- PrintArticle Summary
- Treatment Options
- Tapering Off Barbiturates
- Withdrawal Medications
- Detoxing Cold Turkey at Home
- Barbiturate Withdrawal Symptoms and Timeline
- Signs, Symptoms, and Effects
- Withdrawal Timeline
- Medical Complications
Barbiturates are central nervous system depressants that were once commonly used as sedatives, anticonvulsants, hypnotics, and anesthetics.1
Benzodiazepines have largely replaced barbiturates due to concerns over abuse, but 12 barbiturates are in medical use today.1,4 These drugs are abused for anxiety relief, reduction of inhibitions, or to treat unwanted side effects of other drugs.1
When a person uses barbiturates over a prolonged period of time, they may develop physiologic dependence to the drug and experience withdrawal symptoms if they suddenly stop or reduce their use.2
Barbiturate withdrawal can be dangerous and should not be done alone or at home. Seizures, psychosis, and death have been reported.3
Medically assisted detox is typically the first step toward recovery followed by participation in either an inpatient or an outpatient treatment program. Physicans may prescribe a number of medications during withdrawal treatment. People who were dependent on a short-acting barbiturate may be prescribed a longer-acting barbiturate.
Treatment professionals can help monitor and treat symptoms.
To best ensure a safe detoxification process, those suffering from barbiturate addiction should consider professional withdrawal treatment rather than attempting to quit on their own. Treatment professionals can help monitor and treat symptoms as well as teach coping skills to prevent relapse.
Many different treatment options are available for those experiencing barbiturate addiction and withdrawal. Some of these options include:
Learn more about the different types of withdrawal treatment.
- Detox centers: Medically supervised detox centers help people with drug and alcohol withdrawal. Detox treatment professionals monitor people throughout the withdrawal process, help minimize symptoms, and maximize comfort. Detox centers are often inpatient.
- Inpatient treatment: Some people choose to detox in an inpatient rehab center where they typically remain after the detox phase. Most people stay in residential treatment centers for 30–90 days depending on the severity of their addiction. During inpatient treatment, a person will typically receive some combination of medically supervised or assisted detox, individual or group therapy, support group participation, 12-step programs, medication, relapse prevention, and complementary or alternative therapies.
- Outpatient treatment: People with relatively less severe addictions or those who are at lower risk of experiencing serious withdrawal complications may find suitable care in an outpatient treatment setting. Outpatient care has different levels depending on the severity of addiction. Some may attend counseling, therapy, or physician appointments for just a few hours a week, whereas others may spend 6–8 hours a day in treatment.
- Partial hospitalization: Partial hospitalization occurs when a person resides in the hospital for approximately 6 hours each day but returns home every evening. Partial hospitalization includes detox services, counseling, group therapy, 12-step programs, and aftercare support.
- Intensive outpatient: Intensive outpatient treatment is a viable treatment alternative to inpatient rehabilitation for those looking to save money on treatment costs or who require somewhat less intensive treatment and support. Many people that enter intensive outpatient treatment have already gone through the detox process and want to use the program to continue individual and group counseling or other addiction treatment services.
Tapering Off Barbiturates
When possible, people should taper off barbiturates rather than quitting abruptly. When a person quits suddenly after prolonged use, withdrawal symptoms typically begin within 2–4 days after the last use.2 Withdrawal symptoms can be severe and include the following:2,3
- Circulatory failure
Barbiturate withdrawal treatment often begins with a person tapering off the drug under medical supervision. Tapering may be done at a detox facility or on an outpatient basis with a person seeing their doctor routinely and gradually reducing the dose over time.
Tapering schedules are unique to the person and will depend on many factors, including:
- Individual physiology.
- Duration of use.
- Specific barbiturate abused.
Barbiturate withdrawal medication may be necessary for those who took large doses for a long time, particularly those who abused short-acting barbiturates. People who were addicted to short-acting barbiturates may be switched to a longer-acting barbiturate to taper off the drug.
Those who were addicted to longer-acting barbiturates should discuss treatment options with their physician to determine if barbiturate withdrawal medication is right for them.
Historically, the two most commonly prescribed medications for barbiturate withdrawal were pentobarbital and phenobarbital. Today, pentobarbital is seldom used.
- Phenobarbital: A longer-acting barbiturate with a half-life of more than 86 hours and a larger therapeutic window than pentobarbital. Phenobarbital prevents withdrawal symptoms and allows the recovering user’s brain and central nervous system to gradually return to a drug-free state. 3
Physicians or other healthcare providers may also prescribe medications to relieve other specific withdrawal symptoms. These medications can include sleep aids for insomnia, over-the-counter medications for nausea and vomiting, and anticonvulsants for seizures.
Detoxing Cold Turkey at Home
People who suffer from barbiturate addiction and abuse should seek professional help for barbiturate withdrawal rather than attempting to quit cold turkey. Doing so can be life-threatening, as barbiturate withdrawal can cause seizures and circulatory failure if not properly treated.
People may also be more likely to relapse when attempting to quit cold turkey, which could lead to a barbiturate overdose as well as exacerbate other physical or mental health conditions.
Barbiturate withdrawal is safest when done in a professional detox center with trained and qualified staff. For more information about detox centers and treatment facilities near you, contact our recovery helpline at 1-888-935-1318Who Answers?.
. Drug Enforcement Administration. (2015). Barbiturates. Drugs of Abuse: A DEA Resource Guide.
. Sarrecchia, C., Sordillo, P., et al. (1998). Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication. Ann Ital Med Int 13(4):237-239.
. Sellers, E. (1988). Alcohol, barbiturate and benzodiazepine withdrawal syndromes: clinical management. Recent Advances in Pharmacotherapy 139: 113-118.
. Lafferty, K., Abdel-Kariem, R., and Bonhomme, K. (2014). Barbiturate Toxicity. Medscape.
Barbiturate Withdrawal Symptoms and Timeline
Barbiturates are sedative medications that have been largely phased out in favor of benzodiazepines due to problems with abuse and overdose. 4 In the past, barbiturates were widely used to treat anxiety and insomnia. They continue to be used today as anesthetic agents, as well as for managing headaches, seizures, convulsions, and withdrawal from other substances.3
Despite their decline in medical use, barbiturates are still abused and led to more than 18,000 emergency room visits in 2011.5
Regular users of barbiturates rapidly develop a tolerance and find that they need more of the drug to achieve the same effect. Prolonged use, especially at high doses, can lead to physical dependence, in which the person’s system begins to rely on the drug’s presence. 6
People who have become physically dependent on barbiturates will experience withdrawal effects when they stop using them or lower the dose. Barbiturate withdrawal symptoms can include seizures, and in some instances, death. 6 The symptoms begin within 1-3 days and can last up to 2 weeks or more.
Signs, Symptoms, and Effects
A person going through barbiturate withdrawal may experience insomnia, nausea, anxiety, tremors, and seizures.
A person who is going through barbiturate withdrawal can experience a number of different signs and symptoms, including:
- Tremors or shaking.
- Rapid heart rate.
People who are ready to begin the recovery process from drug and alcohol addiction usually must undergo detox as the first step on the road to healing from substance abuse issues.
Barbiturate withdrawal signs and symptoms can be more severe in people who have other medical complications or psychiatric disorders. People who have been using for a longer period of time or using a very high dose are also more likely to have severe barbiturate withdrawal effects.
Most of the barbiturate withdrawal signs should fully resolve after about 14 days.8 However, some people can experience post-acute withdrawal symptoms including:
- Cognitive impairment including difficulty making decisions, poor memory, and lack of attention. 9
In some cases, these symptoms can last for a year or more. But they generally fade if the person remains abstinent from barbiturate use. 9
It is helpful to maintain treatment after the initial withdrawal so that post-acute withdrawal symptoms can be identified and treated.
The timeline for barbiturate withdrawal varies depending on which barbiturate is being used. All barbiturates have a different half-life, which is a way of measuring how long it takes for a substance to leave your body.
|General Barbiturate Withdrawal Timeline|
|1-3 days.||Signs and symptoms will begin to appear within 3 days after stopping use.|
|2-3 days.||Symptoms intensify, and seizures may occur. Other symptoms include anxiety, weakness, sweating, insomnia, and delirium.|
|3-7 days.||Symptoms begin to fade, but can last up to 2 weeks.|
|14 days and beyond.||Symptoms generally go away, but as noted above, some users may experience troublesome symptoms after the initial withdrawal period. 10|
Barbiturate withdrawal effects can lead to medical complications, especially among people who have prior medical conditions, abuse other substances in addition to barbiturates, or are elderly. However, withdrawal-related complications can happen to anyone.
Appropriate medical supervision and treatment during withdrawal can help prevent many medical complications.
Some of the complications that can occur include:
- Dehydration – A person can easily become dehydrated during withdrawal when experiencing a lot of nausea, vomiting, or diarrhea. If a person is having a hard time taking in adequate fluids during the withdrawal period, the risk for dehydration is very high and can be very dangerous. However, medical treatment can manage the symptoms and help to restore fluid balance.
- Depression or anxiety – Barbiturate withdrawal is sometimes associated with changes in mental health, some of which can outlast other symptoms. Anxiety and depression are common during barbiturate withdrawal, as is insomnia. Barbiturate withdrawal can also cause psychotic episodes during which a person loses the ability to tell what is real from what is not.
- Seizures – Seizures can occur at any point during the barbiturate withdrawal timeline. Often, a person will be tapered off of barbiturates instead of stopping abruptly to help prevent seizures and minimize other symptoms.
- Risk of overdose – If a person relapses during barbiturate withdrawal, they are vulnerable to overdose if they attempt to use the dose they became accustomed to previous to detox. When a person relapses, they do not have the same tolerance that they did before getting clean. Barbiturates have a narrow threshold between a therapeutic dose and an overdose, so it is often a small difference between a dose that will be intoxicating and a dose that will be deadly.
Barbiturate withdrawal often requires treatment from qualified professionals. Our helpline is staffed with treatment placement specialists who can help you find a safe place to detox and recover. Call us today at 1-888-935-1318Who Answers?.
Read next: Barbiturate Withdrawal Medications and Help
. McKeown, N. J. and West, P. L. (2016) Withdrawal Syndromes Clinical Presentation.
. Substance Abuse and Mental Health Services Administration (2013). Detoxification and Substance Abuse Treatment.
. Lopez-Munoz, F., Ucha-Udabe, R., and Alamo, C. (2005). The history of barbiturates: a century after their clinical introduction. Neuropsychiatric Disease and Treatment 1(4):329-343.
. Bernardy, N. (2013). The Role of Benzodiazepines in the Treatment of Posttraumatic Stress Disorder (PTSD). PTSD Research Quarterly 23(4).
. Substance Abuse and Mental Health Services Administration. (2013). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits.
. European Monitoring Centre for Drugs and Drug Addiction. (2015). Barbiturates drug profile.
. Herron, A. and Brennan, T. (2015). The ASAM Essentials of Addiction Medicine. Wolters Kluwer.
. Doweiko, H. (2011). Concepts of Chemical Dependency. Cengage Learning.
. Hajela, R., Abbott, P., and Newton, S. (2015). Addiction Is Addiction: Understanding the disease in oneself and others for a better quality of life. Friesen Press.
. Saddock, B., and Saddock, V. (2008). Kaplan and Saddock’s Concise Textbook of Clinical Psychiatry. Lippincott Williams & Wilkins.