Even though prescriptions for opioids have significantly declined, prescriptions for non-opioid medication have increased, as patients need alternative treatment to pain management. One study published in Clinical Toxicology analyzed Baclofen exposures from 2014 to 2017 and detected a 36% increase in misuse attempts. Misuse can lead to addiction, which may require treatment in a rehab facility.
Although baclofen is a non-opioid treatment for chronic pain, it still carries the risk of dependence and abuse.
Baclofen is a gamma-aminobutyric acid (GABA) analog drug that’s commonly prescribed as a muscle relaxant and antispasmodic. It has been used as an oral medication since the 1960s, and it has been shown to improve spasms in 70% to 96% of patients.1
The medication is given as treatment for spasm, pain, and stiffness as a result of multiple sclerosis, spinal cord injuries, or other spinal cord disorders. It works in the brain or in the spinal cord to block over-excited neuronal pathways.
When used as recommended by a medical person, the medication can improve mobility and facilitate both passive and active physiotherapy.2
Baclofen is taken off-label for the treatment of other conditions such as hiccups or Tourette’s syndrome. Recently, medical professionals have been prescribing baclofen to help in the treatment of substance use disorders. However, this is considered “off-label” use.
In some cases, it can be used as part of combination therapy. This means that patients take it in combination with other medications.
Baclofen gets quickly absorbed from the gastrointestinal tract and enters the bloodstream. It reaches peak concentration in the blood around one to three hours after consumption. The drug’s half-life is three to four hours in plasma.
The United States Food and Drug Administration (USFDA) approved the drug in 1992. Today, it’s available in tablet form, injection form, and powder form.
The cause of the rising number of baclofen prescriptions lies in the fact that millions of adults in the US live with chronic pain. In 2016 alone, it’s been estimated that 50 million people suffered from chronic pain, and 20 million suffered from high-impact chronic pain. Even worse, some pain conditions are related to an increased risk of attempted suicide. In the US, suicide attempts have increased by 30% from 1999 to 2016.
Baclofen is not considered a controlled substance, although there have been reports of its extensive misuse.
Baclofen is taken by mouth, with or without food. The recommended dose is three times a day. Doctors may also recommend to start the medication at a low dose and gradually increase the dose to avoid the risk of side effects.
The drug also comes in a liquid form. Patients are instructed to use a special measuring device/spoon to get the right dose.
Methods of misusing Baclofen are to take it in excess or mix it with other substances. To increase their high, users often combine it with opioids, alcohol, and amphetamines to experience a feeling of euphoria.
Baclofen is considered to be safe when taken as prescribed by a doctor. However, due to its effects on the brain and the central nervous system, the drug is abused for its relaxation effects and the sense of well-being it brings.
Some signs of Baclofen abuse include:
Taking higher doses than prescribed
Using the drug in combination with other medications to increase the effects
Taking it without prescription
When misused, it can lead to an addiction, especially in those who are susceptible to developing an addiction. Regular off-label use can lead to tolerance and dependence.
Taking larger doses to feel the same high, denotes a tolerance of the drug. If an individual can’t stop taking the medication, then this is regarded as a sign of dependence.
Dependence can lead to the development of withdrawal symptoms such as agitation, confusion, delirium, and seizures when the individual abruptly stops taking the drug. Baclofen withdrawal can happen to those who are using the medication as prescribed by a doctor. Due to the severity of the withdrawal symptoms, patients are recommended to seek treatment at a detox center.
There are no known street names of Baclofen. However, the drug has several brand and generic names:
Prescriptions for opioids have been declining. A growing number of states in the US have enacted strict new laws on opioid prescriptions that limit the amounts medical professionals can prescribe for pain management.
The reason for the limitation of opioid prescriptions lies in the fact that about 400,000 people have died from an opioid-related overdose from 1999 to 2017, according to the Centers for Disease Control and Prevention (CDC). Moreover, one study by the University of Pittsburg states that there were roughly 70,000 more opioid overdoses that were not counted due to incomplete death records.
Baclofen is one of the non-opioid medications that medical professionals have been prescribing as an alternative to opioids. The CDC guidelines recommend this opioid as an alternative treatment for patients with chronic pain.
However, according to a study published in Clinical Toxicology, this medication also carries a risk of misuse. The study discovered an increase in exposure associated with the use of the drug and a rise in abuse, related suicide attempts, and hospital admissions in the US. Baclofen exposures increased by 36.2% from 2014 to 2017.3
Poison centers report a growing number of Baclofen exposures. The drug has been related to recreational use, impaired renal (kidney) clearance, and intentional overdose. Some of the adverse side effects are respiratory depression, seizures, myoclonus, cardiac conduction abnormalities, and coma.
Baclofen is also dangerous when taken in combination with other substances. The combination of Baclofen with other substances like alcohol, tranquilizers, or sleeping pills, can depress the central nervous system and increase the risk of side effects. The mix can lead to side effects such as:
Due to the sedation effects of Baclofen, those taking the drug are cautioned against operating automobiles or other dangerous machinery, or participating in other activities that require increased alertness.
To find treatment for alcohol addiction, researchers have been exploring the effects of drugs that are used in the treatment of physical conditions. Baclofen is one of those drugs.
Research into the efficacy of the drug as a treatment for alcohol addiction was inspired by a cardiologist called Olivier Ameisen. Ameisen published in his memoir details about his own recovery from alcoholism using Baclofen.
According to a study published in the Cochrane Database of Systematic Review, the drug has shown some success in clinical trials.
However, the use of Baclofen in the treatment of alcohol addiction is still experimental, and more clinical trials are needed to explore its effectiveness. Prescription of the drug for off-label use is allowed, although the FDA does not approve the drug for the treatment of alcohol addiction.
Epilepsy or other seizure disorder
A stroke or blood clot
Serious side effects and their symptoms can include the following:
Withdrawal symptoms, such as hallucinations and seizures
Baclofen can interact with other substances. In other words, it can change the way a drug works, which can be harmful. It can interact with:
Medication for depression, anxiety, or bipolar disorder
Blood pressure medication
Mixing Baclofen with alcohol can increase the risk of nervous system side effects, including:
Taking Baclofen while suffering from a particular health condition can have adverse side effects. Those with epilepsy may experience worse seizures, and people with kidney problems or a history of kidney disease may not be able to clear the drug from their system properly. Moreover, Baclofen is not recommended to be taken by individuals with a history of stroke.
Moreover, there’s not enough evidence to know whether Baclofen is safe and effective for use in pregnant women. Pregnant women are recommended to use Baclofen during pregnancy only if the benefit justifies the potential risk to the fetus. Nursing women are also cautioned against taking Baclofen, as many drugs can be excreted in human milk.
Baclofen is also known to cause a severe allergic reaction. The most common symptoms of an allergy are trouble breathing and swelling of the throat or tongue.
Taking too much Baclofen can result in an overdose. The main causes of Baclofen overdose are:
Ingesting large doses of the drug due to drug abuse
Symptoms of a Baclofen overdose include:
One study analyzed the toxicity of Baclofen in overdose and investigated dose-related clinical effects. They analyzed 23 cases, of which, eight patients ingested Baclofen alone. The study found that:4
Four people had seizures
Eight patients suffered from a decreased level of consciousness
Eight patients suffered from delirium
Five patients experienced miosis
Seven patients showed signs of dilated pupils
Thirteen patients had absent or depressed reflexes
Hypertension occurred in 13 patients and hypotension in one
Only patients who took doses larger than 200mg experienced coma, delirium, and seizures
Excessively taking Baclofen may lead to dependence and tolerance. Abuse of the drug may also cause a set of withdrawal symptoms when Baclofen is stopped. The withdrawal symptoms are similar to the symptoms of alcohol or benzodiazepine withdrawal.
Withdrawal from Baclofen may occur if the drug has been used for an extended period. The symptoms can be severe, and in some cases, even life-threatening.
The withdrawal timeline can depend on several factors, such as:
The overall health of the individual
The dosage that was taken
How long the person used the drug
The route of administration
Generally, Baclofen withdrawal is similar to alcohol withdrawal. Meaning, it can begin a few hours after a person takes their last dose, and it can take up to 48 hours for symptoms to occur. The peak usually happens within 72 hours. The symptoms can last for weeks, while the psychological symptoms, in some cases, can linger on for months.
The spinal injection version of Baclofen tends to cause more severe withdrawal symptoms. The symptoms can be more difficult for individuals with coexisting comorbid conditions.
Abrupt cessation of Baclofen can lead to the following symptoms:
Visual and auditory hallucinations
Suddenly ceasing to take Baclofen may cause severe withdrawal symptoms that can sometimes last for weeks.
For that reason, it’s not recommended to stop taking it suddenly without professional help. The best method of getting clean is to undergo detox at a treatment center. A medical team will gradually lower the dose until the body is entirely free of toxins.
Due to the risk of severe Baclofen withdrawal symptoms, the recommended first step in addiction treatment is undergoing medically supervised detox. Patients are urged not to attempt detoxing at home or on their own as it can result in adverse health consequences.
A medically supervised detox is the best way to avoid experiencing the most severe withdrawal symptoms. The most adverse symptoms can include hallucinations, delusions, delirium, anxiety, psychosis, and mood disturbances. Other symptoms include tachycardia, hyperthermia, and mania.
During detox, a patient’s dosage of Baclofen is gradually tapered down. A medical team will ensure that the patient stays safe and is as comfortable as possible. Their vitals will be monitored regularly, and they will be assessed for any co-occurring mental health disorders.
An individual suffering from Baclofen addiction can choose between several different addiction treatment programs. The two main programs are inpatient and outpatient care.
Inpatient care comes with many benefits, including 24/7 medical care, a comfortable place to stay, and medication management. It’s intended for individuals suffering from a severe case of addiction. The person lives on the premises and participates in a range of activities, such as:
One-on-one therapy sessions
For others, outpatient care is a more suitable treatment option. It comes with its own set of benefits, such as a lower cost, the ability to stay home while participating, and maintaining daily commitments, living off-site, but attending activities at the facility for a few hours per day. This type of program might not be suitable for an individual battling with a severe case of addiction or who suffers from multiple addictions at the same time. Also, inpatient care is the recommended treatment program for patients suffering from a mental health disorder, like anxiety or depression.
Many individuals who are battling with addiction find help by joining a support group. There are many benefits to connecting with other individuals who have faced the same scenarios and experienced the same negative effects of drug use. A support group is a chance for people to exchange experiences and feelings, coping strategies, and firsthand information about treatments.
After patients complete an inpatient or outpatient care, they graduate to an aftercare program. A patient and their case manager prepare a discharge plan to determine what type of aftercare services they may need.
Although every patient gets an individualized plan, a typical aftercare treatment plan generally involves:
One-on-one therapy sessions
Participation in a twelve-step or alternative support group
Relapse prevention programming
Proper pain management remains an essential need for many Americans. Faced with an opioid epidemic, more and more medical professionals are prescribing alternative non-opioid medications, including Baclofen. Although not as addictive as opioids, there have been many reports of abuse of the drug due to its relaxation effects. The drug has also been found to lead to tolerance and addiction, and a range of withdrawal symptoms such as confusion, psychosis, nausea, and tachycardia. Due to the severity of the withdrawal symptoms, patients are recommended to seek treatment at a detox center, before moving to inpatient or outpatient care.
This information should not replace a visit to a doctor or treatment center. If you are concerned that you or your loved one might be suffering from Baclofen addiction, ask for professional help today.