What is Fioricet Addiction and How Can It Be Treated?

Last Updated: July 5, 2021

Authored by Isaak Stotts, LP

Reviewed by Michael Espelin APRN

Fioricet is a pain reliever often prescribed by doctors to treat chronic tension headaches or headaches due to muscle contraction, although the use of Fioricet for migraines is sometimes encountered. It is a combination of Butalbital, Acetaminophen, and caffeine. Butalbital is a barbiturate, a class of central nervous system sedatives. In contrast, Acetaminophen is an analgesic and antipyretic which can be given for mild-to-moderate pain such as tension headaches. Caffeine is a CNS stimulant that synergistically enhances the effects of Acetaminophen and, therefore, its efficacy. Due to the euphoric effects of butalbital, there is some potential for individuals to abuse the medication, leading to the risk of suffering some severe Fioricet side effects and possibly even a Fioricet overdose. Let’s continue with first answering the questions: what is Fioricet, and how does it work?

What is Fioricet?

Fioricet is a prescription medication for chronic tension headaches and other forms of severe headaches. Although the use of Fioricet for migraines has been documented, there are more effective treatment options available. Therefore the prescription of Fioricet for migraines has decreased in recent years.

Man at home having a tension headache.

People have used the medication for over thirty years after its approval by the FDA in 1984. However, it is mainly prescribed as a last resort by doctors after all other forms of medical treatment have failed.

Components of Fioricet

The medication has three major components, namely, Butalbital, Acetaminophen, and Caffeine.

  • Butalbital is a barbiturate. It’s a drug that works as a depressant to sedate a person’s ability to feel certain sensations at varying levels, depending on their tolerance.
  • Acetaminophen, on the other hand, is an analgesic, which relieves pain and fever. Taking too much of this drug causes severe damage to the liver. In extreme cases, liver transplants are necessary to prevent death.
  • Caffeine, like the one found in coffee, soda, and chocolates, acts as a mild stimulant that can help in certain types of headaches. The amount present in the medication is relatively low.

The primary factor responsible for the addictive potential of the drug has the barbiturate Butalbital. Barbiturates are CNS depressants, similar to alcohol, benzodiazepines, and opiates. At smaller doses, they may create a sense of euphoria, relaxation and increase sociability. However, chronic use may eventually lead to dependence, withdrawal symptoms when the drug is not taken for some time, and subsequently addiction.

Fioricet Side Effects

Taking the drug can cause several side effects. The medication is known to make the user sleepy and calm. These are typical side effects and are nothing to be concerned about.

Common Fioricet Side Effects:

  • Sleepiness
  • Feeling relaxed
  • Feeling intoxicated
  • Insomnia
  • Stomach pain
  • Gums bleeding
  • Changing in urination frequency
  • Feeling dizzy
  • Having a hard time focusing

Sometimes, there might be the first appearance of any of these signs after taking the drug. As a result, one should consider getting an appointment with a doctor. This way, one can discuss whether to continue taking the medicine or not.

If one experiences respiratory problems, convulsions, hives, it’s imperative to seek medical help. These Fioricet side effects signify the body’s serious adverse reaction to the drug.

Fioricet with Codeine

Presently, doctors prescribe Fioricet with Codeine to relieve tension headaches, headaches due to muscle contraction, and sometimes a doctor may prescribe Fioricet for migraines. Codeine was added to increase the therapeutic efficacy of the painkiller. There are medicinal benefits to taking Fioricet with Codeine. However, many adverse health reactions can occur even when taken as directed.

Woman has a headache at the office near laptop.

In addition, Codeine is a narcotic, which makes this combination even more addictive. Because Codeine also has a significant potential for abuse, the combination of Fioricet with Codeine increases the chances of the individual developing an addiction, experiencing severe Fioricet side effects such as dizziness, shortness of breath, respiratory depression, confusion, and convulsions.

How Does One Get Addicted to Fioricet?

In 2007, information showed that the Centers for Disease Control and Prevention recorded higher death rates due to painkiller abuse than cocaine and heroin. In 2010, the National Survey on Drug Use and Health found that approximately 2 million people in the US had used prescription drugs for non-medical purposes for the first time that same year.

Either by prescription from a doctor or non-medical use, an individual can start the journey to barbiturate addiction due to the drug’s tolerance-building nature, which is due to the presence of Butalbital. The potential for addiction is increased when the medication is combined with Codeine. Patients can develop a level of tolerance for both drugs. When this happens, the user needs higher doses to achieve the same results as before.

Some Of the Common Abuse Signs Include:

  • Visiting various doctors to receive multiple prescription (Doctor Shopping)
  • An ever-growing tolerance to the drug, requiring higher doses to cure headaches
  • Experiencing withdrawal after intake of the drug has been stopped or reduced
  • Helplessness in everyday functioning without the drug
  • Focusing purely on taking the drug (obsession)

Cautions for Fioricet Use

Fioricet medication should not be used in certain conditions. First, if one has narcotics and alcohol in the system. Second, it’s if one has an underlying health condition called porphyria (a rare inherited blood disorder).

It’s not recommended to take this drug during pregnancy. Based on current information, it’s not entirely known if using the medication will cause any harm to the unborn child. Several heart defects were documented in babies of mothers who took Butalbital in their pregnancy. In addition, some health experts claim that the baby could be born addicted. If the baby is an addict, the withdrawal symptoms could be life-threatening.

Pregnant woman on the couch thinking about taking Fioricet.

The excessive use of the medication by the mother has many dangerous effects on the baby. For example, there are reports of miscarriage as well as fetal growth. Likewise, if one is a nursing mom, the medication may cause restlessness in a newborn.

Elderly patients (those over 60) may feel depressed after taking the medication due to the CNS symptoms. Therefore, strict adherence to the instructions is imperative. Furthermore, patients with insomnia should not take it.

Fioricet – What Doesn’t Mix

Primarily, because one of the side effects of the medication includes drowsiness, one should not complete any tasks that require being alert all the time, such as driving. One should also avoid mixing the drug with alcohol due to the Acetaminophen it contains. That is because mixing alcohol and Acetaminophen can increase the chances of liver disease.

Acetaminophen is considered to be hepatotoxic, even at therapeutic doses. Large doses of the medication can lead to significant liver damage. Therefore, since Acetaminophen is commonly mixed with many medicines, any additional drug dosage could cause an overdose.

Fioricet Overdose

Overdoses can be triggered by a mixture of the drug with other drugs and the excessive consumption of the medication. Several general factors may lead to a Fioricet overdose. The potential causes of a Fioricet overdose could be addiction, depression, anxiety, suicidal attempts, poisoning, and even the various drug interactions mentioned above. Remember that since it is a combination drug, one can overdose on one component or the other.

The First and Most Evident Signs of an Overdose Are:

  • Appetite change
  • Vomiting
  • Nausea
  • Sweating
  • Disorientation or confusion
  • Lethargy
  • Stomach pain

Later Signs of Overdose Include:

  • Dark or painful urination
  • Yellowing of skin or eyes
  • Increased stomach pain
  • Insomnia
  • Tremors
  • Seizures
  • Fainting

Doctors can perform medical testing throughout Fioricet medication use. It will help monitor side effects, ensuring the medication does its job while safeguarding against an overdose.

Fioricet Withdrawal

Withdrawal symptoms begin to manifest when an addicted individual suddenly quits the substance intake. In the case of this particular drug, the experienced symptoms may include physical effects such as nausea, convulsions, tremors, and psychological effects such as feelings of anxiety, delirium, and hallucinations. Fioricet stays in the system for a long time, due to Bulatbital’s long half-life. As a result, the detox may last longer until the body is completely free of the drug.

People who are withdrawing from the drug also feel emotional, depressed, anxious, and irritable. Some have hypertension, depression of the respiratory system, and confusion.

Treatment and Rehabilitation

Fioricet is an addictive drug, and seeking treatment is more than important as it can save lives. The first step towards recovery is to admit struggling with prescription painkiller addiction and decide on a rehab. Some of the recovery options include inpatient rehabilitation facilities and outpatient treatment centers. Detox, psychological counseling, and aftercare are crucial for recovery.

Some of the Main Rehab Options Are:

  • Inpatient Rehabs. Inpatient rehabs offer constant medical monitoring. They also provide peer support, proper information, and medical assistance. One can choose between a rehab near, or if one thinks that emotional triggers will cause a relapse, a rehab far from home. Usually, the treatment lasts up to 28-30 days, 60 days, 90 days, or if needed – for more than three months.
  • Outpatient centers. Outpatient centers are also a great recovery option. They can be the next step after inpatient rehab, or addicts can go directly to an outpatient center. Outpatient facilities give more freedom to attend the program while continuing to perform some everyday tasks. There are also intensive programs that require more days and hours a week to keep addicts busy and away from the drug.
  • Luxury rehabs. Recently, luxury rehabs have become popular. They will make the stay more enjoyable as they include additional treatment, such as massages, excellent meals, and leisure activities. Not surprisingly, they are more expensive but check with the insurance company what part of the substance abuse treatment can be covered (loans are also an option).
  • CEO rehabs. CEO rehabs are another trend found among substance abuse recovery options. They are fantastic for working individuals, giving access to the Internet and meeting rooms. Many working people and celebrities choose this recovery option as that gives them the confidentiality they need regarding their drug addiction and the chance to keep being productive at the same time.
  • Therapy is one of the main factors for the successful treatment of drug addiction. Therapy and counseling explore the triggers behind the addiction and help individuals cope with cravings. Behavioral therapy gives some structure to one’s life, and by completing step-by-step goals, people often find it beneficial in their recovery journey.

Apart from professionally supervised weaning, patients receive different types of therapies depending on what most suits them. Support and psychosocial activities are provided to divert their attention from compulsive intake of the drug. Mental and psychological therapies are also available, where pain management is taught.

Most of all, patients have significantly lower risks of relapse. Recovering from addiction is a challenging path, but it is possible with the help of the right people and institutions.

Frequently Asked Questions

Is Fioricet Like Percocet?

No, the drug differs from Percocet in several ways. Although both medications are used to treat pain, there are several key differences between them. Fioricet is a combination of Butalbital, Acetaminophen, and caffeine used in the treatment of tension headaches. Percocets, on the other hand, refer to a combination of Acetaminophen and the opioid oxycodone used to treat moderate to severe pain.

Is Fioricet a Barbiturate?

Fioricet is an analgesic combination that contains three active chemical ingredients. One of them is the barbiturate Butalbital. Therefore, the medication can be referred to as a barbiturate-based drug or an analgesic-barbiturate combination used to treat tension headaches.

Is Fioricet a Controlled Substance?

Yes, the drug is classified as a schedule III controlled substance under the Controlled Substance Act. Drugs within this schedule have a lower risk of causing a substance abuse disorder than drugs classified under schedule I and II but still carry a higher risk than schedule IV and V medications.

Is Fioricet a Narcotic?

No, a narcotic is a term generally used to refer to a particular class of drugs known as opioids, CNS depressants that work via opioid receptors located in the brain. Fioricet does not contain any opioids, so it cannot be referred to as a narcotic.

Does Fioricet Make You Sleepy?

Yes, the medication may lead to an increased feeling of drowsiness. However, it is primarily due to the action of Butalbital, one of its active ingredients. Butalbital functions as a CNS depressant and may slow down brain function leading to drowsiness and even sedation.

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Page Sources

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Published on: October 28th, 2015

Updated on: July 5th, 2021

About Author

Isaak Stotts, LP

Isaak Stotts is an in-house medical writer in AddictionResource. Isaak learned addiction psychology at Aspen University and got a Master's Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.