Today, sleep aids and anti-anxiety pills are commonly prescribed medications that typically come in the form of benzodiazepines. But before benzodiazepines, a class of drugs called barbiturates was used for decades. Sleeplessness and anxiety are common problems in the United States and are considered two of the most prevalent ailments. More than 20 percent of adults experience some form of anxiety, and 60 million people suffer from a sleep disorder.
Doctors in the U.S. have prescribed medications to combat overactive minds for more than a century. While barbiturates aren’t regularly prescribed for sleep and anxiety problems today, they were once a widely used and abused drug. That is, until people started to notice it can cause some undesirable effects including tolerance, dependence, and addiction.
When abused, barbiturates can lead to an overdose, especially when mixed with other drugs and alcohol. Several notable people throughout the 20th century died in overdoses that were linked to benzodiazepines, including Judy Garland, Marilyn Monroe, and Jimi Hendrix.
While less common, benzodiazepines are still used recreationally to achieve intoxicating effects that are similar to alcohol. Though barbiturate addiction is a serious chronic disease, it can be treated. Learn more about barbiturates and how addiction can be treated with scientifically supported therapies and experienced clinicians.
Barbiturates are a class of central nervous system depressants that were used to treat insomnia anxiety in the first half of the 20th century. It also can be used to treat seizures and induce sedation. It’s derived from barbituric acid, which was first synthesized in the late 1800s.
They became widely used in the early 1900s and were particularly popular in Hollywood. Today, movies are shot during periods of months or even years. But in the golden age of cinema, Hollywood churned out movies in a matter of weeks. Popular actors lived life in a whirlwind of long shoots and rehearsals.
Plus, the competition was fierce, especially among young actresses. Actors and directors would take amphetamines to help make it through long hours, ensure an energetic performance, and help control weight. To combat drug-induced insomnia and anxiety, they were prescribed barbiturates, a habit that would stick with Judy Garland and Marilyn Monroe.
By the 1950s, people began to notice that barbiturates come with some serious adverse side effects, including dependence and accidental overdose. Benzodiazepines started to replace barbiturates, and by the 1970s, they were all but completely replaced. However, benzodiazepines come with some of the same risks. Today, barbiturates are still used as anticonvulsants and as a general anesthetic.
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Barbiturates are in the category of central nervous system depressants along with other sleep aids and alcohol. Barbiturates work in the brain in similarly to other depressants, and it primarily involves a neurotransmitter called gamma-Aminobutyric acid (GABA). This naturally occurring chemical is responsible for inhibiting excitability in the nervous system. It helps you come down from stress and excitement when it’s time to rest and relax by binding to and activating GABA receptors. People with anxiety and sleep disorders may have emotional or chemical issues that cause a deficiency that makes GABA less effective.
Depressants like barbiturates can increase the efficiency of GABA by binding to a different site on GABA receptors and increase the effect of GABA on the receptor. The result is a relaxed feeling, anti-anxiety, and hypnosis. At high doses or when mixed with other depressants, barbiturates can cause effects similar to drunkenness like euphoria, loss of coordination, drowsiness, loss of inhibitions, and loss of motor skills. Because of this effect, the drug is sometimes used recreationally.
Barbiturates are highly addictive. Even when they’re used at a normal therapeutic dose, if you use them for too long, you may become chemically dependent. Addiction is a serious disease with lasting implications, but the road to addiction usually goes through a few other warning signs. If you have used barbiturates or any other depressant sleep aid, you should be aware of the signs and symptoms that could lead to a serious substance use disorder.
Typically, overusing barbiturates will first lead to tolerance. With regular use, you may start to notice dwindling effects. You may even feel the need to increase the dose or frequency that you’re taking the drug. However, this effect isn’t because the drug is getting weaker; it’s because your nervous system is getting used to it.
As your tolerance builds, your brain might even start producing chemicals to counteract the barbiturates to balance brain chemistry. Next, you may start to develop a chemical dependence. Dependence occurs when your brain starts to rely on the drug to maintain normal functioning. While taking barbiturates, your nervous system and naturally occurring excitatory chemicals are suppressed. When you stop using after becoming dependent, you will start to feel uncomfortable withdrawal symptoms. With the depressant suddenly gone from your system, your brain will be overwhelmed by a wave of excitatory chemicals that can cause anxiety, paranoia, panic, tremors, and even seizures.
If you continue to use the drug, especially if you use it for euphoric effects, you may become addicted. Addiction is characterized by continued use of a drug despite serious consequences.
If you’re worried about a loved one, there are some behavioral signs of barbiturate addiction as well. Visible signs include:
Addiction treatment is a process by which you can address the chemical dependence that comes with substance use and abuse and deeper issues that contribute to addiction. It involves a complex and individualized treatment plan that is created when you first enter a program. When you come to addiction treatment, you will go through an intake and assessment process to help determine your specific needs.
Because barbiturate withdrawal can be potentially dangerous, treatment usually starts with medically managed detoxification. Medical detox usually lasts for about a week as your body adjusts to not having the drugs in its system. Throughout this process, you may be treated with medications to help avoid dangerous complications and ease symptoms. After you complete detox, clinicians will help you determine the next level of care for your needs which can include:
Inpatient programs can include medically monitored service or clinically monitored residential programs. This is ideal for someone who needs a high level of care because of a risky living environment or serious medical or psychological needs.
This is the highest level of care for someone who still lives independently. Intensive outpatient treatment involves more than nine hours of services per week.
This involves fewer than nine hours of clinical services every week.
Barbiturates were outmoded for their adverse effects which included intoxication, and in some cases, paradoxical reactions like panic and anxiety. However, their dependence liability and overdose potential are what makes them dangerous. Barbiturates are highly addictive and can easily lead to chemical dependence when abused. Once you become dependent, withdrawal symptoms can cause potentially life-threatening symptoms such as seizures and delirium tremens.
Overdose is also incredibly dangerous, causing respiratory depression, brain damage, coma, and death. Overdose risk is increased when you combine it with alcohol, opioids, or other nervous system depressants.
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Blakemore, E. (2018, March 1). Golden Age Hollywood Had a Dirty Little Secret: Drugs from https://www.history.com/news/judy-garland-barbiturates-hollywood-studio-drugs
Health Research Funding. (2014, December 23). 21 Fascinating Barbiturates Statistics – HRF from https://healthresearchfunding.org/21-fascinating-barbiturates-statistics/
The National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
U.S. National Library of Medicine. (n.d.). Barbiturate intoxication and overdose: MedlinePlus Medical Encyclopedia from https://medlineplus.gov/ency/article/000951.htm