Long-term use of muscle relaxants has skyrocketed since 2005
Penn Medicine researchers found the drugs were prescribed disproportionately to older adults, often concurrently with opioids, despite warnings against this dangerous combination.
Moreover, in 2016, nearly 70% of patients prescribed muscle relaxants were simultaneously prescribed an opioid — a combination that has the potential to cause dangerous interactions. The researchers also found that muscle relaxants were prescribed disproportionately to older adults during this time period, despite national guidelines warning that this class of drugs should almost always be avoided in patients who are 65 and older. The results were published in JAMA Network Open.
“There are few studies on the short-term efficacy and safety of skeletal muscle relaxants, and almost no data on their long-term effects, so it is very concerning that patients, and particularly older adults, are using these drugs for an extended period of time,” says Charles E. Leonard, an assistant professor of epidemiology. “Providers seem to be reaching for them despite incomplete information on their potential benefits and risks.”
Recommendations generally limit the use of these drugs to a maximum of three weeks, since they have not been shown to work for muscle spasms beyond that duration, and they can cause serious side effects including falls, fractures, vehicle crashes, abuse, dependence, and overdose. Due to these risks, muscle relaxants should be avoided altogether in elderly patients, according to guidelines from the American Geriatrics Society.
Despite these concerns, Leonard and his colleagues hypothesized that the growing opioid epidemic may have led clinicians to prescribe muscle relaxants as an alternative to opioids for long-term pain management.
Leonard adds that, in addition to potential adverse effects, muscle relaxants may not be any more effective in managing pain than medications like Tylenol or Advil.
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