can fioricet get you high?

Although the usage of Fioricet for migraines is not supported by the FDA nor scientific literature, medical professionals may, nonetheless, prescribe it for this condition.  A subset of those who take it may experience a mild analgesia, psychomotor slowing, and a sense of physiological tranquility.  This sensory experience is facilitated principally by action of butalbital, the barbiturate component of Fioricet, on GABAergic systems to suppress CNS activity.

While the caffeine (40 mg) component of Fioricet attenuates some of the CNS depression induced by butalbital (50 mg), it doesn’t fully override it.  For this reason, individuals who abuse, misuse, and/or overuse Fioricet may experience a neurophysiological “high.”  Upon experiencing this mildly pleasurable intoxication [characterized by pain relief and relaxation], users may be more likely to abuse Fioricet in the future.

The FDA initially approved Fioricet in 1984, which at the time, was manufactured by Novartis Pharmaceuticals.  In 2003, manufacturing rights were purchased by Watson Pharmaceuticals and by 2012, Watson acquired the pharmaceutical company Actavis and opted to switch their company name to Actavis Inc.  When Fioricet initially hit the market in the 1980s, the original formulation included 50 mg butalbital, 325 mg acetaminophen, and 40 mg caffeine.

In 2011, the FDA issued a mandate that all combination pharmaceutical products limit acetaminophen constituents to a dosage threshold of 325 mg or below by 2014; this was primarily to reduce likelihood of acetaminophen-induced hepatotoxicity.  To be on the safe side, Fioricet manufacturers reduced acetaminophen contents to 300 mg per dose.  Hence, the new formulation consists of the same 50 mg butalbital and 40 mg caffeine, but slightly less acetaminophen (300 mg) compared to the old formulation (325 mg).

That said, of the constituents within Fioricet, the “high” that some users experience isn’t associated with acetaminophen or caffeine.  The intoxication is derived principally from the 50 mg butalbital, a short-to-intermediate acting barbiturate.  Butalbital is understood to alleviate anxiety, relax muscles, reduce pain, and induce sedation.

The array of neurophysiological effects associated with butalbital remain somewhat unclear due to the fact that it is only manufactured as a component within combination products.  Researchers believe butalbital upregulates the inhibitory neurotransmission of GABA (gamma-aminobutyric acid) by binding to receptor sites within an area known as the chloride receptor ionopore complex.  The chloride receptor ionopore complex is a distinct area from that implicated in the binding of benzodiazepine agents.

Upon binding of butalbital to receptor sites within chloride ionopore complex, chloride channels remain open for a longer duration, allowing for a heightened influx of chloride ions.  The chloride influx causes neurons to become hyperpolarized, which dampens receptivity to excitatory postsynaptic stimulation.  This, in turn, depresses activity within the CNS – likely in a dose dependent manner and leads to a recreational buzz and/or high.

The characteristics of Fioricet intoxication are similar to those associated with other CNS depressants.  Scientific publications indicate that, upon comparison, features of intoxication from butalbital are nearly identical to those of alcohol.  Those who abuse Fioricet and/or ingest abnormally high doses to experience a “high” will likely report a mix of the characteristics below.

The extent to which a person feels “high” following the usage of Fioricet is contingent upon numerous factors including: the dosage ingested, specific formulation, CYP450 isoenzymes, and ingestion of other substances.  Additionally, whether a user have developed tolerance to butalbital can also predict whether a “high” is likely to be attained.  The synergism of these factors will determine the extent to which someone is intoxicated while using Fioricet, particularly the butalbital within it.

The standard dosage of Fioricet for the treatment of headaches is 1 to 2 tablets every 4 hours.  Instructions indicate that patients should not exceed more than 6 tablets per day.  Those who take Fioricet recreationally with the intent of attaining some sort of “high” tend to exceed the recommended dosage guidelines, sometimes by a longshot.

The extent to which these dosage guidelines are exceeded will dictate the degree of the psychological and/or physical high attained by the user.  A slight increase in dosing from the medically recommended amount may lead to a mild or moderate high.  On the other hand, those that ingest a substantially greater amount than recommended by professionals may experience a very potent intoxication.

Tolerance is an important factor to consider whenever contemplating how high someone is likely to get from Fioricet.  An individual that’s been using Fioricet frequently over a long-term may take a seemingly large dose, yet as a result of their chronic usage, no “high” is experienced.  Conversely, a person who’s never ingested Fioricet, and starts with a large dose, is surely to experience some sort of intoxication that may be classified as a “high.”

Individuals that have accrued a high tolerance to Fioricet will necessitate a dangerously large dose to attain any sort of pleasurable intoxication.  Those without a tolerance who take slightly more than the normally prescribed dose (e.g. 4 pills instead of 2) are likely to experience some sort of high.

Though most people are prescribed the standardized Fioricet (50 mg butalbital, 300 mg acetaminophen, 40 mg caffeine), there is another less common format that adds 30 mg codeine to the mix.  Those that are using the opioidergic version of Fioricet with codeine are surely more likely to attain a “high” than those ingesting the standardized version.  The GABAergic effects of butalbital are likely to act synergistically with the opioidergic effects of codeine for a more potent intoxication.

Barbiturates (e.g. butalbital) and opioids (e.g. codeine) are seldom recommended to be ingested together.  Taking slightly too much of each could lead to respiratory depression, hepatotoxicity, and/or death.  Those taking Fioricet with codeine will require a much lower dose than the formulation devoid of opioids to experience a “high.”

Assuming individuals administer Fioricet orally, the 50 mg butalbital within each tablet is metabolized by CYP450 (cytochrome P450) isoenzymes in the liver.  The metabolism of butalbital is mediated principally by the CYP3A4 isoenzyme, as well as CYP2D6 and CYP2C9.  Since a subset of Fioricet users may have genetic polymorphisms affecting expression of these enzymes, some may experience a more significant “high” compared to others.

Particularly, an ultrarapid metabolizer of CYP2D6 may increase likelihood of a high from a lower dose of Fioricet due to the fact that some of the butalbital is metabolized at a faster rate.  Quicker metabolism leads to a sudden delivery of some butalbital (or metabolites) to the CNS, thereby enhancing its effect.  Since most polymorphisms of CYP3A4 slow the metabolism of butalbital, those with CYP3A4 polymorphisms may experience no significant high from an increased dose.

Contrarily, a person with normal CYP3A4 function and simultaneous rapid CYP2D6 and/or CYP2C9 metabolism may report a high from a lower dose due to the quicker sudden circulation of the butalbital.  Someone taking the Fioricet version with codeine (30 mg) will need to be especially cognizant of their CYP450 isoenzyme statuses.  A rapid CYP2D6 metabolizer who takes even slightly more Fioricet (with codeine) than medically intended may experience a high and possibly serious consequences.

In attempt to enhance the high associated with Fioricet, some individuals administer additional drugs and/or supplements.  Perhaps inadvertently or unknowingly, a small percentage of those taking Fioricet may engage in the occasional drinking of alcohol during treatment.  Alcohol alters the neurotransmission of GABA similarly to butalbital, in fact, some studies suggest that butalbital intoxication is nearly indistinguishable from alcohol intoxication.

When Fioricet is combined with alcohol, the synergistic CNS depressant effect from butalbital plus alcohol will be significant.  This will leave an individual feeling intoxicated even if a normal dose of Fioricet is ingested.  Keep in mind that alcohol is just one substance that potentiates the “high” associated with Fioricet, arguably to a dangerous extent.

Nearly any CNS depressant administered along with Fioricet (regardless of its potency) should be regarded as a potentiator of the “high” to be attained.  Oppositely, those who ingest any sort of stimulatory agent would be less likely to experience a high from Fioricet.  Stimulatory agents will cancel out the GABAergic intoxication induced by butalbital.

In addition to pharmacodynamic interactions, users should consider that pharmacokinetic interactions may alter the intoxication associated with butalbital.  A seemingly benign agent like capsaicin acts as a CYP3A4 inducer, meaning it enhances CYP3A4-mediated metabolism, possibly enough to promote faster breakdown of butalbital.  This faster breakdown could (theoretically) facilitate a more potent high from a lower dose.

Note: The aforestated factors that influence a user’s degree of intoxication while taking Fioricet will be contingent upon modality of administration.  This article was written under the assumption that most abuse occurs via oral ingestion.  A subset of abusers may administer Fioricet intranasally (such as by snorting) which may affect their high.

It is necessary to highlight that some individuals have gone as far as to extract butalbital contents from Fioricet in attempt to eliminate caffeine and acetaminophen.  Their impetus for caffeine and acetaminophen elimination is two-fold: caffeine offsets CNS depressant effects of butalbital and acetaminophen is capable of damaging the liver.  Isolation of butalbital delivers a more potent sense of intoxication and reduces risk of hepatotoxicity.

Anecdotal accounts discuss extraction techniques online in various forums throughout the internet.  Whether these extraction techniques are effective is debatable and is likely contingent upon the competency of the person performing the extraction.  All extraction methods involve tampering with the Fioricet tablets and are regarded as illegal.

Those using Fioricet to attain their high are usually not concerned with legality.  They report crushing tablets to form a fine powder, dissolving the powder in water, shaking it, filtering out the APAP and caffeine, and adding to hydrochloric acid.  Many claim that their techniques yield 100% pure butalbital, which if the case, would facilitate a potent neurophysiological high.

Fioricet is utilized recreationally for a number of obvious reasons including: its easiness to obtain, its lack of legal restriction, and relatively low cost (as a generic).  All that’s required is the diagnosis of a tension headache and you may end up with a Fioricet prescription.  Among drug addicts and/or thrill seekers, there’s likely significant temptation to misuse and/or abuse Fioricet on a recreational basis.

There are numerous dangers associated with using Fioricet to experience a neurophysiological “high.”  When used recreationally for intoxication, users are often unaware of a threshold dosing limit for safety.  This upper threshold of dosing is individualized based on other medications a person is taking, his/her isoenzyme function, and body size.

Without knowledge of this upper dosing limit, it is possible that an array of deleterious effects may occur such as: hepatotoxicity, fainting, and possibly death (via respiratory arrest).  For this reason, utilizing Fioricet to get “high” should be considered unsafe and a recipe for potential long-term damages.  Though not everyone abusing Fioricet ends up in the hospital with liver damage and/or respiratory depression – these are possible consequences.

It’s relatively common sense to determine how Fioricet is obtained and used recreationally.  Those that are able to attain a prescription for Fioricet as a treatment for headaches may decide to administer a dosage exceeding the amount recommended by a professional.  Following administration of a large dose, the person will notice a significant change in various aspects of consciousness including cognition, emotion, and perception.

There are two primary ways by which Fioricet is attained for recreational use and/or intoxication.  The first involves consulting a doctor and reporting a tension, post-dural puncture, and/or muscle contraction headache.  Though some doctors will hesitate to prescribe Fioricet, some will dole it out as a first-line intervention.

While most who attain a prescription for Fioricet have legitimate headaches, it could be speculated that a subset of individuals may report headaches simply to obtain the prescription for abuse.  Another subset of individuals may purchase Fioricet illicitly on the internet (e.g. dark net), from a street dealer, friends, and/or family.  In 46 out of 50 states within the U.S., Fioricet is considered a general prescription, whereas in 4 states, it is tightly restricted as a Schedule III substance.

While certainly against medical guidelines, many users report taking 5-6 Fioricet tablets at once to experience the intoxication.  Hypothetically, if a person were to take 6 Fioricet tablets, this would deliver a total of 300 mg butalbital, 1800 mg acetaminophen, and 240 mg caffeine.  This places a serious burden on the liver, especially among those with various forms of hepatic impairment (e.g. cirrhosis).

Compared to a normative dose of 1 to 2 tablets per hour, this triples the amount circulating throughout a person’s system.  These tablets are most commonly ingested orally, but some accounts have documented intranasal insufflation (snorting).  The modality by which Fioricet is ingested can have an impact on degree of intoxication experienced, as well as its duration.

The onset of the Fioricet’s intoxicating effect is considered rapid and is thought to last approximately 4 hours.  The duration of effect may be subject to slight variation depending on specific CYP450 polymorphisms of the particular user.  Some individuals may report a slightly faster peak effect with a shorter total duration of intoxication, while others may report a slightly slower peak effect with a longer-lasting duration.

While intoxicated, individuals will experience psychomotor slowing, physical relaxation, and CNS depression.  The high may be subject to slight variation based on the specific amount of Fioricet ingested.  Some have compared the intoxicating effect of Fioricet to that of alcohol, other benzodiazepines, and select opioids.  Others claim that the intoxication derived from Fioricet is unpleasant and markedly distinct from other CNS depressants.

Those addicted to the intoxication provided by Fioricet may readminister the drug in moderate doses every 4 hours for a maintenance effect.  The purpose of this readministration is to delay the comedown or “crash” experienced after the neurophysiological intoxication subsides.  The timing at which a second dose is administered, as well as the dosage of Fioricet readministered will determine whether the “high” is maintained.

Since most individuals have a limited supply of Fioricet, not all abusers engage in readministration.  However, those looking to remain intoxicated for an entire day may continuously readminister the drug.  The “high” cannot be maintained forever, but some individuals may stay intoxicated until their normal sleep time, allowing them to sleep through part of the inevitable crash.

Unmistakably, Fioricet abusers will experience some sort of “crash” starting immediately after the drug’s effect wears off.  This crash is considered acute, unwanted effects characterized by cognitive deficits, fatigue, and somnolence.  The crash may last several hours or continue for days after a large Fioricet dose.

If someone had been using Fioricet for a long duration, this “crash” may be among the earliest stages of Fioricet withdrawal.  Most individuals will experience unpleasant symptoms that are the exact opposite of the intoxication provided by the drug including: anxiety, depression, mood swings, muscle tension, etc.  Should an individual continue taking Fioricet to avoid discontinuation symptoms, an individual may be considered dependent on the drug for functioning.

In effort to minimize the likelihood that Fioricet is abused and/or misused, I’ve listed some strategies to be employed.  To reduce Fioricet abuse, the most logical intervention is to decrease its total number of prescriptions by considering alternative, less risky first-line options for headaches.  Other treatment strategies include: minimizing off-label prescriptions, determining high risk patients (addiction history or thrill seekers), limiting pill numbers, and/or changing its status to a Schedule III controlled-substance.

If you’ve managed to obtain Fioricet and have ingested a large dose with the intention of experiencing a high and/or buzz, share your experience in the comments section below. To help others get a better understanding of your experience, mention some specifics including: the dosage you took at once (e.g. 6 Fioricet), whether you were taking any other substances along with it (e.g. drugs, supplements, etc.), and how long the effect lasted.  Would you classify your subjective experience as: pleasurable, neutral, unwanted, or negative?

Document whether you attained your Fioricet from a medical doctor, online purchase, a friend/family, and/or street purchase.  For those that have experience using CNS depressants for a “high,” which agents remind you most of Fioricet (e.g. alcohol, benzodiazepines, opioids, etc.)?  Literature suggests that the intoxicating effects of butalbital, the barbiturate component of Fioricet, are most similar to those of alcohol.

Migraine has affected 39 million people in the United States and a billion worldwide. The Migraine Research Foundation says it is the third most prevalent illness in the world where nearly one in four households in the US have at least one family member who suffers from a migraine.

With a number of prescription drugs commonly misused these days, it is not surprising if some people are more conscious in taking prescription drugs. So, is it possible that a person can get addicted to a migraine medicine like Fioricet?

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Fioricet is a tablet which contains three active ingredients, including 325 mg acetaminophen, 50 mg butalbital, and 40 mg caffeine. The drug was approved by the Food and Drug Administration in 1984. But the FDA in 2011 advised drug manufacturers to limit acetaminophen to not more than 325 mg to prevent consumers from developing severe liver damage that was associated with too much acetaminophen.

Acetaminophen acts as a pain reliever and helps in reducing the patient’s fever. Butalbital, on the other hand, relaxes muscle contractions that develop in a tension headache. Similar to butalbital, caffeine, a widely used psychoactive drug, also helps patients to relax muscle contractions and improve blood flow.

The patients who used Fioricet reported varying effects. Some patients reportedly find it effective in managing migraine. A 50-year-old patient said she didn’t find any side effects whenever she used the drug at the onset of her migraine. She said the medicine works after about 20 minutes of taking Fioricet. However, a 34-year-old patient found it “considerably effective” and noted some moderate side effects after taking the drug. The patient took one to two tablets of Fioricet every four hours for the six months. She said each time she takes more than one pill since she finds the first dose ineffective in improving migraine, she will feel very dizzy and will be incapacitated until the effect has worn off. Some patients also reported having the feeling of agitation, insomnia, withdrawal syndrome and hallucination after taking Fioricet.

Among the ingredients of Fioricet, butalbital is the most common and it is potential for abuse. Butalbital is an intermediate-acting barbiturate, which can cause physical and psychological dependence.

In an article published in the Journal of Forensic Science in 2013, butalbital is said to have a central nervous system (CNS) depressant properties, like sedation and the feeling of intoxication. This is the reason why it contributes to driving impairment. Its effect is similar to CNS depressant intoxication which affects the person’s motor coordination. CNS drugs like tranquilizers, sedatives, and hypnotics are among the three classes of medications that are commonly misused.

How does it function? Butalbital mimics the inhibitory effects of the gamma-aminobutyric acid (GABA) which is a neurotransmitter. It binds to GABA receptors which facilitate the effect of feeling relaxed, sedated, and/or drowsy. A research in 2013 said the effects of butalbital on the body make it a controversial drug.

Aside from butalbital, caffeine can also form a dependency on the drug. Caffeine is needed in Fioricet because it can help improve the constriction of the cerebral blood vessels. It also counteracts the sedating effect of butalbital. But caffeine should only be used in low dosage. The World Health Organization even recognizes caffeine dependence as a clinical disorder.

Whether it should be continued to be prescribed to patients in the United States due to its potential for abuse remains a question but clearly, like most drugs, Fioricet should not be used on a daily basis. Even when you are sure that taking Fioricet will help you treat your tension headache, it is better to know the side effects of taking Fioricet to be more aware of its negative effects on the body.

Here are some of them:

Fioricet, like other drugs that have butalbital and drugs containing opioids, is found to make headaches worse, according to the American Board of Internal Medicine. Its side effects also include withdrawal symptoms when a patient stops using it suddenly. Even the ABIM would suggest that a patient with a migraine should find better drugs as these kinds of medications have risks.

Fioricet is a Combination Medication for chronic tension headaches. A tension headache causes moderate pain in the front, sides, or back of the head. Tension headaches are common, and most people experience them occasionally. However, when people suffer from more than ten or fifteen headaches every month, a health care provider may write a prescription for Fioricet. Doctors sometimes also prescribe Fioricet for migraines, which are headaches that cause severe pain in one side of the head along with hyper-sensitivity to light and sound.

A Combination Medication is a drug which includes two or more pharmaceutical ingredients in a fixed dose. There are three ingredients in standard Fioricet: Acetaminophen, Butalbital, and Caffeine. All three ingredients have different effects which combine to soothe headaches.

With these three ingredients at work, Fioricet can be an effective source of headache relief. However, the medication also poses risks for side effects, overdose, and addiction. For this reason, doctors usually refrain from prescribing Fioricet until safer over-the-counter medications fail to help their patients.

Although it’s only a prescription headache medication, Fioricet has the potential to cause addiction. If a person follows their prescription guidelines and uses the medication correctly, the risks of addiction are low. However, if someone takes too much Fioricet, they may develop tolerance to its effects. A person with tolerance to a certain dose of Fioricet will require higher doses of the medication to alleviate their headaches.

When a person with tolerance starts to take more Fioricet, possibly by obtaining more prescriptions, they may eventually become dependent on it. In other words, they may feel unable to get through the day without taking Fioricet; if they stop, they will experience symptoms of withdrawal. These symptoms arise because their body has grown accustomed to Fioricet in high doses.

If a Fioricet-dependent person attempts to weather withdrawal alone, it’s likely they will take Fioricet again just to relieve the symptoms of withdrawal. This is a hallmark characteristic of addiction. Anyone who compulsively abuses Fioricet to avoid withdrawal likely has an addiction to Fioricet. Additionally, people with an addiction to Fioricet will experience cravings for the medication which further compel them to keeping using it.

Moreover, the ingredient Butalbital is an addictive substance in its own right. Butalbital can cause someone to get “high” because it’s a Central Nervous System (CNS) Depressant. Since Butalbital is part of Fioricet, it is possible for someone to abuse Fioricet as a recreational drug. At high doses, Fioricet can intoxicate a person in a manner similar to alcohol. People who abuse Fioricet for this purpose have as much of a risk of developing an addiction as they would have if they repeatedly used an illegal drug.

In most cases, Fioricet withdrawal lasts anywhere from 8 hours to three days after the last dose. Withdrawal is the biggest obstacle to overcoming dependence on Fioricet, which is why rehab centers provide detox programs so that people can safely undergo the withdrawal cycle without the risk of relapse. According to research, it is best to undergo withdrawal under medical supervision because some withdrawal symptoms are dangerous.

Rebound headaches are the most common symptoms of Fioricet withdrawal. Other symptoms of withdrawal include:

Like any medication, Fioricet can cause side effects. People who misuse Fioricet or use it compulsively are at greater risk for experiencing the worst side effects of the medication.

The possible side effects of Fioricet include:

In some cases, a person who takes Fioricet may develop an allergic reaction to the drug. The symptoms of an allergic reaction are trouble breathing, itching, rashes, intense dizziness, and swelling in the face, throat, and tongue.

While Butalbital is the addictive ingredient in Fioricet, Acetaminophen is the ingredient which is liable to cause an overdose. Unfortunately, people who misuse Fioricet as a recreational drug or as a way to suppress withdrawal are most likely to suffer an overdose.

When a person overdoses on Fioricet, the Acetaminophen will damage their liver. In severe cases, an overdose can even provoke fatal liver failure. For this reason, it is dangerous to take Fioricet together with another medication which contains Acetaminophen because it increases the risk of overdose and death. Furthermore, drinking alcohol while taking Fioricet may also inflict liver damage.

A Fioricet overdose is a medical emergency, so it’s important to know the symptoms. An overdose on Fioricet may cause jaundice, a yellowing of the skin and eyes. Other symptoms of an overdose include:

Some formulas for Fioricet contain Codeine, a potent and addictive Opioid. Codeine enhances the pain-relieving effects of Fioricet, but it also poses additional risks for overdose and addiction. Fioricet is the property of the pharmaceutical firm Actavis, one of three generic drug companies which contributed substantially to the Opioid Epidemic according to DEA data.