A barbiturate [a] is a drug that acts as a central nervous system sedative. Barbiturates are effective as anxiolytics, hypnotics and anticonvulsants, but have a potential for physical and psychological dependence, as well as the potential for overdose, among other possible side effects. They have been largely replaced by benzodiazepines and non-benzodiazepines (“Z-drugs”) in routine medical practice, particularly in the treatment of anxiety and insomnia, due to the significantly lower risk of dependence and overdose and the lack of an antidote to barbiturate overdose. Despite this, barbiturates are still used for various purposes: general anesthesia, epilepsy, treatment of acute migraine or cluster headache, acute tension headache, euthanasia, death penalty and assisted suicide.  Pharmacological treatment of barbitura deprivation is a longer process that often involves converting the patient to a long-acting benzodiazepine (i.e., Valium), followed by slow rejuvenation of benzodiazepines. Mental cravings for barbiturates can last for months or years in some cases and counselling/support groups are strongly encouraged by addiction specialists. Due to the high lethality and relatively sudden onset of withdrawal, patients should never attempt to tackle the task of stopping barbiturates without consulting a doctor. Trying to stop “cold turkey” can lead to neurological damage due to excitotoxicity, serious physical injury during seizures, and even death from arrhythmia during attacks of great evil, alongside death from delirium tremens. [ref.
Over time, your body develops an addiction to barbiturates. This means that your body needs the drug, and if you don`t get it, you may experience withdrawal symptoms. These symptoms include: During the 20th century, more than 2500 barbiturates were synthesized, of which 50 were eventually used clinically. Their use was widespread and many still have some of them today. One hundred years after the introduction of the original compound in clinical pharmacology, oxybarbiturates generally continue to be the drugs selected in the treatment of some severe forms of insomnia and certain types of epilepsy. Similarly, some thiobarbiturates and ultra-short-acting barbiturates are still used today as inducers of general anesthesia. Nevertheless, 5 or 6 barbiturate derivatives are currently sufficient to cover the therapeutic applications they still need. There have been some isolated reports of barbiturate use in clubs, possibly by amphetamine and ecstasy users to bring them off the euphoria. There are several barbiturates in the world, but some of them are not available in some countries. One example is thiopental, which is no longer available in the United States. Some of the most common barbiturates are: barbiturates work by enhancing the effects of GABA by binding to a site on the receptor/GABAA chloride channel, a property they share with benzodiazepines; However, the binding sites of the two types of drugs differ, and therefore the effect of barbiturates is less specific. For this reason, the therapeutic index is low.
The resulting risk of overdose means that use as a sedative/hypnotic is no longer recommended. The Convention on Psychotropic Substances was signed in Vienna in 1971. The 34th version of the treaty, developed to regulate amphetamines, barbiturates and other synthetic substances, regulates secobarbital in Schedule II, amobararbital, butalbital, cyclobarbital and pentobarbital in Schedule III and allobararbital, barbital, butobarbital, mephobarbital, phenobarbital, butabarbital and vinylbital in Schedule IV of its “green list” as of January 25, 2014 [update].  However, the combination drug Fioricet, composed of butalbital, caffeine and acetaminophen (paracetamol), is explicitly excluded from controlled status, while its brother Fiorinal, which contains aspirin instead of acetaminophen and may contain codeine phosphate, remains a Schedule III drug. However, barbiturates are still proven drugs used to treat many conditions. They also combine well with other medications such as acetaminophen (Tylenol® or acetaminophen®) to treat certain conditions. One of the most important advantages of barbiturates is their durability. Some of these drugs are only effective for a very short period of time. This is useful for short medical procedures. Others can take hours or even days, which is one reason health care providers still prescribe them to prevent seizures. The Misuse of Drugs Act classifies barbiturates as Class B, which means that these drugs can be purchased with a doctor`s prescription; However, any other form of possession or distribution of barbiturates is considered a criminal offence. The maximum penalty a person can receive for unauthorized possession of barbiturates is 5 years` imprisonment and a fine for possession.
For delivery, the maximum penalty is 14 years in prison and a fine. You should consult your doctor as recommended. Most barbiturates are not intended for long-term use, so you may need to see your doctor for follow-up. This will help them determine if you still need treatment or if other options work better. Currently, the use of barbiturates is limited to very specific therapeutic applications (Charney et al 2001). Thus, phenobarbital and butabarbital are still used as sedatives for gastrointestinal and asthmatic dysfunction, as well as to combat the undesirable central stimulating effects of certain drugs such as ephedrine, dextroamphetamine or theophylline. Phenobarbital is also used in hypnoseedatia withdrawal syndromes. In the field of neurology, barbiturates (phenobarbital and primidone) are still used, not only in the treatment of certain types of epilepsy (partial generalized and tonic-clonic seizures), but also in the emergency treatment of certain types of seizures, such as tetanus, eclampsia, cerebral hemorrhage, status epilepticus or various forms of poisoning. As inducers of intravenous anesthesia, ultra-short-acting barbiturates are beneficial, mainly thiopental and methohexital, the latter also being administered rectally to children or as a sedative in some diagnostic imaging tests. Table 4 shows the therapeutic applications of barbiturates that have survived so far. In 1988, studies of synthesis and binding of an artificial receptor that binds barbiturates by six complementary hydrogen bonds were published.  Since this first paper, different types of receptors, as well as various barbiturates and cyanurates, have been designed, not for their efficacy as drugs, but for applications in supramolecular chemistry, in the design of molecular materials and devices.
Barbiturates are also controlled as Class B drugs under the Substance Misuse Act. Doctors can still prescribe them and patients take them, but unauthorized possession or delivery is a criminal offense. The maximum penalty is 5 years` imprisonment and a fine for possession and 14 years` imprisonment and a fine for delivery. If barbiturates are prepared for injection, they are considered Class A drugs with harsher penalties. One of the main reasons barbiturates are no longer widely used is that they have a higher risk of certain side effects, including: Between the 1920s and the mid-1950s, barbiturates were virtually the only drugs used as tranquilizers and hypnotics (Lehmann and Ban, 1970). Chemically, these drugs are closed-chain urea compounds with malonylurea cores (a combination of urea, a product found in animal feces, and malonic acid, an acid derivative of apples) (Figure 1).