Most people are familiar with back pain, whether it’s due to injury, illness, poor posture, or a sedentary lifestyle. However, for some people, back pain is a constant ailment. In fact, it is estimated that over 16 million adults in the U.S experience chronic back pain. Therefore, it is no surprise that many individuals turn to muscle relaxants such as Flexeril to ease their ongoing discomfort.

Flexeril is one of the most common medications for muscle spasms and pain, with more than 18 million prescriptions written each year. While Flexeril is considered a relatively safe drug with few withdrawal symptoms, it still poses a risk for abuse and addiction.

However, recovery is possible for those who become addicted to Flexeril. With multiple treatment options available, individuals can restore their health and lead new lives free from addiction. Before going into the treatment methods that are available for Flexeril addiction, this article will provide an outline of what this medication is and what its long-term effects are.

What is Flexeril?

Flexeril is the brand name for cyclobenzaprine, a muscle relaxant medication that belongs to a similar class of drugs known as tricyclics —most of which are actually used as anti-depressants. Flexeril is used as a short-term treatment for muscle aches, spasms, and pain associated with injuries, strains, and sprains. It is also sometimes prescribed for fibromyalgia and post-traumatic stress disorder (PTSD).

Flexeril was first synthesized in 1961 by researchers at Merck & Co. and was approved for medical use by the Food and Drug Administration (FDA) in 1977. Due to its structural similarities with tricyclic anti-depressants, Flexeril was initially studied for medical use as an anti-depressant. However, since its approval by the FDA, it is primarily used to treat acute musculoskeletal spasms and other pains associated with injuries.

Other names for Flexeril include:

  • Flexreal
  • Flexerill
  • Flixeril

How Does Flexeril Work?

Flexeril relaxes muscles by reducing muscle hyperactivity by acting on the nerve fibers that directly connect with skeletal muscle (known as gamma and alpha motor systems). While the exact mechanism is unknown, Flexeril is said to act directly on the central nervous system at the brain stem, rather than targeting the muscles themselves. This influence on the motor neurons of the brainstem helps to relieve muscle spasms.

Is Flexeril Addictive?

While Flexeril is considered a non-addictive medication, it has developed a reputation for abuse. Due to the mild high that can be achieved at higher doses (especially when mixed with other substances), addiction can develop.

Individuals can also find its sedative and relaxing effects to be addictive, especially if they are in chronic pain or suffer from conditions such as tension or anxiety. However, in general, it is considered less addictive than other back pain medications.

Tolerance and Dependence Issues

Like most prescription medications, addiction can also occur through the body’s tolerance. The brain can become accustomed to the way drugs like Flexeril affect the central nervous system, especially over the long term. This means that individuals need to take higher and higher doses to achieve the same effects. Tolerance also leads to withdrawal effects such as nausea, headache, and malaise.

Psychologically, Flexeril is also addictive because individuals can find it difficult to cope with their pain if they stop taking the drug. Or they may become dependent on the pleasurable feelings of relaxation it induces. In other words, they may struggle to feel normal without it and this can cause them to be dependent on Flexeril for an indefinite period.

Flexeril Addiction vs. Dependence

It’s worth noting that there is a difference between dependence and addiction. Dependence is a state of adaptation in the body that is caused by regular use of the drug. In this state, the individual isn’t mentally attached or obsessed with the drug. However, withdrawal symptoms can occur following abrupt discontinuation, and medical support may be required to help taper them off the drug.

In the case of Flexeril, dependence is more likely than physical addiction. However, psychological addiction can occur if the individual feels like they cannot function normally without the drug, or if they engage in compulsive use and go to extreme lengths to keep using it.

Statistical Overview of Prevalence of Abuse

Below are some statistics surrounding Flexeril and its associated health conditions:

  • It is estimated that over 2 million adults in the U.S. are using muscle relaxants.
  • The use of muscle relaxants tripled in 2016, with 24.7 million prescriptions written that year.
  • An estimated 2 million U.S. adults report using muscle relaxants like Flexeril in the last month.
  • In 2018, Flexeril was the most prescribed muscle relaxant medication, with over 18 million prescriptions. Next in line was Tizanidine, with 8.9 million prescriptions.
  • In 2010, 12,411 emergency room (ER) visits were related to Flexeril use.
  • Of those ER visits, 18% are estimated to have been mixed with alcohol.
  • Back pain is the 6th costliest condition in the U.S., amounting to over $12 billion per year.
  • It is estimated that around 83 million workdays are lost per year due to back pain.
  • According to the National Institute on Drug Abuse, more than 50 million Americans aged 12 and above have abused a prescription drug at least once in their lives.

Methods of Use

Flexeril comes in 5 mg, 7.5 mg, and 10 mg dosages. It also comes in timed and extended-release (15 mg – 30 mg) formulations that can be taken once daily.

Dosage

Adults and children 15+ can take 10 mg of Flexeril 3 times per day. The highest dosage should be no more than 60 mg in a single day.

Individuals can also start on 5 mg doses 3 times per day during the initial adjustment period.

Physical and Neurological Effects of Flexeril

Flexeril’s primary effects are to provide pain relief and muscle relaxation. However, in higher doses the drug can induce other effects, such as:

  • An altered state of mind
  • A sense of floating
  • A relaxed, sleepy feeling
  • A mild euphoric high

Potential Side Effects

Flexeril can also cause uncomfortable side effects, especially during the first few weeks while the body adjusts. These include:

  • Drowsiness
  • Dry mouth
  • Fatigue
  • Headaches
  • Dizziness
  • Nausea
  • Constipation
  • Blurred vision
  • Confusion
  • Acid reflux
  • Abdominal pain
  • Fever
  • Nervousness
  • Urination problems

Common Flexeril Combinations

Due to the mild high that can be achieved with Flexeril, some people report taking it in excess to achieve higher states of euphoria. Some individuals also mix the drug with other substances, either by accident or to purposefully increase its effects. Some of the most frequent combinations include:

Alcohol

Alcohol and Flexeril are a popular combination, as they can enhance the euphoria and effects of each other. However, as alcohol and Flexeril both depress the central nervous system, it can cause dangerous effects, such as over-sedation. Alcohol can also enhance some of the side effects of Flexeril, such as dizziness and drowsiness. Some of the potential risks associated with mixing alcohol and Flexeril include:

  • Seizures
  • Increased drowsiness and dizziness
  • Poor motor skills and cognitive function
  • Memory loss
  • Slowed, labored breathing
  • Abnormal behavior

Another danger of mixing alcohol and Flexeril is they can lead to overdoses. Having too much alcohol in the system can impair judgment and a person may take more Flexeril than intended — or vice versa.

Stimulants

Flexeril is also sometimes taken with stimulants, like cocaine, to reduce its stimulating effects when the drug is wearing off. In other words, Flexeril can help people sleep or relax after taking stimulants. However, mixing these two drugs is dangerous, not only because they oppose each other, but because they can result in unintended consequences. One of the issues of mixing stimulants and depressants is that they can mask the effects of each drug, leading to overdoses.

Opioids

Despite the dangers of mixing prescription medications, doctors are known to prescribe opioids along with muscle relaxants like Flexeril. In fact, according to some estimates, 70% of people who are prescribed muscle relaxants are also given a prescription for an opioid pain medication like OxyContin.

The danger of mixing opioids and Flexeril is that the combination can create a euphoric high, leading to abuse and addiction. Also, because of the activation of the body’s opioid receptors and the central nervous system, dangerous consequences like respiratory failure, coma, and death can occur.

Other Pain Medications

Like opioids, other pain medications such as acetaminophen (Tylenol) and ibuprofen are also often taken with drugs like Flexeril. If it’s consumed in large doses, or mixed with Flexeril, over-the-counter pain medications can produce unwanted side effects, such as:

  • Slowed breathing
  • Over-sedation
  • Headache
  • Nausea
  • Tiredness
  • Nervousness
  • Heartburn
  • Constipation

Negative Health Consequences


Ongoing Flexeril use can leave lasting and damaging effects on a person’s physical and mental health. Some of these are the result of rare, adverse side effects, which can include:

  • Serotonin syndrome
  • Somnolence
  • Chronic dry mouth
  • Paranoia
  • Depression
  • Increased risk of heart attack
  • Increased risk of stroke
  • High blood pressure
  • Loss of muscle coordination
  • Muscle weakness
  • Sleep problems
  • Blurred vision

Overdose

Another important thing to look out for is a potential Flexeril overdose. Key signs and symptoms of an overdose include:

  • Chest pain
  • Hallucinations
  • Vomiting
  • Rapid heartbeat
  • Slurred speech
  • Difficulty breathing
  • Extreme drowsiness

Severe overdoses are also possible with Flexeril. While these are rare, they consist of:

  • Seizures
  • Extremely low blood pressure
  • Cardiac arrest
  • Irregular heart rate
  • Fever, muscle rigidity, and altered mental state (known as neuroleptic malignant syndrome)

Signs & Symptoms of Flexeril Abuse


The signs and symptoms of abuse can vary from person to person, depending on how much they take and long they’ve used it. However, there are key signs to watch out for.

Physical Signs

Some of the physical signs that indicate someone is abusing Flexeril include:

  • Slurred speech
  • Disheveled appearance
  • Frequent mood swings
  • Sudden weight loss or weight gain
  • Changes in sleep habits
  • Impaired coordination

Behavioral Signs

Any sudden changes in behavior can be clear indicators of a problem. Some of the behavioral signs of Flexeril addiction also apply to other prescription drug dependencies, and can include:

  • “Doctor shopping:” acquiring multiple prescriptions from different doctors
  • Running out of prescriptions early
  • Faking symptoms to get Flexeril prescriptions
  • Hiding or lying about Flexeril use
  • Difficulties controlling Flexeril use
  • Compulsively using Flexeril, despite its negative side-effects
  • Isolating from work, family, and social life
  • Loss of interest in activities or hobbies
  • Insomnia or over-sleeping
  • Worsening performance at school or work
  • Suspicious behavior
  • Financial problems (stealing, debts, losing jobs, inability to pay for necessities)
  • Relationship problems
  • Abusing other substances (“poly-substance use”)

Resources

If you or a loved one are struggling with Flexeril abuse or addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Gordon, S. (2020). Muscle Relaxants for Back Pain Are Soaring: Are They Safe? WebMD.com. https://www.webmd.com/back-pain/news/20200701/muscle-relaxants-for-back-pain-are-soaring-are-they-safe.

Dillon, C., Paulose-Ram, R., Hirsch, R., Gu, Q. (2004). Skeletal Muscle Relaxant Use in The United States: Data from the Third National Health and Nutrition Examination Survey (NHANES III). Spine. 29(8), 892-6. https://10.1097/00007632-200404150-00014

Medical News Today. Cyclobenzaprine, oral tablet. https://www.medicalnewstoday.com/articles/cyclobenzaprine-oral-tablet.

Penn Medicine News. (2020). Long-term Use of Muscle Relaxants Has Skyrocketed Since 2005. Pennmedicine.org. https://www.pennmedicine.org/news/news-releases/2020/june/long-term-use-of-muscle-relaxants-has-skyrocketed-since-2005.

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

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