Butalbital is a sedative drug in the barbiturate family that is sometimes prescribed in combination with other medications such as acetaminophen, aspirin, and codeine for the treatment of tension headaches, migraines, and other pain-management needs.1
Butalbital has the potential to be addictive, particularly if you take it over an extended period. After continual use, severe withdrawal symptoms can occur if you try to take less of the drug or quit taking it altogether.1 The discomfort of these symptoms often makes it difficult to stop taking butalbital without help, so it’s important to know how to find the treatment you need to effectively quit.
What Are the Dangers of Abuse?
Repeated butalbital use can lead to significant physical and psychological dependence. This risk is further amplified by the other drugs it might be combined with, such as codeine, a drug that also has a high potential for misuse, abuse, and addiction. Even when taken as prescribed, over time butalbital may lead to the development of significant physical barbiturate dependence, making it very important to understand the potential dangers associated with it.2
Like all barbiturates, butalbital carries a risk for overdose, especially when mixed with other respiratory depressing drugs and/or alcohol. Butalbital poisoning can cause:2
- Nausea and vomiting.
- Severe respiratory depression or arrest.
Common Signs of Addiction
If you misuse a prescription or otherwise abuse butalbital, you may be at risk for developing what’s known as a substance use disorder (SUD). Some of the criteria for an SUD specifically involving butalbital use include:3
- Taking more substantial amounts of the drug than prescribed.
- Taking it longer than indicated.
- Having a strong desire to stop taking butalbital but having been unsuccessful in doing so.
- Spending a lot of time engaged in activities to obtain or take the drug.
- Continuing to use butalbital in spite of severe health, legal, or occupational problems related to butalbital—for example, having an accident at work after using it and being unable to stop taking the medication in spite of losing your job as a result of your drug abuse.
- Giving up activities that you used to enjoy so you can use the drug.
Tolerance & Withdrawal
Two additional signs that serve as criteria for the diagnosis of a substance use disorder are the development of tolerance to the drug and the onset of withdrawal symptoms when you try to quit.
Tolerance develops as your body reacts less to the presence of a medication, so it needs more of it to get the same effects it once did with smaller amounts.2 Withdrawal is a sign that your body has adapted to the frequent presence of a substance and has grown physically dependent to it. If, after developing significant levels of physical dependence, you lower your typical dose of butalbital or stop using it altogether, you may experience withdrawal symptoms. When present, withdrawal symptoms usually arise within 16 hours of your last dose. They can last as long as 15 days from the time you stopped taking it, provided you don’t start using it again in that time. There is a distinct risk of life-threatening seizures associated with acute barbiturate withdrawal. Additionally, several other withdrawal symptoms may emerge, ranging from unpleasant to severe, including:2,3
- Hand tremors.
If you are concerned that you might be at risk for severe butalbital withdrawal, you should meet with a doctor or other addiction treatment professional to discuss the best course of detox and treatment.
Methods of Detoxification and Treatment Options
Detox and long-term treatment can help you or loved one overcome a butalbital addiction. Some of the most common types of treatment for butalbital addiction and withdrawal management include:
- Detox: Medical detoxification is the first step in treatment if you have a butalbital addiction. As part of a medical detox program, medications and other medical interventions can be used to reduce the discomfort and potentially dangerous complications associated with common withdrawal symptoms, such as agitation and seizures.4 However, detox by itself is not sufficient for sustained recovery.4 Because butalbital addiction is a chronic condition with diverse contributing factors, longer-term treatments are needed after detox is complete.
- Residential treatment. This is a relatively long-term care option that takes place in an inpatient setting; treatment duration may last anywhere from 30 days to 6 months or longer, as needed. Inpatient and residential treatment programs are structured and intensive, with comprehensive therapeutic approaches that focus on examining the underlying mental health and environmental conditions that support your substance use.5
- Outpatient treatment. This type of treatment is a good option for someone who has a full-time job or school schedule and needs to continue living at home while getting help for their addiction. For outpatient treatment to be most effective, the person should have a secure support network and not be at risk of severe withdrawal. A typical program may consist of a variety of interventions to help a person get and maintain sobriety.5
Types of Interventions
There are a variety of therapeutic interventions that can help you learn to stop using and stay clean, all of which can take place in both residential or outpatient treatment settings:6
- One-on-one counseling. Also known as individual counseling, this technique focuses on helping you stop abusing substances, develop the skills needed to cope with cravings and other issues, and successfully stick to your recovery plan.6
- Cognitive behavioral therapy. This treatment teaches people with an addiction to recognize and stop the negative patterns of thinking that might lead to a relapse.6
- Motivational enhancement therapy. This intervention helps people identify their personal motivations for participating in treatment and overcoming the addiction and uses them to strengthen their commitment to sobriety.6
- Family and group therapy. This involves the participation of family members or a group of peers and is often used in conjunction with other interventions.6
- 12-step groups. Narcotics Anonymous (NA) is an example of a 12-step program that may benefit people with butalbital addiction by providing support and encouragement for continued recovery efforts.6
If you are addicted to butalbital, these treatments and interventions can help you manage your addiction and reduce the likelihood of a relapse.
- Pubchem Open Chemistry Database. (2018). Butalbital.
- Food and Drug Administration. (2011). Label: Fioricet® with Codeine C-III (Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate) Capsules.
- American Psychiatric Association. (2013). Diagnostic And Statistical Manual Of Mental Disorders (5th Ed.). Arlington, VA: American Psychiatric Association Publishing.
- National Institute on Drug Abuse. (2018). Understanding Drug Abuse and Addiction: What Science Says.
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
- Substance Abuse and Mental Health Services Administration. (2016). Treatments For Substance Use Disorders.