A prescription-based medication, cyclobenzaprine (known by the brand names Flexeril and Amrix) is similar to tricyclic antidepressants and being both diverted and abused, Drug Enforcement Administration (DEA) reports.
Designed for the short-term relief of limited motion and pain that may be caused by muscle spasms, cyclobenzaprine is a central nervous system muscle relaxer that may stop hyperactive nerve firings that can cause muscles to spasm.
The DEA reports that there were more than 25 million prescriptions written for cyclobenzaprine in 2011, which may be a common medication prescribed for back pain. Flexeril comes in tablet form in both immediate- and extended-release formations to be swallowed.
When abused, cyclobenzaprine may have a sedative and relaxing effect and potentially even cause a euphoric “high.” Flexeril may be abused orally, mixed with other drugs, easily dissolved in alcohol, or crushed to be snorted. Flexeril may not be difficult to obtain as it is not classified by the DEA as a controlled substance.
Anytime someone is using a prescription drug without a prescription, or beyond the scope of a legitimate prescription, it is considered drug abuse. The National Institute on Drug Abuse (NIDA) estimates that more than 50 million Americans aged 12 and over have abused a prescription drug one or more times in life. Prescription drugs may seem safer than illicit ones, making them targets for abuse. All drugs act on natural chemicals in the brain, however, and abusing them can lead to drug dependence and addiction.
Drug addiction cost American society close to $200 billion in 2007, in healthcare costs, legal and criminal justice expenses, and lost workplace production, the Office of National Drug Control Policy (ONDCP) reports. Substance abuse treatment can greatly improve some of the behavioral, social, emotional, physical, and financial issues that may arise as the result of drug abuse.
Treatment should be multifaceted and tailored to each individual. Physical drug dependence is often treated with medical detox, for example. The behavioral and emotional aspects of drug abuse and addiction are often treated with behavioral therapies and group and individual counseling sessions that work to improve coping mechanisms, communication skills, self-confidence, and mental health.
Prescription drugs are abused across almost all age, gender, race, cultural, and socioeconomic demographics, however. For example, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that prescription drug abuse is increasing for older adults in their 50s, which may be of particular concern due to the range of negative side effects that specifically impact this population group. Flexeril in particular is not even generally prescribed to the elderly population, according to the FDA, because of the high risk factors.
Additionally, individuals with a legitimate prescription to Flexeril may develop a tolerance to the drug, requiring them to take higher and more frequent doses to feel its effects. Drug dependence can develop wherein the brain becomes accustomed to the interaction of cyclobenzaprine and begins to rely on it in order to keep functioning the same way.
Dependence on cyclobenzaprine is recognized by the onset of withdrawal symptoms when the drug leaves the bloodstream. These may include fatigue, nausea, headache, and general malaise.
The terms drug dependence and addiction are often used interchangeably; however, they are not the same thing. A dependence on a drug can occur independently of addiction. It is a physical reaction to the brain needing a particular drug to remain balanced. Drug dependence can form even when a drug is taken for medical reasons and used exactly as prescribed. Narcotic drugs, like opioids, and sedatives, like benzodiazepines and tricyclic antidepressants (which are similar in structure to cyclobenzaprine), can cause physical dependence.
Medical help is needed to stop taking a drug after a person has become dependent on it, as withdrawal symptoms and drug cravings may be significant. Instead of stopping the drug suddenly, these drugs can be tapered off slowly, or their dosage slowly reduced over a period of time to minimize withdrawal. This should only be done under medical supervision. Significant dependence, often created by the nonmedical use of drugs, is best treated with medical detox where medications may be used and medical supervision is available around the clock.
Addiction is not just physical but also behavioral. Addiction is classified as a disease by the American Society of Addiction Medicine (ASAM) that is related to changes in brain structure and chemical makeup as the result of substance abuse. The main indicator of drug addiction is a loss of control over drug use. An individual battling addiction may make multiple attempts to stop using the drug, may take more than intended at one time, or may take the drug for longer than initially desired. Individuals suffering from addiction may use drugs in situations that could potentially be hazardous and continue abusing them even when negative consequences are clear.
A drug overdose occurs when a toxin is unable to be successfully metabolized and removed from the body, and certain bodily functions are negatively affected. In the case of cyclobenzaprine, the Journal of Occupational Medicine and Toxicology reports that more than 100 mg of the drug taken in one dose can cause a toxic overdose.
The FDA publishes the following as potential overdose signs of Flexural:
Less common and more serious symptoms of a Flexeril overdose, according to the drug’s prescription information published by the FDA, include:
Overdose is complicated by the addition of other medications, illicit drugs, or alcohol, which can enhance the potential side effects of each substance or cause a negative interaction between them.
The DEA reported that in 2010, there were over 10,000 mentions of cyclobenzaprine in calls to the American Association of Poison Control Centers. The Drug Abuse Warning Network (DAWN) published that in 2011, more than 11,000 people sought emergency department (ED) treatment for abuse of cyclobenzaprine.