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Updated on February 8, 2022

Barbiturate Overdose

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.

A doctor may prescribe barbiturates to treat:

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

Barbiturates are very addictive. They carry a high risk of addiction and overdose.

Because of this, doctors don't prescribe them very often. They have largely been replaced by benzodiazepines.

If individuals misuse barbiturates, barbiturate poisoning or drug overdose is a risk. In more severe cases, the improper use of barbiturates can lead to death.

Symptoms of Barbiturate Overdose

Tolerance to the lethal effects of barbiturates can occur little by little. This makes an overdose a major health risk. 

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.

If alcohol, opiates, or other CNS depressants are taken with barbiturates, the risk of overdose and death increases. 

Here is a list of overdose symptoms:

  • 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

There is also the additional risk of hypoxia (a decreased amount of oxygen to the brain). Individuals with hypoxia may suffer both short- and long-term health problems. These include coma and permanent brain damage. Severe muscle damage as a result of falling and lying on a hard surface is also a risk.

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.

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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 acts as an anticonvulsant and has low toxicity (meaning 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, and 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. Its effects may last longer than 6 hours and cause drowsiness or headaches. In severe cases, it may also cause a rash or shallow breathing. 

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, and 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. 

Are Barbiturates Illegal?

Barbiturates are legal in the United States. 

Phenobarbital is a common antiepileptic drug around the world. Low-resource countries may prescribe this type of barbiturate as a first-line treatment because of its low cost. 

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

Classification for barbiturates varies according to:

  • 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 of abuse and low risk of dependency. 

It is illegal to purchase or consume this type of drug without a doctor’s prescription. Selling barbiturates without proper documentation or misusing these drugs can result in arrest.

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 of barbiturates include:

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

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Risks & Side Effects of Barbiturate Use

Using any type of barbiturate can cause side effects. It is important to speak with a physician if any of these side effects occur. 

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

  • Clumsiness or unsteadiness
  • Dizziness or lightheadedness
  • Drowsiness or sleepiness 
  • "Hangover" effect

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

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

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

Because barbiturates are so potent, you can still experience side effects after quitting them. They can remain up to 15 days after use.

Regular, even prescribed use of barbiturates can lead to tolerance and dependence. Continued misuse can result in barbiturate poisoning and, in some cases, death.

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

Using barbiturates during pregnancy increases the chance of congenital disabilities.

Symptoms of Barbiturate Abuse

Signs of barbiturate abuse include:

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

Individuals who abuse barbiturates may seem like they drank too much alcohol. This is because of the excitement or euphoric effects caused by the drug. 

A “hangover” effect can occur up to 22 hours after an individual takes a hypnotic barbiturate drug.  

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Barbiturate Withdrawal

Individuals misusing barbiturates shouldn’t stop drug use suddenly. Abrupt barbiturate withdrawal can be dangerous and result in death.

Barbiturate withdrawal is similar to alcohol withdrawal.

Symptoms include:

  • Restlessness
  • Anxiety or apprehensive
  • 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 Substance Abuse & Addiction

There are many treatment options available for substance abuse and addiction, including:

Inpatient Programs

Inpatient treatment centers are a comprehensive option for those who struggle to stay sober without medical supervision. You'll live in substance-free housing and have access to 24/7 care from qualified professionals.

You'll undergo detoxification, behavioral therapy, and other services. These usually last 30, 60, or 90 days, sometimes longer.

Most programs help set up your aftercare once you complete the inpatient portion of your treatment.

Partial Hospitalization Programs (PHPs)

Partial hospitalization programs (PHPs) are also called intensive outpatient programs (IOPs). Partial hospitalization programs provide similar services to inpatient programs. Medical services, behavioral therapy, and support groups are included.

The main difference is in a PHP, you return home to sleep. Some services provide food and transportation (this varies by program).

PHPs are suitable for new patients as well as people who have completed an inpatient program and still need intensive treatment.

Outpatient Programs

Outpatient treatment is less comprehensive than inpatient or PHPs. These programs organize your treatment around your schedule. They provide therapy, education, and support in a flexible environment.

People who have a high motivation to recover and cannot leave their responsibilities at home, work, or school are ideal patients.

Outpatient programs may be a portion of your aftercare after an inpatient or partial hospitalization program.

Medication-Assisted Therapy (MAT)

Some medicines can help reduce the negative side effects of detox and withdrawal. Others can help you reduce cravings and normalize body functions.

Disulfiram, acamprosate, methadone, and naltrexone are the most common medications used to treat substance use disorders (SUDs).

When combined with other evidence-based therapies, such as cognitive behavioral therapy (CBT), MAT can help prevent relapse and increase your chance of recovery.

Support Groups

Support groups such as Alcoholics Anonymous (AA), Narcotics Anonymous(NA), and Al-Anon are open to anyone with a substance use disorder. They are peer-led organizations dedicated to helping each other remain sober.

They can be the first step towards recovery or part of a long-term aftercare plan.

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Resources

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  1. “Barbiturate (Oral Route, Parenteral Route, Rectal Route) Side Effects.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Sept. 2020, www.mayoclinic.org/drugs-supplements/barbiturate-oral-route-parenteral-route-rectal-route/side-effects/drg-20069290.
  2. “Barbiturate Intoxication and Overdose: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, June 2019, www.medlineplus.gov/ency/article/000951.htm.
  3. “Barbiturates Drug Profile.” Drug Profiles, European Monitoring Centre for Drugs and Drug Addiction, www.emcdda.europa.eu/publications/drug-profiles/barbiturates_en.
  4. “Barbiturates.” DEA, www.dea.gov/factsheets/barbiturates.
  5. Nobay, F., and N.M. Acquisto. “Barbiturates.” Encyclopedia of Toxicology (Third Edition), Academic Press, 14 Apr. 2014, www.sciencedirect.com/science/article/pii/B9780123864543006965.
  6. “Phenobarbital: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, 15 May 2020, www.medlineplus.gov/druginfo/meds/a682007.html.
  7. Prescription CNS Depressants DrugFacts. National Institute on Drug Abuse, 24 July 2020, www.drugabuse.gov/publications/drugfacts/prescription-cns-depressants.
  8. Skibiski, Jeanie. “Barbiturates.” StatPearls [Internet]., U.S. National Library of Medicine, 10 July 2020, www.ncbi.nlm.nih.gov/books/NBK539731/.

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