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Addiction: Substance Abuse Community
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Avatar universal

GOING C/T OFF OF FIORINAL NEED ADVICE PLS

I suffer from chronic pain & have for almost 18 years. I have been on & off of fiorinal for years. This round I've been on them since Dec/06 I saw my Dr. he gave me phenobarbital so I won't have seizures during the detox. I am concerned about what might happen though even with the phenobarbital as I was taking as many as 16 fiorinal per day. I don't want to go to hospital unless it's absolutely necessary. I have read about making some kind of detoxing solution to help with WD symptoms but I don't know what it consists of so if anyone can help there, I would greatly appreciate it. My husband is staying home with me til I get thru it. Dr said to take my BP daily. What else am I in for? I took my last dose last night. Already have a headache this a.m. I know I will have the typical sweats etc but am I in for anything life threatening? I began taking 6 to 8 pills per day but over time I became tolerant so Dr kept giving me more. Now I get 392 pills per month (14 per day) & I want off of this. I am also on Dilaudid 8mg 11 pills per day. This will be next but first I have to get thru detoxing off of the fiorinal. Can anyone give me some advice as to how to deal with WD & what else I might expect?

Thanks in advance.
Jen
32 Responses
Avatar universal
Hi and welcome!   Phenobarbital is used in the hospital for detox from Fiorinal/Fioricet. It will cover you in a few ways: Keeps your seizure threshold up and slows withdrawals. How is it prescribed for you? Did you take any yet?  Did he put you on a tapering dose schedule with the phenobarbital?

Dealing with withdrawal: Stick to the taper plan,rest,remain calm (your nervous system needs to heal),force fluids and eat small meals.  I don't know about a "solution"...do you mean the Thomas Recipe"?

Headache is a major withdrawal sympton along with anxiety and insomnia. Be sure to stick with the taper!
Avatar universal
Hi Vicki, thanks for your response. I have been reading several of your posts & I was hoping you would see mine. The Dr didn't say anything about taping from the phenobarbital. He gave me 30mg tablets & it says take 2, 4 times per day. I have started today & I'm feeling yucky & my body hurts all over but that may be from my medical conditions that I was taking the fiorinal for to begin with. I took my 1st phnobarb dose at 6 this a.m. & 2nd dose at noon. I was taking 2 fiorinal (along with Dilaudid) about every 2.5 to 3 hours so like I said, I was taking up to 16 fiorinal in a day. I had been trying to cut back on both fiorinal & Dilaudid over the last 2 weeks so some days I would only take 8 Dilaudid instead of 11 or 12 & 12 to 14 fiorinal instead of 16. I am ashamed to say that there were days that I took 18 fiorinal but that was only when I had what I can only refer to as "eye drillers". The worst headache pain behind my eye/s. That was always the pain that sent me to emerg when I wasn't on any meds at all.

Yes it was Thomas' recipe & I found it here but I don't really understand it. I'm wondering if I should try some caffeine pills for the headache when it starts to get really bad or maybe start them now in hopes that it won't get as bad. What do you think about that? My pharmacist said I should think about it. He also told my husband that I shouldn't be doing this at home as it is far too dangerous.

I know that you know alot about this so were you on it at some point & if so, how did you come off of it? What symptoms did you have etc? I hope you won't mind sharing. Thanks again for responding. I didn't think that anyone had responded. I clicked the link & was surprised to see your response. Thank you again. I'm hoping that I can give my husband any kind of good news as he is very afraid that something may go wrong.

Thanks again,
Jen
Avatar universal
Mind sharing???   Never!!   I live to share!!   I know it's hard to get good info on this drug. Most of the time it gets laughed at. It just doesn't get any respect!!  LOL  You will hear from "My Mayberry" as well.  Listen to him!

Okay...I was hopelessly addicted to Fioricet for many,many years. Decades. Toward the end,I was taking upward of 20 per day and THAT was just to feel "normal". I was in deep trouble.  I started a taper in Feb of 2009 and it ended in Nov. of that year. It was long and slow. I did not go to the hospital,not that it's wrong it was because I'm a nurse...very sad.
I had medical supervision but "did" my own taper and I used Fioricet to do it.  It worked very well for me but only for ME. I know my medical history,of course,so I was willing to try it on my own. I had very few issues or problems with that taper. It was tolerable. I know what the withdrawal is like because I withdrew hundreds of times when I was "out" of my "medicine". Pathetic!

So, I do believe in tapering and this drug needs a taper. Phenobarb is,of course,a barbiturate so it should help you but I've never taken it. So,I can't speak to it.  I just know that your brain receptors need to be covered and they are right now...

Here's your plan:  Call your doctor and talk about this,okay?  It doesn't have to be this hard for you. Complicating all of this is the opiate. I wouldn't taper that if this were me. I'd want to get rid of the barb first. It's easier on you physically.  So,doctor visit. Force fluids. Eat small meals. Rest and stay calm. Don't worry!!!  Stay in touch!!  xo
Avatar universal
I forgot...about the headaches. Awful!!   Just treat them by replacing what you're missing.
Aspirin and caffeine and lots of fluids...
Avatar universal
Jen...While I was out running I was thinking about you and...Do this: Please call your doctor tonight and talk to him . I think your Phenobarb needs to be adjusted. You should not feel this terrible...Let me know,okay. I'll worry all night and won't eat until you post back!!   LOL
Avatar universal
I'm not feeling as bad as I was this a.m. Altho my heading is feeling kind of funny. I can't really explain the feeling. My Dr & my pharmacist work closely together so my pharmacist came up with the calculations. He gave my Dr 2 different options & he chose the 2x 30mg 4 times a day. I had probably 300 fiorinal left which I gave to hubby to lock up. I am still taking my Dilaudid plus T3 so I'm hoping it helps.

The headaches....oh the headaches....yes I remember those all too well....HORRIBLE...so my pharmacist has ordered some caffeine pills for me & they will be in tomorrow. I don't drink much caffeine at all. I have 1 cup of coffee in the morning & that's it. No soda pop. If the headache gets that bad I will force myself to drink some coffee.

I don't want you to worry about me. I WILL be okay. I have to do this & I would really prefer to do it at home. I have anxiety about hospitals. Do you think that the phenobarb is not strong enough? Now you have me worried... lol

I have slept most of the day away & I'm hoping I will continue to do that until it's over but I probably won't be so lucky but please try not to worry if I don't post back right away because I am sleeping a lot...I'm also guessing that tomorrow will be worse....this I know from experience....1 time I ran out of the fiorinal & I had to go a full 24 hours without it. When I got the fiorinal I took a little less than what I was prescribed for the day & on the next day I woke up & I just knew that something was wrong. I couldn't hear out of my right ear & my pupils kept getting bigger then smaller then bigger then smaller etc....I immediately thought I need caffeine so I had a large cup of coffee & tried to wait it out but hubby was freaking out & he started searching online & he thought that I might be going into shock so he talked me into going to the e.r. They gave me a shot of dilaudid (I don't know why cuz I had dilaudid) & I felt a bit better....honestly, I think it was just my nervous system...maybe a panic attack...I don't know but it scared me for sure!

I will definitely keep you posted on my progress & if I don't feel right in the a.m. I will call my pharmacist & see about adjusting the phenobarb but I'm curious if you think it should be a higher dose. Incidentally, you are not the only nurse that I have heard of who was on & became dependent on fiorinal. I have always called this the devil's drug because it works very well for my headaches but it's so hard to stop. I've got a home hydroccolator so I have hot packs ready for body aches & I've got freezer packs ready for headaches. It's gonna be a long week....maybe 2....Dr gave me enough phenobarb for 2 weeks...GOD Please don't let it last that long!!!!

Thanks again for all the info & for sharing your story...I'm very happy for you that you kicked it to the curb....if you can do it....so can I right? Now go eat something LOL
Avatar universal
Yes...you can do it!!

I worry about everything!! If I'm not worrying,I'm not breathing!!  I'm fine...

I don't know for sure about the phenobarb. I've never had to do the calculations for conversion from Fiorinal so...phenobarb just isn't used that often,anywhere. So,I was simply suggesting in case you needed an adjustment to a higher dose.  They know what they're doing and you're lucky you've got the doc and pharmacist! I defer completely...but do keep them both in the loop as to how you feel.

I agree...this drug is the drug of no return!   Please stay cozy and calm. The drug really messes with your nervous system so that's why I keep saying that. It all gradually settles down and you'll feel good again.  You'll feel wonderful!
Avatar universal
oh I hope you're right!! I so want to feel good again but I can't help but think that the reason I began taking them will still be there when I am off of everything....I just don't know how bad the pain will be....I'm hoping that the Dr.s at the pain clinic are right when they say that these pills actually end up causing more pain because of how they work on your nervous system....I'm not in the medical field so I don't remember the exact terminology that he used but it made total sense when he said it! As a matter of fact, the Dr's on the Dr Phil show who evaluated Alexandra (part of the Dr Phil family) said the same thing so at that point I was convinced that the pills are causing more pain. I've been told by several Drs that it's not realistic to think that I will be able to live my life without some kind of pain med. I just told them that I would at least like a chance to try. Thanks so much for everything....I'm not so scared now....we'll see what tomorrow brings!!
Avatar universal
LOL...I'm still working so...here I go:

The doctor is very right. The pills cause more pain. I know this to be true. I was given this med when I was 17...a gazillion years ago!!  I had migraines. The stuff worked and for years I took it respnsibly. That was the problem. I grew up with it so it was part of me. UGHHH!!   Constant headaches=constant pills.  I was able to function perfectly,I thought. LOL  But,really,I did fine on them but I was so hooked!  Fast forward to present and I guess I've had 3 migraines since I've been off of Fioricet. The damn pills contributed to most of my problem! A lot of it is rebound pain so I was forced to keep taking it and it worked very nicely. I never felt what you would call high but I certainly liked it and functioned very well until the end came and that was ugly.
So,I know you're doing the right thing. Many people with chronic pain take "drug holidays"
just to evaluate their true pain level.  It will work out! Don't think about all that right now. Just try to live in the moment...
Avatar universal
I have been asking my Dr about this "drug holiday" thing that I read about & he didn't have any answers for me....it just scares me to think of the pain I will be in when I get thru this & how I will cope with it......I don't want to continue this cycle...I'm so tired of it....it truly fee;s like a ball & chain.....can't make plans to go away unless I know I have enough meds & if I end up being gone longer than originally planned, it's uh oh....what do I do now? It happened to me in 2007 I went to the U.S. in Nov & I was only supposed to be gone for 3 weeks...I ended up being gone for almost 6 weeks & it was really hard finding a Dr to give me what I normally take.....I had to go to a late night clinic & I was extremely lucky to have found a Dr who knew what would happen if I didn't get them. He called my Dr at his home that night & I got my scripts....went to the nearest pharmacy & filled them....I just don't want to live like this anymore....I am also taking low dose alprazolam or diazopam for my anxiety....I am getting really anxious now wondering what will happen tomorrow.....it's good to be able to talk about it so I thank you again for taking the time :)
1135275 tn?1586565652
well this all seems to be a very sloppy and poor taper. if i'm understanding correctly, you discontinued fiorinal cold turkey and started phenobarbital? this doesn't work because phenobarb takes so long to build up in your blood. you need a loading dose....otherwise it's mostly useless. by the time the phenobarb builds up to the levels you need, you will already have gone thru most of the withdrawal.

i really think this is a poorly executed taper...if you are still having issues, ask your pharmacist about a loading dose. problem is that i don't know what kind of loading dose you would need now that you've already started taking it....but more eductated people than myself could figure it out.

you can have severe symptoms weeks into discontinuing this drug, so if they happen to say you're in the clear as far as seizures go, i'd take it with a grain of salt.

now that the phenobarb is already in your system, though...it has a really LOOONG half life, so by no means should you go back to the doses of fiorinal you were taking. you could easily overdose. by long half life, it is in upwards of 200 hours. that means the dose you have taken today will reduce by half in 200 hours....which still leaves a lot in your system. then, that dose will reduce by half in 200 hours. each person is different, so the rate of elimination is different, but still it's very long. much longer than butalbital. this is also why a loading dose is important, because to reach the theraputic range, it can take weeks....which is why a loading dose is usually given. rehab facilities are much better at this than family doctors or pharmacists. not that they don't know the information....but they don't have much experience with it. treating this addiction is rare. treating it with phenobarbital is even more rare and the only places with info on how to do it tend to be rehab facilities. doctors learn it but never use it, so obviously it's forgotten by the time they need to put it into practice.

anyway....i'm not sure what to tell you. i would agree with your pharmacist that this shouldn't have been done at home, though. as to the headaches...caffeine pills will help. i would slowly reduce your dose on those, too...caffeine can cause MAJOR rebound headaches. you can only know what your pain is like once you have discontinued both the butalbital and the caffeine. i suffered migraines almost daily. i took fioricet plus excedrin to help with them...but they were there all the time. in march i ended up with an ulcer so i HAD to stop everything. haven't had a migraine since. i never would have imagined it!
Avatar universal
Try not to worry about future pain...What are you anxious about for today? Are you expecting something bad to happen?

What country do you live in?
Avatar universal
ok I was feeling not too bad but after reading my_mayberry's post I am bordering on freaking out....I have high anxiety but I have valium if I need it but nobody said anything to me about a loading dose of phenobarb. Now I am scared!!!! I have a very bad duodenal ulcer. I've had 2 stomach scopes. The 1st showed tiny ulcers from my esophogus all the down to my duodenum. Had triple therapy treatment 3 times & then had 2nd scope. The smaller ulcers were gone but the largest one in my duodenum is still the same. but this is not my concern right now....I am on 2nd day without fiorinal so I am going to call my pharmacist about this loading dose. I want to try to be as clear as I can here. I am not tapering anything right now. I stopped the fiorinal completely. Last dose was Tuesday night. I started the phenobarb on Wed morning.

Vicki, I live in Canada. I'm about 5 miles outside a very very small town so the closest hospital is about 30 to 40 mins away. I was worried about what to expect in terms of WD & I read somewhere that one could have CA & that worried me. If it's phenobarb that they would give me in hospital, what would be the difference in just taking it at home other than the obvious....I would have med professionals watching over me....do you think that I should be in the hospital?
Avatar universal
Hey Vicki, another question for you. My hubby took my bp & it was 98 over 60. Is this ok or would you say it's low?
Avatar universal
When you had to stop everything, how did you do it? Did you go to a facility or do it at home? C/T or slow taper? What type of WD did you have, how bad was it etc...Anything that you can tell me will help.

Thanks in advance.
Jen
1135275 tn?1586565652
Caffeine will make ulcers worse too. Did mine. Dont freak...just ask your pharmacist.
1135275 tn?1586565652
Oh...and when i stopped, i was already on a low dose so i didnt need a taper. At the heighg of my addiction, though...i was taking about as many fiorinal as you were and my taper was about a year long. I didnt change to phenobarb.
Avatar universal
Okay...Mayberry and I live in the US. It's been many,many years since I've heard of a phenobarb withdrawal from a barbiturate. Both Mayberry and I used the Fioricet and tapered for a long time. 9 months for me and a year for him.

I'm an RN  and although I am NOT a member here in that capacity,I'll tell you this:

I ALWAYS err on the side of caution. So,yes,I think you should be in a hospital for a number of reasons. You're anxious,you don't feel as good as you could(in my opinion),and it's just a whole lot less stressful for you if you're in a controlled environment (hospital) Also,from a humanitarian point of view: You just shouldn't have to suffer and worry!  Plus, if there was a negative situation at home,you're too far away from a facility and most importantly,you have other health concerns. I don't know how old you are or any history so I don't know if that's too low a blood pressure for you...it would be for me but someone else might think it's perfect so...I think you'd feel much safer at the hospital.

Check back and let us know what you decide...don't worry...
Avatar universal
Thank you both for all the info...I called my pharmacist & he said that I would have had the loading dose only if I had gone to the hospital. He also told me that after I'm done with the 2 weeks of phenobarb, he would give me another script for tapering the phenobarb. I am like you Vicki, if I'm not worrying, I'm not breathing but I don't usually worry about myself so it's a bit strange for me. My BP at my dr's on Monday was completely normal. If memory serves I believe it was 120 over 68 so I think it is a bit low. Since you're a nurse I thought you would know how low is too low.

I am 45. I have fibromyalgia, chronic myofascial pain, chronic fatigue syndrome, DDD in my neck as well as arthritis, duodenal ulcer, my left shoulder is almost thawed now after having frozen shoulder, I have a history of bi-lateral pulmonary embolism, I've recently lost about 20 to 25lbs in a short period of time due to stress & I'm a smoker, I have endometriosis. I had surgery for stage 3 endo in 2005 & they found a large benign mass attached to my bladder....I have probably forgotten something but the FM, CFS, CMP & DDD is by far the worst of my medical conditions which is why most of the drs I've seen have said that it's unrealistic to think that I can live a med free life. I have read that I should be taking valium on a regular basis until I get thru this as well. I have been taking 5mg & it says to take 10 to 20 mg so I may try 10mg in the a.m. when my anxiety is at it's worst & maybe 10mg before bed.

I will keep you posted with regards to the WD & I will probably have a million questions for you if you don't mind answering....I'll keep posting when I can. Thanks so much for all the info that you both have shared.

p.s. I'm not sure how to post to more than 1 person at a time as only 1 name highlights for me for some reason but THANK YOU BOTH!!

Jen :)
Avatar universal
Okay...loading dose in the hospital...yes,that's true. But,that's why we're not sure why he didn't just use the Fiorinal to taper you down...you could ask him.

Your b/p is not dangerously low but it's low and you have medical issues so...keep an eye on it. It's certainly better than being too high but again you decide. A hypotensive person will feel weak and dizzy quite often; like all day long...

It's fine if you have a million questions! Just remember, I'll only address the Fiorinal;I'm not here in a medical capacity. Of course, it's really hard to take the nurse out of the girl! I'll help as much as I can and you do sound stable to me..your thoughts are clear,etc...You know what to do. A lot of this is anxiety. Just remember,the hospital is there for a reason!!
And don't hesitate to call the pharmacist!

It's fine just to post. We don't need salutations!  Matt and I along with everyone will certainly see when you write...but I appreciate that...very sweet.

You only need the valium if you think you do!  :) Mostly,you need distraction and a nap!
1135275 tn?1586565652
Well yeah...a loading dose is done in the hospital because it needs to be done...thats why this taper just seems unusual to me. The fact that you didnt have one means you probably wont reach full theraputic effect until the end of your 2 weeks...or even longer...by which point you will be tapering that dose. I dont know...just odd to me. Maybd you wont have any problems, though. Good luck! Let us know how its going!
Avatar universal
I got the caffeine pills & I took 1 200mg pill. My pharmacist said that he calculated that I had been taking approximately 600mg of caffeine per day. I will only take the caffeine pills if my head is pounding. I have kind of spurts of anxiety. My Dr would have preferred if I had done a slow taper but I have been attempting that for 3+ years & it just won't work because every time I decrease by 1, 2, 3 or more pills, something happens in my life that causes major stress which causes more pain & I end up going back up so the choice to do this C/T is mine. I just told my dr that I'm done with the roller coaster & I want off. 1 year ago on the 26th of this month I lost my sister to cancer. She was 62 & had been battling cancer for 12 years. 2 years ago on the 8th of this month I lost my best friend (my mom). This was extremely hard on me emotionally & I have been having problems in my marriage as well. So the slow taper, while it may be the best & safest way to go, it's just not possible for me in my current situation. My Dr doesn't think that it's a big deal to just stop. It's my pharmacist who seems a bit concerned. When I attempted to stop 3 years ago, I told my Dr. then I went to my pharmacist & told him that I was about to stop them & he was the 1 who told me that I couldn't just stop so he called my Dr & a few mins later I had a script for phenobarb. About 2 or 3 days into it, I got a call that my mom was getting close to passing so I decided not to stop the fiorinal. I drove 4 hours to be with my mom & I spent 2 weeks with her basically nursing her back to health. She lived another 10 months after that. So part of my problem is stress. When I am under stress it causes more pain which equals more meds. Anyway, I thought it would be worse today but so far it's not so bad. I hope it stays this way but in reality, I know it won't. Thanks for the support. I really do appreciate it.
Avatar universal
No Jan.  It IS possible in your current situation. On any given day,any one of our lives can be touched by sadness,loss,lonliness,or fear. It's called LIFE and it can turn our worlds upside down.  So,think about this: Are you taking the medicine due to stress and anxiety?
Don't answer,just think...3 1/2 years is a long time. There's always going to be something that will challenge us and the right time never comes...It's my own opinion but you'll never get off the roller coaster until you convince yourself you have to. Doing this your way is increasing your anxiety!
At the very least, please get some therapy/support/recovery care in your life.It will help you!  Good luck.
Avatar universal
Vicki, I really do appreciate your advice & support but SAYING it's possible in ANY situation is not correct. I will tell you a bit more about me ok...

Since I moved back home to Canada (my hubby is American so I lived in the U.S. for 7 very long years) my hubby has done everything within his power to try to prove that I am a drug addict HOWEVER, after seeing 3 of the leading drug addiction specialists in Canada, all 3 Dr.s said that my problem is not drug addiction, it's PAIN.

I was married before for 13 years to an abuser who threw me into a wooden support beam in my basement. He grabbed hold of both of my arms & threw me into the beam & I hit the beam right between my shoulder blades & my head also hit the beam. Another time, he got up from the kitchen table & booted me with his heel in the mouth while I was sitting in a kitchen chair. I flew from the chair & went through the drywall & my head hit a stud in the wall. That took 4 stitches in my lower lip where I still have a scar.

Since you're a nurse, I'm sure you know that they don't use stitches anymore for those types of injuries however I had a gaping hole in my lip so they didn't have a choice. Another time he threw me down the stairs as I was trying to flee & I ended up with a broken foot & torn ligaments/tissue all the way up to my knee. I have had countless black eyes & broken bones & because I was 19 when I married him & he was 31, I was stupid enough to believe all the horrible things that he said to me on a daily basis: nobody would ever love me, I was stupid & ugly & my personal favorite, he would blow up my mother's home with her in it if I ever left him. So I stayed with him out of fear.

13 years of abuse is what caused my fibromyalgia/myofascial pain & chronic fatigue so when I take my meds, I take them for PAIN. I don't get "high" & I don't feel the euphoria that everyone talks about. As a matter of fact, my Dr prescribed Marinol which is marijuana in pill form but THAT med DID make me feel high so I stopped taking it because I felt as though I couldn't drive. My Dr then told me to grow or buy my own marijuana to see if I could get some pain relief that way I could control the amount that I smoked so I wouldn't get "high". My Dr has tried on several occasions to talk me into having a morphine pump surgically implanted in my abdomin to which I have declined.

Maybe I am in the wrong forum. I don't know. What I do know is that you can call it addiction or call it dependence, my body is used to having these meds on a daily basis. Before I ever married husband #1, I wouldn't even take an extra strength Tylenol!

So, I finally mustered up the strength & courage to leave the POS that left my body in this condition because I knew that I deserved better. Well, better came along about a year & 1/2 later & I moved to the U.S. to be with him. Still struggling daily with pain but doing okay until 2 police officers came to my home. Long story short, hubby #2 was accused of murder.

After fighting for approximately 3 years to prove his innocence, investigating the crime myself & taking it to Federal Court in an attempt to expose the POS who DID commit the crime, the stress of all of that (& believe me I left a lot out), I could no longer deal with the daily pain so I chose to go back on the meds so I could function & not want to feel like dying every day of my life because the pain was so bad. The whole point of taking these meds was so I could LIVE WITH the pain, NOT DIE (or want to) from it. Anyone with chronic pain knows that meds don't cure or fix the pain. They don't take it away by any means. They simply make it easier to live with pain.

Vicki, 3 & 1/2 years IS a long time. It's a long time to fight a law suit, a long time to be married to an abuser, a long time to look into the eyes of an innocent person who believes that everyone who ever knew him thinks that he is a murderer, a long time to fear for your own safety, your own life & the life of the one you love and it's a long time to hurt.....mentally, emotionally AND PHYSICALLY....My greatest wish would be to have a "normal" pain free life.... unfortunately I don't.......but thank you for judging me.....

Btw, today is my 7th day without fiorinal.
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