Butalbital Abuse and Dependence

Barbiturates may be habit-forming: Tolerance, psychological dependence, and physical dependence may occur especially following prolonged use of high doses of barbiturates. The average daily dose for the barbiturate addict is usually about 1500 mg.

As tolerance to barbiturates develops, the amount needed to maintain the same level of intoxication increases; tolerance to a fatal dosage, however, does not increase more than two-fold. As this occurs, the margin between an intoxication dosage and fatal dosage becomes smaller.

The lethal dose of a barbiturate is far less if alcohol is also ingested. Major withdrawal symptoms (convulsions and delirium) may occur within 16 hours and last up to 5 days after abrupt cessation of these drugs.

Intensity of withdrawal symptoms gradually declines over a period of approximately 15 days. Treatment of barbiturate dependence consists of cautious and gradual withdrawal of the drug.

Barbiturate-dependent patients can be withdrawn by using a number of different withdrawal regimens. One method involves initiating treatment at the patient’s regular dosage level and gradually decreasing the daily dosage as tolerated by the patient.

Butalbital is a barbiturate medication. Barbiturates work by binding to gamma-Aminobutyric acid (GABA) receptors in brain cells. GABA is a chemical signal sent between brain cells that slows down other chemical signals. Other drugs can increase GABA, including benzodiazepines, alcohol, and gabapentin.

Barbiturates used to be prescribed to control seizures before safer medication became available. Barbiturates cause high levels of sedation and can be addictive if abused.

What Is Fioricet?

Fioricet is the brand name for a combination medication that contains acetaminophen, butalbital, and caffeine.

Butalbital chemical structure is similar to other barbiturates and it has similar effects. Butalbital alone is a Schedule III controlled medication as classified by the Drug Enforcement Administration (DEA). Schedule III medications have the potential for abuse. Fioricet, however, is not scheduled federally and falls under exemption rules by the DEA.

Fioricet contains enough acetaminophen that it is not considered to have high abuse potential. Despite this limitation, some states still classify it as a scheduled medication. Fioricet is a scheduled medication in:

  • Georgia
  • Illinois
  • Maryland
  • New Mexico
  • Rhode Island
  • Utah
  • West Virginia

Fioricet Street Names and Brand Names

The Fioricet generic name is acetaminophen/butalbital/caffeine. Fioricet does not have many known street names if any at all. However, butalbital goes by a few street names:

  • Barbs
  • Blockbusters
  • Christmas trees
  • Downers
  • Pinks
  • Red Devils
  • Yellow jackets

Different brand names for butalbital, acetaminophen, and caffeine include:

  • Capacet (discontinued)
  • Esgic
  • Fioricet
  • Margesic (discontinued)
  • Phrenilin Forte
  • Zebutal

What Is Fioricet Used For?

Fioricet is used for tension headaches. A tension headache is mild to moderate pain in the head that can be located in the front, back or the sides. People describe having a tension headache as feeling like they have a tight band around their head.

Tension headaches are the most common types of headaches, but Fioricet is not commonly prescribed for them because there are safer options to use.

Tension headaches can last for minutes, or they can last for days. Some people experience more than 15 days of headaches in a month. When that many headaches are experienced it’s identified as a chronic tension headache.

Each of the ingredients in Fioricet works to help with the managing headaches:

  1. Acetaminophen: Stops the production of a chemical in cells called prostaglandin. Prostaglandin tells brain cells to fire pain signals. Blocking prostaglandin stops or lowers the experience of pain.
  2. Butalbital: Attaches to GABA receptors in brain cell membranes. Butalbital increases levels of GABA in the brain, which slow down pain signals. The ingredient causes drowsiness and sleepiness.
  3. Caffeine: A stimulant for the central nervous system (CNS). When blood pressure is too low in the brain, blood vessels expand and push on adjacent brain cell tissue. Caffeine causes vessels to tighten, or constrict, which helps decrease pain from headaches.

How Addictive Is Fioricet?

Is Fioricet addictive? It could be, but it’s likely not very addictive in the Fioricet combination pill form.

Butalbital — one of the ingredients in Fioricet — is combined with other medications to reduce its abuse potential. The DEA classifies butalbital as a Schedule III substance, so it has the potential to be abused when it’s on its own. Fioricet has a low potential for abuse but is not commonly prescribed.

Fioricet Addiction Statistics

Barbiturate abuse peaked in the 1960s and 1970s but has drastically declined since then. Benzodiazepines have mostly replaced barbiturates.

Most organizations in the United States, including the DEA, do not track barbiturate abuse statistics because barbiturate abuse is uncommon. Barbiturates are included with other prescription drugs for monitoring purposes. Prescription drugs are the second-highest abused category of drugs after marijuana.

Key Points: Fioricet Addiction

Keep the following key points in mind regarding Fioricet Addiction:

  • Fioricet contains acetaminophen, butalbital, and caffeine
  • Fioricet is used to treat tension headaches
  • Butalbital is a barbiturate medication that has the potential for abuse
  • When butalbital is combined with acetaminophen, like in Fioricet, it is not considered an abusable drug
  • Barbiturate abuse is not common in the United States