Are Muscle Relaxers Addictive? Dependence, Withdrawal, and Safe Use

If you are currently using muscle relaxers and are concerned about whether they can be habit-forming, rest assured, you are not the only one asking these questions. Many individuals visit Alpas Wellness in La Plata, Maryland, seeking guidance and caring support as they begin to work through muscle spasm pain, medication, and possible dependence.

The more you understand about the risks associated with muscle relaxers, the better empowered you’ll be to make decisions about using them, or about detoxing from muscle relaxers medically, should it become necessary.

Quick Answer: Are Muscle Relaxers Addictive?

To provide a quick answer to those who ask “are muscle relaxers addictive?,” the answer is yes; certain muscle relaxers have the potential to be habit-forming, mainly if used over a long period, in higher doses, or in combination with other sedative medications, such as alcohol or opioids [1].

According to the Cleveland Clinic, for some, the calming and sedative effects of certain muscle relaxers may lead to increased misuse, especially among individuals who are attempting to manage or alleviate symptoms of anxiety, insomnia, and/or emotional distress [1].

What are Muscle Relaxers (and Why Do They Have the Potential to be Habit-forming)?

Muscle relaxers are a type of medication prescribed by doctors to relieve muscle spasms, reduce muscle stiffness, or relax tense or tight muscles. Many muscle relaxers act on the central nervous system (CNS), which includes the brain and spinal cord, to provide relaxation and sedation [1].

Muscle relaxers fall into one of two major classifications:

Skeletal Muscle Relaxants: These muscle relaxers are prescribed to treat acute muscle spasms resulting from musculoskeletal injuries, such as back strain or neck strain. Some examples include cyclobenzaprine, tizanidine, methocarbamol, metaxalone, and orphenadrine.

Antispasticity Drugs: Antispasticity drugs are prescribed for neuromuscular conditions that cause continuous muscle stiffness, such as multiple sclerosis (MS) or spinal cord injury (SCI). One common antispasticity medication is baclofen.

Why do Muscle Relaxants Create a Calming Effect?

Most muscle relaxers depress the central nervous system and, as such, many produce feelings of sedation, relaxation, or calm. For some users, the calming effects of muscle relaxants, when combined with relief from stress-related symptoms and/or improved sleep, will lead to misuse [1][2].

The risk for the misuse of muscle relaxants increases when the drug is combined with alcohol or the use of other central nervous system depressants, such as opioids. This may result in respiratory depression, defined as shallow breathing that reduces oxygen levels in the body [3].

Dependence vs. Addiction vs. Tolerance

The following definitions of dependence, addiction, and tolerance will help clarify the difference between these three terms.

What is Tolerance? Tolerance occurs when the body adapts to a medication and the same dose no longer produces the same effect. Individuals often report their medication does not work as well as it used to [2].

What is Physical Dependence? Physical dependence means the body has adapted to the drug and reacts negatively when the substance is reduced or stopped. Withdrawal symptoms can develop even when the medication was taken exactly as directed [1].

What is Addiction? Addiction involves behavioral changes, not just physical symptoms. Some symptoms of addiction will include:

• Using more than prescribed
• Taking the muscle relaxant more frequently than prescribed
• Seeking early refills or prescriptions from multiple providers
• Mixing muscle relaxants with alcohol, opioids, or benzodiazepine medications
• Continuing use despite health, relationship, or work-related problems

Which Muscle Relaxants Have the Highest Risk of Developing Dependence?

Not all muscle relaxants carry the same risk of being abused. Understanding the differences among muscle relaxants is especially important to those users with a history of substance abuse or who are taking other medications that depress the central nervous system [1][3].

High Risk for Misuse/Addiction

Carisoprodol (Soma): Carisoprodol is available in oral tablets and is classified as a Schedule IV controlled substance, meaning it has an accepted medical use but carries a potential for abuse or dependence. Because it is metabolized into meprobamate, which has known abuse potential, Soma is frequently cited when asking, “Why Are Muscle Relaxers Addictive?” [2].

Diazepam (Valium): Diazepam, available as tablets and oral liquid, is a benzodiazepine used to treat muscle spasms. As with carisoprodol, it is also a Schedule IV drug with well-documented risks for developing dependence and withdrawal [1].

Moderate to Variable Risk

Cyclobenzaprine, Tizanidine, Methocarbamol, Metaxalone, Orphenadrine: These muscle relaxers are not classified as controlled substances; however, there are documented reports of misuse. The risk increases substantially when used for extended periods, at greater than recommended dosages, or in combination with other CNS depressants [1].

A Special Note on Baclofen

Baclofen, while not associated with the development of cravings or euphoria, can cause severe withdrawal symptoms if stopped suddenly after long-term use. Research has documented seizures and hallucinations as a result of sudden withdrawal from Baclofen, and a severe form of psychosis (delusions and disordered thinking) can occur [4].

Can You Have Withdrawal Symptoms from Stopping Muscle Relaxers?

Yes, you can have withdrawal symptoms from stopping muscle relaxers, mainly when used regularly or for long periods (greater than three weeks).

Common withdrawal symptoms include:

• Anxiety or agitation
• Insomnia
• Nausea
• Tremors
• Rebound muscle pain or spasms
• Malaise (vague feelings of discomfort and fatigue)

When Withdrawal is More Serious:

High dosage, long-term use, stopping use abruptly, or using other substances (polysubstance use) increase the risks of withdrawal. Baclofen withdrawal can be hazardous and may include hallucinations or seizures [4].

What to Do If You Are Worried About Stopping:

Do not stop taking muscle relaxers suddenly without consulting a healthcare provider. Contact your prescriber to discuss tapering. If withdrawal symptoms are significant, medically supervised detoxification may be indicated. Alpas Wellness provides medically managed detoxification services with 24/7 monitoring and symptom management.

Does Short-Term vs. Long-Term Use Affect Addiction Risk?

Short-Term Usage:

Most skeletal muscle relaxants are designed for short-term use, often up to 2 or 3 weeks. Clinical recommendations suggest that the benefits for acute low back pain are modest and the medications are not intended for indefinite treatment [5].

Long-Term Usage:

Long-term use of muscle relaxants increases the risk of developing tolerance, physical dependence, cognitive impairment, sedation, falls, and withdrawal symptoms upon discontinuation. According to the Mayo Clinic, this is a particular concern for older adults [6].

Duration of Use Recommendations:

• 7 days or less: Ask about expectations for benefits and a stop date [5].
• 1 to 3 weeks: Discuss if tapering is necessary [5].
• Months or more: Do not discontinue use until discussing a tapered plan or medically monitored detoxification with your prescriber [5].

How to Safely Use Muscle Relaxants and Reduce the Risk of Addiction

Check Off the List of Safer Ways to Use Muscle Relaxants:

• Use the lowest effective dose for a limited time; e.g., do not use longer than 3 weeks [5].
• Don’t consume alcohol or other sedatives while taking a muscle relaxant [3].
• Don’t drive until you understand how the medication affects you [1].
• Keep a log of the doses you take and your symptoms.
• Store medications securely and dispose of unused pills properly.

Questions to Ask Your Prescriber:

• What is the date for stopping the medication? [5]
• Is it necessary to taper? [5]
• What non-medication options are available together with this? [5]

Options to Reduce the Need for Muscle Relaxants:

Some ways to reduce reliance on medication include physical therapy, stretching, ergonomics, heat/ice, and good sleep hygiene. Sleep hygiene refers to healthy habits that support sound, restorative sleep.

When to Seek Help

Red flags for misuse and dependence are:

• Taking extra or higher doses than prescribed
• Cravings
• Withdrawal symptoms upon missing doses
• Combining muscle relaxants with other substances, such as alcohol or other drugs
• Obtaining prescriptions from multiple doctors
• Preoccupation with obtaining or using the medication
• Obtaining drugs from illicit sources
• Hiding use
• Continuing use despite it interfering with activities, responsibilities or relationships

What Can Treatment Look Like?

Treatment may involve an assessment, a medical tapering protocol, medically supervised detoxification, and therapy such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT).

What to Expect at Alpas Wellness:

Care at Alpas Wellness is personalized, evidence-based, and delivered with compassion. Clients receive medical and therapeutic care while addressing co-occurring mental health concerns in a residential environment focused on recovery.