Is Baclofen a Controlled Substance?

Baclofen (available in oral tablets and liquid, intrathecal, and topical forms) is classified as an antispasticity medication and muscle relaxant.

It works by inhibiting the overactive firing of neurons that control your muscles.

Baclofen decreases muscle spasticity by acting on neurons in the brain and spinal cord.

Physicians prescribe baclofen to treat spasticity that occurs due to neurological conditions such as multiple sclerosis, spinal cord injury, and certain types of neurological disorders.[1]

For patients diagnosed with more advanced spasticity-related neurological disorders, physicians may surgically implant an intrathecal pump into their patients’ lower backs to administer baclofen directly into the cerebrospinal fluid (CSF).

Controlled vs. Regulated Are Not the Same

Many people searching “is baclofen a controlled substance” are really asking whether the medication is closely monitored or potentially addictive.

Understanding the difference between controlled and regulated helps clear up confusion.

What “Controlled Substance” Means

Governments regularly monitor controlled substances according to their classification and their potential for abuse and addiction.

Under the U.S. Controlled Substances Act, some drugs are placed into one of five schedules based on their accepted medical use and potential for abuse or physical or psychological dependence.[2]

Schedule I: High potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use under medical supervision.

Schedule II: High potential for abuse, which may lead to severe psychological or physical dependence. These drugs have currently accepted medical use in treatment in the U.S..

Schedule III: Moderate to low potential for physical dependence, and high potential for psychological dependence. These drugs have a currently accepted medical use.

Schedule IV: Low potential for abuse relative to the drugs in Schedule III. Abuse of a drug in this schedule may lead to limited physical dependence or psychological dependence relative to the drugs in Schedule III.

Schedule V: Low potential for abuse relative to the drugs in Schedule IV. Abuse of a drug in this schedule may lead to limited physical dependence or psychological dependence relative to the drugs in Schedule IV.

Controlled substances, as defined by Title 2 of the U.S. Controlled Substances Act, are regulated by the United States Drug Enforcement Administration (DEA), and based on how drugs are classified, controlled substances differ in terms of how they can be prescribed and monitored.

Some healthcare systems monitor baclofen prescriptions through electronic health records, even though it is not a controlled medication.

Is Baclofen a Narcotic?

No.

In the healthcare field and in judicial systems, the term narcotic is reserved for prescription medications derived from opium that are used for pain management.

Why Baclofen Gets Mistaken for a Narcotic

Many individuals feel drowsy, sleepy, or sedated when they begin receiving baclofen or increase their dosage of baclofen. This effect may seem similar to what occurs with opioid pain medications. Because baclofen is a prescription medication, some individuals wrongly assume that baclofen must be classified as a narcotic because it does have similar short-term sedative effects.[3] Baclofen does not produce euphoria like opioids.

Addiction Potential: Can Baclofen Be Addictive?

Questions about addiction are especially important for individuals seeking help for drug or alcohol detox or dual diagnosis treatment.

Dependence vs. Addiction

The difference between addiction and dependence is significant.

Addiction refers to compulsive drug-seeking behavior with a loss of control, while physical dependence is when your body becomes accustomed to using a drug regularly, so if you stop suddenly you will experience symptoms of withdrawal.[2] Baclofen has not been shown to produce addiction-related behaviors, but it produces physical dependence.[3]

Compulsive behaviors associated with drug dependence and withdrawal have also been reported in several cases where patients were taking baclofen for muscle spasms, but they had histories of substance use disorder or substance abuse. Research shows that an individual can misuse baclofen when they use it in excessive quantities, or in conjunction with other sedative drugs or alcohol.[3]

Withdrawal Risk

An additional crucial point of information for baclofen patients is that an abrupt stop when taking baclofen can lead to a withdrawal syndrome that can include severe symptoms, including agitation, confusion, hallucinations (seeing, hearing, or feeling things that aren’t there), delusions (false, unshakable beliefs), and disordered thinking and speech, seizures, and potentially even death.[4]

Therefore, healthcare providers generally recommend tapering off baclofen to avoid withdrawal symptoms.

Patients receiving baclofen therapy via intrathecal delivery are at higher risk for complications if delivery is disrupted.[5]

Signs of Problematic Use

Early recognition of potentially problematic behaviors allows for intervention and assistance to help a patient appropriately quit taking baclofen if necessary. Problematic baclofen use does not always look dramatic.

Signs of problematic use may include:

• Taking more than the prescribed dose or taking doses more frequently than directed
• Using baclofen to feel calm or sedated rather than to manage muscle spasticity
• Combining baclofen with alcohol or other sedating prescription drugs without approval
• Running out of medication early or experiencing withdrawal symptoms between doses

Recognizing these signs early allows for safer intervention and support.

Safety and Interaction Notes

It is not recommended that anyone use baclofen while drinking alcohol or using other sedatives, unless those medications have been prescribed and supervised by a physician.

Using baclofen and drinking alcohol or using other sedatives may lead to over-sedation or respiratory depression (shallow or slow breathing that limits the ability to take in sufficient amounts of oxygen).[6]

Patients should never abruptly stop taking baclofen unless under the care of a physician, usually with a planned taper.

When to Get Help

If you or people you know have been misusing baclofen, taking baclofen at higher doses than prescribed, or taking baclofen with other substances, a professional evaluation will provide support and guidance for your next steps.

Should you experience withdrawal symptoms such as confusion, hallucinations, delusions, and disordered thinking and speech, or seizures, please seek immediate medical attention.[4]

Confidential assistance is offered to patients and families seeking support in managing misuse of prescription medications and mental health challenges. Evidence-based (practical application of the findings of the best available current research) treatment is available.

Frequently Asked Questions