Muscle Relaxers

What are Muscle Relaxers?

Muscle relaxers or muscle relaxants are prescriptions used to treat severe muscle pain and discomfort caused by back pains and muscle spasms. Having a muscle spasm means that one or more of your muscles is contracting, and the cramping or twitching is out of your control. It can occur for a lot of several reasons and can sometimes be very painful.

Prescription drugs used as muscle relaxers can differ in their composition, chemical structures, and the way they work in the brain. In general, muscle relaxers work as central nervous system (CNS) depressants and cause a sedative effect or prevent the nerves from sending pain signals to the brain. The onset of action is fast, and effects typically last from 4-6 hours.

Like other prescription drugs, muscle relaxers pose a risk for abuse and even addiction. According to the National Center for Biotechnology Information (NCBI) [1], centrally acting muscle relaxants are a potential drug of abuse. Although skeletal muscle relaxants are occasionally the primary drug of abuse, they are often used along with other central nervous system depressants, such as narcotics or alcohol. The major toxic effects are respiratory depression and coma. 

While other drugs such as heroin and meth get a great deal of attention when it comes to abuse and addiction, the potential for muscle relaxers to become part of a user’s cocktail of preferred substance, if not the outright drug of choice, can’t be ignored. To determine the signs a person is addicted to prescription drugs such as, muscle relaxers, it’s important to understand what they are and how they work.

Muscle Relaxers
Muscle relaxers works by acting on the central nervous system, blocking pain sensations that would otherwise travel from sore and spasming muscles to the brain. This pain-blocking mechanism can contribute to abuse of the medication and may result in addiction.

What Do Muscle Relaxers Do?

There are two types of muscles, smooth and striated. The molecules within muscle fibers are responsible for muscle contraction. A muscle spasm is an involuntary muscle contraction that can be very painful and uncomfortable. The contractions happen when the muscle lacks several nutrients. Nutrient deficiency in the muscles can happen for various reasons, such as fatigue, overuse, diabetes, exposure to excessive heat, kidney disease, and more. Muscle relaxers work by lessening the tightness or stiffness or in the muscles, which decreases discomfort and pain. Some muscle relaxers may target the central nervous system, while others target the muscle directly. 

Like all prescription medications, muscle relaxers should not be shared, misused, or abused. Taking muscle relaxer tablets more than the prescribed dosage or taking them more frequently than advised is highly dangerous and can lead to addiction. Muscle relaxers should also never be combined with antihistamines or alcohol. Despite the severity of muscle relaxer side effects, quitting them can be difficult to do for someone who has become dependent on this drug. 

Muscle Relaxer Abuse

Muscle relaxers have the potential for abuse and addiction. In addition, extended and continuous use can lead to increased tolerance and physical dependence. For this reason, muscle relaxers are intended as a short-term treatment and not to be prescribed for more than 2-3 weeks.

Unfortunately, many people take muscle relaxers alone or in combination with other illegal drugs for nonmedical reasons, such as producing or enhancing feelings of dissociation and euphoria. 

According to the U.S. Drug Enforcement Administration (DEA)[2], Carisoprodol (brand name Soma) is a Schedule IV drug and is one of the most commonly diverted and misused drugs. In addition, the Center for Disease Control and Prevention (CDC) [3] suggests never to combine muscle relaxants such as Soma, or Flexeril with alcohol and other substances or medications. Muscle relaxer abuse can lead to serious dangers such as an increased risk of overdose, resulting in seizures, hallucinations, coma, and death.

Types of Muscle Relaxers

Muscle relaxers abuse can have a number of harmful effects, including seizures, behavioral changes, and withdrawal. It is essential to recognize and understand these signs of addiction early, as long-term use can lead to worsened side effects.

Muscle relaxers reduce levels of activity in muscle cells and change how the central nervous system transmits spasmodic messages. These chemical effects lead to the relaxation of muscle tissue and in some situations, paralysis.

The two main classes of muscle relaxers include:

Antispastics

This class of muscle relaxers is commonly prescribed to relieve and mitigate pain from spasms and other neurological conditions. It directly affects the spinal cord or the skeletal muscles with the aim of improving muscle tightness and spasms. This class of drug can help with conditions that cause spasms, such as multiple sclerosis (MS) or cerebral palsy, as well as spinal cord injuries.

  • Baclofen
    • This drug sold under the brand name Lioresal or Gablofen. It is primarily used for spasticity in spinal cord injury patients or those with multiple sclerosis. Most common side effects include drowsiness, confusion, muscle weakness, vertigo, and nausea.
  • Tizanidine
    • It is sold under the brand name Zanaflex. This drug has both antispastic and antispasmodic effects. Individuals take it to help manage spasticity from spinal cord injuries or MS. Side effects may include drowsiness, itchiness, constipation, hallucinations, and low heart rate [4].
  • Dantrolene
    • This medication can help ease muscle spasticity. Brand names are, Revonto, Dantrium, and Ryanodex. Oral dantrolene may damage the liver.
    • The side effects of this drug may include breathing changes that happen due to weakness in the respiratory muscles and muscle weakness.

Muscle Relaxers
It is not recommended to take muscle relaxers with alcohol due to the potential for dangerous side effects.

Antispasmodics

These are used during emergency situations and during surgical procedures and to cause paralysis. These drugs help reduce muscle spasms via the central nervous system. They inhibit the transmission of neurons in the brain.

There are two types of antispasmodics: benzodiazepines and nonbenzodiazepines.

Benzodiazepines block certain chemicals in the brain, and nonbenzodiazepines act on both the brain and spinal cord.

  • Diazepam
    • Diazepam is a benzodiazepine. Physicians may prescribe diazepam for severe muscle spasms and for spasticity associated with neurological disorders. Diastat and Valium are common brand names of this drug. Common side effects of this drug include fatigue, muscle weakness, drowsiness, loss of muscle movement.
  • Carisoprodol
    • Carisoprodol is a nonbenzodiazepine. Adults can take this medication for the relief of severe, painful muscle conditions. A common brand name for this drug is Soma. It has the potential for being abused.
    • It can cause drowsiness and dizziness and isn’t recommended for long-term use or by those with a history of addiction. Doctors also warn people of the dangers of combining this medication with alcohol.
  • Cyclobenzaprine
    • Cyclobenzaprine is a nonbenzodiazepine. It can treat muscle spasms that happen with serious muscle conditions when a person combines it with rest and physical therapy.
    • Amrix, Flexeril, and Fexmid are brand names of this drug. Its sedative properties limit its use during the day. Common side effects may include dizziness, irritability, confusion, and headache.
  • Metaxalone
    • It sold under the brand name Skelaxin. It has the lowest sedation potential and the fewest reported side effects of the muscle relaxers.
    • People cannot take it with drugs that affect the amount of serotonin in the body due to the risk of serotonin syndrome.
    • Common side effects may include dizziness, irritability, an upset stomach, and headache.

Over-the-counter (OTC) Muscle Relaxers

An OTC muscle relaxer does not require a prescription, but it may bear the same risks as a prescription muscle relaxer.

Methocarbamol

Methocarbamol is an OTC nonbenzodiazepine, antispasmodic medication. It is sold under the brand name Robaxin. Usually prescribed to treat back pain, it’s considered less sedating than other options. Side effects may include drowsiness, headaches, confusion, dizziness, and upset an stomach.

Abuse and addiction to muscle relaxers may develop after receiving a prescription from a healthcare professional or after abusing them recreationally. Habitual, long-term use, and recreational use of prescription muscle relaxers, can lead to addiction requiring inpatient drug rehab.

5 Signs Of Muscle Relaxer Abuse

It is not easy for someone to identify the signs of muscle relaxer abuse and addiction, especially in cases where the person hides their use. Yet, identifying early signs and interventions may help prevent prescription drug abuse from turning into an addiction.

Discovering the common signs of muscle relaxer addiction may help loved ones intervene at an early stage of prevention.

1. Taking Muscle Relaxers Without A Prescription

Someone who takes muscle relaxers without a prescription is doing so at great risk of developing dependency, side effects, and addiction. Abuse of prescription muscle relaxers in a way not intended or prescribed by a qualified doctor is a sign of addiction.

A person who uses muscle relaxers outside of the supervision of a doctor should be considered as potentially suffering from substance use disorder, particularly in cases of recreational or long-term use.

There are federal laws that prohibit the buying of controlled substances such as sedatives, pain relievers, or stimulants without a valid prescription. Consuming prescription drugs without a prescription is not only dangerous but also illegal.

People who take high doses of these prescription drugs, or abuse them for nonmedical reasons, are at great risk of overdose. When muscle relaxers are combined with other central nervous system depressants, such as alcohol, dangerous side effects are likely to happen.

2. Side Effects Of Muscle Relaxer Abuse

Many people become addicted to prescription muscle relaxants after receiving a prescription from trusted doctors.  Practitioners may attempt to treat muscle spasms and back pain with over-the-counter (OTC) medications, such as acetaminophen and other non-steroidal anti-inflammatories.

Only if these treatments fail, a doctor may prescribe skeletal muscle relaxants for short durations with physical therapy or alone.

Prescription muscle relaxants attach to GABA receptors and influence neurotransmitters in the brain, leading to sedative and relaxant effects.

Individuals who take muscle relaxants after treatment and others who abuse these drugs recreationally may become physically dependent on and addicted to them.

People who become addicted to prescription muscle relaxants may develop physical symptoms.

Some common side effects caused by short-term muscle relaxant abuse can include:

  • Dry mouth
  • Drowsiness or slurred speech
  • Confusion
  • Nausea or vomiting

Long-term side effects of abusing muscle relaxers include:

  • Insomnia
  • Liver damage
  • Seizures
  • Hallucinations
  • Irregular heartbeat
  • Heart failure
  • Tremors
  • Paralysis

3. Behavioral Changes

Behavioral changes may be the first signs a person exhibits addiction to these drugs. At first, these signs may be subtle. People who abuse muscle relaxants may start to remove themselves from family and friends.

As the addiction progresses, it can lead to changes in the person’s physical health, mood, obligations, and engagement with professional and personal relationships.

When a person continues to abuse muscle relaxants, behavioral changes become more obvious.

Behavioral signs of prescription drug abuse might include:

  • Refilling prescription medications often.
  • Taking a higher dose of medication than recommended or prescribed
  • Doctor shopping or switching doctors in order to get multiple prescriptions.
  • Getting prescription drugs through unauthorized means
  • Stealing or hiding funds used to cover expenses of drug use

4. Symptoms Of Muscle Relaxer Withdrawal

Withdrawal symptoms caused by muscle relaxers happen when a person who has become dependent or addicted to the substance suddenly stops using them. These symptoms happen as the body and brain struggle to adapt to chemical changes.

This may happen when a person simply forgets to take a medication or cannot purchase more of the drug.

Muscle relaxer withdrawal symptoms include:

  • Nausea
  • Insomnia
  • Lethargy
  • Muscle aches
  • Headache
  • Chills and sweating
  • Irritability or agitation

These withdrawal symptoms can last several days, up to a few weeks, or more. Withdrawal from prescription muscle relaxants can be physically painful and need medical assistance.

5. Drug-Seeking Behavior

Drug-seeking behavior is portrayed by a person’s powerful urge and desire to use prescription drugs, leading to impulsive, manipulative, and other high-risk behaviors.

Individuals who become dependent on or addicted to prescription medications may go to great lengths to get them.

Individuals with a prescription drug use disorder may show signs of deceitful behavior with family members and doctors.

Common drug-seeking behaviors include:

  • Scams to get prescription medicines
  • Assertive demands for a specific drug
  • Mood disturbances and suicidal thoughts
  • High-risk or impulsive behaviors, such as theft
  • Buying illegal prescription medications on the street

Find the Right Addiction Treatment at We Level Up NJ

Someone who has become dependent on or addicted to prescription muscle relaxers should seek addiction treatment. Drug treatment programs are designed to medically support addicted individuals as they detox and experience withdrawal symptoms.

During your rehabilitation, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. 

We Level Up NJ provides proper care with round-the-clock medical staff to assist your recovery through our medically-assisted Detox Program. So, reclaim your life, call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

alternatives to benzodiazepines
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Sources

[1] NCBI – https://pubmed.ncbi.nlm.nih.gov/1927837/

[2] DEA – https://www.justice.gov/archive/ndic/pubs10/10913/10913p.pdf

[3] CDC – https://www.cdc.gov/opioids/patients/prevent-misuse.html

[4] NIH – https://medlineplus.gov/druginfo/meds/a601121.html

[5] We Level UpPrescription Drug Abuse