In many respects, the illicit use of barbiturates started off as simple misuse of the drug. The drug was used for its "slowing" effect it had on the nervous system. It was used as a coping mechanism, for people who felt that the numbness and sensations it created helped them with daily consciousness. Given the relative ease with which it could be taken orally or mixed with cocktails, the use started to increase. Through prescription abuse, a new element of illicit use began to emerge:
In 1948, the Supreme Court of the United States gave the Food and Drug Administration (FDA) permission to investigate pharmacies' records of barbiturate prescriptions. The results showed a shocking pattern of abuse. In one case a single prescription for barbiturates was refilled sixty-one times. The last three of those refills were approved after the patient had already died from a barbiturate overdose. In another incident, more than 180,000 barbiturates simply disappeared from a Tennessee drug store. Records indicated that drug manufacturers had sent the pills to the store, but the staff at the store was unable to explain where they went.
The illicit use of the drug through prescription abuse became rampant with the drug. At the same time, a new illicit use began to emerge as users began to mix the drug with other drugs to achieve more divergent effects. A combination of being able to acquire the drug from their parents' use as well as through black market means represents another facet of illicit use of the drug. According to the 1972 Consumers Union Report on Licit and Illicit Drugs, the year 1969 alone saw 10 billion barbiturate doses were scheduled for production. The identification and governmental action taken on the illicit use of barbiturate helped to stem its consumption in the 1980s, when other illicit uses of drugs became more evident.