Barbiturate Drug Addiction, Withdrawal, and Rehab Treatment

What are Barbiturates?

Barbiturates belong to a class of drugs called sedative-hypnotics, a type of central nervous system (CNS) depressant.¹ Through their interaction with the GABA neurotransmitter system, they act to inhibit or slow certain types of brain activity and have been used to treat seizure disorders, insomnia, and pre-operative anxiety, and to induce coma in instances of increased intracranial pressure.² Barbiturates have also been used as anesthetic induction agents for surgeries and other procedures.²

Various individual barbiturate drugs are Schedule II, III, or IV controlled substances, meaning that while they have legitimate medical indications, there is a known potential for misuse.³

In 2020, 50,000 individuals aged 12 or older reported past year misuse of barbiturates.⁴ Referred to by street names including Barbs, Goof Balls, Pinks, Reds, Blues and more, barbiturates are sometimes misused for their ability to induce mild euphoria, as well as reduce anxiety, decrease inhibitions, and manage unwanted effects of illicit substances.⁵

Examples of Barbiturates

Though relatively few prescription barbiturates remain available for limited medical use, a list of more historical examples of barbiturates includes:^1-3

• Amobarbital (Amytal).
• Secobarbital (Seconal).
• Phenobarbital (Luminal).
• Pentobarbital Sodium (Nembutal).
• Thiopental Sodium (Pentothal).
• Butalbital (Fiorinal).

The risk of dangerous side effects such as oversedation and respiratory depression may increase when barbiturates are used in combination with alcohol, benzodiazepines, or opioids like heroin—all of which can make lethal overdose more likely.⁶ The risk of toxicity and overdose may be additionally heightened in cases of concurrent respiratory diseases or impaired liver function.⁷

Signs and Symptoms of Barbiturate Addiction

A barbiturate addiction involves the compulsive, uncontrollable use of barbiturate drugs despite the negative impact of such use. Addiction may entail physiological changes (such as tolerance and dependence) but also behavioral changes that impact all aspects of the individual’s life. Addiction development is accompanied by functional changes in the brain that impact an individual’s motivation, thought processes, and behaviors—so much so that the drug becomes the priority above all else.¹

It can be difficult to recognize when barbiturate misuse has turned into an addiction. If you are concerned for yourself or a loved one, it is important to see a healthcare provider. Only a mental health professional can diagnose you with a substance use disorder. With the proper diagnosis, you can begin the path to treatment and recovery.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the manual that clinicians use to diagnose substance-related disorders and other mental health issues, outlines the following criteria used to diagnose a sedative, hypnotic, or anxiolytic use disorder involving barbiturates:⁸

• Barbiturates are taken in larger amounts or over a longer period than was intended.
• There is a persistent desire or unsuccessful efforts to cut down or control barbiturate use.
• A great deal of time is spent on activities necessary to obtain, use, or recover from the effects of barbiturates.
• Individuals experience cravings to use barbiturates.
• Recurrent barbiturate use results in a failure to fulfill major obligations at work, school, or home.
• The individual continues to use the barbiturate despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the drug.
• Important social, occupational, or recreational activities are given up or reduced because of barbiturate use.
• The individual uses barbiturate drugs in situations that are physically dangerous.
• Barbiturate use continues despite knowledge of it causing or exacerbating physical or psychological problems.
• The individual develops a tolerance for the barbiturate.
• The individual experiences withdrawal symptoms when they stop taking the barbiturate.

Barbiturate Withdrawal

People who become physically dependent on barbiturates may experience withdrawal when they abruptly stop taking the barbiturate or drastically reduce their dose. Symptoms of barbiturate withdrawal can include:⁶

• Restlessness.
• Tremors.
• Elevated body temperature.
• Sweating.
• Insomnia.
• Anxiety.
• Seizures.

Barbiturate Addiction Treatment and Rehab

If you are concerned that you or a loved one misuses barbiturates or other prescription medications, there is help available. The ideal addiction treatment program depends on a number of personal factors and is tailored to meet your unique needs. Thus, treatment looks different for everyone but may include:^6,9

Detoxification. Medically managed detox is the process your body undergoes as it cleanses itself from a substance and experiences withdrawal. For an individual who has been misusing barbiturates or who has been taking them in conjunction with alcohol and/or opioids, withdrawal can be extremely uncomfortable and dangerous. Therefore, detox should take place in a specialized treatment facility, which includes 24-hour monitoring by medical professionals and doctors, who can help you wean off barbiturates and other substances safely and as comfortably as possible.

Inpatient treatment. Inpatient care consists of 24/7 treatment in a hospital or residential setting. While living there, the days are generally structured with a variety of group and individual therapies, counseling, and education. If it is necessary, medication can also be used to help you overcome your addiction.

Outpatient treatment. Outpatient programs allow you to live at home or in a sober living environment during treatment. There are different levels of outpatient care, and the one that’s best for you will depend on your specific needs but may include:⁹

• Partial Hospitalization Programs (PHPs). PHPs provide treatment throughout the week for 6–8 hours per day. Services include counseling, education, therapy, and access to medical services, when needed. These programs mirror inpatient programs but don’t require you to live at the facility during treatment.
• Intensive Outpatient Programs (IOPs). IOPs are relatively less time-intensive than PHPs. Depending on your needs, the number of days per week and hours per day may vary within an IOP. However, the range of rehabilitation services offered in IOPs are generally similar to those provided in PHP settings.
• Traditional Outpatient Programs. Traditional outpatient care can consist of group and individual therapies and sometimes medications. They are typically by appointment and can be scheduled around your work or school schedule. These programs may be beneficial for people with mild to moderate substance use disorders or who have sufficiently recovered from more severe disorders.

While there are many behavioral therapies used in addiction treatment, 2 evidence-based therapies often used include:⁹

• Cognitive-behavioral therapy (CBT). CBT focuses on targeting maladaptive thoughts and associated behaviors to make healthy changes to both. It is one of the most well-studied and effective types of therapy for substance use disorders.
• Contingency Management (CM). CM uses tangible rewards (i.e., gift cards or vouchers for food or healthy forms of entertainment) to motivate behavioral change. For example, for each drug-free urine test, a person may get a reward. For each subsequent drug-free test, the reward may increase. The rewards continue until healthy behavior patterns are established.

Most insurance plans offer some coverage for substance use disorder treatment. For those who do not have insurance or cannot afford to pay, some treatment centers may offer sliding-scale payment plans or low-cost or free services. If you or a loved one needs treatment for barbiturate misuse, sedative-hypnotic use disorder, or other substance use disorder, there is help available and sustained recovery is possible.