So Long Soma

Soma, a well-known brand name of the drug carisoprodol, is prescribed by doctors in the U.S. as a muscle relaxant. However, it does have the potential to cause addiction. Soma is now a Schedule III or Schedule IV controlled substance in about twenty states, and the DEA may soon make it a Schedule IV drug in all states. Carisoprodol has been removed from the market in other nations, due to its potential for addiction.

 All potentially addicting drugs are scheduled, meaning the physician has to have a DEA number to legally prescribe them. Non-scheduled drugs (antibiotics, antidepressants, blood pressure or diabetes medication) aren’t addicting, and the doctor doesn’t need a DEA number to prescribe these. They aren’t tracked by the DEA. Drugs are scheduled I through V, depending on the potential for addiction and the degree of therapeutic usefulness. Schedule I drugs have very high potential for addiction, and very little therapeutic use. Other medications are more beneficial with less risk of addiction. Heroin and Ecstasy are two examples of Schedule I drugs. At the other extreme, Schedule V drugs have some risk of addiction, though fairly low. Examples are low-dose codeine and other low-dose opioids.

 I hate Soma. I can’t remember the last time I wrote a prescription for it. I see too many people who have become addicted to it, or who use it with opioids. There are other better and safer muscle relaxants.

Soma gets metabolized to meprobamate, an old-timey barbiturate. Doctors used barbiturates as sedatives before the safer benzodiazepines came on the market.

 Some addicts say they like the high that they get when they mix Soma with opioids. Since I treat opioid addicts, I see the dangers of mixing Soma with maintenance medications like methadone and buprenorphine. Just like benzodiazepines, Soma has a synergistic effect with opioids, causing more sedation than expected. This is how it can kill. The user takes opioids with Soma, it turns into a barbiturate, and the combination puts the person into a deep sleep. In fact, this combination can make them sleep so deeply that the respiratory center of the brain, which tells us to breathe when we sleep, turns off. The person stops breathing, and without oxygen, vital organs like the brain and heart die, and the person never wakes up.

 At the recent ASAM conference in Washington, D.C., one presenter reminded us of how addicting carisoprodol can be: in one study, around 65% of patients with a personal history of a substance use disorder misused carisoprodol when it was prescribed to them for over three months. And even worse, only 18% of the prescribing doctors knew that this medication is metabolized to meprobamate. (1)

 If you have a history of any sort of addiction disorder and your doctor is prescribing Soma, talk to her. It’s likely that another safer and more effective medication can be found. Soma is only FDA approved for two or three weeks of continuous use, anyway.

  1. Reeves, RR; Carter, S; Pinkofsky, HB; Struve, FA; Bennett, DM; “Carisoprodol (Soma) Abuse Potential and Physician Unawareness; Journal of Addictive Diseases, Vol. 18 (2), 1999, pp 51-56.
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15 responses to this post.

  1. Posted by Momay' on April 26, 2011 at 4:47 am

    I’ve always hated Soma. My ex took it and abused it badly for quite some time. I always knew when he was taking it as he would over do it, slur, stagger, and drool. Sometimes it would be so bad he couldn’t function. He would take it and do stupid things like try to drive then couldn’t remember anything he did while under it’s influence. I tried talking to his doctor at one point but since I was not the patient he wouldn’t talk to me.I for one would be glad to see it go.

    Reply

  2. Posted by CushieBug on May 17, 2012 at 3:12 am

    Although there are risks in taking this drug, for some individuals it is the only effective option. Over the last few years, I have been prescribed 13 different medications to manage pain, and the low-dose Soma is the only one that has helped without causing a problem functioning. The normal dose allows me to sleep at night- My pain is severe enough that it wakes me up at night, even when I have taken other types of pain or sleep medication. Patients should be reviewed carefully before administering the drug or any addictive medication, but it should not be outlawed just because some abuse it.

    Reply

  3. Posted by Barry on May 10, 2013 at 1:43 am

    Soma is a double edged sword. I broke over 24 bones(pelvis, scapula, collarbone, ribs, hand), fractured 2 vertebrata, head injury and a collapsed lung, not to mention road rash from hell from a motorcycle accident 10 years ago. I also have pulmonary fibrosis.

    First, it takes my pain away better than lortab. I won’t take oxy. The downside,, I can only take it at night, get too drowsy. I take 1/2 of one around dinner and a whole one around 11pm. My pain is gone, muscles attached to all those broken bones relaxed, I have to sleep on my stomach from my injuries or I pay dearly. Can’t turn my neck v good without a Soma. I cant sleep face down, On a Soma, I can sleep 8 hours.

    Second, Pulmonary Fibrosis is also called stiff-lung and coal miners lung. My ribs don’t move when I breathe. You get it using asbestos, casting metal, dusty work, etc. The soma helps that too. In fact I have found Soma to be a God send.

    On the downside, it’s hard to quit, there are withdrawals unless you taper. It metabolizes into meprobromate, a Barbituate from the late 50s.

    I have a terminal lung disease and Soma is giving me relief with ribs relaxing and expanding a little more. It is not fair that because some stoners have to take 20 at a time that a guy on his way out should be looked down on for seeking and FINDING something that makes you feel better. Believe it or not, a lot of people can take med’s as prescribed. I take less than prescribed. It’s no different than a hunting rifle. You can use it as intended, or you can murder somebody. People just can’t tell themselves no.

    Besides, you can still get it on the Internet. If someone wants to take 10-20 a day,, they can get them. People can’t tell themselves NO! even me. After 10 years on them, I feel like I should get off them. It won’t be easy, I will be in more pain and don’t know about my breathing. Already on home oxygen. I guess it comes down to,, Do I want to be in terrible pain nearing the end of my life?( some years left hopefully)

    Reply

  4. Posted by Carla on June 18, 2013 at 8:39 pm

    Sorry, but I find a blanket refusal to prescribe this drug ridiculous. You should look at your patients’ histories. I had a car accident about 20 years ago and injured my back and left shoulder. I re-injured the shoulder a few years back. For the last 4 years, I’d say I go through maybe 15 Somas a year in a bad year, sometimes none – I don’t want it to lose its effectiveness, so I take it only when things are really bad. I take one before bed only when muscle swelling or pain is too severe to rest comfortably. I won’t take them during the day. I recently discovered that the accident caused disk damage, which has now begun to cause spasming from time to time. The orthopoedist who diagnosed the disk problem wrote me a prescription for Soma – I never needed it, so I didn’t use it. Over a year later I had some spasming. Obviously, the prescription had expired, so I brought the unused prescription in and asked if I could have an updated one. The doctor told me he wouldn’t prescribe Soma anymore, but gave me samples of Skelaxin which not only didn’t work, but gave me terrible headaches (I hear it’s a different mechanism). He then prescribed Flexaril – are you kidding me? It was so strong I could barely function. Now, if I were likely to get addicted, wouldn’t I have run out and filled the scrip (as I now wish I had)? All he would need to do is look at my history through my insurance to see that I rarely take this drug, and am not an addiction risk. My brother-in-law recently passed. he was a drug addict and alcoholic. He regularly went to ER and was given pain pills, sleeping pills – whatever he wanted, like it was candy. I think it’s ludicrous to make people with legitimate reasons for using these drugs, and who have a long history of non-abuse suffer because there are addicts out there. I have not yet found a drug that works as well as Soma. I have now once asked for (and received) a prescription from my primary care doctor – but now I feel sheepish and furtive for even asking for a prescription. I do not appreciate being treated like a drug addict because doctors have now decided to treat all patients as drug addicts!

    Reply

  5. Posted by Doug Roach on July 1, 2013 at 11:52 pm

    You doctors would’t have a job if you were in Portugal. We can get any drug there WITHOUT a script. So much for fighting your doctor for what works. Oh, prostitution is also legal, That’ll take care of some stress and don’t worrie about crime cause there is NO street crime. Make anything legal and it takes the profit out of the black market. I’m Moving soon and will send you a photo of me eating SOMAS!

    Reply

  6. Posted by cloudy on February 16, 2014 at 4:15 am

    somas are tricky! i have severe spinal arthritis, spinal stenosis, degenerative disk disease, hip deterioration, etc etc including severe muscle spasms. i thought it was a miracle drug it took away ALL pain even better than a pain pill! however tolerance builds at lightning speed and not to mention unfortunately ~ even thought im not an addict~ i loved how they made me feel! No pain AND a false sense of wellbeing and i could function……. they almost ruined my life i got to taking ten to fifteen as often as i could and with that comes a whole new side of fucked up side effects ~ blackouts, falling and hurting myself, passing out, stealing the horrible list goes on and on. then i drove one day well i blacked out and hit a parked car i hit steering wheel so hard i knocked myself out next thing i remember is being arrested for dui(drugs) at the hospitalin front of former co workers and my family. i had never so much as got a parking ticket in my life! i felt completely worthless i lost my job almost lost my hu

    Reply

  7. Posted by ed on March 26, 2014 at 6:19 pm

    I took 350mg soma 4 times a day for months for terrible back injury and it helped greatly. It was not addictive at all so no one should make a blanket statement. At one point I had taken it everyday for a year and then didn’t take any and had no withdrawal symptoms at all. The studies on possible addictions by soma mainly focused on those type of people who already had addiction problems. Anything can be addictive to people’s minds, but it doesn’t mean we all are like that. Since then and after more injuries, pulled muscles and such and now spine problems I have never found the relief I need from muscle relaxers like I had with soma, but now everyone’s afraid to precribe it even for those of us who never had an addiction to it. Dependence on medication to make it through life and try to live without spasms and pain is not the same as addiction or abuse. It’s bad that some boards have forced many of us who truly need certain medications to go without proper treatment. Proper treatment is treatment that works for a person and brings their level of living up from the pits of pain and spasms.

    Reply

    • Posted by Tammy on October 26, 2016 at 6:54 pm

      I was on soma 4, check this, 17 yrs, 4 times a day. One day I walked in 4 my doctors appointment. I was told because of the side effects she could not write me 4 soma. I went down the road of trying different relaxants 4 my knee dropping, throwing up, God horrible spasms. Nothing else has helped. Because one person says there bad and addictive dosent mean that fits the bill 4 revert one. 17 years and I didn’t experience with draws. I was put on zanaflex yesterday. I was told they have some of the chemicals as some. Guess we’ll see.

      Reply

      • Posted by Ronnie on February 17, 2017 at 1:50 pm

        You said it! I was on soma for 12yrs due to a spinal injury and 3 failed surgeries. I was taken off soma after all those years and the only thing I experienced was a return of over the top PAIN! I stopped cold turkey with no withdraws. My pain management clinic doctor will not, no way even listen to what I try to explain. My family doctor however did listen and agreed that after all those years on it and the great results I had that he could help me get my quality of life back. Though still limited on how long or far I can walk, I love how that with it allows me to get out instead of being closed up in the house with no contact with the public or having friends. Different meds work differently for different people. Doctors however draw a line and say, these meds work for everyone. NO! I wish there was a way to get the medical community to listen and take a look at each person on a case by case basis. Btw, my pain clinic doc hates that I get soma from my PCP! Instead of looking at my quality of life using it with a completely closed mind.

  8. Posted by kelly M on April 21, 2014 at 3:07 am

    what else can i take besides soma its the only one that works for me. I cant take a lot of stuff my body has bad side effects.

    Reply

    • any other muscle relaxant besides Soma.

      Reply

      • Posted by Robert Peacock on June 24, 2014 at 6:52 am

        My Doctor and I are going through this, For spinal injuries, degenerative disc disease and severe arthritis in my lower back, I’ve been receiving treatment for almost 9 years. I had a history of Acute back spasms that my “General Practitioner would prescribe 800 mg Ibu and 350 mg Soma, as I refused hydrocodone. Over the years, the side effects became less, (less sleepy, etc…) So I had some bit of a tolerance when I had a serious back injury. Through treatment from a Pain Management Specialist, we went through many options to find what actually worked in regard to the specific damage I had and we settled on Carisoprodyl 350 mg and Demerol 100 mg, again with 800 Ibuprofen as an anti-inflammatory. 4 or 5 years ago, the DEA decided that Doctors could only prescribe Demerol for the 1st 10 days after surgery, period, so my doctor and I had to find another pain med, We decided on Dilaudid (4 mg) and it was an abrupt change from the demerol. Dilaudid, for me, had a very strong onset, and a very abrupt decline, so we “buffered” it with 50 mg Tramadol. Used in conjunction with Soma, this worked well until about 2 years ago when my Doctor started being pressured by the DEA and the FDA to stop prescribing Soma. The Soma worked for me in that most of the muscles in my back tend to stay very taught and tremor and Soma relieved this. Since I can no longer get the Soma prescribed, we’ve tried Flexoril ( Cyclobenzeprene ), Zanaflex (tizanidine hydrochloride) and both of these have no noticeable effect in my system in regards to these symptoms. I’m now in the first month of using 500mg Methocarbamal, which is in the same family as Soma, but so far it doesn’t seem to be working as well as the Carisoprodyl did. The Methocarbamol IS actually providing some relief however while I take it with 4 mg Dilaudid, 50 mg Tramadol, and 800 mg Ibuprofen. Good luck to you, heck, good luck to us all. I’m still unsure as to why we can no longer get Carisoprodyl prescribed, the reason I was given is that Soma had been upgraded to schedule 4. This makes NO sense to me as I live on schedule 2 medication 6 times daily. Comparatively, the addictive danger of Soma is rather lost on me while I continue to live on Dilaudid, but then they didn’t ask my opinion. To make a long story short, so far, after 3 weeks, the methocarbamol seems to be the best Soma alternative I’ve tried, however it is NOT as effective for me. Everybody is different, but this has been my experience.

  9. Many people think that there is a risk in taking the drugs. But, not every time, there are many effective drugs also. I have been prescribed with pain medication drug that helped me a lot in managing my sitting job. The prescription for the drug, soma also allows me to sleep happily at night. It is all that the patients must be reviewed properly
    i.e. can be with Soma drugs. http://jrms.com.mx/blog/blog/2015/04/30/soma-muscle-relaxant-for-lower-back-pain/

    Reply

  10. I had a car accident with 5 major back surgeries. Have hardware all in my back. Have been on soma for 5 years. I take it as prescribed. Hate to say this but anyone could be a carwreck away from severe injuries. Hope the ones who are making these decisions have the most severe back problems then they will wish they had not made stupid decisions based on addicts. Why dont we just ban food for fat people, all alcohol, no gambling for gamblers, no porn for addicts, no tv with any sex movies and stupid uneducated people. I know for a fact the ones who make the rules always base their decisions on weak minded people who will not control themselves with their own abuse problems. It is americas way to hurt the innocent because of the bad. It will be like alcohol history and bootleggers.

    Reply

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