Is Baclofen a Controlled Substance?
Baclofen is a commonly prescribed muscle relaxant that is often used to treat conditions such as muscle spasms, muscle tightness and muscle cramping. It has been FDA-approved to help reduce muscle spasms due to conditions such as multiple sclerosis, cerebral palsy, or other types of spinal cord injury. Baclofen has shown to be an effective treatment for muscle pain and works by interacting with the central nervous system resulting in feelings of relaxation and pain relief. In some cases, it is being explored as an opioid replacement medication due to having similar pain-relieving qualities. Because it acts on the central nervous system, there is a risk of developing an addiction to the drug. Does this mean baclofen can be considered a controlled substance?
Baclofen is not a pain killer. It only helps to relieve pain associated with specific types of muscle conditions. Baclofen is not a controlled substance in the US. However, if taken in large quantities, the drug can lead to pleasurable feelings similar to that of alcohol intoxication. This in turn can lead to dependence and addiction.
What is Baclofen?
Baclofen is an antispasmodic agent used to treat certain types of muscle tightness and stiffness, often called muscle spasticity. It is a skeletal muscle relaxant that impacts the spinal cord nerves to decrease the severity of the muscle spasms. The drug reduces the release of excitatory neurotransmitters in the presynaptic space. This stimulates inhibitory neuronal signals in the postsynaptic space, which results in spasticity relief. Baclofen also releases GABA receptors that interact with the central nervous system and produce pain-relieving properties, relax the body and can lead to feelings of elation and sedation.
When taken, the drug gets absorbed quickly into the bloodstream and can reach its peak concentration within an hour after the last dose. The half-life for baclofen is between 3-6 hours. Because of this short time, the drug is often administered frequently in order to achieve optimal and lasting effects.
Common side effects of baclofen
- Dizziness
- Weakness
- Confusion
- Headache
- Nausea and vomiting
- Constipation
- Difficulty sleeping
- Frequent urination
- Shallow breathing
- Hallucinations
- Tingling
- Fever
- Seizures
Is Baclofen a Controlled Substance?
No. Baclofen is not considered to be a controlled substance in the US and is not regulated under the Controlled Substance Act. It has muscle relaxant properties with no potential for abuse. However, misuse of the drug in an attempt to enhance its effects can lead to dependence and addiction.
Baclofen Abuse and Addiction
When taken as prescribed by a health care provider, baclofen is safe and effective. It is not known to cause addiction. However, baclofen has pain-relieving and muscle-relaxing qualities. This can make it susceptible to abuse of the drug, which leads to building up a tolerance for the drug and then leads to the development of physical dependence to the drug. Abuse of the drug can induce feelings of euphoria similar to the feeling of alcohol intoxication.
Baclofen withdrawal is extremely uncomfortable and can cause many users to relapse and continue using the drug. Withdrawal symptoms can be more severe for those who have taken high doses of the drug resulting in symptoms such as stiff muscles, low blood pressure, itchy skin and numbness. Other adverse side effects that can occur during withdrawal include the return of muscle spasticity, lightheadedness and tingling sensations. In order to avoid uncomfortable and dangerous withdrawal symptoms, it is best to gradually taper off the medication.
In extreme cases of abuse, users can overdose on baclofen. Overdose can occur with just 100mg. Taking more than 200 mg is even more dangerous and worsens overdose outcomes.
Abuse and addiction to baclofen usually involve taking it in excess or taking it in addition to other drugs such as alcohol. When used with other mind or mood-altering substances, baclofen can cause a high and can become extremely addictive resulting in weak or shallow breathing, confusion, hallucination or seizures.
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Baclofen for treatment of Alcohol Use Disorder
One of the popular off-label uses of baclofen includes assisting in the treatment of substance use disorders such as alcohol abuse. Alcohol use disorder is characterized by frequent periods of excessive alcohol consumption and chronic relapsing of alcohol abuse. Recent studies have found that baclofen can be considered a treatment option for those who are experiencing alcohol withdrawal symptoms.
How can a muscle relaxant help treat symptoms of alcohol withdrawal? Baclofen interacts with the GABA receptors in the brain. This involves the regulation of neurotransmitter systems for dopamine, serotonin, memory pathways and other cognitive functions. Research suggests that the way baclofen interacts with GABA receptors produces the ability to nullify cravings for certain types of substances including alcohol.
In a 2016 study of 113 people with alcohol use disorder, the research found baclofen helped to reduce cravings and alcohol consumption even among participants with very poor motivation to stop drinking. In a 2021 clinical trial of 120 people with alcohol use disorder, the findings suggested baclofen helped to increase abstinent days and decrease days of heavy drinking.
In one study, researchers found that baclofen did not actually help reduce the amount of alcohol consumed. It did however alter the subjective effects of alcohol, which contributed to the decline in alcohol cravings. Another study found that baclofen helped to dissociate the link between an initial drink and subsequent alcohol consumption. Other studies show the drug helps to reduce alcohol cravings and alcohol-related anxiety during the alcohol withdrawal period.
Baclofen vs Cyclobenzaprine
Baclofen and cyclobenzaprine are medications often prescribed to treat specific types of muscle pain. Baclofen is FDA-approved for the treatment of muscle spasms due to multiple sclerosis or spinal cord injury. Cyclobenzaprine is FDA-approved in the treatment of muscle spasms due to general muscle injury. Both drugs fall under the same category of muscle relaxants but are used to treat different types of conditions. This is especially true when it comes to off-label uses.
- Baclofen is used to help reduce muscle spasms related to cerebral palsy
- Baclofen is used to help manage symptoms of alcohol-related liver disease
- Baclofen is used to help reduce alcohol cravings as well as alcohol-related anxiety disorder
- Baclofen is used to help treat nerve pain
- Baclofen can also be used to treat gastroesophageal reflux disease
- Baclofen can be used to help relieve symptoms of hiccups
Cyclobenzaprine is a skeletal muscle relaxant and works by activating the central nervous system. By slowing down the brain and spinal cord, it reduces signals from the brain that promote muscle spasms and can result in the relaxation of the muscles. Off-label uses of cyclobenzaprine include treating specific symptoms of PTSD, treating symptoms of myofascial pain and treating symptoms of sleep disturbances due to fibromyalgia.
Baclofen is considered the first choice of medication when treating muscle spasms caused by spinal cord injury. Cyclobenzaprine is shown to be more effective in treating conditions for general back pain. Both medications can lead to sleepiness, dizziness, fatigue and fainting.
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Treatment for Substance Use Disorder
Baclofen was initially created to address conditions of epilepsy. It was then reintroduced in 1971 for its efficiency in treating various types of muscle spasticity. Baclofen is not a controlled substance and has little to no risk of abuse or addiction. However, when used with other substances like alcohol, dependence on the drug can develop leading to withdrawal symptoms and addiction. Behavioral health programs such as Hotel California by the Sea provide effective treatment for those addicted to prescription medications such as baclofen.
We offer treatment in detox, residential, PHP and IOP. We utilize evidence-based methods such as CBT, DBT and EMDR therapy to help our clients understand the root causes of their addiction or co-occurring mental health disorders. Hotel California by the Sea is dedicated to helping clients achieve their goals in sobriety and overcome their addiction.
References:
https://recovered.org/other/baclofen
https://medlineplus.gov/druginfo/meds/a682530.html
https://zinniahealth.com/substance-use/baclofen
https://www.ncbi.nlm.nih.gov/books/NBK526037
https://www.verywellhealth.com/baclofen-vs-cyclobenzaprine-8612973
https://www.addictioncenter.com/drugs/baclofen
https://pmc.ncbi.nlm.nih.gov/articles/PMC6328471
https://www.medicalnewstoday.com/articles/baclofen-and-alcohol#what-the-research-says