The rise and fall of the "red devils" of the sedative era

Health · Published 2 October 2026 Swipe more like this →

In short: Once a widely abused staple of the 1960s, secobarbital was a go-to for insomnia and anxiety. Known by colorful street names, this potent barbiturate eventually lost its place in mainstream medicine to safer alternatives, leaving a complex legacy in both clinical and end-of-life care.

Secobarbital is a short-acting barbiturate that functions by slowing activity within the brain. Primarily used for short-term insomnia treatment or to reduce anxiety before surgical procedures, it works by inducing sedation and hypnosis. However, its high potential for dependence and addiction led to its widespread abuse and eventual decline in clinical use by the 1970s.

The drug's reputation was heavily shaped by its appearance; often sold in bright orange or red bullet-shaped capsules, it earned nicknames like "red devils," "reds," or "ruby slippers." This era of recreational use in the 1960s and 1970s was marked by accidental overdoses. Today, the medication has largely been replaced by the benzodiazepine family, which is considered a safer option for treating similar conditions.

The medication's profile is complex and carries significant risks. For instance, taking it for more than two weeks can diminish its effectiveness for sleep. Abruptly stopping the drug can trigger severe withdrawal symptoms, including seizures, confusion, or uncontrollable shaking. Furthermore, it can interfere with the effectiveness of hormonal contraceptives, making it a critical consideration for patients of childbearing age.

Beyond clinical sedation, secobarbital plays a role in end-of-life protocols. In the Netherlands, it is one of the options for assisted dying via oral consumption of concentrated syrup. In the United States, it has been a common drug prescribed under physician-assisted dying laws in states like Oregon, Washington, and Vermont.

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