What Are the Effects of Mixing Butalbital and Alcohol?

Butalbital is a powerful central nervous system depressant in the barbiturate class of drugs. Unlike many other drugs in the class, butalbital is most frequently prescribed for specific pain that is difficult to manage. With numerous impairing side effects such as significant drowsiness as well as a higher risk of dependency and potential poisoning, butalbital is considered a “last resort” pain medication.1

Butalbital carries many health risks on its own. Many people who take butalbital are unaware of the added dangers posed by using the drug with alcohol. The interaction of alcohol and butalbital can lead to a person slipping into a coma and even cause death.

The Side Effects of Butalbital

Butalbital is a barbiturate that is available in a various forms that often combine it with acetaminophen, aspirin, or caffeine. It is most commonly prescribed for the treatment of hard-to-control tension headaches. Like other barbiturates, butalbital is a drug that is easy to become addicted to.

One of the most serious aspects of taking butalbital is that while tolerance of the drug builds rather quickly, tolerance to overdosing on the drug doesn’t build as fast. As people build tolerance to the effects of butalbital, they may take more and more of the medication to achieve the same effects as before. Taking too much butalbital before the body is able to handle the side effects can easily result in an overdose.1

Because butalbital is addictive and users are at risk of overdose with this drug, the danger of combining butalbital with alcohol (and/or other sedative medications) is even more serious. Both butalbital and alcohol are depressants, which affect the central nervous system. Taking too much butalbital can lead to intoxication and symptoms such as:1

  • Drowsiness.
  • Sluggishness.
  • Slurred speech.
  • Staggering.
  • Clumsiness.
  • Confused thinking.
  • Shallow breathing.
  • Liver damage.
  • Respiratory arrest.
  • Loss of consciousness.
  • Possible coma.

The Side Effects of Mixing Butalbital With Alcoholic Drinks

The interaction of alcohol and butalbital can be dangerous because both substances affect the central nervous system in the same or similar ways.2 A person who takes these substances together has increased the risk of serious side effects from both alcohol and butalbital.

One of the dangers of butalbital used with alcohol is a potentially life-threatening overdose. This most often occurs in people who aren’t experienced with taking butalbital and are unaware of how strong the drug is. These people may not understand how serious the interaction of alcohol and butalbital can be. Alternately, chronic users looking to enhance the effects of butalbital and alcohol by combining them are at severe risk of an overdose.1

Worries of Mixing Alcohol with Other Drugs

Dependence and Withdrawal of Butalbital and Alcohol

Regular use of butalbital can cause physical dependence. Once a person is physically dependent on butalbital, trying to withdraw from the drug can worsen severe headaches, which are only relieved by more butalbital.3

Attempting to stop using butalbital abruptly is dangerous. This can lead to:

  • Tremors.
  • Agitation.
  • Elevated heart rate.
  • High blood pressure.
  • Seizures.

Symptoms of butalbital withdrawal can start within 4-8 hours of stopping the drug and are frequent in the first 48 hours. Withdrawal symptoms can sometimes go on for a week to 10 days.

Withdrawing from butalbital is best managed in an inpatient setting.3 Tremors, hallucinations, and seizures also can occur during withdrawal from alcohol, therefore inpatient detox is also recommended for someone who’s seeking to stop using alcohol.

When a person has been using alcohol and butalbital in combination, the potential for severe medical issues due to withdrawal is much higher than when someone is withdrawing from just alcohol or butalbital alone. Medical supervision in a detox program is crucial for a person who’s withdrawing from both substances at the same time.4

Treatment for Addiction to Butalbital and Alcohol

Treatment for addiction to butalbital and alcohol starts with detox. Mental health professionals evaluate the individual to determine the most appropriate addiction recovery program. Once the evaluation is completed and the person is admitted for supervised detox, typically there will be ongoing assessment and oversight by a doctor as well as daily assessments by nursing staff to monitor the person's health and safety throughout the withdrawal process.

Detox programs typically offer a variety of recreational and therapy activities designed to enhance the person's experience in the program.

After detox for butalbital and alcohol addiction, some people may be admitted to a longer-term treatment facility for a few days or weeks. Other people may enter an outpatient program for ongoing treatment, which requires meetings for several hours per week.

The right kind of ongoing recovery assistance or aftercare for addiction to butalbital and alcohol depends on the individual's needs during treatment. Treatment is important for anyone struggling with addiction to butalbital and alcohol. Because of the heightened health risks faced by those with both butalbital and alcohol dependencies, attempts to quit using these substances should not be made without proper medical supervision.

Hotline to Call

Please call our 24-hour hotline if you need information about treatment for addiction to butalbital or alcohol for yourself or for a loved one who’s experiencing the effects of mixing butalbital and alcohol.


1. U.S. National Library of Medicine. Medline Plus. (2014). Barbiturate Intoxication and Overdose.

2. U.S. National Library of Medicine. Daily Med. (2010). Butalbital, Aspirin and Caffeine.

3. Weaver, M.F. (2015). Prescription Sedative Misuse and Abuse. The Yale Journal of Biology and Medicine, 88(3), pp. 247–256.

4. Center for Substance Abuse Treatment & Substance Abuse and Mental Health Services Administration. (2006). Treatment Improvement Protocol (TIP) Series, No. 45.: 4 Physical Detoxification Services for Withdrawal From Specific Substances. Substance Abuse and Mental Health Services Administration: Rockville, MD.