Barbiturate Addiction

Barbiturates were once used more widely in the United States, but their side effects led them to be replaced when a new central nervous system depressant was introduced. However, barbiturates are still used in some settings today. And, as depressants, they can cause alcohol-like intoxication effects when used recreationally. However, misusing barbiturates can be dangerous, leading to addiction and overdose, along with other uncomfortable side effects.

Learn more about barbiturate addiction in the United States and how it can be treated. 

What Is a Barbiturate?

Barbiturates are central nervous system depressants used for various medical purposes, including sedation. They have also been used as an anti-anxiety medication and anticonvulsant. Barbiturates were first introduced in the late 1800s and became a first-line drug for various ailments throughout the first half of the 20th century. 

They have a significant risk for addiction and overdose when misused or used for long periods. They were largely replaced in the 1960s with the introduction of benzodiazepines, which have a safer profile of side effects. However, barbiturates are still used in some cases today. 

As a depressant, barbiturates can have intoxicating effects similar to alcohol, including relaxing euphoria, sedation, relaxation, inhibition suppression, memory impairment, and motor skill impairment. They can also cause muscle-relaxing effects.

Barbiturates can also lead to physical dependence fairly quickly with frequent use or high doses. Once a person develops a substance use disorder involving barbiturates, it can be dangerous to quit cold turkey without medical supervision. Barbiturate addiction isn’t as common as alcoholism or the abuse of benzodiazepines, but the drug may be sought for its intoxicating effects. 

Why Is Barbiturate Misuse Dangerous?

Barbiturates are powerful depressants that slow down activity in the central nervous system. They bind to gamma-Aminobutyric (GABA) receptors and increase the effectiveness of the GABA neurotransmitter. GABA is a natural chemical involved in calming you down and helping you rest and digest. Barbiturates can significantly increase the effects of this neurotransmitter, slowing down your central nervous system and relieving anxieties, muscle tension, and arousal.

However, in high doses, barbiturates can also have an effect on important functions of the central nervous system, like regulating breathing. High doses of a barbiturate can cause respiratory depression, or when your breathing slows or stops. This can lead to oxygen deprivation, brain damage, and death. Depressant overdoses can also make you lose consciousness or go into a coma.

Barbiturates can lead to an overdose in relatively moderate doses if they are mixed with other depressants like alcohol or benzodiazepines. They can have the same reaction with opioids. 

Depressants like barbiturates can also cause potentially dangerous symptoms during withdrawal. When your brain becomes dependent on a barbiturate, your nervous system is consistently being slowed down by a foreign substance. Your brain chemistry adapts around it and comes to rely on it to maintain balance. If you stop suddenly, your brain chemistry may become overexcited, leading to dangerous symptoms like seizures. 

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Why Do Barbiturates Cause Addiction?

Addiction is a chronic disease that occurs when the brain’s reward center learns to treat drug use as a vital life-sustaining activity. Addiction is characterized by compulsive substance use despite negative consequences. Because using the drug becomes compulsive, it can be difficult to control, even if you know you shouldn’t use it. As a progressive disease, addiction can start to take over most of the major aspects of your life, including your health, relationships, jobs, and finances.

Two women discussing barbiturate addiction

Addictions occur when a drug causes the release of a chemical that your reward center picks up on. Your reward center also works with mood-lifting, feel-good chemicals that encourage you to repeat healthy tasks. 

Activities such as eating a good meal and even having a good social interaction can release these chemicals. Motivation is an important part of being a healthy complex organism, so the reward system is good at creating powerful compulsions, like food cravings. However, drugs like barbiturates that create euphoria also cause the release of feel-good chemicals like dopamine. 

When your reward center reacts to drug use like it’s an important life-sustaining activity, you may start to develop a substance use disorder. If you are using barbiturates, you might begin to have powerful cravings for the drugs when dealing with stress or other everyday situations. Addiction is often joined by chemical dependence, which is when your brain chemistry adapts to the drug, and without it, you experience uncomfortable withdrawal symptoms. At this point, you may continue to take the drug compulsively just to feel normal. 

What Is the Scope of Barbiturate Addiction?

The use of central nervous system depressants as a recreational drug in the United States is common. Of course, the most common depressant is alcohol. According to the 2018 National Survey on Drug Use and Health, more than 67 million people binged alcohol within the last month of the survey. Prescription drug misuse is also common, with more than 16 million people misusing prescription psychotherapeutic drugs in 2018. 

Benzodiazepines are among the most common prescription depressants that are misused. In 2018, 5.4 million people over the age of 12 misused benzodiazepines. More than 2.4 percent of Americans over age 12 misused prescription sedatives in general, which includes barbiturates.

In the midst of the opioid crisis, polydrug use is common, which is when people use multiple drugs simultaneously. Sedatives like barbiturates can be extremely dangerous when they’re mixed with other substances like opioids or alcohol. Together, the sedative effects potentiate, and it becomes more likely to experience an overdose with moderate doses of each individual drug.

How Can Barbiturate Addiction Be Treated?

As a depressant, it’s important to address a barbiturate addiction with medical and clinical treatment. It is dangerous to attempt to quit barbiturates cold turkey. The sudden cessation of a depressant medication can cause some potentially life-threatening symptoms, especially if you’ve become used to high doses. 

A handful of barbiturates

When you enter a recovery program to overcome your barbiturate dependence, you’ll complete an assessment process that places you in the right level of care. Barbiturate addiction treatment will likely start with medical detox. A physician might start you on a tapering period to avoid withdrawal symptoms like seizures and delirium tremens as the drug exits the body.

After detox, you will go to the next level of care that you need. If you continue to have high-level biological or psychological needs, you may go through an inpatient (residential) program with medically monitored or clinically managed services. You might move onto intensive outpatient or outpatient treatment when you can live on your own.

During treatment, you may receive different therapies that best address your needs. Many people attend individual and group therapy sessions, as well as family therapy. Behavioral therapies are also common in addiction treatment, especially cognitive behavioral therapy, which is instrumental in relapse prevention planning.

Sources

American Psychiatric Association. (2017, January). What Is Addiction? Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

ASAM. (n.d.). What is the ASAM Criteria? Retrieved from https://www.asam.org/resources/the-asam-criteria/about

RXlist. (2018, September 24). Barbiturates: Side Effects, Dosages, Treatment, Interactions, Warnings. Retrieved August 28, 2020, from https://www.rxlist.com/consumer_barbiturates/drugs-condition.htm

RxList. (2018, February 6). Benzodiazepines Drug Class: Side Effects, Types & Uses. Retrieved from https://www.rxlist.com/benzodiazepines/drug-class.htm

SAMHSA. (2018). Key Substance Use and Mental Health Indicators in the … Retrieved August 21, 2020, from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

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