM sleep – which is vital to achieving the restorative power of the sleep cycle. As a result, while sleep may be achieved, it may not end up feeling restful. This can also be an issue for people who use it recreationally. Chronic loss of REM sleep can lead to psychological complications.
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3. Pentobarbital (Nembutal)
The Open Chemistry Database describes pentobarbital as a drug that is used to help people with insomnia problems or as a sedative before surgery. It can also be used, in small doses, as an anticonvulsive – that is, it can control seizures. Developed in the 1930s, it was first used as a sleeping pill. On the street, it is referred to as yellow jackets or nembies.
It is because of this high risk that Nembutal, the brand-name version of pentobarbital, is currently best known as an end-of-life drug. It is generally not available in the US or Europe, except in places where euthanasia has become legal.
4. Secobarbital (Seconal)
The street names of this drug include reds, pinks, red birds, or pink ladies. Like pentobarbital, secobarbital is best known these days as a drug used for euthanasia. Otherwise, according to the Physician’s Desk Reference, it is most commonly used for presurgical sedation; however, it can also be used for the other common benefits of barbiturates described above, including controlling seizures and aiding with sleep.
The PDR explains that tolerance – that is, the process of the body getting used to the drug and requiring more to obtain the same effect that is achieved initially – can develop very quickly with secobarbital. In fact, tolerance that renders the drug’s effectiveness nearly inert can occur in as little as two weeks. This highlights how rapidly addictive the drug is.
Tuinal has been all but discontinued in the US and Europe. A potent blend of amobarbital and secobarbital, it is referred to by the street names of rainbows, reds and blues, or double trouble. The combination makes for a much smaller divide between the effective dose and an overdose, making this drug very difficult to prescribe in safe, effective doses. This accounts for the fact that it is nearly impossible to find. However, it has been possible for some people to obtain old, probably expired pills, and attempts to get it from other parts of the world are still made.
Dangers of Abuse and Withdrawal
As described above, a number of barbiturates are used in assisted suicide; this is because these drugs can quickly result in suppressed respiration, leading to death. Part of the reason these drugs fell out of favor medically is that it can be difficult to determine an accurate dosage that provides the desired effect without causing an overdose. This is also the most specific danger of abusing barbiturates: It can be very easy to overdose on the drugs rather than achieve the desired pleasurable effect.
As a result, it can be even more dangerous to mix barbiturates with other sedative drugs like benzos, opiates, or alcohol. Doing so risks potentially fatal respiratory distress and failure.
Barbiturates are also dangerous to withdraw from, making addiction to them a double-edged sword. As described in a study from the National Library of Medicine’s PubMed, the withdrawal syndrome for barbiturates can result in a variety of dangerous symptoms, including:
- Circulatory failure
For this reason, if a person is struggling with barbiturate abuse or addiction, it is important to get professional help for the detox and withdrawal process to avoid these risks.
Benzodiazepines: A Better Alternative?
As mentioned above, barbiturates are being used far less than they were originally, partly because they were replaced by the drug benzodiazepine class. At first, this class of drugs was considered to be a much lower abuse risk, and therefore was offered as a safer alternative to barbiturates. In many cases, when used properly, they are. As explained in the Medical Pharmacology, benzos are much easier to dose in safe amounts.
However, subsequent experience and research, such as this article from American Family Physician, demonstrates that chronic abuse of these drugs – including simply using them for too long – can lead to addiction. And, similar to barbiturates, the detox process from benzos can lead to similarly dangerous seizures and other withdrawal symptoms. As a result, benzo use must also be monitored and undertaken with the awareness that these drugs are highly addictive.
Barbiturates are dangerous drugs even in their professional, medical application. Using them recreationally can quickly lead to addiction, if not swift overdose. For these reasons, if a person is suspected to be using barbiturates recreationally, or of being addicted to them, addiction treatment is urgently indicated. This is not only because the drugs themselves are dangerous, but because stopping use can also result in a potentially dangerous withdrawal syndrome.
A reputable, research-based treatment program can help. Through therapy demonstrated to help people learn to manage addiction and substance abuse, an individual struggling with addiction to barbiturates can take the first step toward abstinence and a brighter outlook for recovery.