Phenobarbital Addiction

Phenobarbital is a long-acting barbiturate used to treat seizures, anxiety, and withdrawal symptoms in those suffering from a drug or substance dependence problem. It may also be prescribed to treat other conditions.

Barbiturates like phenobarbital are highly habit-forming and very dangerous to mix with many drugs and substances. For these reasons, barbiturates are not as commonly prescribed as they once were.

Benzodiazepines and other medications have risen in popularity as safer alternatives for many of the conditions once treated by barbiturates. However, phenobarbital and other barbiturates are still prescribed and used in hospital settings. Many doctors consider phenobarbital to be safe and effective when used as directed.

Phenobarbital is the oldest epilepsy medication still on the market. Today, it is mostly prescribed as a seizure medication rather than for anxiety or sleeping problems.

Phenobarbital and barbiturates are still sold on the illicit street market as well.

Many users of phenobarbital — whether they began using the drug as they were prescribed or recreationally — become dependent. The road to recovery can be a long and difficult one, especially because the withdrawal symptoms from phenobarbital can be extremely uncomfortable and even dangerous and life-threatening.

How Does Phenobarbital Work?

As a barbiturate, phenobarbital works as a depressant in the central nervous system, slowing activity in the brain.

How Is It Used?

Most commonly, phenobarbital is taken as a tablet. It may also be ingested as a liquid elixir or injected.

Taken as a tablet or in liquid form, the drug will begin to take effect in about 30 to 60 minutes, and it will last from five to 12 hours.

The half-life of phenobarbital is around 80 hours in adults, and 110 hours in children.

How Long Does Phenobarbital Stay in Your System?

Phenobarbital is excreted through urine after being metabolized in the liver.

It can be detected by a urine drug test for up to 15 days after a dose, resulting in testing positive for barbiturates.

Is Phenobarbital Addictive?

Barbiturates, including phenobarbital, are highly addictive and habit-forming.

This is one reason their use has been in decline as safer drugs have entered the market.

Users develop a tolerance to the drug, which increases the risk of abuse. Users may need to take higher and higher doses to achieve the desired effect.

This makes the drug very addictive, and it also increases the likelihood of an overdose, as users take higher doses over time.

Side Effects

Phenobarbital is a serious medication with a wide range of side effects, which include:

• Drowsiness
• Headache
• Dizziness
• Increased excitement
• Nausea
• Vomiting
• Clumsiness
• Constipation
• Decreased sexual interest
• Nightmares
• Insomnia
• Diarrhea

If an individual is experiencing severe side effects after taking phenobarbital — whether they’ve taken the drug recreationally or as prescribed — they should seek medical attention immediately.

Signs of a Serious Phenobarbital Reaction

If someone takes phenobarbital and begins to show signs of a serious reaction, emergency care should be sought out immediately. The following may be signs of an allergic reaction or overdose:

• Difficulty breathing, including slowed breathing
• Swelling of the eyes, cheeks, or lips
• Suicidal thoughts
• Loss of control of eye movement
• Fever
• Confusion
• Rash
• Bone pain
• Indications of a blood clotting problem (unusual nosebleeds, blood in urine, or cuts that don’t stop bleeding)
• Skin blistering
• Peeling skin

Dangers

In addition to dependency problems and possible allergic reactions, phenobarbital has other potential dangers.

• Overdose: Because of the tolerance users develop to phenobarbital, overdose is a real danger that all users, recreational or medical, need to be aware of.  A reason barbiturates are considered so dangerous is the line between a high dose and dose that will cause a life-threatening or fatal overdose is very thin.
  Individuals who crave more of the drug than their usual dose should consult a medical professional to discuss their dependency problem. Users who exhibit signs of an overdose need emergency medical care. 
• Dangerous interactions with other drugs: Another reason barbiturates are considered so dangerous is that they cannot be combined with many other drugs or substances, including alcohol, blood thinners, sleeping medications, sedatives, oral steroids, and more. Mixing phenobarbital with these substances can be dangerous and even life-threatening. 
• Withdrawal dangers: Withdrawal from barbiturates can be extremely severe and dangerous, resulting in seizures or even death. For this reason, users should never abruptly stop taking phenobarbital or try to quit their use cold turkey. 
• Issues with use in pregnancy: Phenobarbital can be harmful to a fetus. Pregnant or nursing women should not take this drug or other barbiturates. 

Signs of Phenobarbital Abuse

Whether an individual uses phenobarbital recreationally or as a prescription medication, they will likely exhibit symptoms of use, which may include:

• Increased relaxation
• Rushes of euphoria
• Reduced inhibition
• Slurred speech
• Impaired judgment
• Poor coordination and balance

Symptoms that appear to be worsening may signal that a person is falling deeper into phenobarbital addiction.

Increased use and phenobarbital abuse may be indicated if an individual:

• Seems to be taking the pills more frequently or at times they weren’t before
• Becomes defensive about their use of phenobarbital or tries to hide it
• Appears to be going to numerous doctors (It may be a sign that they are doctor shopping or attempting to get multiple prescriptions to satisfy their addiction.)
• Begins to withdraw from society, spending less time with family and friends and/or becoming less involved with work or life responsibilities
• Starts to have unusual money problems (This may be a sign they are seeking out more drugs on the street market.)

Withdrawal

Phenobarbital withdrawal can be severe and even life-threatening. Often compared to alcohol withdrawal, but perhaps more dangerous, phenobarbital withdrawal should only be attempted under medical care.

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Seizures are very common during acute barbiturate withdrawal and can be fatal. 

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Because of the dangers involved, a medical professional will often gradually reduce a user’s phenobarbital dosage very slowly. This is safer and less unpleasant for the individual.

In addition to seizures and convulsions, withdrawal symptoms may include the following:

• Anxiety
• Muscle twitches
• Weakness
• Dizziness
• Vision problems
• Vomiting
• Fainting
• Insomnia
• Shaking

Users may also experience extreme confusion during withdrawal from phenobarbital. This confusion is similar to what is often experienced by individuals who are dependent on alcohol during detox. It is called delirium tremens (DTs). Symptoms of this include:

• Intense restlessness
• Suicidal thoughts
• Extreme disorientation
• Visual hallucinations

If untreated, this extreme withdrawal sickness can lead to high fever, heart failure, and death.

Withdrawal symptoms may be more severe for those who have taken phenobarbital long term as well as for those who have developed a high tolerance and are, therefore, accustomed to a higher dose.

Safe Detox

The initial phase of phenobarbital treatment will be medical detox. This should be done in a treatment center with trained medical professionals.

These professionals will create a strategy for withdrawal, usually weaning an individual off phenobarbital at a slow and steady level to avoid the most dangerous and uncomfortable side effects of detox.

Most individuals will feel relief from the physical effects of withdrawal within 14 days.

Choosing a Treatment Center

After physical withdrawal, an individual still has to overcome their psychological addiction to phenobarbital. This is why a comprehensive treatment program is necessary for true recovery.

When choosing a treatment center, it’s important to look for a facility with medical staff trained in barbiturate withdrawal so that they can provide relief during the extremely difficult detox process.

However, it’s just as important to choose a program that offers support for psychological dependency as well. Most individuals with a substance use disorder (SUD) have underlying issues that drove them to addiction in the first place. They may have been self-medicating to treat their own depression, anxiety, or trauma.

Without addressing these concerns, they will likely be triggered to return to barbiturate use, or another substance, after detox.

Choosing a treatment center that offers a full range of therapy services is the best way to ensure that an individual is ready to reenter society. Options like cognitive behavioral therapy (CBT) will help an individual to identify triggers in their everyday life that may have led them to drug use before. It will also help them to develop new habits and better coping skills.

Conclusion 

Although less popular now than in the 20th century, barbiturates like phenobarbital are still used recreationally and to treat conditions like epilepsy.

While safe when used as prescribed, particularly in a medical setting, these drugs have many side effects and are highly habit-forming, with a high potential for abuse and overdose. Because withdrawal effects can be severe and even life-threatening, users should never attempt to quit on their own or to quit abruptly.

Instead, they should seek out a medical facility that can offer a safe withdrawal strategy as well as intensive therapy, allowing for full recovery.

Sources

(September 2018) Phenobarbital. MedlinePlus. U.S. National Library of Medicine. from https://medlineplus.gov/druginfo/meds/a682007.html

(January 2019) How Long Does Phenobarbital Stay in Your System? Buddy T. Verywell Mind. from https://www.verywellmind.com/how-long-does-phenobarbital-stay-in-your-system-80312

Phenobarbital. Body and Health Med Broadcast. Canada.com. from https://bodyandhealth.canada.com/drug/getdrug/phenobarbital

(June 2018) Everything You Need to Know About Barbiturates. Kathleen Davis FNP. Medical News Today. from https://www.medicalnewstoday.com/articles/310066.php

(May 2018) Uses and Effects of Barbiturates. Kendra Cherry. Verywell Mind. from https://www.verywellmind.com/what-are-barbiturates-2794873