Fioricet Abuse and Addiction

Written by Theresa Valenzky

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

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Last Updated - 10/25/2022

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Updated 10/25/2022

Fioricet can be a helpful drug for some people. However, as a Schedule III controlled substance, it carries a high risk of abuse, dependence, addiction and overdose. If you or a loved one use Fioricet, it is important to know how to take the drug safely and minimize its risks.

What Is Fioricet?

Fioricet is the brand name for a combination medication containing acetaminophen, butalbital and caffeine. The three drugs, when used together, can sometimes be effective in treating certain types of pain:

  • Butalbital is a central nervous system depressant. 
  • Acetaminophen is an analgesic.
  • Caffeine helps shrink blood vessels, which may help some headaches.

The combination agent is available under the brand names Fioricet, Bac, Esgic, Vtol LQ and Zebutal, and the generic name butalbital. Fioricet with codeine is also available.

Fioricet has been steadily falling out of favor for years due to the availability of safer headache treatments. Fewer than 700,000 Americans received a prescription for Fioricet in 2019.

What Is Fioricet Used For?

Fioricet has historically been prescribed to treat migraines and other severe headaches. However, the drug has become steadily less popular over the past few years and is no longer mentioned as a treatment in newer headache treatment guidelines for doctors. Instead, more recent and safer medicines like triptans and calcitonin gene-related peptide (CGRP) inhibitors are prescribed more frequently, as they are safer and more effective than Fioricet.

Fioricet Addiction and Abuse

Fioricet is a sedative and a controlled substance. Like other controlled substances, a Fioricet addiction can develop, especially if the person takes more of the drug than prescribed or uses it more often than prescribed. The U.S. government combines barbiturates in the same class as other sedatives and found about 2.2% of Americans misused this type of drug as of 2020.

When a person feels the intense pain of migraines, they may do whatever it takes to alleviate it, including taking more Fioricet than prescribed.

To make matters worse, some people who use Fioricet illicitly combine it with other types of drugs to magnify the effects. Not only can this behavior solidify an addiction, but it can also be incredibly dangerous.

Fioricet High

Barbiturates like Fioricet can produce a high that is similar to the effects of alcohol. As a central nervous depressant, the butalbital in Fioricet enhances the activity of the neurotransmitter GABA in the brain, which slows down brain activity. This produces symptoms of a high, including drowsiness and disinhibition.

Signs of Fioricet Addiction

There are several symptoms and signs of an addiction to Fioricet, including the following:

  • Taking higher doses to achieve the same effects
  • “Doctor shopping” or “pharmacy shopping” to get Fioricet prescriptions
  • Feeling hopeless without access to the drug
  • Being obsessed with obtaining and taking Fioricet
  • Being unable to function without Fioricet
  • Borrowing or stealing other people’s Fioricet

When the effects of regular doses of Fioricet are not achieved, patients may take higher doses, which can lead to addiction.

Side Effects of Fioricet

Fioricet has many side effects that limit its use. Some of the most common side effects of the drug include:

  • Drowsiness
  • Lightheadedness or dizziness
  • Shortness of breath
  • Nausea or vomiting
  • Abdominal pain
  • Feeling intoxicated 

Long-term Side Effects of Fioricet Addiction

Fioricet use can have many long-term side effects, including a continued risk of abuse, dependence, addiction and overdose. As a Schedule III controlled substance, Fioricet use does not get safer the longer you use it. Instead, your risk for addiction continues as long as you stay on the drug.

Taking Fioricet over the long term can also have negative consequences for the headaches the medication is sometimes prescribed to treat. Medication-overuse headaches are strongly linked to barbiturates like Fioricet, and people who take the drug to treat their headaches have a twofold increased risk of medication-overuse headaches.

Fioricet Interactions

As a central nervous system depressant and psychoactive drug, Fioricet has many drug interactions. These include:

  • Monoamine oxidase (MAO) inhibitors
  • Opioids and other depressant pain relievers
  • Other tranquilizers, including sedatives and benzodiazepines

Unless otherwise instructed by your doctor, you should avoid taking Fioricet with other central nervous system depressants and tranquilizers. You should also avoid drinking alcohol while on the medication.

Fioricet and Alcohol

You should avoid alcohol while taking Fioricet. Both substances are central nervous system depressants, and combining them may increase the risk of overdose or death. Butalbital, the main barbiturate ingredient in Fioricet, stays in the blood for a very long time, and half of a drug dose will remain in your body 35 hours after taking it. For this reason, you should avoid drinking for several days after a Fioricet dose to be safe.

Withdrawal From Fioricet

Withdrawal symptoms can occur when you take a barbiturate like Fioricet over the long term and suddenly stop. These can be unpleasant and dangerous and typically start two to four days after the last barbiturate dose. Withdrawal symptoms include:

  • Anxiety
  • Restlessness
  • Trouble sleeping
  • Tremor
  • Dizziness
  • Seizures
  • Psychosis

Fioricet Overdose Risk

Fioricet has a high overdose risk, especially when combined with other substances. Barbiturate overdose deaths were very common in the 1970s, which is a significant factor in why barbiturates like Fioricet are prescribed less often today. Stars like Marilyn Monroe and Judy Garland lost their lives due to barbiturate overdoses.

If you suspect someone is overdosing on Fioricet, you should call 911 immediately. The symptoms of a Fioricet overdose include extreme sleepiness and slowed breathing, which can be fatal.

Find Help for Fioricet Addiction in Ohio

It may be possible for some people who are addicted to Fioricet to stop taking the drug for good without any outside intervention. However, the majority of individuals require medical treatment to achieve long-term sobriety. The chances of better managing the addiction are much higher when you enter a rehab center experienced in dealing with Fioricet addiction.

Going through medical detox under supervision is much safer than attempting to detox alone. After detox, treatment can immediately begin to help you make the necessary changes and behavioral modifications to achieve and maintain sobriety. Having professionals supervise the addiction treatment can ensure you are properly assessed and guided through the appropriate type of treatment.

View Sources

Drug Enforcement Administration. “Controlled Substances.” August 2, 2022. Accessed August 20, 2022.

ClinCalc. “Butalbital; Acetaminophen; Caffeine.” Accessed August 20, 2022.

American Headache Society. “The American Headache Society Position S[…]to Clinical Practice.” Journal of Head and Face Pain, December 10, 2018. Accessed August 20, 2022.

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health I[…] Drug Use and Health.” October 2021. Accessed August 20, 2022. “Barbiturates.” February 5, 2019. Accessed August 20, 2022.

Fischer, Michelle A.; Jan, Arif. “Medication-overuse Headache.” StatPearls, July 4, 2022. Accessed August 20, 2022. “Fioricet.” March 22, 2022. Accessed August 20, 2022.

Sarrecchia, C.; Sordillo, P.; Conte, G.; Rocchi, G. “Barbiturate withdrawal syndrome: a case […] headache medication.” Annali italiani di medicina interna : organo ufficiale della Societa italiana di medicina interna, 1988. Accessed August 20, 2022.


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