Hey Alice,

A kid had some pills and told me they were "bars." What kind of pills are these?

Dear Reader,

The "bars" you're inquiring about may refer to barbiturates, a class of depressant medications that cause relaxed states and drowsiness. Other street names include "barbs," "barbies," "downers," "blue devils," "sleepers," "yellow jackets," and "pink ladies." Health care providers prescribe barbiturates, such as pentobarbital and secobarbital, to treat insomnia, tension, anxiety, and seizures. Barbiturates are also used pre- and post-surgery as sedatives. The pill or capsule forms are often described by the color (red, yellow, blue, or red/blue), while other kinds are taken intravenously. They're highly addictive drugs, and because they're often misused, most health care providers tend to use benzodiazepines (a different class of sedative) with less risk of overdose. 

Usually taken by mouth, barbiturates work as central nervous system (CNS) depressants, meaning they slow normal brain function, producing a state of intoxication similar to alcohol intoxication. Barbiturates are classified according to how fast they produce an effect and how long that effect lasts: ultrashort, short-term, intermediate, and long-acting. Barbiturates that are used short-term take effect almost immediately and are often used during surgery. Intermediate barbiturates take about 15 to 40 minutes to take effect and may last up to six hours. These pills are used for sleep disorders and are a common choice for "barb" abusers. Long-acting barbiturates, used for calming anxiety and reducing seizures, may last up to twelve hours.

The effects a person experiences can depend on dosage and tolerance. Lower doses can produce slurred speech and mild impairment of thought and coordination. As the dosage increases, side effects include memory loss, mood swings, and increased hostility. Depending upon the dose, frequency, and duration of use, a person can rapidly develop tolerance, which may lead to a physical and psychological dependence on barbiturates. For example, barbiturates may be used to treat insomnia. However, if they're used every day, after just a few weeks they're usually no longer effective. With greater tolerance, a person will have to take higher doses to achieve the desired effects. This is when it becomes risky, because the difference between an effective dose and a lethal dose is slim.

If too much of a barbiturate is used, or if it's used too regularly, it can become an addictive behavior. Addiction to barbiturates can cause depression, paranoia, hostility, and memory impairment. Withdrawal from barbiturate addiction can be very uncomfortable for the user and even life-threatening. When a person's body develops a dependency, their brain specifically adapts to function with the addition of the drug. When they stop using, they can become nervous, tense, and anxious. That's why it's highly advised to be under the close supervision of a health care provider when taking these medications and to inform the decision to stop using them.

Under the supervision of a health care provider, barbiturates can be effective in treating sleep disorders and other conditions. That's the key — supervised use! For more information about barbiturates and other drugs, check the National Institute on Drug Abuse and U.S. Drug Enforcement Administration. You can also take a look at the Go Ask Alice! Alcohol and Other Drugs archives to learn more about other sedatives.

Alice!

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