You are getting very sleepy…but is it caused by a barb or benzo? Both substances start with the same letter (and are a bit of a mouthful), they are in the same drug classification and both have sedating effects on the body that result in a feeling of calm and relaxation. The two substances have many similarities so it’s understandable why they are often mistaken for one another, but barbiturates and benzodiazepines are not the same things. 


Barbiturates Overview

Barbiturates are a sedative, whose calming and relaxing effects are likened to those that are caused by alcohol. They are most commonly used to treat specific conditions such as seizures, anxiety, or as an anesthetic for surgery. Being central nervous depressants, they reduce nerve activity resulting in muscle relaxation, slowed heart rate, and breathing. 

Barbiturates are classified as Schedule II substances having considerable potential for being misused and being habit-forming. 

How Do They Work?

Barbiturates cause central nervous system depression by affecting the gamma-aminobutyric acid neurotransmitter, also known as GABA. Specifically, barbiturates bind to GABA channels, causing them to remain open for a prolonged period of time which in turn, creates a negative charge. This negative change in voltage makes brain cells less responsive to nerve impulses (i.e. depressed).

Barbiturates have a narrow therapeutic dosage range. Small differences in doses can produce very large differences in side effects. Having such a fine line between a safe and a potentially dangerous dosage increases the likelihood of barbiturates having unintended consequences. 

When Are They Used?

Nowadays, barbiturate use is limited to pre-operative settings and is rarely found on the black market. Due to a high likelihood of being abused or resulting in addiction, this type of sedative is rarely prescribed for managing ailments. If it is, it is done for a very short time frame. 

This drug does not mix well with others. It can be fatal if combined with opioids, antidepressants, antihistamines, over-the-counter (OTC) medications, alcohol, as well as its close pharmaceutical relative, benzodiazepines, among other substances. Barbiturates have largely been replaced by benzodiazepines due to their high risk of causing addiction or a fatal overdose.


Benzodiazepines Overview

More commonly referred to as “benzos”, benzodiazepines are also a class of sedatives that can have hypnosis or amnesia-inducing effects.  The way they function is almost identical to that of barbiturates, but with a few noticeable differences. Benzos are commonly prescribed to treat conditions such as anxiety, seizures, and insomnia. They have a relatively high likelihood of causing physical and emotional dependency, even when dosage instructions are followed but are still considered to be much safer than barbiturates. As such, they are typically only prescribed for short-term use. Some of the most well-known benzos are Valium and Xanax.

How Do They Work?

Similar to barbiturates, benzodiazepines primarily affect the body via the GABA neurotransmitter, which is responsible for sending calming messages to the body. Benzos change the voltage in the brain to be negative which causes brain cells to be less sensitive. The primary difference between the two is that benzodiazepines do not stimulate the GABA receptor directly, they simply make GABA receptors more efficient. Benzodiazepines still produce a calming effect but aren’t as depressing to the central nervous system as barbiturates, and are considered to be the weaker of the two (but still potentially dangerous none-the-less).

When Are They Used?

Benzos can be considered as barbiturates 2.0. They are prescribed to treat the functions of barbiturates used to such as seizures, anxiety, and insomnia. They are very fast-acting and are perhaps best known for their use in treating panic attacks. Because they are more widely available than their predecessor, benzos have greater rates of abuse and benzo addiction is much more commonplace.


The Difference Between Barbiturates and Benzodiazepines

These two “downers” have more in common than they have differences. They fulfill nearly identical purposes and work in very similar manners. The key difference between the two is that one is much more dangerous than the other, which led to its subsequent replacement. Although benzodiazepines are meant to be a safer alternative to barbiturates, these types of drugs are far from harmless. Both drugs are prone to being habit-forming and can result in fatal overdoses.