Are Muscle Relaxers Addictive?

Do I Need a Muscle Relaxer?

A muscle relaxer or muscle relaxant is a type of medication that helps treat muscle spasms or muscle spasticity. 

Muscle spasms or cramps occur unexpectedly and involuntarily. These spasms are contractions of either a muscle or group of muscles, often happening due to the following health conditions:

• Lower back muscle pain
• Neck pain
• Fibromyalgia (a disorder that includes musculoskeletal pain, fatigue, sleep, memory, and mood problems). 

Muscle spasticity refers to a continuous muscle spasm that causes stiffness or tightness and affects motor skills like walking or talking. This can happen, because the brain or spinal cord has suffered some damage in the parts related to movement. For example, multiple sclerosis (MS) is a condition that can lead to muscle spasticity. 

However, not all muscle relaxers will treat muscle spasms or vice versa. 

Muscle relaxers comprise two categories: 

• Antispastic agents — Baclofen, Dantrolene, and Diazepam are just some examples of antispastic agents. These types of drugs can help treat problems caused by cerebral palsy, for example. 
• Antispasmodic agents — these drugs help provide relief for musculoskeletal problems. Antispastic agents have not been shown to be effective in these types of cases. 

While these drugs treat problems like low back pain, they are not more effective than painkillers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). 

However, evidence supports muscle relaxants for short-term relief of acute low back pain when someone cannot tolerate NSAIDs or acetaminophen or find them ineffective.  

Before taking muscle relaxants, it is best to talk with a doctor. They can help you determine if different prescription drugs or over-the-counter (OTC) medications are more suitable. 

Using a muscle relaxer for chronic problems has not been proven to be effective in the long term. There is also an additional health risk of safety. 

Is it Bad to Take Muscle Relaxers Every Day?

The prescription provided by a doctor will determine how long you should take a muscle relaxer.

In general, a doctor should limit the use of a muscle relaxer to no more than 2 to 3 weeks. This is because there is little evidence regarding the long-term effectiveness and safety of these medications. 

The Drug Enforcement Administration (DEA) now considers the muscle relaxer carisoprodol (Soma®) as a Schedule IV controlled substance. This means it has a low potential for abuse. Chronic use of this drug could increase dependence. 

Also, researchers from the University of Florida College of Pharmacy published interesting findings about muscle relaxers. In the short term, the combination of muscle relaxers and low-dose opioids did not pose any more significant health risk than opioids alone. However, when people took both drugs for several weeks, the risk of overdose increased. 

Finally, a very large study concluded that muscle relaxers were effective for acute low back pain. However, the evidence to support these drugs for chronic low back pain was not as convincing. 

Prior studies have shown that 10% to 30% of individuals who take opioids also take a muscle relaxer. 

Are Muscle Relaxers Addictive?

Not all muscle relaxers have abuse potential and are habit-forming. However, some muscle relaxers function like antidepressants or other types of drugs. Because of this, withdrawal symptoms can arise. 

It is best to speak with a healthcare professional before taking any muscle relaxer to understand all possible side effects and risks. 

3.69 million people (12 years old and up) took carisoprodol (Soma®) for non-medical reasons in their lifetime. In 2011, the number of people who misused carisoprodol was 3.06 million. 

- 2012 National Survey on Drug Use and Health

Types of Addictive Muscle Relaxers

Different addictive muscle relaxers have the potential for abuse and physical dependence. 

Here is a list of the main ones:

• Diazepam (Valium®) — this prescription drug belongs to the group of medications called benzodiazepines. Other examples of benzodiazepines include clonazepam (Klonopin®) and alprazolam (Xanax®). Diazepam helps to calm an excessive and abnormal amount of brain activity, but it carries the increased risk of serious problems, such as sedation or when used with other medications or alcohol. Long-term or excessive use of diazepam could develop physical tolerance, meaning the drug could lose some effectiveness. Overall, diazepam is not often the first go-to treatment option.
• Carisoprodol (Soma®) — one study showed that the effects of carisoprodol could resemble those of other central nervous system (CNS) depressants like pentobarbital. The DEA recently released the Diversion Drug Trends (of controlled and non-controlled medications), stating that carisoprodol was a drug that often was misused in the United States. 
• Cyclobenzaprine (Amrix® and former brand name Flexeril®) — cyclobenzaprine’s chemical structure is like that of a type of antidepressants called tricyclic (it has three rings of atoms). Because of this similarity, cyclobenzaprine has certain effects that can make some more prone to abusing the drug. 

Signs You are Addicted to Muscle Relaxants 

Addiction comes in many forms. However, some signs can indicate if someone has an addiction to muscle relaxants. 

Some of these signs include people who:

• Take a muscle relaxant when a prescription no longer indicates it 
• Require more of the drug to feel the same effects 
• Constantly think about a muscle relaxant, including how to obtain more, the effects it causes, and when to take it
• Fake symptoms for more prescription refills 
• Change physical appearance, hygiene, and behavior suddenly 
• Combine a muscle relaxant with other substances like alcohol to experience a more intense high or come down from stimulant drugs like cocaine.
• Overdose 

Muscle relaxant overdose signs and symptoms include:

• Drowsiness 
• Cardiovascular problems, including tachycardia (fast heart rate) and arrhythmias (irregular heartbeat) 
• Agitation
• Confusion
• Difficulty speaking or moving 
• Dizziness 
• Nausea 
• Vomiting 
• Hallucinations 
• Tremors or seizures 
• Loss of consciousness
• Respiratory depression

Do Muscle Relaxers Have Withdrawal Symptoms?

Yes. Many muscle relaxers can cause withdrawal symptoms, although it does not always mean an addiction has formed. 

For example, like tricyclic antidepressants, cyclobenzaprine has effects on the body that can cause withdrawal symptoms after a person stops taking the drug. Stopping cyclobenzaprine suddenly after taking it for a long time could cause nausea, headache, and malaise (not feeling well). 

Another muscle relaxer called tizanidine (Zanaflex®) may also produce withdrawal symptoms and rebound hypertension (high blood pressure). 

Doctors may set up a tapering plan (to lower doses gradually over time) to minimize the risk of withdrawal. 

Long-Term Side Effects of Muscle Relaxers

Doctors should only prescribe muscle relaxers for no more than 2 to 3 weeks. There is little evidence to support such drug use for extended periods. Long-term use could have serious side effects, including:

• Falls
• Fractures or sprains
• Vehicle crashes
• Misuse and dependence
• Overdose

Because of these risks, the American Geriatrics Society does not recommend muscle relaxers in older individuals. 

Muscle relaxer use doubled from 2005 to 2016 in the general population. There was a disproportionately high use of muscle relaxers in older adults. 

- JAMA Medical Journal Study

Treatment for Muscle Relaxer Misuse & Addiction

If you or a loved one have an addiction to muscle relaxers, there are many therapy options available, such as:

• Cognitive-behavioral therapy — counseling sessions could help address the underlying causes of addiction and provide coping techniques. 
• Outpatient or inpatient treatment programs — these clinics offer supervision and support groups through the detox period and help individuals maintain abstinence. 

While recovery is difficult, it is also possible. Taking the first step of seeking help paves the path to a healthier life.