Barbiturates vs Benzodiazepines

Author: NP Addiction Clinic
Published: August 30, 2022

Barbiturates and benzodiazepines belong to a class of drugs we describe as depressants. They act on the central nervous system to make the user feel calmer, relaxed, sedated, or sleepy. People use these drugs as part of a prescription, but many people also abuse them or use them illicitly.

In the past, doctors used barbiturates for a wide range of treatments. Today, the medical establishment has transitioned to using benzodiazepines in many cases due to their lower toxicity and potential for addiction.

What Are Barbiturates?

Barbiturates are a drug class derived from barbituric acid. They found use in the 1900s for many applications, namely: anesthetics, sedatives, anticonvulsants, and hypnotics. People still use them today, but in many cases illicitly. Benzodiazepines have largely replaced barbiturates in medical settings because of their reduced toxicity and lesser addictive qualities.

Barbiturates are available in four mechanisms: ultra-short acting, short-acting, intermediate-acting, and long-acting. Doctors administer them as prescription drugs, although they aren't used as commonly as in the past. Prescribed drug names include:

  • Amytal
  • Seconal
  • Butisol
  • Nembutal

You may also see these names people commonly use to refer to barbiturates:

  • phenobarbital
  • amobarbital
  • secobarbital
  • butabarbital
  • pentobarbital

According to the Drug Enforcement Administration, barbiturates belong to three different drug classes under the Controlled Substances Act: Schedule II, III, and IV. This means they have a potential for dependence, addiction, and abuse and are more tightly controlled.

Why Do People Use Barbiturates?

Barbiturates are all central nervous system depressants, similar to alcohol and opioids (although they function slightly differently). Doctors have prescribed them for a range of medical uses, including:

  • headaches
  • insomnia
  • seizures (epilepsy)
  • anxiety disorders
  • sedative-hypnotics
  • inducing anesthesia
  • euthanasia (lethal injection or capital punishment)

Currently, many medical uses of barbiturates have been phased out in favor of other drugs. Barbiturates can be extremely dangerous when used outside of medical supervision because of their overdose potential and lethality. If you or a loved one is abusing any form of barbiturates, please contact a professional to seek treatment. You may see nicknames or 'street names' associated with the illicit forms, such as:

  • Barbs
  • Block Busters
  • Christmas Trees
  • Goof Balls
  • Pinks
  • Red Devils
  • Reds and Blues
  • Yellow Jackets

Don't hesitate to call a specialist if you've noticed drug abuse occurring. It is important to seek addiction treatment in these cases.

What Are Benzodiazepines?

Benzodiazepines, better known as 'benzos', are a class of drugs that scientists accidentally discovered in the 1950s. Since their discovery, clinicians have prescribed them for many situations ranging from anxiety disorders to sedation for medical procedures.

Professionals consider benzos to be safer than their predecessor barbiturates because they result in fewer overdoses and demonstrate less toxicity when taken by themselves.

Prescribed drugs include:

  • Valium®
  • Xanax®
  • Restoril®
  • Ativan®
  • Klonopin®

You may also see these names of common benzodiazepines:

  • alprazolam
  • clonazepam
  • chlordiazepoxide
  • clorazepate
  • diazepam
  • halazepam
  • lorazepam

These have the same drug classification and are listed as Schedule IV controlled substances.

Why Do People Use Benzodiazepines?

Doctors prescribe drugs like Valium and Xanax for anxiety disorders and insomnia. While these are common uses, benzodiazepines have a wide range of uses clinically, including the treatment of:

  • insomnia
  • anxiety
  • panic disorders
  • agitation
  • muscle spasms
  • alcohol withdrawal
  • seizures

Doctors also use them as a central nervous system sedative for medical or dental procedures. Although safer than barbiturates, they unfortunately still have a chemical structure that can lead to tolerance, dependence, and addiction. Many people use them illicitly or purchase them illegally. Some other names for benzodiazepines you may see are:

  • benzos
  • downers
  • nerve pills
  • tranks

The Difference Between Barbiturates and Benzodiazepines

The key difference between the two is that benzodiazepines are typically much safer than barbiturates, whether taken as part of a prescription or illicitly. Although someone who overdoses on benzodiazepines may experience different symptoms than a normal dosage, overdoses are rarely fatal compared to other drugs (when taken in isolation). There are also reversal drugs available to stop an overdose from getting worse, namely flumazenil.

In contrast, barbiturates are much more toxic than benzodiazepines. Overdosing results in much worse complications, and the perfect reversal drug doesn't exist like in the case of benzodiazepines (flumazenil) and opioids (naloxone). The withdrawal symptoms of barbiturates are also serious and can be deadly if not treated properly.

If you're addicted to barbiturates, you should seek addiction treatment to safely cope with the withdrawal under supervised medical care.

Similarities

Despite their chemical and safety differences, barbiturates and benzodiazepines treat a host of the same health concerns. Doctors prescribe them to treat anxiety disorders, alcohol withdrawal, and as sleeping pills to fight insomnia.

They both have the same effect on the human body, depressing the central nervous system and causing a mild sedated physical experience. People use them as a muscle relaxant, and those who suffer epilepsy take them to prevent seizures.

Are They Addictive?

Using either drug can build up a tolerance, create dependence, or lead to addiction and substance abuse. Both drugs have the potential to lose their positive effects over a longer term and require a higher dosage to experience the same effects. You may even form a physical dependence after two weeks.

If you're currently taking a form of either drug or know someone who is, realize they can be habit-forming and addicting. Keep an eye out for the following signs and symptoms.

Signs and Symptoms of Addiction

The following are signs and symptoms you should look for if you suspect you or someone you know has an addiction or abuse problem:

  • muscle weakness
  • blurred vision
  • excessive tiredness or drowsiness
  • Poor judgment or thinking
  • pharmacy and doctor shopping
  • Asking someone else for their pills
  • wanting or saying you'll cut back but not doing it
  • changes in mood or behavior
  • using combinations of benzodiazepines and other substances

Withdrawal Symptoms

If you've developed a dependence or even just taken these drugs a short time, you will likely experience at least mild withdrawal symptoms when you stop treatment. It's extremely important to manage your treatment routine with your doctor, especially with barbiturates. Stopping using these without tapering, or trying to go 'cold turkey', can result in death.

Barbiturate withdrawal isn't easy. It can be painful, and if you don't manage it properly you can die from it. It doesn't matter if you're taking barbiturates as part of a prescription, or illicitly; please don't quit them cold turkey.

Mild to moderate symptoms of a barbiturate withdrawal include:

  • anxiety and restlessness
  • insomnia
  • dizziness

More severe symptoms include:

  • seizures
  • psychosis
  • respiratory and circulatory failure
  • coma
  • death

Benzodiazepines are advantageous because like the relatively low risk of an overdose death, the withdrawal symptoms tend to be milder. Even so, please discuss how to taper off your dosage with a medical professional. Do not suddenly stop taking benzodiazepines.

Withdrawal symptoms from benzodiazepines (including Xanax and Valium) include:

  • Sleep loss or disturbed sleep patterns
  • general irritability
  • tension
  • anxiety and panic attacks
  • hand tremors
  • sweating
  • difficulty concentrating
  • nausea and dry-heaving
  • weight loss
  • heart palpitations
  • headaches
  • muscle pain or stiffness

In rare cases, people experience more severe symptoms such as seizures and psychotic reactions.

We recommend seeking professional help if you are trying to quit taking barbiturates or benzodiazepines. In the case of barbiturates, it can save your life. Please call a medical specialist and let them walk you through the best way to manage a withdrawal.

Can You Overdose on Barbiturates and Benzodiazepines?

The short answer is yes. Both drugs present a potential for overdose but the severity of the overdose differs greatly between the two. Benzodiazepines are much safer than barbiturates.

The greatest risk for overdose comes from other drug interactions, specifically other central nervous system depressants like alcohol and opioids.

If you are using other prescription medications or have a substance abuse problem, it's extremely important to talk to your doctor before starting treatment with benzodiazepine or barbiturate drugs.

Signs and Symptoms of an Overdose

Overdoses occur based on a number of factors, the main one being the amount and dosage someone ingests. Other factors play a role such as age, health, and underlying genetics, but one of the primary causes of an overdose is when people take other substances at the same time.

People rarely experience fatal overdoses with benzodiazepine use. In cases where an overdose does occur, and no other drugs were taken, you may notice:

  • mild drowsiness to excessive sedation
  • normal or almost-normal vital signs
  • slurred speech
  • minor or no central nervous system depression

Barbiturates are prone to causing an overdose, which is one reason why professionals have tried to phase them out. When someone takes other substances at the same time, they can intensify and multiply overdose symptoms of both drugs. If you notice these symptoms, it's important to call a medical professional:

  • difficulty breathing
  • excessive drowsiness or fatigue
  • trouble walking, speaking, and swallowing
  • amnesia
  • lack of coordination
  • blurry vision
  • unresponsiveness
  • hallucinations
  • low blood pressure
  • deep unconsciousness or coma

Anytime you notice any of these signs, you should be sure you or the affected person didn't take other drugs. They will increase the risk of an overdose significantly. Call a medical professional immediately as overdoses can result in respiratory problems.

Overdosing is typically a sign someone is abusing benzodiazepines and barbiturates, or other substances as well.

Treatment Options

If you're struggling with benzodiazepines and barbiturates you should talk to your doctor or consider a treatment center like NP Addiction Clinic. Quitting isn't something you need to do alone; in fact, you shouldn't do it alone, especially in the case of barbiturates.

You will feel extremely at home with our compassionate treatment professionals and around-the-clock support systems. Not only do we focus on managing your initial withdrawal, but we also provide support and counseling to arm you with the tools to continue fighting long after your withdrawal is over. We also offer specialized treatment in cases of pregnancy or PTSD.

Call one of our specialists today at (772) 281-5051. We're ready to listen.

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