Barbiturates may bring the 1960s and 1970s to mind, the eras when they were used recreationally by celebs and countless others, but they are still around today. And while they are not prescribed as widely as they once were, people are still using them today, and they are no less dangerous.
Historically, the sedative was prescribed to treat anxiety, insomnia, and seizures. Today, benzodiazepines are prescribed for those conditions because they are considered a safer alternative.
Brevital, like other barbiturates, is psychologically and physically addicting. The medication is generally not used outside of a medical setting, but it has ended up in the hands of people who wish to abuse it alone and with other substances. Because it is habit-forming, Brevital dependence can happen rather quickly, and for many, it will take professional treatment to break free from its grasp.
Brevital, known generically as methohexital sodium, is a rapid, ultra short-acting barbiturate anesthetic medication. It is administered to patients before surgery to help them fall asleep faster. Ultra short means sedation comes quickly after the medication is given intravenously. Brevital is also prescribed to help people get to sleep. The substance itself is a white freeze-dried mixture that becomes soluble in water.
As with other barbiturates, Brevital affects the central nervous system and slows down activity in the brain. It also works similarly to how benzodiazepines work, another class of medications prescribed for people who have anxiety, insomnia, and other disorders.
Health care providers administer Brevital to patients via intravenous injection into a muscle or a vein. It also can be given as a rectal injection. According to Drugs.com, the medication can reach the brain within 30 seconds when injected. Sleep can happen anywhere from two to 10 minutes after the drug is administered intramuscularly, or it can occur five to 15 minutes after rectal administration.
The medication should be used only in a hospital or other clinical setting where a user’s vitals can be consistently monitored, such as their breathing, blood pressure, and heart function. The dose given depends on the person’s medical condition and how they respond to this method of treatment.
The potent Schedule IV drug can be habit-forming, particularly when it is used for long periods or taken in larger amounts than prescribed. While it is intended to be used only in clinical settings, such as a hospital or ambulatory care, it does find its way outside of those settings and is abused recreationally. Common ways it is abused include:
Chronic abuse can lead to physical and psychological dependence on the drug.
People who abuse Brevital may exhibit symptoms that are similar to those of alcohol intoxication. They also may exhibit feelings of euphoria. People who are addicted to the drug may:
If you or someone you know abuses Brevital and experiences physical and/or psychological changes after stopping, you are likely in withdrawal. Withdrawal symptoms include:
Seek emergency medical help if you or your loved one is experiencing seizures. Call 911 or take the affected person to a nearby hospital emergency room. If you are experiencing any of these symptoms, and they have not reached the stage of being life-threatening, then it is critical that you seek professional addiction treatment as soon as possible.
Addiction treatment at a licensed facility is advised for people who can’t stop using or abusing drugs and alcohol. When one enters treatment for Brevital addiction, the person will start the process with medical detoxification. Detox addresses the physical and psychological damage that Brevital abuse may have caused. This 24/7-monitored process is conducted and overseen by health care providers who understand drug addiction and are qualified to treat people who are in drug or alcohol withdrawal.
Medical detox ensures the person gets through the withdrawal process safely and reduces the chance of relapse. This period can be uncomfortable and unpredictable, so it is reassuring to have medical staff there to monitor the process.
For three to 10 days, the client is slowly weaned off the substance as it leaves the body. A tapering process may be used during this time to give the body time to adjust to not having the drug in its system. A physician will determine if a taper is appropriate and how long that process will run. Medications may be given to handle any side effects or symptoms that occur during this time.
Once medical stability is gained, the client is ready to move on to the next step, which is to enter the appropriate treatment program. The proper program is based on the results of an initial evaluation that is also a part of the detox process.
This evaluation can determine how far along an addiction is and if a person has dual-diagnosis, which is when a mental health disorder exists alongside a substance use disorder at the same time. A program that treats both disorders together in the recovery period is critical to a dually diagnosed person’s treatment success.
Depending on the severity of the Brevital addiction, clients can choose to treat their addiction in a partial hospitalization program or an inpatient (or residential) setting, or they might want to enter an intensive outpatient program. Research suggests that the longer people stay in treatment, the better their chances are of remaining sober after treatment ends. The National Institute on Drug Abuse (NIDA) recommends that treatment lasts at least 90 days or three months.
While in treatment, clients have the opportunity to address the issues that lie at the root of their addiction and gain the strategies and tools needed to manage their triggers and commit to long-term sobriety. No two treatment programs are exactly the same. They each will look different based on the person’s unique needs. Effective programs may include any combination of these:
Some people recovering from Brevital abuse may want to continue going to an outpatient program or receive aftercare services for continued support after their treatment program ends. These options can give them the focus and strength they achieve their recovery goals and avoid relapse.
Ongoing medical care and therapies also can help them manage post-acute withdrawal symptoms that linger for months or even years after substance use has ended. Recovering users also can attend 12-step meetings, join an alumni program for people in recovery, or continue therapy as they continue their journey to live a substance-free life.
Barbiturates like Brevital have a high addiction and dependence liability, especially for people that abuse the drug. However, part of the reason barbiturates fell out of common use was because of its potential to cause chemical dependence after regular use. Using the drug for too long, even in regular doses, can cause you to develop tolerance and dependence. As tolerance grows, you will feel like you need higher amounts to achieve the same effects. As you continue to use the drug through your growing tolerance, your brain will start to rely on it. Dependence is considered a substance use disorder, which can lead to serious consequences like addiction and overdose.
Overdose is one of the other reasons barbiturates have been largely replaced by safer options. High doses can lead to potentially dangerous overdose symptoms. Through the 20th century, many fatal overdoses were linked to barbiturates, including the deaths of many high profile celebrities like Judy Garland and Marilyn Monroe.”
Overdose often occurs after a relapse or when you take unpredictable illicit drugs. Even illicit pills that are reported to be a prescription drug like Brevital may be contaminated by an unknown substance. Drug dealers are able to press powdered drugs into pills fairly easily with devices that can be bought online.
Barbiturates are at their most dangerous when they’re mixed with other depressants or opioids. Alcohol, benzodiazepines, and opioid pain relievers can interact with drugs like Brevital to cause a phenomenon called potentiation.
Potentiation is when two drugs that have similar effects work together to create more intense effects than they would separately. This can cause a fatal overdose even if the two drugs are at relatively low doses individually.
Signs and symptoms of a Brevital overdose include:
Brevital suppresses the nervous system to achieve its desired effects, but in high doses, it can suppress vital functions. Overdose deaths are often caused by slowed breathing leading to a lack of oxygen, coma, and death. It can also cause heart-related complications.
Other adverse effects that can occur as a consequence of a Brevital overdose include injuries to the body from a fall, pneumonia, and miscarriages. A Brevital overdose requires immediate medical attention, call 911 or seek help at a hospital. Not treating a Brevital addiction raises the chances of having a fatal overdose.
Barbiturate Tolerance: Effects on GABA-Operated Chloride Channel Function. (2003, March 17). from https://www.sciencedirect.com/science/article/pii/000689939291583Z?via=ihub
Brevital (methohexital) dosing, indications, interactions, adverse effects, and more. (2017, July 14). from https://reference.medscape.com/drug/brevital-methohexital-343090
Brevital Sodium – Drug Summary. (n.d.). from http://www.pdr.net/drug-summary/Brevital-Sodium-methohexital-sodium-1769
FDA. (n.d.). “Brevital.” U.S. Food and Drug Administration. from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/011559s051lbl.pdf
NIDA. (January, 2018). “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
Markel, D. H. (2016, August 05). Column: Marilyn Monroe and the prescription drugs that killed her. from https://www.pbs.org/newshour/health/marilyn-monroe-and-the-prescription-drugs-that-killed-her
ScienceDirect. (n.d.). Drug Potentiation. from https://www.sciencedirect.com/topics/immunology-and-microbiology/drug-potentiation