Facts and Information about Barbiturates:
- The primary action of barbiturate medications is to bring about drowsiness, decrease anxiety, and help with sleep. These medications have a wide range of effects that range from mild sleepiness to complete sedation, as with anesthesia. Barbiturates are in the sedative-hypnotic (tranquilizers) class of medications because they depress the central nervous system.
- Barbiturates are derived from a chemical called barbituric acid. The history about how this chemical was developed began with a chemist, named Adolf Von Baever, in 1864. Oddly, this chemist first synthesized a chemical compound, called malonylurea, by condensing animal urine (urea) with a substance found in apple juice (diethyl malonate). In 1903, another chemist, Emil Fischer, and Dr. Joseph Von Mering, used Adolf Von Beaver’s initial findings to develop the compound they called barbital. Furthermore, they discovered the hypnotic properties of the compound, and found that it could be used to euthanize dogs. The drug was marketed under the trade name Veronal, for use in veterinary medicine.
- About a decade later, in 1911, the same chemist Emil Fischer and Dr. Mering, synthesized phenobarbital for use in humans (GINAD, 2017). In the years that followed, many additional barbiturates were developed. The barbiturates were widely prescribed during the 1950’s and 1960’s as a sleep aid.
- There were also some highly publicized overdoses, during that same era, related to the use of barbiturates. The medical community came to realize the danger of overdose, and physiological dependence, associated with barbiturates, and prescriptions began to decline. There is still use for barbiturates in medicine, however, we now have safer medications that can be used as sleep aids and sedatives.
- Alcohol and barbiturates have much in common with regard to their effects. Like alcohol, the barbiturates cause dis-inhibition, relaxation, impaired judgement, slurred speech, decreased motor coordination, and produce a mild euphoria. The effects of barbiturates usually last from 4 to 16 hours, depending on the type of barbiturate taken. During the first 30 minutes to 1 hour they can also, like alcohol, have a stimulating effect on some people.
- Some common barbiturate names include:
- phenobarbital (Luminal)
- amobarbital (Amytal)
- thiopental (Pentothal)
- secobarbital (Seconal)
- mephobarbital (Mebaral)
- pentobarbital (Nembutal)
- butabarbital (Butisol)
- combination of amobarbital and secobarbital (Tuinal)
- The barbiturates are generally prescribed in pill form, however, may be hard to identify because there are a variety of shapes and colors, depending on the brand and type of medication. Liquid barbiturates are generally only used in a hospital setting.
- Barbiturates should NEVER be taken while drinking alcohol. Alcohol and barbiturates together have, what is called, a synergistic effect. The synergistic effect means that the combined impact of two drugs is greater than the effect of either drug when taken alone. When barbiturates are used with alcohol, the effect of the medication is four times stronger, than when taken alone (Combs, Hales, & Williams, 1980).
- Many medications have this synergistic effect, either with alcohol, or other medications. This is why it is especially important to read the drug interactions section, in the medication guide that comes with your prescription, whenever you get a new medication from the pharmacy. Additionally, it is important to make sure your medical provider is aware of any medications, or illicit drugs, you are taking. Remember, your visit with your health care provider is legally confidential. Therefore, it’s important, and okay, to be honest with your health care professional. It is also crucial for your own well-being.
- The barbiturates also have a very small margin of safety. The margin of safety is the difference between the effective dose of a drug, and the dangerous dose of the drug that can cause potentially fatal side effects. If a medication has a small ‘margin of safety’ it is a pharmaceutical that must be taken cautiously, with strict adherence to the dosage instructions. In simple terms, a medication that has a small margin of safety can easily lead to overdose, even if the dosage is increased by just a small amount.
- The sorrowful untimely deaths, of both Marilyn Monroe and Judy Garland, were attributed to overdose from barbiturate medications (Clark, 2001 & Kormam, 1962). Whether intentionally, or accidentally, many other celebrities have also succumbed to the dangerous effects of barbiturates. It is a dangerous medication that should always be taken exactly as prescribed.
- Some people, who abuse barbiturates, will crush the medication and inject it into a vein. The medication is very thick so it requires a large gauge needle. Someone who is frequently abusing this type of medication, may have large sores on their arms, or other areas used for injecting the drug.
- Some common street names that may be used to indicate a barbiturate medication include: barbs, downers, sleepers, blue heavens, blue devils, goof balls, purple hearts, pink ladies, lily, gorilla pills, stumblers, yellow jackets, and so on. New slang terms develop, and often change frequently, related to illicit drug use.
- The illicit use of barbiturates, sadly, has increased among young people. When taken illicitly, they are most often used to treat the negative effects of other illegal stimulant type drugs (for example, using to much cocaine or meth), to reduce anxiety, and to get “high”. Pentobarbital and secobarbital are more commonly abused, because they are in the short-acting barbiturates class, which means their effects are felt more quickly (Coupey, 1997).
- Use of barbiturates can quickly lead to dependence. Additionally, once dependence has developed, if barbiturates are discontinued abruptly, the withdrawal syndrome can cause life threatening symptoms which include: seizures, confusion, delirium, coma, and death. Medically supervised detox is the safest way to stop this type of medication.
- These drugs are not prescribed often because they have such a high potential for abuse, dependence, and overdose. The pictures below are not exaggerations of what can happen if barbiturate medications are misused.
How do barbiturates work:
- Our brains contain tiny nerve cells (called neurons) and chemical messengers (called neurotransmitters). We have some neurotransmitters that produce excitation, or stimulation, of the nerve cells in the brain. We also have some neurotransmitters that cause inhibition, or depression, of the nerve cells in our brains.
- A neurotransmitter is released from the end of one nerve cell, into the synapse, which is the small space between the nerve cells. Next, the neurotransmitter crosses the synapse and attaches to specific receptors on the end of the receiving nerve cell. When a neurotransmitter (messenger) attaches to a receptor it causes changes, inside that nerve cell, that can be either stimulating changes, or inhibitory changes.
- The barbiturates work by acting on a neurotransmitter/messenger, in the brain, called GABA. GABA causes inhibition (depression or decreased activity) in the central nervous system. Remember, the brain is part of the central nervous system. If the central nervous system is depressed we feel things like drowsiness, sleepiness, etc… This is why barbiturates are referred to as sedatives. They cause sedating affects in our nervous system.
- Our respiratory center is also located in our central nervous system. When our central nervous system is inhibited too much, it causes the respiratory center to be depressed. Since the respiratory center controls our breathing, depression of this area can cause a person to stop breathing. A person will usually have fallen asleep before they stop breathing, therefore this generally causes respiratory arrest during sleep, which results in death.
- Again, because there is such a small difference between the amount of the drug that causes the desired amount of sedation, and the amount of the drug that causes a coma or death, these drugs can be very dangerous. A medical provider makes very careful calculations based on a person’s weight, metabolism, other medications they may be taking, and other factors, to calculate a safe dose when prescribing a medication. They should NEVER be used without the supervision of a medical professional. You obviously would not want to “estimate” your own dose!!
- Everyone, but especially young people, need to be made aware of the dangers of this type of drug. Too often, young people do not understand how a drug works, resulting in tragedy. It is estimated that there are over 3000 deaths, every year, from barbiturate overdose in the United States (GINAD, 2017). People of all ages, often have a false sense of safety when a medication is available by prescription, or “legally available“. This is not true. Prescription medications are not sold over the counter and require a medical provider’s supervision, (and a prescription), for good reason. Many prescription medications can be dangerous, if not taken properly. Barbiturates are a good example of a medication that is very dangerous to take recreationally, and can result in death.
Resources for help:
If you or a loved one is struggling with drug addiction.
Please reach out for help.
- SAMHSA’s National Helpline: 1 (800) 662 HELP
- Substance Abuse & Mental Health Services Administration (SAMHSA)Website
- National Council on Alcoholism and Drug Dependence
- Intervention Resource Center: 1 (888) 421 4321
- List of Helplines and Crisis Hotlines
Clark, G. (2001). Get happy: The life of Judy Garland. New York, NY: Random House.
Combs, B., Hales, D., & Williams, B. (1980). An invitation to health: Your personal responsibility. Menlo Park, CA: Benjamin Cummings.
Coupey, S. (1997). Barbiturates. Pediatric Review. Aug;18(8): p. 260-4.
Global Information Network About Drugs [GINAD]. (2017). Barbiturates. Retrieved from http://www.ginad.org/en/drugs/drugs/222/barbiturates-
Kormam, S. (1962). “Marilyn Monroe Ruled ‘Probable Suicide’ Victim”. Chicago Tribune. Aug(8)1962. Retreived from http://chicagotribune.newspapers.com/