Barbiturates are central nervous system depressants that were used in the 1960s and 70s for the treatment of sleep disorders, seizures, and anxiety. Barbiturates are not widely used today due to the advent of new and safer drugs such as benzodiazepine that have largely replaced barbiturates. Apart from the medicinal use, barbiturates are often used as recreational drugs to achieve euphoria or as ‘downers’ to counter the effect of stimulant street drugs such as cocaine, it also might cause overdose and withdrawal symptoms.
Barbiturates are dangerous not just because of their potential for addiction and abuse but also due to their narrow therapeutic window. There is very little margin between the dose of barbiturate that is therapeutic to the dose that causes an overdose which may result in coma and death.
Barbiturate intoxication is the state when the mental and physical control of the individual is diminished under the effect of a drug, barbiturate in this case. It is the state of being inebriated after excessively consuming barbiturates. Barbiturate intoxication results when barbiturate depresses the central nervous system and alters the individual’s perception, mood, thought process, and motor skills. Barbiturate intoxication is similar to alcohol intoxication since alcohol is also a central nervous system depressant.
Following are the signs and symptoms of barbiturate intoxication:
- Clouding of the brain
- Loss of balance
- Slurring of speech
- Nausea
- Decreased heart rate
- Impaired coordination
- Muscle weakness
- Reduced consciousness
- Decrease in urine output
No, you cannot mix barbiturates and alcohol since the two of them have a similar effect on the brain. Both barbiturates and alcohol are central nervous system relaxants or depressants. They both act through the GABA receptors on the brain. GABA is the principal inhibitory neurotransmitter and it is responsible to slow down nerve impulses thereby decreasing the activity of the brain.
When alcohol and barbiturates are used simultaneously the dose required to cause an overdose decreases significantly thereby increasing the chances of fatal events taking place. Barbiturates and alcohol can never be mixed since they both synergize the adverse effects of each other leading to deteriorating physical and mental health.
Using alcohol and barbiturate together increases the chances of developing an addiction since both are powerful addictive substances when misused. Abuse of either of the two can rapidly lead to dependence and addiction and when used concomitantly they can lead to painful withdrawal symptoms and the detox and recovery from barbiturates abuse becomes quite complex in such a setting.
Risks of Mixing Alcohol and Barbiturates
Mixing Alcohol and barbiturate results in dangerous consequences. Some of the main depressive effects of barbiturates and alcohol include reduced heart rate, low blood pressure, and depressed and shallow breathing. It further results in hypothermia, lethargy, and loss of consciousness.
Combining barbiturates with alcohol can severely suppress breathing, lower blood pressure, and impair consciousness. This can lead to shock, coma, or death.
Shock means inadequate blood flow to vital organs. Barbiturate toxicity may cause it through effects on circulation and the heart; this is not necessarily hypovolemic shock, which specifically involves loss of circulating fluid or blood. Treatment is a medical emergency.
The respiratory center in the brain is depressed under the action of barbiturates and alcohol which results in labored and shallow breathing, depriving the body of sufficient oxygen required by vital organs such as the brain and heart. Consequently, it impairs the brain’s ability to function normally and the individual loses consciousness and enters in a state of coma.
Long-term combined use can harm health and increase injury and overdose risks. Liver, memory, and other complications vary between individuals; it is inaccurate to say that liver failure or irreversible neurological damage always occurs.
Barbiturate toxicity occurs when the drug’s effects become harmful, for example causing marked sedation, low blood pressure, or suppressed breathing. Do not wait for coma before seeking emergency help.
Tolerance and physical dependence can develop during regular use, including prescribed treatment. Physical dependence does not automatically mean addiction. Increasing doses is dangerous because tolerance does not reliably protect against respiratory or cardiovascular toxicity.
Moreover, individuals involved in poly-substance abuse often use barbiturates as they mix barbiturates with other substances to enhance the euphoric effect such as alcohol, opioids, and benzodiazepines.
Barbiturate overdose can be fatal. Risk rises with dosing errors, nonmedical use, and combinations with alcohol, opioids, benzodiazepines, or other sedatives. A single mortality percentage cannot predict an individual’s outcome.
One should be aware of the signs and symptoms of barbiturate overdose so that they can easily spot this situation and provide prompt medical emergency treatment to their loved ones when need be.
Following are the signs and symptoms associated with barbiturate overdose:
- Loss of coordination
- Staggering gait
- Speech disturbances
- Difficulty concentrating
- Sluggishness
- Thirst
- Dilated or constricted pupil
- Rapid or weak pulse
- Decreased heart rate
- Slow and shallow breathing
- Coma
- Death
Possible complications include aspiration pneumonia, injury, kidney problems, and brain injury from lack of oxygen. They are not inevitable in every survivor. Prompt emergency treatment can reduce harm.
Call emergency services for suspected overdose, severe sleepiness, unresponsiveness, slow or abnormal breathing, or collapse. If the person is not breathing normally, follow dispatcher instructions for CPR. Provide medicine containers or a list if available, without delaying help.
Hospital treatment supports breathing and circulation and manages complications. Activated charcoal is used only in selected circumstances by clinicians because of aspiration risk. Do not induce vomiting or give charcoal, food, or drink at home.
When barbiturates have overdosed with opioids, Naloxone can help in reversing opioid overdose by regaining the consciousness of the individual. However, Naloxone has no role in reversing barbiturate-induced coma.
Some barbiturates still have specific medical uses, including seizure treatment. Regular use can lead to tolerance and physical dependence, so any reduction should be planned with the prescriber rather than attempted abruptly.
Barbiturates affect GABA-mediated signaling and other nervous-system processes. With regular exposure the nervous system adapts, and rapid reduction can cause dangerous withdrawal. This is more complex than a simple increase or deficiency of GABA.
The onset and duration of withdrawal depend on the particular barbiturate, dose, duration of use, and individual factors. Symptoms may begin within hours or be delayed with long-acting drugs. A fixed 8-to-15-hour start or two-week end is not reliable.
Barbiturate withdrawal is associated with a plethora of symptoms that are indicative of this condition. They are as follows:
- Tremors
- Fatigue
- Difficulty sleeping
- Agitation
- Restlessness
- Anxiety
- Nausea
- Vomiting
- Stomach cramps
- Suicidal thoughts
In severe cases it can result in:
- Hallucination
- Increased body temperature
- Seizures
Severe withdrawal can include seizures, hallucinations, delirium, and dangerous changes in temperature or circulation. These require emergency care. The claim that 75% of everyone withdrawing has seizures, or 66% delirium, should not be generalized without a defined clinical population.
Barbiturate Withdrawal Timeline
Timing varies and should not be used to decide that a person is safe. The following are broad clinical considerations, not a home withdrawal schedule:
- Early withdrawal: Anxiety, tremor, insomnia, or nausea may develop, but severe complications can also occur early.
- Progression: Seizures, hallucinations, confusion, or marked physical deterioration require emergency care at any stage.
- Ongoing monitoring: Symptoms may fluctuate, especially with long-acting medicines or other substance use.
- Follow-up: A clinician should review persistent symptoms and adjust the plan; absence of symptoms on a particular day does not justify an unsupervised dose change.
Treatment begins with assessment and safe withdrawal planning when necessary. It may involve a supervised taper or other specialist management. The aim is stabilization and ongoing care, not rapidly removing every trace of the drug.
The appropriate setting depends on withdrawal risk, other illnesses, safety, and available support. Significant barbiturate dependence can require inpatient monitoring; the choice is not simply a matter of resisting temptation.
Moreover, individuals dealing with any mental illness such as anxiety or depression also have the facility for dual diagnosis rehab where an integrated approach is utilized and both conditions are being treated simultaneously. Inpatient rehab facility lasts for 30 to 90 days depending on the program selected by the individual. In-patient programs offer various amenities such as gyms and pools among other facilities.
There are many evidence-based therapies to bring about positive change in the lifestyle of an individual. These therapies include:
- Cognitive Behavioral Therapy (CBT)
- Individual counseling
- Family counseling
- Group counseling
- 12-Step facilitation therapy
- Chemical dependency education
Outpatient care may be appropriate for selected people after clinical assessment, with reliable monitoring and support. It is not automatically less effective than inpatient care, but must not be used where the withdrawal risk requires hospital treatment.
If you or your loved one are dealing with barbiturate addiction you should take the first step to recovery and choose our rehab facility with a tailored plan to optimize your addiction treatment.
