Barbital overdose and abuse.

Bailey, David N., and Jatlow, Peter I.: Barbital overdose and abuse. A new problem. Am J Clin Pathol 64:291-296, 1975. The unusual epidemiology and toxicology of barbital overdose and abuse are demonstrated by eight recent cases. Since barbital is used primarily in laboratory buffers and is not available as a prescription or over-the-counter drug in the United States, barbital overdose and abuse have until recently been rare. In several instances the barbital was stolen from a clinical or research laboratory. Serum concentrations were often "astronomically" high compared with those of other barbiturates, including phenobarbital. Concentrations severalfold greater than would be considered lethal for other barbiturates were consistent with survival, and all patients, including one with a serum concentration of 120.2 mg per dl. (higher than any previously reported), recovered with only conservative therapy (no peritoneal or hemodialysis). Patients could be awakened when the concentration was less than 16.0 mg per dl. Serum barbiturate concentrations greater than 20.0 mg. per dl. in a living patient should warrant serious consideration of barbital ingestion. In addition to the eight overdoses, 16 abusers of barbital were detected during 1974 by drug-abuse screening of urine.