Barbiturate Overdose Risks, Treatment, and More

Key Takeaways

• Barbiturates are central nervous system depressants used to treat various conditions - Jump to Section
• Lethal barbiturate doses vary; alcohol increases overdose risk - Jump to Section
• Overdose symptoms include incoordination, slurred speech, and possibly coma - Jump to Section
• Barbiturates come in many forms, like capsules and liquids, for various conditions - Jump to Section
• Barbiturates are legal with a prescription; illegal use can result in arrest - Jump to Section
• Side effects range from drowsiness to rare severe breathing problems - Jump to Section
• Regular use can lead to dependence and potentially fatal reactions - Jump to Section
• Abuse symptoms resemble alcohol intoxication with potential 'hangover' effects - Jump to Section
• Withdrawal symptoms can be dangerous and include seizures and delirium - Jump to Section
• Treatment includes medical detox, inpatient and outpatient rehab, and support groups - Jump to Section

What is a Barbiturate Drug?

Barbiturates are classified as central nervous system (CNS) depressants. This means that they can slow brain activity and breathing and cause sedation.¹

A doctor may prescribe barbiturates to treat:¹

• Seizure disorders (like epilepsy) 
• Insomnia 
• Anxiety before surgery 
• Induction of coma (due to head injury)
• Anesthesia

The improper use of barbiturates can lead to an overdose and potential death. Because of this, doctors typically prescribe benzodiazepines instead of barbiturates.

Are Barbiturates Addictive?

Barbiturates have a high risk of abuse and addiction. Therefore, they’re classified as Schedule II, III, and IV depressants.⁴

Classification for barbiturates varies according to:⁴

• Type of medication
• Potential for abuse
• The severity of psychological or physical dependence

Schedule II barbiturates have a high potential for substance abuse and severe physical dependence. Schedule IV barbiturates have a lower potential for abuse and a low risk of dependency.⁴

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What is a Lethal Dose of Barbiturates?

Lethal doses will vary from one barbiturate drug to the next. For example, the lethal dose for amobarbital is 2 to 3 grams. The lethal dose for phenobarbital is 6 to 10 grams.^2,3

Tolerance to the lethal effects of barbiturates can occur little by little. This makes an overdose a major health risk. If alcohol, opiates, or other CNS depressants are taken with barbiturates, the risk of overdose and death increases.  

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Symptoms of Barbiturate Overdose

Here is a list of overdose symptoms:²

• Incoordination
• Slurred speech
• Trouble thinking 
• Clammy skin
• Coma
• Respiratory depression (slowed, ineffective breathing)
• Changes in vital signs (slowed heart rate, low blood pressure, less oxygen circulation) 
• Shock

If anyone experiences any overdose symptoms, contact medical authorities immediately. Provide them with full information regarding the substances consumed because it may affect their treatment. If opiates were involved in the dose, they might use the emergency medicine called naloxone (Narcan) to treat the overdose.⁵

Barbiturate Overdose Risks

A barbiturate overdose can increase the risk of hypoxia, a decreased amount of oxygen in the brain. You may suffer short and long-term health problems from hypoxia, including:²

• Permanent brain damage
• Severe muscle damage from falling and lying on a hard surface
• Coma

Examples of Barbiturate Drugs

Barbiturate drugs are available in different forms, including:

• Capsule
• Tablet
• Elixir (sweet-flavored liquid)
• Solution

Some of the main barbiturate medications available in the United States are:

Mephobarbital (Mebaral®) 

This medication is an anticonvulsant with low toxicity, meaning it has fewer side effects. It may also help treat anxiety or apprehension.

Sleepiness is one of the primary side effects caused by this medication. Other less common side effects include: 

• Agitation
• Nightmares
• Ataxia 

Phenobarbital (Luminal®)

This medication helps to treat medical conditions like seizures or anxiety. Medical professionals may also prescribe this drug to reduce withdrawal symptoms. 

The half-life of phenobarbital is 100 hours, meaning that it’s metabolized and excreted over several days. It takes 100 hours for the effective dose to be reduced by one-half, another 100 hours to reduce the effective dose to a quarter of the original dose, etc. Its effects usually last longer than 6 hours and may cause drowsiness or headaches. In severe cases, it may also cause a rash or shallow breathing. 

Phenobarbital is a common antiepileptic drug around the world. Because of its prolonged duration of action, it may be dosed much less frequently than other common anticonvulsants. Low-resource countries may prescribe this type of barbiturate as a first-line treatment because of its low cost and prolonged duration.⁶

Pentobarbital sodium (Nembutal®)

This short-acting medication helps treat medical conditions like insomnia and anxiety. It also serves as a euthanasia drug for animals and humans. 

The United States government has included pentobarbital sodium in lethal injections. Symptoms of this drug include: 

• Confusion
• Low blood pressure
• Sleepiness

Phenobarbital is one of the most common prescription anticonvulsants in the world. In the United States, this barbiturate medication is a second-line treatment for epilepsy. 

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Are Barbiturates Illegal?

Barbiturates are legal in the United States. However, purchasing or consuming it without a doctor’s prescription is illegal. Selling barbiturates without proper documentation or misusing these drugs can result in arrest.⁴

Buying barbiturates on the street or online increases the risk of consuming contaminated or expired drugs. The risk of overdose is also high. 

Common street names for barbiturates include:⁴

• Barbs
• Block Busters
• Christmas Trees
• Goof Balls
• Pinks
• Red Devils
• Reds & Blues
• Yellow Jackets

Side Effects of Barbiturate Use

Using any type of barbiturate can cause side effects. If any of these side effects occur, talk to a physician. Barbiturate side effects can range from common to rare; these include:¹

Common Side Effects

Some of the more common side effects of barbiturate use include:

• Clumsiness or unsteadiness
• Dizziness or lightheadedness
• Drowsiness or sleepiness 
• “Hangover” effect

Uncommon Side Effects

Some of the less common side effects of barbiturate use include:

• Anxiety or apprehension
• Constipation
• Fainting sensation
• Headache
• Irritability
• Nausea or vomiting
• Nightmares 

Rare Side Effects

Some rare side effects of barbiturate use include:

• Sores or ulcers in or around the mouth 
• Breathing problems (wheezing or chest tightness)
• Chest pain
• Fever
• Rash or hives

Risks of Barbiturate Use

Regular barbiturate use can lead to tolerance and dependence, even if you’re taking them as prescribed. Continued misuse can result in barbiturate poisoning and, in some cases, death.²

Some people are hypersensitive to barbiturates. They’re at risk of drug rash with eosinophilia and systemic symptoms (DRESS). The mortality rate of individuals with DRESS is 10%.⁸

Lastly, using barbiturates during pregnancy increases the chance of congenital disabilities.³ Because barbiturates remain active in your system for prolonged periods, you can still experience side effects after quitting them. They can remain up to 15 days after use.

Symptoms of Barbiturate Abuse

Signs of barbiturate abuse include:⁸

• Drowsiness
• Sedation
• Ataxia (incoordination) 
• Respiratory depression (slow, ineffective breathing)
• Headache
• Gastrointestinal problems 
• Confusion 
• Memory, judgment, and motor skill impairment

If you abuse barbiturates you may seem like you’re drunk on alcohol. This is because of the relaxation and sleepiness caused by the drug. A “hangover” effect can occur up to 22 hours after you take barbiturates.  

Barbiturate Withdrawal

If you’ve been misusing barbiturates, you’ll experience withdrawal symptoms when you stop. Abrupt, barbiturate withdrawal can be dangerous and result in death.⁸

Barbiturate withdrawal is similar to alcohol withdrawal.

Symptoms include:⁸

• Restlessness
• Anxiety or apprehension
• Stomach pain
• Nausea and vomiting
• Seizures 
• Delirium tremens (disorientation, visual hallucinations, hyperthermia)

Symptoms of barbiturate withdrawal tend to disappear after eight days or so. 

Treatment Options for Barbiturate Abuse

If you or someone you know is addicted to barbiturates, seek professional help. A barbiturate addiction often requires professional treatment and medical support.

Available treatment options for barbiturate abuse include:

• Medical detox: Medically supervised detox used to avoid harmful withdrawal effects
• Inpatient rehabilitation: Involves checking yourself into a rehab facility for 24-hour medical supervision 
• Outpatient rehabilitation: A treatment program where you’re freely allowed to leave the rehab facility
• Support groups and aftercare programs: Provides a much-needed community to help maintain sobriety after treatment

Summary

Barbiturates are depressants that can affect your CNS and cause a sedative effect. They’re  often used to treat seizure disorders, insomnia, anxiety, and more.

Barbiturates are listed as Schedule II, III, and IV depressants. They have a high potential for addiction and dependence.

It’s possible to overdose on barbiturates. However, lethal doses will vary from one barbiturate drug to the next.

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