Baclofen Addiction, Abuse, and Treatment

Baclofen Addiction, Abuse, and Treatment

Table of Contents

Introduction

Baclofen is a pain medication that many people aren’t familiar with. You might be aware of the addictive nature of opioids. Every day, opioid-related drug overdoses kill over 130 people in the US.1 Addiction treatment in a rehab facility can help with recovery from substance use disorders.

Notably, some experts compare the rise in baclofen use to the increase in opioid use in the past. Baclofen exposures increased in 43 states from 2014-2017. Wisconsin, Virginia, and Missouri had the highest increase in the rates of nonsuicidal use.2

In 2014, doctors wrote 4.76 million baclofen prescriptions. The number increased to 5.70 million in 2016 and slightly decreased to 4.58 million in 2017.3 With the current trends in use, global sales will exceed $400 million in 2024.4

Abusing this drug isn’t as dangerous as opioid abuse. Nonetheless, there is a substantial risk of many negative health consequences, including coma and death.

What is Baclofen?

This medication is a muscle relaxant or muscle relaxer. It is used to relax stiff and tight muscles caused by multiple sclerosis and spinal cord injuries. A doctor may also use the drug to treat nerve pain and other conditions, such as:5

  • Alcohol abuse and dependence: Excessive alcohol use
  • Alcoholic liver disease: Liver damage due to long-term heavy drinking
  • Trigeminal neuralgia: Severe burning pain on the face due to nerve damage
  • Hiccups: Involuntary contractions of the muscles involved in breathing
  • Gastroesophageal reflux disease: Long-term digestive disorder that causes heartburn

Baclofen is only available on a doctor’s prescription.

How Does It Work?

No one knows the precise mechanism of action in baclofen. Animal studies suggest the drug decreases electrical activity in the brain and spinal cord. It may work by:

Increasing the release of brain chemicals (neurotransmitters) that block electrical activity in the brain and spinal cord.

Reducing the release of neurotransmitters that increase electrical activity in the brain and spinal cord.

The overall effect is the depression of activity in the brain and spinal cord, which may be responsible for relieving muscle stiffness and tightness. As a depressant, it causes euphoric effects, reduces stress, and can reduce pain sensations.

The drug comes in the form of oral tablets and liquid. An injectable form is also available, which is injected into the spinal cord by a medical professional. Brands in the US include Lioresal, Kemstro, Ozobax, and Gablofen. The first two brands are no longer available. However, generics drugs may be available.

Street Names of Baclofen

Currently, no street names of the drug are known. Nonetheless, the emergence of the street price (street value) suggests the drug has already reached the illegal drug market. Prices on the illegal market will continue to vary. 

Is Baclofen Addictive?

Baclofen can lead to addiction if it causes:

Abuse

Abuse refers to the inappropriate use of a drug to experience its effects. Drug abuse includes using a substance in higher doses, more frequently, or for longer than recommended. There are only a few reports on baclofen abuse. The first case of abuse came to light in 1998. According to the report, 14 young people abused 60 to 600 mg of the drug at a party.6

Nonetheless, more reports of abuse/misuse have appeared over the years. Out of 15,397 baclofen exposures from 2014 to 2017, 40% involved no other substances. Among baclofen-only exposures, researchers found 250 cases of abuse and 558 cases of misuse.2

Dependence

Dependence occurs when a person cannot function normally without using a drug. An addictive substance can cause physical or psychological dependence, or both. Scientific studies show that baclofen can cause both psychological and physical dependence.

Withdrawal

Abrupt discontinuation of an addictive drug causes many undesirable effects. They are called withdrawal symptoms. Withdrawal from this drug can cause hallucinations, seizures, and even death.

Baclofen has been shown to cause abuse, dependence, and withdrawal. Therefore, it is considered to be addictive. Nonetheless, it is important to remember that many other factors also contribute to addiction. These include a drug’s inherent ability to cause addiction, a person’s genetics, and environmental factors.

Class and Schedule

Class

Baclofen belongs to a class of medications known as skeletal muscle relaxants. There are two broad classes of muscle relaxants. They are:

Centrally Acting Muscle Relaxants

Drugs in this class relax stiff muscles by reducing nerve stimulation in the brain and spinal cord. Examples include methocarbamol and tizanidine.

Peripherally Acting Muscle Relaxants

Drugs in this class work by blocking signals from nerves to muscle fibers. Examples include dantrolene, vecuronium, and rocuronium.

Is Baclofen a Narcotic?

Baclofen is not a narcotic. It does not act on the opioid receptors in the brain. However, like opioids, it may be used to treat severe pain. It’s not a controlled substance.

Is Baclofen on the Schedule?

The DEA categorizes substances based on their abuse potential and approved medical use. As per the Controlled Substance Act (CSA), there are Five drug schedules.

Drugs with the highest abuse potential are included in Schedule I. Examples of Schedule I controlled substances include heroin, LSD, and ecstasy. Drugs in Schedule V have the lowest abuse potential compared to those in other schedules. Examples include Lomotil, Motofen, and Lyrica.

The use of two drugs – gabapentin and baclofen – has soared in recent years. Experts worry that people may have started to take these drugs as an alternative to opioids. Amidst rising concerns of abuse, Kentucky, Tennessee, and Michigan categorized gabapentin as a Schedule V controlled substance.

Many other states are expected to control gabapentin soon. Unlike gabapentin, baclofen is not controlled throughout the US.

Is Baclofen Safe?

Yes. It’s been used since 1977. Any drug that has received an FDA-approval is typically safe. This is because the FDA requires the drug to pass several tests before it reaches the market. These include tests in both humans and animals. The journey from invention to market typically takes more than a decade.

The FDA continues to monitor a drug’s safety years after the drug has reached the market. This is known as post-marketing surveillance (PMS). There were 27 cases of withdrawal and 6 deaths during the first 9 years after the FDA approved baclofen for marketing.7 However, details on the exact causes and other contributing factors are not known.

Most notably, the injectable form comes with a boxed warning on the label. Boxed warnings (or black box warnings) inform prescribers about the potentially fatal risks of a prescription drug.

Thus, it is evident that baclofen is likely to cause fatal complications in some users. However, it does not mean that the drug is not safe. Instead, a boxed warning aims to promote the safe use of powerful drugs.

How is It Used?

Misusing or abusing the drug can be very dangerous and may cause death. Thus, it is critically important to use the drug as prescribed. Below are the things to remember while using the drug.

Use the drug only as recommended. Never take it in higher doses than prescribed or in frequency or duration longer than recommended.

You may take it with or without food.

Read the instructions on the prescription carefully. If you have any queries, talk to your doctor or pharmacist.

If you are using the oral solution (Ozobax), measure your dose using a device. The measuring device is usually supplied with the medication. Ask your pharmacist for the device if you do not get one with the medication.

Do not stop taking the drug even if you feel better.

Use in Pregnancy

Limited data exists on the effects of its use in pregnant women. A doctor may prescribe the drug only if the benefits outweigh the potential risks to the fetus.

Use During Breastfeeding

Baclofen taken by mouth can pass into a mother’s milk. However, the amount present in milk is not known. If you are nursing an infant, talk to your doctor before taking this drug. Your doctor may ask you to stop the drug or stop breastfeeding.

Is Baclofen a Drug of Abuse?

Baclofen is not considered a drug of abuse. Thus, the DEA has not yet categorized it in the list of controlled substances. Nonetheless, it has been more than two decades since the first case of abuse was reported.

How is It Abused?

Baclofen is used to reduce cravings in alcohol abuse and heavy smoking. Some people may abuse it, as it causes euphoria and calming effects. Some people also abuse other prescription drugs such as sleeping pills and antidepressants to enhance the effects. Most importantly, its use in suicide attempts has soared in recent years.

Between 2014 and 2017, US poison centers recorded 15,397 cases of baclofen exposures. Among them, 8185 cases were suicide attempts, 624 involved abuse, and 1022 involved misuse.2

During 2014 to 2017