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Flexeril Addiction and Treatment Options

Flexeril is a brand name for the central nervous system depressant drug cyclobenzaprine, which is also sold under the brand name Amrix.

Cyclobenzaprine is prescribed as a muscle relaxant for the short-term relief of muscle spasms which are related to musculoskeletal conditions. It is meant to be used as an adjunct treatment along with physical therapy and rest to treat acute pain and discomfort. 


Prescription Drug Abuse

More than 6 percent of the American adult population misused a prescription medication at least once in 2017, the National Institute on Drug Abuse (NIDA) publishes. Prescription drug misuse is common, and it comes with many risks. 

Flexeril Use

The U.S. Food and Drug Administration (FDA) publishes that cyclobenzaprine should only be prescribed for a short period of time — no more than two to three weeks. Long-term use of this medication is not recommended.

It is possible to overdose on Flexeril. Mixing the drug with other depressant substances, such as alcohol or drugs, which interact with serotonin levels in the brain, can be very hazardous.

Flexeril is not a controlled substance, but it does have the potential for diversion and abuse. 

Flexeril may be abused, as it can cause relaxation and euphoria.



Recognizing Flexeril Abuse

Flexeril is a prescription medication that needs to be dispensed by a medical professional for a necessary and legitimate medical concern. Any time this is not the case, it is considered medication abuse.

The following are possible signs of Flexeril abuse:

  • Exaggerating symptoms to obtain Flexeril
  • Taking the medication without a medical need or prescription for it
  • Using more Flexeril in between regular doses
  • Taking the drug in a way other than it is intended to be taken, such as chewing it or crushing it and snorting it
  • Continuing to take Flexeril after a prescription has run out
  • Going to more than one doctor, called doctor shopping, to try and get additional prescriptions

Flexeril abuse can also be indicated by keeping the medication close at hand. For example, there may be Flexeril in easy-to-reach locations like a nightstand, in the car, in a handbag, or similar places. Loved ones may notice empty multiple Flexeril medication bottles in the trash.

Physical signs of abuse can include mood swings, interrupted sleep patterns, and changes in appetite. When someone is abusing Flexeril, physical health can decline, causing weight fluctuations and a lack of concern for personal hygiene. 

Substance abuse can cause a person to spend more time alone and have less desire to participate in recreational or social events that may have been a priority before. School and work production often slide. Obligations and familial commitments may be consistently overlooked.

Social circles often change as a result of Flexeril abuse, as a person is likely to spend the majority of their time thinking about how and where to get the drug, using it, and then coming down from it.

When someone is under the influence of Flexeril, they are likely to appear sluggish, drowsy, dizzy, relaxed, and mentally impaired. They may struggle to remember things.

Flexeril intoxication may be similar to being drunk since cyclobenzaprine and alcohol are both central nervous system depressants. It may also lower inhibitions, slow reaction time and reflexes, and make a person more prone to accidents, injuries, and risk-taking behaviors.

This kind of substance abuse can cause a person to act in ways that are out of character. Family and friends may notice a shift in personality altogether. A person may become secretive, distant, and unpredictable as a result of this abuse. 


Hazards of Flexeril Abuse

The prescribing information for Flexeril, published by the FDA, reports that that dizziness, dry mouth, and drowsiness are the most common negative side effects of the medication.

Additional adverse reactions to the drug include the following:

  • Fatigue
  • Headache
  • Stomach pain
  • Vomiting
  • Constipation
  • Irritability
  • Diarrhea
  • Nausea
  • Acid reflux
  • Nervousness
  • Respiratory infection
  • Cognitive difficulties

Flexeril is very similar to tricyclic antidepressant (TCA) medications. It cannot be mixed with other drugs or medications that interact with serotonin levels in the brain, such as monoamine oxidase inhibitors (MOAs).

Serotonin syndrome can be life-threatening, the Mayo Clinic warns. It can cause seizures, hallucinations, fever, irregular heart rate, mental confusion, agitation and restlessness, high blood pressure, loss of muscle coordination, and a possible loss of consciousness.


Overdose Signs and Risks

Flexeril is a central nervous system depressant medication, which means that it lowers body temperature and blood pressure, slows heart rate, and calms the system, leading to relaxation.

As of February 2003, the maximum dosage for cyclobenzaprine is 30 mg a day, which is generally given in doses of 5 mg three times a day, or the extended form is dosed at 15 mg once per day,  Prescriber’s Digital Reference, PDR publishes. Too much Flexeril at one time can be toxic.

Taking a higher dose at once, mixing Flexeril with another drug or alcohol, or taking it in a way other than it is meant to be taken (which is swallowed orally) can lead to overdose. Crushing and snorting or chewing an extended-release Flexeril tablet can be toxic, as it causes the entire dosage to be released into the bloodstream at once. 

The journal ALiEM (Academic Life in Emergency Medicine) explains that cyclobenzaprine has anticholinergic effects. This means that the medication blocks certain nerve impulses in the brain and along the central nervous system.

An overdose can cause the following:

  • Urine retention
  • Sedation
  • Irregular heart rate
  • High blood pressure
  • Agitation
  • Tremors
  • Slurred speech
  • Confusion
  • Chest pain
  • Nausea
  • Vomiting
  • Dizziness
  • Coma
  • Hallucinations

Unlike with a TCA overdose, a Flexeril overdose is not likely to cause seizures. It may still be fatal without swift medical intervention, especially if the drug has been combined with another drug.

In 2010, the U.S. Drug Enforcement Administration (DEA) reported that there were more than 10,000 case mentions of cyclobenzaprine to the American Association of Poison Control Centers, and more than 12,000 emergency department visits (EDs) related to cyclobenzaprine. This was more than a 100 percent increase from the number of ED visits in 2004.


Long-Term Issues Involving Flexeril Abuse

Again, Flexeril is not designed or recommended to be taken for longer than a few weeks. It is also intended to be used in conjunction with other treatment methods as a muscle relaxant.

If the drug is abused and used for non-medical purposes, all of the possible complications and risk factors go up.

In addition to the possible chance of fatal overdose, Flexeril misuse may also lead to physical drug dependence. The brain can get used to the way that Flexeril changes the chemical balance of the neurotransmitters, or chemical messengers, which can mean that the body will struggle to keep things stabilized on its own. Nausea, headache, and feelings of general malaise are potential side effects of this dependence.

Physical dependence is often a complication of addiction, although it does not in and of itself indicate addiction. Addiction is a behavioral disorder in addition to being a brain disease.

NIDA publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for addiction. These criteria include the following:

  • Cravings for the drug
  • Taking the drug for longer and in higher doses than initially intended
  • A desire, and unsuccessful attempts, to stop taking the drug
  • Large amounts of time spent obtaining, using, and recovering from the drug
  • Drug use interfering with family, school, and/or work obligations
  • Giving up social and recreational activities for drug use
  • Continued use of the drug even with the knowledge that it will be physically or psychologically harmful
  • Using the drug in physically risky situations
  • Keeping up the use of the drug despite interpersonal issues related to it
  • Tolerance for the drug, indicated by the need to increase the dosage for the same effects to be felt
  • Drug dependence and withdrawal symptoms

Two or three of these signs is considered mild addiction. Four to five symptoms are considered moderate, and six or more is classified as severe.

Addiction is a chronic and compulsive brain disease. While there is no cure for addiction, it can be treated through comprehensive treatment programs.


When and How to Get Help for Flexeril Abuse

Any misuse of Flexeril is abuse and is cause for concern. If it is difficult to stop taking the drug or any of the signs of addiction are present, an addiction treatment program will be beneficial.

Treatment programs range from outpatient services with meetings and sessions a few times a week to more structured and rigorous inpatient programs. The more significant the addiction, the higher the intensity of treatment.

Physical dependence and withdrawal symptoms are present when Flexeril abuse is stopped. Medical detox is often the first stage of a treatment program.

Individual and group therapy sessions can help to identify the reason for Flexeril misuse and help to develop healthy coping skills and relapse prevention techniques to manage addiction. 

Support groups are beneficial for creating sober peer interactions and support into ongoing recovery.

To find a treatment program, primary care or mental health professional can be a great resource. The Substance Abuse and Mental Health Services Administration (SAMSHA) also hosts a Behavioral Health Treatment Services Locator that can be used to find services in any area in the United States. Flexeril addiction can be effectively managed through a variety of services and programs. You just need to take the first step toward that assistance.

Sources

(December 2018). What Is the Scope of Prescription Drug Misuse? National Institute on Drug Abuse. Retrieved February 2019 from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse

(June 2013). Highlights of Prescribing Information Amrix. (June 2013). U.S. Food and Drug Administration. Retrieved February 2019 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021777s006s009lbl.pdf

(April 2013). Flexeril. U.S. Food and Drug Administration. Retrieved February 2019 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/017821s051lbl.pdf

(January 2017). Serotonin Syndrome. Mayo Clinic. Retrieved February 2019 from https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

(2019). Cyclobenzaprine Hydrochloride- Drug Summary. PDR. Retrieved February 2019 from https://www.pdr.net/drug-summary/Cyclobenzaprine-Hydrochloride-cyclobenzaprine-hydrochloride-3089

(February 2014). Cyclobenzaprine Vs. TCA Toxicity. ALiEM. Retrieved February 2019 from https://www.aliem.com/2014/02/cyclobenzaprine-tca-toxicity/

(January 2013). Cyclobenzaprine. U.S. Drug Enforcement Administration. Retrieved February 2019 from https://www.deadiversion.usdoj.gov/drug_chem_info/cyclobenzaprine.pdf

(July 2018). The Science of Drug Use and Addiction: The Basics. National Institute on Drug Abuse. Retrieved February 2019 from https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics

Behavioral Health Treatment Services Locator. Substance Abuse and Mental Health Services Administration. Retrieved February 2019 from https://www.findtreatment.samhsa.gov/

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