Cyclobenzaprine (Flexeril) Addiction

What is Cyclobenzaprine (Flexeril)?

Cyclobenzaprine, commonly known by its brand name Flexeril, is a muscle relaxant prescribed to treat injuries, pain, and tenderness. It works on the central nervous system by blocking pain messages sent from the muscles to the brain. The drug is intended to be used short-term according to the guidance of a healthcare professional. If used as prescribed, it has few side effects and health risks. However, the drug’s sedative effects make it one with a high potential for abuse.

Flexeril Side Effects

Side effects may occur when cyclobenzaprine is taken improperly, with higher doses increasing the risk of side effects. These include1:

  • Drowsiness
  • Dry mouth
  • Dizziness and nausea
  • Headache
  • Confusion
  • Elevated heart rate
  • Impaired cognitive functioning
  • Anxiety
  • Abnormal thinking
  • Seizures

Severe side effects, including seizure and seriously impaired thinking and behavior, are more likely when cyclobenzaprine is combined with other drugs. Alcohol can be particularly dangerous when used concurrently with cyclobenzaprine because the two substances compound each others’ effects. 

Dependence and Abuse Potential

Cyclobenzaprine (Flexeril) is not considered a controlled substance by the US Drug Enforcement Administration (DEA). This means that it is not considered a drug with a high risk for chemical dependence. However, the drug still has potential for abuse due to its relaxing and sedative properties, which can be increased in combination with alcohol and other depressant substances. Withdrawal symptoms, a key component of addition, is also possible when Flexeril is discontinued suddenly. These symptoms include headache and nausea.
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Is Flexeril Addictive?

The potential for addiction to cyclobenzaprine is considered relatively low, which is why it is not classed as a Scheduled substance according to the DEA even though its use requires a doctor’s prescription. However, the drug has been implicated in instances of non-medical use, commonly in conjunction with the use of other substances like alcohol and benzodiazepines. Flexeril is considered to enhance the effects of these substances.

Flexeril Addiction Statistics

Since cyclobenzaprine is most commonly used in conjunction with other drugs, little research has been done to examine cyclobenzaprine. Nonetheless, emergency room visits involving Flexeril have increased to 12,411 in 2010, almost double the ER visits involving the drug from previous years2. This represents an 84% increase from 2004 to 2011. Its use may have increased after 2012 when similar medication, carisoprodol (Soma, commercially) was classified as a Schedule IV substance, making it harder to obtain3.

Signs of Cyclobenzaprine Abuse and Addiction

Abuse and addiction to cyclobenzaprine may occur when the drug is combined with other substances, used past the prescribed time frame, or in higher doses than prescribed. Signs that a person may be abusing or addicted to cyclobenzaprine include:

  • Cravings to use the drug and feel its physical effects
  • Social withdrawal from family and friends
  • Inability to fulfill obligations at work or at home
  • Continuation of drug use in the presence of negative effects
  • Purposefully taking the drug at higher doses or frequency than prescribed
  • Needing higher doses of the drug to achieve the same effects
  • Withdrawal symptoms when cyclobenzaprine is discontinues
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Flexeril Overdose

Flexeril has the risk of overdose, especially when taken at high doses or combined with other substances like alcohol or opiates. Signs of overdose may include4:

  • Excessive drowsiness
  • Rapid heartbeat
  • Dizziness
  • Nausea and vomiting
  • Slurred speech
  • Tremors
  • Hallucinations
  • Difficulty speaking
  • Loss of consciousness
  • Coma
In severe cases, overdose may lead to cardiac arrest seizures, and Neuroleptic Malignant Syndrome, which involves impaired mental state and autonomic dysfunction5. Food and Drug Administration (FDA) guidelines suggest gastrointestinal decontamination to treat a Flexeril overdose, including gastric lavage and activated charcoal. 

Slang for Cyclobenzaprine

Cyclobenzaprine is the generic name for the drug Flexeril. Its illicit street name may be some derivative of the brand name like flexies, flexreal, or filxeril. 

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Treatment for Flexeril Abuse

Flexeril abuse may be treated in a variety of different ways depending on the degree of abuse and addiction and its combination with other drugs. Typically, the first and most efficient treatment for Flexeril abuse is detox. Since cyclobenzaprine withdrawal isn’t as severe as other substances, a medically supervised detox may be more important to those who commonly use Flexeril in combination with other drugs. In these cases, medication may be prescribed to treat the symptoms of withdrawal.

In addition to medical detox intervention, those recovering from Flexeril abuse may benefit from in-person group or individual counseling to provide support and encouragement during the process. Therapy may be able to help identify triggers and motivations for the use of Flexeril with the aim of recognizing them in the future and being able to fight them. It may also be used to help people reintegrate into their social life and begin to confront work and family responsibilities that may have been neglected during the course of addiction. 

Inpatient treatment programs may be beneficial to those who prefer to have round-the-clock support and access to extensive treatment programs without the pressure of their normal routines. This kind of treatment is best suited to those with severe Flexeril addiction or those who abuse multiple substances. 

References:
  1. Drug Enforcement Administration—Diversion Control Division. (2019). Cyclobenzaprine.
  2. Substance Abuse and Mental Health Services Administration. (2011). Drug Abuse Warning Network 2011: National Estimates of Drug-Related Emergency Department Visits.
  3.  https://www.sciencedirect.com/science/article/abs/pii/S0376871619302522
  4. S. National Library of Health—MedlinePlus. (2019). Cyclobenzaprine.
  5. S. Department of Health and Human Services; U.S. Food and Drug Administration (FDA)—FDA Approved Drug Products. (2013). FLEXERIL (CYCLOBENZAPRINE HCL) TABLETS.