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Fioricet Abuse, Addiction, And Treatment Options

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

January 11, 2019

Fioricet, although not a DEA controlled substance, contains multiple drugs that may cause adverse reactions, withdrawal symptoms, and intense feelings of drowsiness and sedation. Fioricet is commonly abused with other substances like alcohol, increasing the effects of sedation, dangers of use, and need for treatment.

What Is Fioricet?

Fioricet is a combination medication consisting of butalbital, acetaminophen, and caffeine. This medication is generally prescribed to treat tension headaches or migraines. Because Fioricet is a mixture of different drugs, they all work together to relieve headache pain and discomfort. Butalbital is a barbiturate, or sedative, that is effective for decreasing anxiety and causing relaxation and sleepiness. Acetaminophen works to reduce the pain for a headache and caffeine works to increase the effects of acetaminophen.

Fioricet is available in capsule and tablet form and is directed to be taken orally by mouth. The medication is prescribed with caution because of butalbital, which is habit-forming and has the potential for abuse. As a barbiturate, butalbital is addictive and may lead to physical dependence. When abused, Fioricet may lead to addiction.

Fioricet abuse occurs when the drug is taken in ways other than directed, in large amounts, or without a prescription. The butalbital found in Fioricet may produce a high, or feelings of euphoria and intoxication. After prolonged Fioricet abuse, a person is likely to show various signs and symptoms of addiction.

Signs And Symptoms Of Fioricet Abuse And Addiction

One sign of Fioricet abuse and addiction is needing to take more of the drug to achieve the desired effects, which is called tolerance. Butalbital, a barbiturate ingredient in Fioricet, is likely to cause tolerance after prolonged use of high doses. Taking too much Fioricet may also result in an increase of side effects. Experiencing more side effects may suggest the drug is being abused.

Potential Fioricet side effects may include:

  • confusion
  • depression
  • drowsiness
  • lightheadedness
  • stomach pain
  • trouble sleeping
  • upset stomach

The high from Fioricet may cause someone to appear sleepy, drowsy, and sedated. Even at fairly low doses, barbiturates can make a person seem drunk or intoxicated. They may seem distant or uninterested in activities they usually engage in. Their appearance may change and become more messy and unkempt. Relationships may begin to deteriorate and they may neglect responsibilities at home work or school.

Someone abusing Fioricet may also suffer from barbiturate addiction or dependence. The average barbiturate dose someone needs when suffering from barbiturate addiction is around 1500 mg a day, on average. Butalbital, a barbiturate in Fioricet, consists of only 50 mg. They may be taking multiple large doses of Fioricet, which can be dangerous.

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Dangers Of Fioricet Abuse And Addiction

Because Fioricet is composed of multiple substances, overdose may occur as a result of too much caffeine, acetaminophen, or butalbital. Toxicity, or poison levels, may be too insignificant for caffeine to result in overdose. However, overdose may occur from too much butalbital or acetaminophen, which means overdose symptoms may vary. In general, symptoms of a Fioricet overdose may include:

  • abnormally low blood pressure
  • coma
  • confusion
  • difficulty breathing (respiratory depression)
  • dizziness
  • general feeling of illness and discomfort
  • loss of appetite
  • nausea and vomiting
  • severe drowsiness
  • sweating

If left untreated, a Fioricet overdose may cause death. An overdose should be treated as a medical emergency, and 9-1-1 should be contacted immediately. It’s estimated around 1 in 10 people who experience overdose die from barbiturates or a mixture that contains barbiturates, like Fioricet, usually from heart and lung problems.

Drinking alcohol with Fioricet, or using it with street drugs, can increase the risk of overdose and intensify feelings of drowsiness or sedation. Fioricet may also enhance the effects of other central nervous system (CNS) depressants like benzodiazepines or other sedatives. Taking too much Fioricet can be harmful, but stopping use may be difficult if the person has developed a dependence.

Fioricet Withdrawal And Detox

Physical dependence is likely to onset after using Fioricet for long periods of time and in high doses. Dependence occurs as a result of butalbital, which means a person may experience uncomfortable symptoms of withdrawal when they stop use.

Symptoms of Fioricet withdrawal may include:

  • anxiety
  • dizziness
  • hallucinations (seeing or hearing things that aren’t there)
  • mood changes/irritability
  • restlessness
  • seizures

Intense withdrawal symptoms may occur within 16 hours after last use and can last up to 5 days. The intensity of withdrawal symptoms tend to decrease after a period of around 15 days. Because symptoms are intense and can last for several days, many people may turn to drugs or alcohol to self-medicate uncomfortable symptoms.

To avoid further substance abuse, Fioricet withdrawal may require a medically supervised detox program. A medically supervised detox program takes place in a hospital or treatment center and ensures safety, comfort, and support during the worst of withdrawal. Staff may administer medications to alleviate symptoms and reduce dependence. Although helpful for preparing a person for treatment, detox programs are not treatment for addiction.

Treatment For Fioricet Addiction

Addiction to any prescription drug, like Fioricet, is treatable. Effective treatment should incorporate a variety of methods, including behavioral therapy, medication, and social and professional supports. Fioricet addiction may be treated by a process called tapering, which involves slowly decreasing the dosage of a drug to lessen dependence and avoid symptoms of withdrawal.

Behavioral therapy, in either an inpatient rehab center or outpatient settings, can be an effective route for treating Fioricet abuse or addiction. A variety of therapies, like cognitive behavioral therapy (CBT), can be useful for changing a person’s thinking, attitudes, and behaviors towards drug use. Therapy can also increase life skills needed to cope with different life stressors that lead to further substance abuse.

Fioricet abuse may also occur in combination with other drugs and alcohol. If the person is also struggling with other substances of abuse, then effective treatment should address all addictions. While there is no right treatment best for everyone, treatment plans are highly individualized and focus on the unique needs and circumstances of the person receiving treatment.

National Institute on Drug Abuse - Prescription Drug Abuse

U.S. National Library of Medicine: DailyMed - Fioricet

U.S. National Library of Medicine: MedlinePlus - Acetaminophen, Butalbital, and Caffeine, Barbiturate intoxication and overdose

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