What Is Phenobarbital Abuse?

3 min read · 5 sections

Phenobarbital is a barbiturate drug that has a moderate potential for abuse and the development of physical dependence. While not as readily available as some drugs of abuse, an individual who abuses phenobarbital is opening the door for a potentially dangerous situation that can include long-lasting physical and emotional effects. Individuals who abuse phenobarbital should seek professional help in a formal substance use disorder treatment program.

What Is Phenobarbital?

The barbiturate phenobarbital is marketed under several different brand names, including Luminal and Nembutal. Barbiturates make up a class of drugs that act as central nervous system depressants, meaning they suppress the actions of the neurons in the brain and spinal cord.

Their primary mechanism of action is to increase the efficiency and availability of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). When activated, this neurotransmitter has the effect of inhibiting the firing of other neurons in the central nervous system.

The Drug Enforcement Administration (DEA) classifies phenobarbital as a Schedule IV controlled substance, signifying that it can result in the development of physical dependence when used for a significant length of time, and it is a potential drug of abuse.

What Are Barbiturates?

Barbiturates were once the primary medications used in the treatment of anxiety disorders and issues with anxiety; however, they were frequently misused. Their role in this capacity has been largely taken over by benzodiazepines (e.g. Valium, Xanax, etc.), which were considered to have less potential for abuse.

Information provided by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that barbiturates are not as freely prescribed as they were before the development of benzodiazepines. Misuse of barbiturates often occurs in younger individuals who procure the drug by stealing it or getting it from someone who has a prescription for the drug. According to the data from 2022, approximately 1.3 percent of individuals over the age of 12 reported abusing sedative medications; SAMHSA lists benzodiazepines, barbiturates, and certain sleep aids under the title of “sedatives.” However, the vast majority of individuals who are prescribed these medications (nearly 85 percent) do not misuse them.

Phenobarbital Misuse

Phenobarbital is a relatively fast-acting barbiturate drug. This means that individuals who use the drug will feel its effects rather quickly, and the effects may not last as long as the effects of other similar types of drugs. This can result in individuals bingeing on the drug in order to maintain its effects or using it in combination with other drugs, such as alcohol.

Using phenobarbital is associated with a number of psychoactive effects. Individuals who misuse the drug often experience symptoms that are extremely similar to drinking moderate to heavy amounts of alcohol, such as :

  • Being giddy
  • Having fewer inhibitions.
  • Slurring their words.
  • Experiencing issues with motor coordination.

Using larger amounts of phenobarbital can result in aggressiveness, irritability, lethargy, and unconsciousness or coma.

Signs of Phenobarbital Addiction

According to the American Psychiatric Association (APA), someone who develops a substance use disorder as a result of using a barbiturate would be classified with a hypnotic, sedative, or anxiolytic use disorder. Some of the signs that an individual is abusing a barbiturate like phenobarbital may include the following:

  • The person is using phenobarbital and does not have a prescription for the drug or a condition that the drug would normally be prescribed for, such as seizures.
  • A person frequently appears to be significantly intoxicated but there is no smell of alcohol.
  • Any use of phenobarbital with other drugs, such as alcohol, cannabis, prescription medications, or illicit drugs, is a significant warning sign that an individual is abusing the drug.
  • Empty prescription bottles for phenobarbital are found in the person’s clothes, room, car, etc.
  • A person demonstrates alternating periods of lethargy, irritability, and wanting to be isolated, with periods of being more sociable and functioning relatively normally.
  • A person with a prescription for phenobarbital begins to notice that some of their prescription is missing. This may be an indication that someone close to the person is stealing the drug and abusing it.

Based on the diagnostic criteria for a substance use disorder from APA, the warning signs that an individual is developing a formal substance use disorder as a result of phenobarbital misuse might also include:

  • Frequent use of the drug in a manner inconsistent with its prescribed purposes, leading to distress or impaired functioning
  • Frequent cravings to use the drug
  • Developing significant tolerance to phenobarbital even though one does not have a prescription for it
  • Developing a withdrawal syndrome when one cannot use phenobarbital or get as much phenobarbital as normally used
  • Issues with controlling use of phenobarbital, such as:
    • Spending significant amounts of time using the drug, trying to get the drug, or recovering from its use
    • Frequently using more of the drug than originally intended
    • Continuing to use phenobarbital even though one realizes that use is causing issues with health and/or emotional functioning
    • Giving up important obligations or previously cherished activities in favor of using the drug
    • Expressing a desire to stop or cut down on use of the drug but not doing so
  • Use of phenobarbital causing significant distress or issues with personal relationships, work, school, or another important area of life
  • Failing to meet important obligations as a result of use of phenobarbital

Although a formal substance use disorder can only be diagnosed by a licensed mental health clinician, when anyone notices two or more of the above signs or symptoms, it’s important to discuss the situation with the person and suggest that they seek professional help.

Other Risks Associated with Phenobarbital Misuse

Aside from the development of a substance use disorder, there are several other potential risks associated with using or abusing phenobarbital, even at prescribed doses, for significant periods of time. Research has indicated the following:

  • Even in individuals who have been prescribed phenobarbital for the treatment of seizure disorders, there is an association between long-term use of the drug and cognitive impairment. This includes issues with attention, memory, and problem-solving, as well as in other important areas that most likely reflects several significant alterations in the brain.
  • Individuals who use phenobarbital for lengthy periods of time are at risk to develop a number of other health issues, such as an increased susceptibility for the development of cancer, stroke, and heart attack.
  • Individuals using phenobarbital for lengthy periods may develop a number of psychiatric symptoms that can include depression, anxiety, and even psychotic-like symptoms or delusional beliefs.
  • The potential risks associated with long-term phenobarbital use are magnified in individuals who misuse the drug. They are especially more likely to occur in individuals who misuse the drug in combination with other drugs, such as alcohol, illicit drugs, other prescription medications, etc.

Finally, individuals who abuse a drug like phenobarbital are at extreme risk to suffer severe overdose effects. Overdose from phenobarbital is potentially dangerous; remember that phenobarbital has been used in lethal injections in the United States and other countries. Abusing phenobarbital with other substances increases this risk.

Phenobarbital Withdrawal

The withdrawal process from phenobarbital may result in the development of seizures, and the seizures can actually be fatal. Therefore, it is extremely important that anyone who has misused phenobarbital on a regular basis consult with a licensed physician before discontinuing use of the drug.

Treatment for Phenobarbital Addiction

Overcoming phenobarbital addiction requires comprehensive care and support. If you or a loved one are struggling with phenobarbital misuse, seeking professional treatment is crucial for a safe and successful recovery.

Treatment options for phenobarbital addiction include:

  • Medical Detox: Safely manage withdrawal symptoms under medical supervision.
  • Inpatient Rehab: Receive intensive therapy and 24/7 support in a structured environment.
  • Outpatient Rehab: Attend therapy sessions while maintaining your daily life.
  • Therapy: Address underlying causes of addiction and develop coping mechanisms.
  • Support Groups: Connect with others in recovery for encouragement and accountability.

Don’t wait to get help. Reach out to our compassionate and knowledgeable navigators today at to discuss your treatment options and create a personalized plan for recovery. With the right support, you can overcome phenobarbital addiction and build a healthier, more fulfilling life.

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