Based on today’s knowledge regarding drugs and alcohol, it may seem far-fetched to think of opium and alcohol used as a medication to help with sleep. These drastic measures displayed their ineffectiveness shortly after they were deployed, and scientists sought other means of treating ailments like anxiety and sleep disorders. 

An estimated 50 million American’s struggle with 80 different kinds of sleep disorders today, and that’s in addition to another 20 to 30 million having intermittent sleep issues each night. Although medical professionals have widely phased out barbiturates, they were once the most popular method of treating sleep disorders. 

Barbiturates date back to 1864, and the substance was introduced to the market in 1904. Once it was perfected, nearly 2,500 variations were created to help with sleep disorders, seizures, and anxiety. After many years of what they thought to be successful, physicians in 1912 realized these drugs cause dependence. Physicians noticed delirium and severe withdrawal symptoms after abrupt cessation. 

Barbiturates like phenobarbital, allobarbital, and barbital depress the central nervous system (CNS) to produce a calming effect. Unfortunately, since barbiturates are so addictive, even moderate doses can have fatal consequences. Benzodiazepines have slowly replaced barbiturates to treat the same conditions, as well as Z-drugs, which are geared to assisting in sleep. 

Despite barbiturates losing their place in modern medicine over the years, they’re still highly sought out drugs on the black market. If you haven’t used a barbiturate drug, it’s impossible to understand how addictive the drugs are. It’s not necessarily the intoxication factors that are deadly; it’s the withdrawal symptoms if you fail to get the necessary help.

Symptoms of Barbiturate Withdrawal

Those who misuse or abuse barbiturate drugs increase their chances of developing a dependence or addiction. Once this occurs, it’ll make stopping barbiturates even more challenging because of the severe withdrawal symptoms you’ll experience. If you’re ready to stop using barbiturates, you should seek immediate medical attention from addiction specialists. They’ll refer you to medical detoxification for support from a caring and empathetic staff. This stable environment will allow you to overcome your symptoms in a safe place with access to emergency services. 

The most common barbiturate withdrawal symptoms include the following:

  • Anxiety
  • Nausea
  • Vomiting
  • High fever
  • Restlessness
  • Exhaustion
  • Insomnia
  • Aggression

Other more severe symptoms of prolonged use include:

How Long Does Barbiturate Withdrawal Last?

Barbiturate withdrawal syndrome is going to affect everyone differently. The process and severity of symptoms will vary from one situation to another based on various factors. The factors contributing to this include:

  • How long you’ve used barbiturates
  • The last dose of the barbiturate drug
  • Age
  • The half-life of the particular barbiturate
  • Frequency of use
  • How the barbiturate was consumed
  • Metabolism
  • Support network
  • Tolerance
  • Polydrug use
  • Dietary habits
  • Support network

In a majority of cases, individuals can get through barbiturate withdrawals in one to two weeks. However, for some, the experience could last anywhere from three to four weeks. Mild barbiturate users will overcome the process much quicker than heavy users. 

A general barbiturate withdrawal timeline consists of the following:

  • Days 1-3: You’ll begin experiencing withdrawal symptoms within the first or second day after cessation. It’s common for those stopping to report anxiety, nausea, and vomiting. Sleep will become challenging to achieve, and users report exhaustion and agitation. The symptoms will peak 72 hours after the last dose. Users report milder symptoms when they place themselves in the care of medical professionals to help overcome the severe symptoms safely. 
  • Days 4-7: Day five is when users report feeling better. Physically, your body has pushed the toxins out that have built up from barbiturate use. The body is at a point where it’s starting to balance out, causing you to feel some relief. You’ll still experience sleep problems, cravings, mood swings, and anxiety, but physical symptoms should disappear. Continued support in a professional facility will be the key to getting through this.  
  • Week two and beyond: A person that’s severely addicted to barbiturates will benefit from detox in the short-term but will need to move into long-term care to address their continued symptoms. They could still experience withdrawal symptoms two weeks into the process, meaning that continued care is crucial to avoid relapsing. 

Managing the Symptoms of Barbiturate Withdrawal

barbiturate-withdrawal

As was mentioned above, barbiturate withdrawal can be severe, and in some cases, fatal. In almost all cases, completing a stint in medical detox is vital for survival to overcome dependency or addiction to barbiturates. During medical detox, clinicians will slowly taper the individual down to manageable levels of the drug. 

Other medications could also be prescribed to manage the psychological and physical symptoms they’ll endure during this process. The primary focus in medical barbiturate detox is to focus on the comfort of the individual and manage symptoms and vitals to ensure their safety. Barbiturate withdrawal may require administering psychiatric medications to help stabilize the person before they start addiction treatment. 

Barbiturate Medications and Detox

Unfortunately, there aren’t medications designed to manage barbiturate withdrawal symptoms like there are for opioids. Clinicians will focus on managing the symptoms during barbiturate detox, which could include specific sleep aids to overcome insomnia, which is the primary side effect. Other medications to treat nausea and vomiting may also be used. Despite the particular circumstances, you should never withdraw alone from barbiturates without medical care. The severity of symptoms could be impossible to overcome alone. 

Barbiturate Overdose

Understanding the effects, symptoms, and risks associated with a barbiturate overdose can be the difference between life or death. Since barbiturates belong to a group of drugs known as sedative-hypnotics that treat seizure disorders, anxiety, and sleep disorders, they’re known for their addictive tendencies. When used in high doses, they cause euphoria and drowsiness, which is what users seek when they abuse the drug. 

The most common side effects of barbiturates include:

  • Drowsiness
  • Low blood pressure
  • Nausea
  • Headache
  • Sedation
  • Euphoria
  • Skin rash
  • Clouded thinking
  • Altered or decreased consciousness
  • Lack of balance or vertigo
  • Coordination problems or muscle weakness
  • Slurred speech
  • Decreased urine output
  • Slowed heart rate

Severe barbiturate side effects include:

  • Coma
  • Confusion
  • Abnormally slow breathing
  • Fainting
  • Hallucinations
  • Temporary breathing cessation

Rare side effects of barbiturates include:

  • Liver injury
  • Erythroderma
  • Agranulocytosis
  • Stevens-Johnson syndrome
  • Megaloblastic anemia

Barbiturates have a narrow therapeutic index, which means a small difference in dose can result in significant side effects in patients. If you combine barbiturates with other drugs like benzodiazepines, opioids, antidepressants, or over-the-counter (OTC) drugs, it could be fatal.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 405,000 American’s over the age of 12 reported using barbiturates in 2018. Another 32,000 reported misusing barbiturates.  

Signs of barbiturate overdose include:

  • Clammy skin
  • Shallow breathing
  • Dilated pupils
  • Rapid or weak pulse
  • Respiratory failure
  • Coma

These symptoms are noticeable, and awareness is key to get immediate medical attention. 

Responding to a Barbiturate Overdose

If you believe that someone has overdosed on barbiturates or any drug, you should call 911 immediately, especially if breathing has slowed or stopped altogether. The presence of medical professionals will significantly improve the chances of survival in the event of an overdose, which can be fatal. 

Knowing if the person has mixed a barbiturate with an opioid will be helpful for first responders when they arrive on the scene. They could administer Narcan as a first treatment. Narcan will help a person regain consciousness and reverse opioid overdose effects, although the drug won’t reverse a barbiturate-induced overdose.

Drugs that Interact With Barbiturates

Barbiturates are Schedule II substances, indicating they have definite potential for psychological and physical dependence or abuse. Barbiturates are habit-forming, and tolerance, physical dependence, and psychological dependence could occur after prolonged use of the drugs. You should always speak to your doctor about other drugs you’re using before taking barbiturates. 

The most common drugs that interact with barbiturates include:

  • Alprazolam
  • Alcohol
  • Anticoagulants
  • Atazanavir
  • Antihistamines
  • Clonazepam
  • Diazepam
  • Corticosteroids
  • Birth control pills
  • Boceprevir
  • Doravirine
  • Doxycycline
  • Griseofulvin
  • Estrogen
  • Hypnotics
  • Lurasidone
  • Monoamine oxidase inhibitors (MAOIs)
  • Sedatives
  • Steroids
  • Phenytoin
  • Ritonavir
  • Ranolazine
  • Telaprevir
  • Sodium valproate
  • Tranquilizers
  • Zolpidem
  • Valproic acid
  • Zaleplon
  • Voriconazole

The information above doesn’t include all potential interactions. You should always speak with your doctor before using any medication.

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