Headaches are a common phenomenon doctors and researchers know surprisingly little about. We do know there are several different causes of headaches, and different types respond to different treatments, but there is still more to learn. Most people experience headaches every once and a while. But some people experience them often, which may lower their quality of life and get in the way of them from achieving certain goals. Some people experience particularly intense headaches that can be hard to bear. Butalbital is a drug that’s used to treat a particular type of headache called a tension headache.

Butalbital is used in several prescription medications, including Fioricet, which is primarily used to treat pain caused by headaches. But butalbital can also be misused and abused as a recreational substance. Plus, Fioricet also contains codeine, an opioid medication with addiction potential.

Butalbital addiction can be a serious disease that affects multiple areas of your life, including your health, relationships, and finances. However, butalbital addiction can be treated. Learn more about Fioricet abuse and your treatment options if you become addicted.

What Is Butalbital?

Butalbital is a substance that’s used to treat pain that specifically comes from muscle tension, especially tension headaches. It often comes in formulations that mix the drug with other pain relievers, including paracetamol, aspirin, codeine, and even caffeine. Fioricet is a brand name that contains butalbital, along with acetaminophen, caffeine, and codeine phosphate. This formulation is designed to treat tension headaches that are caused by muscle tension.

Butalbital is a central nervous system depressant, which means it’s in a class of drugs that work to slow down activity in the nervous system. Slowing down the nervous system can help to facilitate mental and physical relaxation. In this case, butalbital can help relax muscle tension, which can cause pain. The drug works by interacting with a chemical called gamma-Aminobutyric acid (GABA), which is a chemical messenger that binds to its receptors and slows down electrical firing in the nervous system. It’s a key chemical in rest and sleep. Barbiturates, like other depressants, increase the effectiveness of GABA, which slows down the nervous system even more.

Butalbital is also in a class of depressants called barbiturates, which were more commonly prescribed throughout the 20th century, before the advent of benzodiazepines. Barbiturates were introduced in the late 19th century and were commonly prescribed to treat anxiety and insomnia through to the 1960s. They were also used to treat seizures and as a sedative. However, barbiturates come with a risk of chemical dependence, addiction, and accidental overdose.

Benzodiazepines replaced barbiturates in many of their common uses, especially when it comes to anxiety relief and sleep aids. But barbiturates are still used to treat specific problems like seizures, convulsions, and muscle spasms, especially when other options aren’t effective.

How Does Butalbital Work?

Butalbital works in a way that’s very similar to other depressants, including alcohol and benzodiazepines. When you take butalbital, it’s absorbed into your bloodstream through digestion and then distributed throughout your body. Like alcohol, it binds to GABA receptors, but it does so on a different binding site than GABA would bind to, so it doesn’t block your natural brain chemical. Other drugs, like opioids, work by mimicking a naturally occurring chemical and fulfilling its role in the brain.

Instead, barbiturates work to potentiate GABA. They bind to the GABA receptor and make GABA more effective. Under normal circumstances, GABA opens a channel to a negative charge that slows down nervous system activity. Barbiturates keep that channel open for longer, making GABA more effective.

However, like alcohol, barbiturates can cause intoxicating effects and euphoric relaxation. For that reason, it has significant abuse potential. Butalbital is a federally controlled substance that’s classified as a Schedule III drug. That means it’s considered to have a moderate abuse potential and accepted medical uses. According to the Food and Drug Administration (FDA), the prolonged use of barbiturates can cause tolerance, dependence, and addiction.

Tolerance refers to the diminishing effects of the drug as your brain adapts to the medication. Dependence occurs when your brain chemistry is reliant on the drug to maintain balance. Addiction refers to a disease that affects the reward center of the brain, causing compulsions to use the drug that are hard to control.

What Are the Signs of Butalbital Addiction?

Addiction to a prescription drug usually occurs after a period of regular use. Barbiturates can sometimes cause dependence after just a few weeks of consistent use. High doses that are used for recreational purposes may increase your risk of dependence and addiction. The early stages of an addiction may be difficult to notice. Since it’s no one’s goal to become addicted to a drug, addiction usually begins slowly without you noticing. Denial is a common hallmark of a substance use disorder, and it may take time for you to see that you have a problem.

The first sign of a growing substance use problem is tolerance. Tolerance happens when your brain and body begin to get used to the drug. You may feel like butalbital isn’t as effective as it was when you first started taking it. Its therapeutic effects may be diminished, and you may feel like it is not as powerful as it once was as a recreational drug. When you notice a growing tolerance to a barbiturate, chemical dependency isn’t far behind.

Chemical dependence happens after your brain has adapted to the drug to the point that you’re relying on it to maintain balanced brain chemistry. When you stop using butalbital, you’ll start to experience uncomfortable withdrawal symptoms. Depressants are the most dangerous drug category when it comes to withdrawal. You’re likely to experience irritability, insomnia, and anxiety, but you may experience tremors and seizures. For that reason, it’s often necessary to seek help from a doctor before you quit abruptly.

Finally, addiction involves powerful cravings and compulsive behavior when it comes to finding and using butalbital. One of the telltale signs of addiction is continued use despite serious consequences. Other signs include:

  • Trying and failing to cut back or stop
  • Use that puts you in danger (very high doses)
  • Neglect of responsibilities
  • Loss of interest in regular activities
  • Needing larger doses over time
  • Spending more and more time using
  • Physical and mental problems caused by drug use
  • Relationship problems caused by drug use

What Is Involved in Butalbital Addiction Treatment?

Treating addiction to depression like butalbital will depend on your needs and condition. You may start treatment with a medical and clinical assessment. Addiction is intended to address medical, psychological, and social problems that are related to your substance use disorder.

Since butalbital withdrawal can be dangerous, you may begin treatment with a tapering process with a doctor’s help. In some cases, medical detox is necessary. Detox involves 24-hour medically managed care. If you continue to have high-level medical or psychological needs, you may go through an inpatient treatment program with round-the-clock care.

When you’re ready to live at home without significant risk to your health or sobriety, you may go through a partial hospitalization (PHP) or intensive outpatient program. These levels of care involve many hours of treatment services each week while you live at home.

How Dangerous Is Butalbital Addiction?

Barbiturates fell out of common use because of their potential danger. Unlike benzodiazepines, many barbiturates had a significant risk of deadly, accidental overdose even if the drug isn’t mixed with other substances. Butalbital is even more dangerous when the drug is mixed with other substances, especially opioids and other depressants like alcohol and benzodiazepines.

During an overdose, barbiturates can cause life-threatening symptoms, including respiratory depression, which is when your breathing slows down or stops completely. This can lead to brain damage, coma, or death.

Is Butalbital Withdrawal Dangerous?

When you’ve developed a chemical dependence on a psychoactive substance, quitting can cause you to experience uncomfortable withdrawal symptoms. The withdrawal symptoms you experience will depend on the type of drug you’re dependent on. Stimulants can cause fatigue and low mood, opioids can cause flu-like symptoms, and depressants can cause insomnia and irritability. As a central nervous depressant, butalbital can cause some of the most dangerous withdrawal symptoms, especially if you quit cold turkey.

As your body gets used to butalbital, it adapts to its consistent presence in your system. Butalbital slows down activity in your central nervous system. As it adapts, your brain may compensate by producing more stimulating chemicals or reducing the number of GABA receptors.

When you stop taking butalbital, your brain chemistry will no longer have the nervous system depressing force of the drug in your system, and the excitatory functions of your brain will cause overexcitement in your nervous system. That can cause serious symptoms like agitation, anxiety, nausea, vomiting, sleep problems, tremors, shaky hands, hallucinations, high fevers, sweating, and seizures. In some cases, hypertension and an increased heart rate can lead to heart failure and other life-threatening symptoms.

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