Fioricet is typically prescribed for tension headaches, but because of the propensity to abuse it and to develop dependence on it, the drug is viewed as a medication of concern given that it contains butalbital, a barbiturate. Also included in the formulation are acetaminophen, a pain-relieving agent, and caffeine, a stimulant designed to add to efficacy. Fioricet may help with headaches in the short term, but abuse and chronic use may induce tolerance, dependence, and withdrawal symptoms. Abuse usually begins when a patient exceeds prescribed doses or uses the medication in smaller amounts more frequently to reach desired levels of sedative and relaxing effects. Some users seek out the medications for other indications, such as stress reduction, anxiety relief, or insomnia, thereby adding to the risk of developing psychological dependence. After a while, tolerance develops, and larger and larger doses are needed to get a similar effect, which could lead to increased accidental overdose as well as dangerous drug-drug interaction and withdrawal effects.

The possibility of medication-overuse headache, clinically known as the rebound headache syndrome, is a third area of concern when it comes to the abuse of Fioricet. Using Fioricet often creates an instance of the very headache that it was designed for, creating a vicious cycle in which increasing amounts of the medication are taken to relieve worsening symptoms. So in this way, quickly becoming dependent is the worst thing for the user because he would end up being Fioricet dependent. Psychological dependence occurs when an individual develops a perception that he needs the drug to function or cope with daily stresses and thus engages in compulsive drug-seeking behavior. This description provides a definition of physical dependence: an increase in tolerance to butalbital, where withdrawal symptoms can develop from mild to severe after discontinuing the drug.

Because of potential dangers, withdrawal symptoms from Fioricet can be dangerous, especially if the drug is withdrawn suddenly after prolonged use. Common withdrawal symptoms include extreme anxiety, agitation or anger, restlessness, tremors, nausea and vomiting, racing heart, high vascular pressure, and profuse sweating. Among the severe symptoms are seizures, and should they occur with withdrawal, sudden cessation may become life-threatening. The best way to withdraw from Fioricet would be under the supervision of an informed physician, with a gradual tapering of dosage. With less medication in the body, the sides will lessen or avoid altogether. The greatest danger will be overdose, especially when combined with alcohol, central nervous system depressants, or other drugs like opioids and benzodiazepines. The effect of these substances enhances the sedating effect of Fioricet and presents an increased risk of respiratory depression, unconsciousness, and death. Moreover, heavy doses of acetaminophen, a main ingredient of Fioricet, are capable of causing severe liver damage, or liver failure, especially when mixed with alcohol.

Fioricet is very efficacious for tension headaches; however, because it is potentially addictive, giving it as prescribed by a healthcare provider will help prevent numerous instances of misuse and dependence. They should not exceed the prescribed amount, should only use it in a short duration, and must not take alcohol or sedatives in combination with the drug. Cravings, inability to stop, or symptoms of withdrawal are good reasons for anyone to seek medical assistance. Fioricet remains effective in treating tension headaches; it is important to avoid possible abuse. Responsible use and medical supervision will help mitigate against these risks. Patients should use these guidelines to get the most out of Fioricet while minimizing the risk of dependence or diversion.