Barbiturate Withdrawal Medication and Treatment
Barbiturate withdrawal can be dangerous and should not be done alone or at home. Medically assisted detox is typically the first step toward recovery.
Takeaways from this article:
Barbiturate withdrawal treatment options
Barbiturate withdrawal medication
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 on 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. Physicians 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 Options for Barbiturate Withdrawal
Treatment professionals can help monitor and treat withdrawal symptoms for barbiturates. 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:
- 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.
Withdrawal Medications for Barbiturates
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.
Read Next: Barbiturate Withdrawal Symptoms & Timeline
. 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.