Butalbital: Barbiturates may be habit-forming: Tolerance, psychological dependence, and physical dependence may occur especially following prolonged use of high doses of barbiturates. The average daily dose for the barbiturate addict is usually about 1500 mg.
As tolerance to barbiturates develops, the amount needed to maintain the same level of intoxication increases; tolerance to a fatal dosage, however, does not increase more than two-fold. As this occurs, the margin between an intoxication dosage and fatal dosage becomes smaller.
The lethal dose of a barbiturate is far less if alcohol is also ingested. Major withdrawal symptoms (convulsions and delirium) may occur within 16 hours and last up to 5 days after abrupt cessation of these drugs. Intensity of withdrawal symptoms gradually declines over a period of approximately 15 days.
Treatment of barbiturate dependence consists of cautious and gradual withdrawal of the drug. Barbiturate-dependent patients can be withdrawn by using a number of different withdrawal regimens. One method involves initiating treatment at the patient’s regular dosage level and gradually decreasing the daily dosage as tolerated by the patient.
Esgic Plus, like Fioricet, is a prescription medication used to treat tension headaches. It contains a combination of butalbital (a barbiturate), acetaminophen, and caffeine. Abuse and dependence can occur due to the presence of butalbital, which has sedative and relaxing effects that some people may misuse.
Abuse of Esgic Plus
Abuse refers to using Esgic Plus:
- In larger amounts than prescribed.
- More frequently than directed.
- For purposes other than its intended use, such as to achieve a sense of euphoria or relaxation.
Signs of Esgic Plus Abuse:
- Taking the medication without a prescription or beyond the prescribed dose.
- “Doctor shopping” to obtain multiple prescriptions.
- Combining it with alcohol or other drugs to enhance its effects.
- Neglecting responsibilities due to drug use.
Dependence and Addiction
Dependence occurs when the body adapts to the medication, leading to withdrawal symptoms if it is abruptly discontinued. Over time, this can progress to addiction, characterized by compulsive use despite harmful consequences.
Physical and Psychological Dependence:
- Physical dependence: Headaches, nausea, irritability, or insomnia upon stopping.
- Psychological dependence: Craving the drug and feeling unable to cope without it.
Risks of Misuse
- Butalbital dependence:
- Long-term or high-dose use increases the risk of dependence.
- Abrupt discontinuation can cause withdrawal symptoms, including anxiety, tremors, hallucinations, or seizures.
- Acetaminophen toxicity:
- High doses can severely damage the liver, particularly when combined with alcohol.
- Rebound headaches:
- Overuse may cause medication-overuse headaches, worsening the condition it’s meant to treat.
Treatment for Abuse and Dependence
- Medical detoxification:
- Gradual tapering of the dose under medical supervision to manage withdrawal symptoms safely.
- Counseling and therapy:
- Behavioral therapies, such as cognitive-behavioral therapy (CBT), can help address underlying issues contributing to abuse.
- Support groups:
- Groups like Narcotics Anonymous (NA) offer peer support and resources for recovery.
Prevention
- Use Esgic Plus only as prescribed.
- Avoid long-term use unless under strict medical supervision.
- Regularly communicate with your healthcare provider to reassess the need for the medication.
If you or someone you know is struggling with Esgic Plus abuse or dependence, seek help from a healthcare provider or addiction specialist immediately.