Pentobarbital (Nembutal) Addiction And Treatment Options

Pentobarbital is a dangerously addictive sedative. Treatment of pentobarbital consists of cautious and gradual withdrawal of the drug. This type of treatment is most easily completed in an inpatient treatment center.

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Due to its highly addictive nature, pentobarbital is considered to be a highly controlled substance by the Drug Enforcement Agency. It is common for people to stay addicted to pentobarbital due to the life-threatening withdrawal syndrome that occurs when the drug leaves the body. Suddenly stopping this medication can cause a severe reaction.

Pentobarbital seems to be making a comeback, as the prescription drug problem grows bigger in the U.S. It was commonly abused in the 1940s and 50s as a sleeping pill/anti-anxiety medication of choice. Even one of Hollywood’s most famous stars, Marilyn Monroe, is suspected to have died from Nembutal overdose. The younger demographics don’t recall these tragic overdose cases and use “nembies” with a naive sense that nothing bad will happen to them if they take the drug themselves.

What is Pentobarbital (Nembutal)?

Pentobarbital is a short-acting sedative. A part of the barbiturate drug class, it is a central nervous system depressant or “brain relaxer.” Pentobarbital is commonly used to put patients to sleep before surgery, treat sleeping problems, and to treat seizures in an emergency situation.

Pentobarbital is the generic name for the following prescription drugs:

  • Nembutal
  • Pentosol
  • Repocal
  • Sopental

The active ingredient in pentobarbital, nembutal sodium, is a salt that is quickly absorbed and rapidly distributed to all body tissues in high concentrations. The brain, liver and kidneys are the organs most affected by pentobarbital.

Pentobarbital is a white powder that can be dissolved in water and injected into large muscle groups, or split into pill capsules for oral consumption. It has often been noted as the highest ranking drug among doctors for patient assisted suicide, due to its intense toxic effects with minimal pain. However, if the person has existing pain source, pentobarbital may increase their sensitivity to that pain.

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Signs And Symptoms Of Pentobarbital (Nembutal) Addiction

Nearly 60 percent of people addicted to sedatives also regularly abuse alcohol. Symptoms of pentobarbital addiction appear very similar to those of chronic alcoholism. These symptoms can include:

  • Slurred speech
  • Decreased energy
  • Difficulty breathing or swallowing
  • Trouble walking/ wider steps
  • Slowed heartbeat/weak pulse
  • Confusion
  • Irritability
  • Insomnia
  • Body aches
  • Rash/large blisters
  • Fainting
  • Memory loss

Some people may experience a reverse reaction when abusing pentobarbital. Where they become excitable and experience agitation with abnormal thoughts, accompanied by anxiety.

Chronic abuse of pentobarbital can also cause varying degrees of liver or kidney damage and megaloblastic anemia (a condition where the bone marrow produces large, abnormal red blood cells.)

Dangers Of Pentobarbital (Nembutal) Abuse

The main danger behind pentobarbital misuse are the physical and psychological dependence symptoms brought on by the drug. The toxic dose has considerable range, between two to 10 grams, depending on the individual case. The difference between a safe and lethal dose of pentobarbital can be a very slight amount. This is why safe dosages of this drug must be determined by a doctor because they are dependant on a person’s weight, age, and past addictive behaviors.

Overdose is another danger of abusing pentobarbital. This happens when too large a dose is ingested at one time, which is easily done. Overdosing on pentobarbital causes the central nervous system functions to slow down drastically. Symptoms of pentobarbital overdose include:

  • Slowed or labored breathing
  • Decreased heart rate
  • Weakness
  • Limpness
  • Lack of urination
  • Pinpoint pupils
  • Weak or thready pulse

Complications of pentobarbital overdose can include pneumonia, edema, congestive heart failure, and kidney failure.

It is not uncommon for the elderly, people with existing conditions of depression, and very ill people to overreact to pentobarbital. Pregnant women and nursing moms should never take pentobarbital as it has been proven to be harmful to unborn babies. It has also been found to cause higher risks of cancer in laboratory studies performed on animals.

This drug is especially dangerous when mixed with other central nervous system depressants such as alcohol or narcotics. Pentobarbital can also cause birth control to lose its effectiveness. Taking pentobarbital with other anti-seizure medications can also cause a toxic reaction that can be fatal.

It is rare, but occasionally it has been reported that some people experience an allergic reaction to pentobarbital. This causes a life-threatening condition called, anaphylaxis. The person may experience difficulty breathing, rashes or sores, and swelling of the face, lips, tongue, or throat. This can lead to inability to breathe that may result in death if not treated in a timely manner.

Pentobarbital (Nembutal) Withdrawal

Withdrawal from pentobarbital can be seriously life-threatening and really never should be attempted without professional medical supervision. Dependance on pentobarbital can occur quickly. Pentobarbital withdrawal is considered to be one of the most difficult withdrawal syndromes to endure.

Because barbiturates interfere with the neurotransmitters that are used as the communication network in the brain, suddenly stopping this medication will overwhelm the brain with nerve impulses. This can result in frightening hallucinations and life-threatening seizures.

Withdrawal typically begins within 8 to 12 hours of the last dose. The symptoms that typically occur first may include:

  • Mass amounts of anxiety
  • Excessive sweating
  • Fever
  • Shortness of breath
  • Rapid heart beat
  • Paranoia
  • Muscle twitching or tremors
  • Distorted visual perception
  • Nausea and vomiting
  • Insomnia

After 16 hours from the last dose some people can enter a state of delirium. It is also possible for seizures to occur, but they usually subside after three days or so. The symptoms that occur first can last anywhere from five to fifteen days, but it can take up to six months to feel completely back to normal and rid of pentobarbital.

Medically-Supervised Pentobarbital (Nembutal) Detoxification

Due to the extreme and life-threatening effects caused by pentobarbital withdrawal, medically supervised treatment is considered to be the only safe why to detox from this substance. Doing so on one’s own would be virtually impossible.

Medically supervised or residential drug treatment is the best choice for treating addiction. It gives people time to clear their minds and bodies of the drugs they’ve fallen victims to and prepare and plan for a lasting recovery.

This type of treatment allows medical professionals to monitor individuals needs, adjust withdrawal doses when necessary, and provide a therapeutic outlet for those that need to talk with someone about their addiction.

Getting through the initial detox is the first major step towards full recovery. It is vital to success and is much more likely to result in a positive outcome when done in a medically supervised setting.

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Treatment For Pentobarbital (Nembutal) Addiction

Once the initial detox is complete most people find it helpful to attend a residential program. Where they live in a facility with others who are also battling their own addictions. These types of facilities can offer comprehensive programs that include psychotherapy, group therapy, classes, structured schedules and social activities.

With the combination of these treatments individuals learn why pentobarbital is so addictive and how to recognize environmental triggers that can result in a relapse. Individuals learn to live in a relaxed state without the drug and can become more self-aware during this potentially life-changing process.

Upon returning home, it is common to continue some form of therapy or attend support meetings. Addiction is a difficult enough disease on its own. But when a substance with the attribute of pentobarbital is thrown in the mix, it becomes that much harder to overcome.


National Center for Biotechnological Information – Pentobarbital
U.S. National Library of Medicine, MedlinePlus – Pentobarbital overdose

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