Muscle relaxers are among the most commonly prescribed medications for back pain, neck strain, and muscle spasms. Most people take them for a short time without any problem. But "muscle relaxer" is not one drug. It is a broad label covering medications that work in very different ways, and their addiction risk ranges from very low to significant. One in particular, carisoprodol (Soma), is a federally controlled substance because of its misuse potential, and another, baclofen, can cause dangerous withdrawal if stopped suddenly. This guide explains which muscle relaxers can be addictive, why, the warning signs of misuse, withdrawal risks, and how to get help.
Muscle relaxers are medications used to relieve muscle spasms, stiffness, and related pain. They fall into two broad groups:
- Antispasmodics, used mainly for short-term muscle spasms from injuries such as back or neck strain. Examples include cyclobenzaprine, carisoprodol, methocarbamol, metaxalone, and tizanidine.
- Antispastics, used for spasticity caused by neurological conditions such as multiple sclerosis, spinal cord injury, or cerebral palsy. Examples include baclofen and dantrolene. Tizanidine is also used for spasticity.
Most muscle relaxers act on the central nervous system rather than directly on muscles. They produce sedation, which is part of why they relieve discomfort, and also part of why some can be misused.
| Medication | Common Brand | Misuse and Addiction Potential | Key Concern |
|---|
| Carisoprodol | Soma | Significant | Federally controlled (Schedule IV); converts to meprobamate, a sedative |
| Diazepam | Valium | Significant | A benzodiazepine sometimes used for muscle spasm; dependence and dangerous withdrawal |
| Baclofen | Lioresal | Low to moderate | Dependence and potentially severe withdrawal if stopped suddenly |
| Tizanidine | Zanaflex | Low | Rebound high blood pressure and fast heart rate if stopped suddenly |
| Cyclobenzaprine | Flexeril, Amrix | Low | Sedation; interactions; overdose risk, especially with other depressants |
| Methocarbamol | Robaxin | Low | Sedation and dizziness |
| Metaxalone | Skelaxin | Low | Sedation; generally less sedating than others |
"Low" does not mean zero. Any sedating medication can be misused, especially in combination with alcohol, opioids, or benzodiazepines.
Carisoprodol stands out among muscle relaxers. When the body processes it, a significant portion is converted into meprobamate, an older anti-anxiety sedative with well-established potential for dependence. This helps explain why people taking carisoprodol may feel relaxed, euphoric, or intoxicated.
Because of growing evidence of misuse, the Drug Enforcement Administration placed carisoprodol into Schedule IV of the Controlled Substances Act in 2012. That classification places limits on prescribing and refills and signals a recognized risk of dependence.
Carisoprodol became notorious as part of a dangerous drug combination sometimes called the "holy trinity" or "Houston cocktail": an opioid, a benzodiazepine, and carisoprodol taken together. Each drug depresses the central nervous system, and together they can dramatically increase the risk of slowed or stopped breathing, overdose, and death. This combination was linked to pill mill prescribing in the 2000s and 2010s. Combining sedating medications in this way is extremely dangerous, even at doses that might seem safe individually.
Many guidelines now recommend that carisoprodol be used only for short periods, typically two to three weeks, and avoided in people with a history of substance use disorders.
Diazepam (Valium) is a benzodiazepine that is sometimes prescribed for muscle spasms. Benzodiazepines carry a well-documented risk of dependence and addiction, and stopping them suddenly after regular use can cause dangerous withdrawal, including seizures. In 2020, the FDA required its strongest boxed warning on all benzodiazepines to address risks of misuse, addiction, physical dependence, and withdrawal. Anyone prescribed diazepam for muscle spasm should use it for the shortest time possible and never stop abruptly after extended use without medical guidance. You can learn more through our benzodiazepine addiction page.
Baclofen is rarely misused to get high, but long-term use can lead to physical dependence. Stopping baclofen abruptly can cause withdrawal symptoms that include anxiety, confusion, hallucinations, increased spasticity, high fever, and seizures. Withdrawal from baclofen delivered directly into the spinal fluid through an implanted pump (intrathecal baclofen) can be life-threatening, and the FDA has issued a boxed warning about abrupt discontinuation of intrathecal baclofen. Baclofen should always be tapered under medical supervision.
Interestingly, baclofen is also studied, and sometimes used off-label, as a treatment for alcohol use disorder. That use requires careful medical oversight.
Tizanidine has low misuse potential, but stopping it suddenly after regular high-dose use can cause rebound high blood pressure, fast heart rate, and increased spasticity. It should be tapered.
Cyclobenzaprine is chemically similar to tricyclic antidepressants. It is not considered highly addictive, but it is sedating and can cause dangerous effects in overdose or when combined with other depressants. It can also contribute to serotonin syndrome when combined with certain antidepressants or other serotonergic drugs.
- To intensify or extend the effects of opioids or alcohol
- To relax, sleep, or reduce anxiety
- To come down from stimulants
- To self-treat chronic pain beyond what was prescribed
- Because the pills are easy to obtain from family members' medicine cabinets
Older adults are a particular concern. They may receive multiple sedating prescriptions and are more vulnerable to falls, confusion, and dangerous interactions. Several muscle relaxers appear on lists of potentially inappropriate medications for older adults. Our guide to prescription drug misuse in older adults covers these risks.
- Taking more than prescribed or more often than directed
- Running out of pills early or seeking refills from multiple doctors
- Using muscle relaxers without a prescription
- Combining them with alcohol, opioids, or benzodiazepines to feel a stronger effect
- Continuing to use them after the injury or spasm has resolved
- Excessive drowsiness, slurred speech, poor coordination, or confusion
- Feeling anxious, restless, or unwell when not taking them
- Hiding use from family or doctors
Withdrawal depends heavily on the specific drug, dose, and length of use.
- Carisoprodol: anxiety, insomnia, irritability, tremor, muscle twitching, and in heavy users, hallucinations or seizures. Medical supervision is recommended after regular heavy use.
- Benzodiazepines such as diazepam: anxiety, insomnia, tremor, and potentially seizures. A gradual, medically supervised taper is essential.
- Baclofen: potentially severe, including hallucinations, high fever, and seizures. Never stop abruptly.
- Tizanidine: rebound high blood pressure and rapid heart rate. Taper under guidance.
- Cyclobenzaprine and methocarbamol: withdrawal is usually mild, such as nausea, headache, and malaise, when it occurs.
For an overview of how withdrawal differs across substances, see our guide to withdrawal symptoms from drugs and alcohol.
The biggest risk with most muscle relaxers is not addiction on its own but combination. Mixing muscle relaxers with alcohol, opioids, benzodiazepines, sleep medications, or gabapentinoids can cause severe sedation, slowed breathing, and overdose. Signs of a dangerous reaction include extreme drowsiness, inability to wake up, slow or shallow breathing, blue or gray lips, and confusion. Call 911 immediately if you see these signs, and give naloxone if opioids may be involved.
For many common back and neck problems, muscle relaxers offer only modest, short-term benefit, and several clinical guidelines suggest they be used sparingly. Other approaches often help as much or more without sedation or misuse risk:
- Staying active. Gentle movement and walking usually speed recovery from acute back pain more than bed rest.
- Heat. Superficial heat has reasonable evidence for short-term relief of acute low back pain.
- Physical therapy. Targeted exercises, stretching, and strengthening address the underlying problem.
- Non-sedating pain relievers. Anti-inflammatory medications or acetaminophen, when safe for the individual, may be enough.
- Massage, acupuncture, and spinal manipulation. These have some evidence for short-term relief in certain conditions.
- Mind-body approaches. Yoga, tai chi, and cognitive behavioral therapy for pain can reduce chronic pain and improve function.
For people in recovery from a substance use disorder, discussing these options with a clinician before starting any sedating medication is especially important.
- Take muscle relaxers only as prescribed and for the shortest time needed.
- Do not drink alcohol while taking them.
- Tell your doctor about all other medications, especially opioids, benzodiazepines, sleep aids, and antidepressants.
- Avoid driving or operating machinery until you know how a muscle relaxer affects you.
- Ask your doctor before stopping baclofen, tizanidine, carisoprodol, or diazepam after regular use.
- Store medications securely and dispose of leftovers through a take-back program.
- If you have a history of substance use disorder, tell your prescriber so they can choose a lower-risk option.
Treatment typically begins with a medically supervised taper or detox, particularly for carisoprodol, benzodiazepines, or baclofen. From there, care may include cognitive behavioral therapy, treatment for co-occurring anxiety or depression, and, importantly, a plan for managing the underlying pain or muscle condition without relying on sedating medications. Physical therapy, exercise, and multidisciplinary pain care often play a central role. Our guide to rehab for chronic pain explains how integrated programs approach pain and addiction together. You can also explore programs through our prescription drug addiction directory.
Most muscle relaxers have a low risk of addiction when used as prescribed for a short time. The major exceptions are carisoprodol (Soma), a Schedule IV controlled substance that converts into the sedative meprobamate, and benzodiazepines such as diazepam. Baclofen and tizanidine have low misuse potential but can cause serious withdrawal if stopped suddenly. The greatest danger comes from combining muscle relaxers with alcohol, opioids, or benzodiazepines. Use them only as directed, never stop certain ones abruptly, and talk to a doctor if use starts to feel out of control.
Frequently asked questions
Some are. Carisoprodol (Soma) and benzodiazepines such as diazepam have significant misuse and addiction potential. Most others, including cyclobenzaprine, methocarbamol, metaxalone, and tizanidine, have low addiction risk when used as prescribed, though any sedating drug can be misused.
Yes. The DEA placed carisoprodol (Soma) in Schedule IV of the Controlled Substances Act in 2012 because of its misuse potential. The body converts part of it into meprobamate, a sedative with known dependence risk.
Cyclobenzaprine has a low risk of addiction. However, it is sedating and can be dangerous in overdose or when combined with alcohol, opioids, or other depressants. It can also contribute to serotonin syndrome with certain antidepressants.
Yes. Stopping baclofen abruptly after regular use can cause anxiety, confusion, hallucinations, high fever, increased spasticity, and seizures. Withdrawal from intrathecal baclofen can be life-threatening. Always taper baclofen under medical supervision.
The so-called holy trinity is a dangerous combination of an opioid, a benzodiazepine, and carisoprodol. Together they can severely depress breathing and cause overdose and death, even at doses that might seem safe individually.
No. Alcohol combined with muscle relaxers increases sedation, impairs coordination, and can slow breathing to dangerous levels. Avoid alcohol entirely while taking muscle relaxers.
This article was reviewed by the RehabsNearMe Editorial Team for accuracy, clarity, and relevance. Information may be sourced from publicly available treatment resources, government agencies, and healthcare references where applicable.
Last reviewed: October 2026
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