I was recently prescribed Xanax (2 mg) for excrutiatingly annoying muscle spasm in my back.
The first time, I took a half a pill and was quite calm, even tolerant of my screaming kids. When I needed another dose the next day, I took a half-pill and it did nothing. I assume that due to my alcoholic nature and past experiences that I’ve got a high tolerance to medications.
Now, I have to take a whole pill, and sometimes another quarter-pill to get the same effect.
Is there a way to combat med tolerance? Abstinence for a few days? Weeks? I feel like I’m being very wasteful with an expensive script because the on-label dose is starting to feel like a waste of time, but I certainly don’t want to become dependent upon a barbiturate.
QtM might be helpful here, and since I’ve so generously complemented him in the past, I’m hoping he might chime in for me.
Valium and Xanax are commonly prescribed for muscle spasms.
I’m a recovering alcoholic…15.5 years TYVM, so no alc in the mix. That, I believe, is what causes my high tolerance to virtually any med. I have to tell the dentist to crank up the nitrous and when needing pain meds no silly 5mg Vicodin even touches it.
I make a conscious effort to monitor my prescription usage vigilantly. My doc is aware of my past condition but kinda clueless when it comes to accumulated tolerance.
If you are developing tolerance, I’d be very careful of going the abstinence route because Xanax is a benzodiazepine and they can cause major symptoms when you try to detox from them. If you’ve been using Xanax for a while, you can have seizures from trying to stop all at once.
I would tell (and have told) any recovering alcoholic patient of mine to not use Xanax or any other benzodiazepine unless all other options had been exhausted.
Xanax is a crummy muscle relaxant anyway, and while Valium is a bit better in that regard, it should be reserved for severe intractable spasms which have not responded to other medications and treatments.
IMHO (and it’s an educated HO), recovery and benzos tend to not mix too well.
I have often compiled statistic for varioius research medical universitites and I have seen consistantly that even people with addictive personalities do not develope tolerance to TRUE severe pain.
In other words if they use the higher risk drugs like morphine for pain, they do not require more dosage.
Valium is a muscle relaxant often used as a minor tranquilizor so is better than Xanax which is supposedly less addictive and used such things as panic.
Interestingly enough when used for panic situations Xanax does not require higher dosages either.
It is the abuse of the meds that leads to higher dosage. So if you feel you need higher dosages to achieve the pain relief, STATISTICALLY speaking (not medically) the stats are saying that you are getting a plecebo effect from the meds and you shouldn’t be taking it.
So from a pure statistical standpoint you shoud go off the meds and have your doctor replace it with another muscle relaxant or perhaps a strong dose of an NSAID, if you can tolerate it.
I had a back problem and found ORUDIS (take at a prescription dose) helped where none of the other NSAIDs did.
My SIL is the same way with vicodin. She has to take 3 750 mg before she even bats an eyelash. I’ve never heard of Xanax prescribed for that either. Learn something new every day.
No idea. It’s a crappy muscle relaxer. It helps with anxiety, but is relatively contra-indicated in people with a history of alcoholism or addiction.
Frankly, ethanol is probably a more effective muscle relaxer, on a pharmacological level. Of course, I don’t prescribe that for muscle spasms either.
Sadly, many (most, IMHO) physicians are very ignorant about the needs of recovering individuals.
First sober day: June 21, 1990
Also IMHO, based solely on my clinical observation: The vast majority (over 80%) of muscle relaxers are prescribed for folks who do not really have muscle spasm, but rather muscle tension or soreness. Here, the chief effect of the muscle relaxer is to make the patient say “I don’t give a rat’s ass about the pain anymore”.
