Fiorinal Addiction: Signs, Symptoms, and Treatment

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Fiorinal addiction is not as common as many other types of prescription drug dependencies as the barbiturate is less frequently prescribed than other pain and headache medications. When taken as prescribed, Fiorinal proves highly effective in alleviating pain.1   

What Are the Signs and Symptoms of Fiorinal Addiction?

It is not always easy to identify signs and symptoms of Fiorinal addiction. A person may hesitate to associate addiction symptoms to use of a prescription drug given to them by their doctor.2

Many prescription medications obtained legally and used properly can pose the same addiction risk as those obtained illegally, especially when taken at a high dose and/or over a long period of time.

If you or a loved one are taking Fiorinal and are concerned about a developing addiction, it’s essential to learn about the warning signs. Common signs and symptoms of a Fiorinal addiction include:3

  • Experiencing urges and cravings to use Fiorinal
  • Taking Fiorinal in larger amounts or for longer than you’re meant to
  • Spending a lot of time getting, using, or recovering from the use of Fiorinal
  • Having problems at work, home, or school because of Fiorinal use
  • Continuing to use Fiorinal, even when it causes problems in relationships
  • Giving up important social, occupational, or recreational activities because of Fiorinal use
  • Continuing to use Fiorinal even when you have physical effects caused by the drug, such as nausea or vomiting, trouble sleeping, or muscle pain
  • Continuing to use Fiorinal even when you have psychological symptoms that could have been caused or made worse by the drug, such as anxiety or depression
  • Needing higher dosages to get the same effect as when you first start taking Fiorinol, which is called a tolerance
  • Developing withdrawal symptoms—such as flu-like symptoms, painful muscles, or seizures—relieved by taking more of the drug

Misuse of Fiorinal may continue despite negative consequences; this continued use is not a lack of willpower but rather a demonstration of the development of physical dependence on Fiorinal or addiction to it.4

Recognizing signs of addiction in a loved one can be difficult, as hiding addictive behaviors are common.4 If you are concerned that you or your loved one has a Fiorinal addiction, it’s important to reach out for help. Talk to the prescribing health care provider or an addiction specialist for support and guidance.

Who Is at Risk of Fiorinal Addiction?

While no factors predict, dictate, or guarantee the development of an addiction, certain risk factors may make a person more vulnerable to chronic substance abuse that develops into physical dependence and addiction.

Fiorinal is a barbiturate that is often combined with other medications. Barbiturates are sedative-hypnotics that are classified by the Drug Enforcement Agency (DEA) as controlled substances. 5 Fiorinal is classified as a Schedule III drug, meaning it is considered to have a moderate to low potential for physical and psychological dependence. 6

However, Fiorinal is often combined with other medication in the treatment of pain and tension headaches. Fiorinal may be combined with aspirin or with paracetamol, also known as acetaminophen, which is the active ingredient in Tylenol. In some preparations, Fiorinal may be combined with codeine, which is a Schedule II controlled narcotic. Schedule II drugs have limited medical use and a high potential for misuse.6

If you have a history of a substance abuse disorder, you may know that addiction is a chronic, often relapsing, disease. The codeine in Fiorinal may trigger a relapse or secondary addiction.7

Any pain medication can become addictive, including over-the-counter medicines like Tylenol and aspirin, especially when the underlying source of the pain is not addressed and the medication is taken for a long period of time and the dose begins higher than recommended or is increased dramatically over time. This is because when the body develops a tolerance to pain relievers, especially narcotics—such as codeine—or barbiturates, the person must take more of the substance for pain relief. Developing a tolerance may lead to addiction even when taking Fiorinal began with proper medication use.8 If the person has begun to misuse the substance to achieve feelings of euphoria, sedation, or detachment, these sensations will also become harder to achieve with lower doses of the medication.

If you require pain management and are high-risk for Fiorinal addiction, it is essential to formulate an addiction prevention plan with your health care provider.  Your doctor may refer you to a specialist, such as a neurologist, to determine if another treatment plan can allow you to decrease your Fiorinal dose or stop taking it over time.

Environmental and personal factors may also contribute to an increased risk for addiction. A traumatic, abusive, neglectful, chaotic, or unstable childhood environment is associated with an increased risk of developing a substance use disorder later in life. Studies show that those whose family members also have a history of substance use disorders may also be at higher risk of developing addiction, due to behavior modeled to them during formative years and to potential genetic factors. 7

How Is Fiorinal Addiction Treated?

Taking the first steps to get help for a Fiorinal addiction may feel overwhelming, but there are several methods of treatment. In many cases, individuals receive a “step-down” model of support that helps them transition from a highly structured form of care to an outpatient setting gradually. Treatment options for Fiorinal addiction include the following.


Fiorinal addiction treatment often begins with a detoxification (detox) process because you may have a physical dependence on the medication. 9 To begin the recovery process, the body needs to eliminate the Fiorinal from its system and learn to function normally without daily medication use.

Depending on how severe your withdrawal symptoms are and other factors like your medical history, your health care provider will decide whether you need medical detox or if it’s safe for you to taper off the medication in a non-clinical environment. Detoxing from barbiturates such as the butalbital in Fiorinal can be dangerous. Close medical supervision is often needed to safety detox. Studies show that a slow taper off of the medication is safer, minimizing risks.10

Your detox plan may also take into account your need for continued pain management and include alternative non-barbiturate and non-narcotic medication therapy or alternative pain management measures.

Inpatient Treatment

After being discharged from a medical detox facility, you may begin inpatient residential treatment for your Fiorinal addiction.11

Inpatient treatment starts with an in-depth assessment to determine your individual treatment needs. Next, your counselor will formulate a personalized treatment plan to map out your care. The treatment plan includes the type of programs you will attend during your stay. Programs may consist of 12-step AA meetings, educational classes, goal-setting groups, or individual and group therapy. Your treatment plan may also include specialty treatment modalities such as behavioral therapy. Traditional inpatient treatment usually lasts around 30 days, but some programs are longer.11

Outpatient Treatment

After your inpatient stay, you may be referred to outpatient treatment. In some cases, you may be referred immediately to an outpatient program instead of an inpatient center. Outpatient treatment usually involves a part-time day program at a treatment facility or local clinic. You will live in the community and continue to see an individual counselor, participate in group therapy sessions, specialty programs such as behavioral therapy, and begin 12-Step meetings. Living in your community while attending outpatient treatment can provide you with the social support you need to manage cravings and triggers experienced in your day-to-day life. 12

Aftercare and Ongoing Support

Once you have completed outpatient treatment, the maintenance phase of recovery begins. Aftercare usually involves weekly support group meetings in addition to 12-step groups, such as Narcotics Anonymous (NA). You continue to engage in your relapse prevention plan, most often with daily 12-step meetings and sober support in the community.13

Engaging in sober communities is shown to improve long-term recovery outcomes, so please seek out any guidance you may need to find sober supports. Additionally, lean on supportive family members and friends who are. Recovering from addiction is a lifelong endeavor that is far more difficult to accomplish alone than with a drug-free support community.14

If you have any more questions about overcoming your Fiorinal addiction or need additional help to find treatment options or sober communities, don’t hesitate to contact our caring and knowledgeable treatment specialists at 800-681-1058 (Info iconWho Answers?) . We can help get you on the road to recovery today.


  1. Brose, W. G., Datta, D., & Kromelow, J. (2020, May 23). Clinical Use of Opioids for Chronic Pain. Pain Management for Clinicians, 655-677.
  2. Fields, H. L. (2011, February 24). The doctor’s dilemma: opiate analgesics and chronic pain. Neuroview, 69(4), 591-594.
  3. McLellan, A.T. (2017) Substance abuse and substance use disorders: Why do they matter in healthcare? Transactions of the American Clinical and Climatological Association, 128, 112-130.
  4. Schafer, G. (2011). Family functioning in families with alcohol and other drug addiction. Social Policy Journal of New Zealand, 37(2), 135-151.
  5. S. Department of Justice Drug Enforcement Administration. (2020). Drugs of Abuse: A DEA Resource Guide / 2020 Edition.
  6. S. Department of Justice Drug Enforcement Administration. Drug Scheduling.
  7. Enoch, M.A. & Goldman, D. (2001). The genetics of alcoholism and alcohol abuse. Current Psychiatry Reports. 3(2),144-51.
  8. Silberstein, S. D., & McCrory, D. C. (2001). Butalbital in the treatment of headache: history, pharmacology, and efficacy. Headache: The Journal of Head and Face Pain, 41(10), 953-967.
  9. Lobmaier, P., Gossop, M., Waal, H., & Bramness, J. (2008, June 28). The pharmacological treatment of opioid addiction—a clinical perspective. European journal of clinical pharmacology, 66(6), 537-545.
  10. Suddock, J. T., & Cain, M. D. (2021, July 5). Barbiturate Toxicity. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  11. Weinstein, Z.M., Wakeman, S.E., & Nolan, S. (2018). Inpatient Addiction Consult Service: Expertise for Hospitalized Patients with Complex Addiction Problems. Medical Clinics of North America. 102(4), 587-601.
  12. Annis, H. M., Schober, R., & Kelly, E. (1996). Matching addiction outpatient counseling to client readiness for change: The role of structured relapse prevention counseling. Experimental and Clinical Psychopharmacology, 4(1), 37–45.
  13. Nash, A. J. (2020, February 3). The twelve steps and adolescent recovery: A concise review. Substance Abuse: Research and Treatment, 3,
  14. Jason, L. A., Wiedbusch, E., Bobak, T. J., & Taullahu, D. (2020, May 13). Estimating the Number of Substance Use Disorder Recovery Homes in the United States. Alcoholism Treatment Quarterly, 38(4), 506-514.


Pen iconAuthor
Hannah Sumpter MSW
Hannah Sumpter, MSW, BA
Case Manager, Therapist, Author
Hannah Sumpter, MSW, holds a Bachelor's degree in Theology, as well as a Master’s degree in Social Work, with an emphasis in Mental Health. She has combined both degrees to work in the addictions field for over ten years, both as a case manager and therapist. Throughout her professional experience, she has grown in her passion for serving those with an addiction, as she is able