Is Phenobarbital Still a Danger Today?

If you were born before the 1980s, the barbiturate phenobarbital is something that you probably remember. Sold under trades names like Nembutal or Luminal, it was once frequently prescribed in the 1950s through the 1970s as an anti-anxiety medication and pre-anesthetic.In this period, it was common practice for doctors to prescribe phenobarbital as a sedative before major surgery to help calm patients down.

These medications, while extremely useful when first developed and sold on the market, have a high potential for abuse. Today they are considered a Schedule IV substance by the United States Drug Enforcement Administration.

Generally speaking, it’s unlikely you or anyone you know will get prescriptions for phenobarbital or other barbiturate class drugs. While we occasionally get inquiries related to phenobarbital at Boston Drug Treatment Centers, these are relatively uncommon today.

The addictive potential is not quite like that of opioids or other commonly misused substances. However, it is addictive enough that pharmaceutical companies started developing replacement drugs within less than a decade of phenobarbital seeing widespread use. Today, benzodiazepines, a different class of anti-anxiety and sedative drugs, have largely replaced barbiturates in most use cases.

Is phenobarbital still used today?

Today, barbiturates like phenobarbital are only widely used in veterinary medicine and for controlling epileptic seizures in humans. They may also still be used rarely for pre-surgery anxiety or as sedatives if patients have an adverse reaction to benzodiazepines. Notably, high doses of phenobarbital are used in many American states as part of the lethal injection procedure, which is testament to their deadly potential.

Compared to how things were in the 1950s through to the early 1980s, it’s extremely unlikely you will encounter phenobarbital as a street drug. The demand for barbiturates specifically has dropped dramatically in the time that benzodiazepines became a leading choice for sedative medication.

Even when prescribed, most people who use phenobarbital do not get hooked on them, making cases of addiction quite rare. By contrast, because benzodiazepines are so commonly prescribed, the chances of having a problem with these comparatively safer drugs are much higher.

How does phenobarbital work?

As with other sedatives, phenobarbital suppresses activity in the body’s central nervous system, making it more difficult for different nerve connections to pass signals through. It does this by making the neurotransmitter gamma-aminobutyric acid (GABA) act more efficiently in the body. GABA is an essential chemical that prevents the overactivity of nerve signals. Phenobarbital reduces the natural absorption of this chemical, allowing GABA levels to rise in the body.

In low doses, phenobarbital can cause sedation, slowing down movements and thoughts, much like other depressant substances like alcohol and benzodiazepines. In high doses or when combined with other depressants like alcohol, this effect may become even more pronounced, potentially stopping a person’s breathing or heartbeat.

What are the causes and signs of phenobarbital misuse?

Compared to many benzodiazepine class drugs available today, phenobarbital lasts a relatively short time in the body. The quick action and short effect of phenobarbital make it good for applications like epilepsy control and less than ideal as an anti-anxiety drug.

This fast onset and quick duration may cause regular users to constantly take the drug, use higher than recommended doses, or combine it with other sedatives. This kind of misuse can be habit-forming, even after a relatively short period.

This results in, what could be variously called a depressant, anxiolytic, sedative, hypnotic, barbiturate use disorder under the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5. People who develop these kinds of drug use disorders are likely to misuse similar drugs like benzodiazepines or alcohol in addition to barbiturates.

The immediate effects of phenobarbital use are similar to drinking large quantities of alcohol and may include the following:

• Heavy sedation
• Loss of coordination
• Slurred speech
• Irritability
• Loss of inhibitions
• Aggression
• Unconsciousness
• Labored breathing
• Suffocation

Signs that a person may have a substance use disorder related to phenobarbital include the following:

• Using phenobarbital without a prescription
• Stealing or misusing prescriptions intended for another person or an animal
• Intoxication without an accompanying alcohol smell
• Wide and rapid swings in mood and behavior
• Not using prescribed phenobarbital in a directed manner
• Combining prescribed or illicit phenobarbital with alcohol, cannabis, benzodiazepines, or other drugs
• Frequent cravings for phenobarbital or similar depressants

Phenobarbital use can be habit-forming and is associated with serious long-term effects, including but not limited to the following:

• Learning and problem-solving issues
• Brain damage
• Permanent cognitive impairment

Find help for phenobarbital use disorder

Phenobarbital should only be used as directed by your physician. Though the relative odds of encountering a problem with the drug is quite rare these days, it’s important to recognize the potential dangers, should you be prescribed the drug or if someone in your household has access to it.

If you think that you or a loved one have problems with phenobarbital use, our team at Boston Drug Treatment Centers is ready to help. Good luck, and be well!