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So enough with the serious posts about the idiots of the world.  This one is going to give you the knowledge to impress your friends, and frighten your enemies.  In fact, this information might get you laid!

Full disclosure: I did only enough research as look on Wikipedia.  Seriously, I was looking up what the half-life of Soma was (since my Lexi was on the shelf and I didn’t have the ambition to flip through it) and I found this information out.  Laziness provides you with yet more entertainment!

Oh, and before one of you crackheads nitpicks me for this, I use the brand names throughout this post.  Yes, I know that the only dispensed **Soma** out there is that stupid-as-shit 250 mg crap out there (which if you stock, you are a fucking tool).

We all know the drug Soma (or its generic name Carisoprodol).  We get calls about it, we get bothered about it, some of you may even be on it! (No, you can’t get an early refill).  But how much do you actually know about it?

Soma was intended as an antiseptic.  A superior antiseptic!  No bullshit!  I guess if you consider the people who are hooked on this stuff have killed all the neurons that product truthful statements, personal hygiene, common sense, month supply calculations and other socially acceptable behavior then maybe the drug did work at intended.

So it came out instead as a muscle relaxant.  For all of those chemistry nerds, I present to you two images for your consideration.






One of these is Soma.  The drug we all know and love.  The other is a drug called Meprobamate also known as Miltown/Equanil for those of you who are close to retiring.  See a similarity?  Are you old guys out there chuckling?  (hint: Soma is on the left).

The funny thing about Miltown (other than having a stupid name) is that its a tranquilizer, and is no longer used in the United States because the benefits do not outweigh the risk.  It is considered addictive at doses not higher than therapeutic.  Gee, does this sound familiar?

Soma was a chemical modification of Meprobamate to make it better, less potential for abuse, and thereby less risk of overdose…… Where have we heard this before?  Oh wait…  Heroin!

Soma just -recently- became a controlled substance (January 2012).  Miltown has been a controlled substance since 1967.  Most countries other than the good old ‘Merica has banned or severely restricted the use of Soma due to its potentiating effects with the narcotics, alcohol, and other fun shit leading to shitty dancing, unwanted babies, pharmacist alcohol abuse, and sometimes (but not NEARLY ENOUGH) death.

Are you slapping your head yet and wonder what the fuck is wrong with this picture?  Let me spell it out for you.

Soma converts (probably a good chunk) into Miltown in the body.  Miltown has been a controlled substance since the 60’s due to abuse, and Soma JUST FUCKING RECENTLY (sorta) became a controlled substance.  Now I’m only a stupid pharmacist, but didn’t someone at the FDA and DEA a long fucking time ago look at these two chemical structures and say; “Gee, MAYBE we should make this a controlled substance right off the bat since that fucking isopropyl group on the end will just get whacked right off in the body and make Miltown.. A CONTROLLED SUBSTANCE!”  Am I the first person on the planet to fucking realize this?


Comments #

Comment by Elizabeth on 2013-10-26 05:10:54 -0700 #

This is why we love you oh ‘Angry One’. You make the obvious seem like sublime words from the mountain top !!!

Comment by Rod on 2013-10-26 05:56:31 -0700 #

A lot of what the FDA does makes no sense.

Comment by Carol on 2013-10-26 07:25:21 -0700 #

Soma wasn’t just recently categorized as a controlled substance, you deficient pharmacist. It’s been controlled in some states and not controlled in others and I guess your state finally caught up with all of the smarter states. What stupid state do you live in, anyway?

Comment by Joe on 2013-10-26 11:02:23 -0700 #

Yes, some of us “old” pharmacists who are about ready to retire knew about this many years ago, but, like you we have no say in what really goes on in the pharmaceutical world. Keep up the good work.

Comment by OChem survivor on 2013-10-26 17:20:54 -0700 #

The chem nerd in me loves this. Sigh.

Comment by tais garcia on 2013-10-27 05:59:07 -0700 #

I guess stupidity is global…(from Brazil by the way)
really enjoy your posts…

Comment by G. Cole on 2013-10-27 10:43:37 -0700 #

Fierce blog Angry Pharmacist! You see the SOMA-COMA patients/fans on a regular basis, trying to fill the prescriptions early. The prescribers are just as guilty of starting this notion that SOMA is forever, refill after refill. Logic is rare with our convoluted, upside down health system. It is so much easier to write a prescription than to actually help a person in need. Especially with undiagnosed psychosis, depression, addiction, or personality disorder is in the background. Really! Motivational interviewing should be a billable service, it take lots of time. Most clinics do not have the resources for this. The SOMA patient may just need counseling, physical therapy, or detox. I recommend calling the prescriber when a patient exhibits aberrant behavior, nip it in the bud!

Comment by Ihatemyjob on 2013-10-27 18:53:29 -0700 #

My 1999 publication of Facts and Comparisons (I know, why do I have it?) says Soma is a congener (in the same class) as Miltown, AND it states under Contradictions to not take 1 if allergic to the other. So it seems to me that they did know the compounds were related. I can’t explain why they didn’t classify Soma as a C-IV. Mr Helpful with a walk down 15 yr old memory lane.

Comment by Mark on 2013-10-28 10:57:29 -0700 #

Sounds like you need a little Xanax for that neuroticism of yours. Let me write you a prescription.

Comment by Michael Koch on 2013-10-29 05:56:51 -0700 #

This is old news.

Comment by Duhrph on 2013-11-03 19:15:55 -0800 #

Hi Carol,

Angry is correct. He stated that soma recently became a (federally) controlled substance. Notice he cited dea and FDA and not the state board of New Mexico or Minnesota. Who’s deficient now?

Comment by Kelly on 2013-11-07 16:36:26 -0800 #

Hey angry pharmacist!

just an FYI. Starting January 2014, Express Scripts will no longer be covering Advair and Breo.

Comment by RxDawg on 2013-11-08 20:20:30 -0800 #

To play the devil’s advocate, lomotil and Imodium are chemical twists from morphine. A small kink in the chain can make a VERY big difference in effects in the body. In fact, you can actually get high if you take enough lomotil. The reason atropine is in it is to deter abuse, not for the antimuscurinic effects (atropine is not absorbed orally at all). Way back when the crackheads would crush lomotil and shoot it up. But if they do that now, the atropine is….unpleasant =)

Comment by Scriptpro on 2013-11-14 12:42:55 -0800 #

From Facts&Comparisons
The major pathway of carisoprodol metabolism is via the liver by cytochrome enzyme CYP2C19 to form meprobamate. This enzyme exhibits genetic polymorphism (see Patients With Reduced CYP2C19 Activity section)”

You, sir, have won an internets. You have also won a golden pestle. On a side note, I never see Soma anymore, just flexeril.

Comment by mks7 on 2013-11-19 04:36:35 -0800 #

Everyone on here is just as moronic as the people they bash. Most trusted profession? Sorry asshole it’s actually nurses that are the “most trusted profession.” That is if you want to go by some lame study, which I assume you were at some point. Sorry you couldn’t cut it in med school and are now stuck slumming it behind the counter at Walgreen’s, but don’t blame the public for your shitty under achieving life.

Comment by Justin on 2013-11-25 22:07:06 -0800 #

I’m a pharmacy tech, but I have a degree in biochemistry ( still workin in the pharmd bullshit) and I considered this situation in my sophomore year. It’s sad, an goes to show the experts at the fda and dea streamlining ndas, half assign and rubber stamping. Besides, there’s marijuana to worry about. And C2 hydrocodone.

Comment by Do you have the blue watsons on 2013-11-26 22:08:46 -0800 #

On that same theme, Miltown is a tranquilizer so there isn’t really any reason that it should ever be prescribed with xanibar 2 mg. Oh wait soma is a muscle relaxer not a tranquilizer………fuck that time I spent in pharmacotherapy learning about metabolism…….

Comment by Tara on 2013-11-27 05:41:04 -0800 #

I’m pretty sure Shulgin pointed out the carisoprodol=>meprobamate metabolism link back in PihKAL, which is probably where I read about it…he was talking about some of the things that Pharma companies do in order to sidestep expiring patents, I think that isolating and patenting stereoisomers of existing drugs was mentioned as well.

For what it’s worth, I’ve had a Soma Rx a couple times over the years and have never really been convinced of its recreational appeal. It made me tired and made my back stop hurting, but that’s about it. Flexeril worked as well but zonks me out for a full 12 hours which is a real hassle if I need to be functional the next day. Thankfully I don’t have chronic issues that would require me to take either regularly, I don’t think I’d like that at all!

Comment by Crustybutz on 2013-11-29 02:38:52 -0800 #

In my little slice of heaven my cracked out customers ask for refills on Caris- poodles (pronounced like to curly haired dog) being the efficient person I am I knocked the caris off and simply call them poodles now. I can tell anyone in my pharmacy to grab the poodles off the shelf and no one looks at me like I’m nuts. Two other terms I am trying to get in the mainstream pharmacy vocab. Mommy meth or milf meth for all of these cracked out housewives woofing down the adderall.

Comment by Crustybutz on 2013-11-29 05:44:59 -0800 #

Looks like someone spilled the quadbars down the drain and can’t get an early refill

Comment by Teresa on 2013-12-04 04:04:51 -0800 #

I’m a 61 yr old female with Rheumatoid and osteoarthritis. Also Morton’s Neuroma’s in both feet, the one in my rt foot was operated on twice and it grew back more painful.I’ve had 5 whiplashes so I have a lot of pain in my neck as well. I get spasms in my rt foot frequently and burning pain. So somewhere’s in the 200’s I was prescribed Norco and Soma. However last Friday (after being on the drugs since 2005 or so, the MD says no more for me.
I looked up about safe withdrawal and it said to titrate off of it. So, what can I do. Looks like it’s going to be a very painful Christmas for me this year, Help!!

Comment by The mooch on 2013-12-15 21:32:51 -0800 #

Just count the pills 1,2,3,4,6 oh shit I have to start again
Thanks for being the Vicodin police, Go to med school if you want to be a Doctor. Remember 1,2,3,4,5,6,8 shit got to start over well at least you made it to 8. Stop your shit fill the script let the junkies junk, the old people be old and people that need their meds take their medication that is why we have a pharmacy on every corner. Just remember you dope when they ban all drugs there will be no need for any angry pharmacists

Comment by jujubee on 2013-12-16 01:45:54 -0800 #

Nice diatribe. I remember finding your blog long ago, losing contact, now re-finding it. What a joyful read to come home to after another long evening on a neuro floor. I’ve grown to love, love, love the pharm techs and pharmacists in our hosp…they are the true brains of the operation. But in a state with such a high rate of addiction of opioids/meth/you-name-it, I tend to feel like an RNpusher, and the pharm dept is the supplier. Pain certification: Pain is what they SAY it is, now go push! It gets fantastical with our acute on chronic protocol. Have never given Narcan either. It’s amazing the tolerance people have. Now I want a side of Fresca and a sandwich with that!

Comment by thekatdocs on 2014-01-07 15:56:32 -0800 #

I didn’t know 6-8 years of schooling and getting a Doctor of Pharmacy (PharmD) degree was considered underachieving. Did you know that many pharmacists also have an undergraduate degree as well in addition to the PharmD? It’s customers like you who come into the pharmacy with this mentality, belittling the staff in every way possible..that is why there is such a site like this. Also, not everyone wants to go to medical school… but maybe YOU DID and didn’t make the cut? From your comment I can only assume so.

Comment by Jesse on 2014-02-12 06:27:18 -0800 #

Be mad at yourself for your addiction. I’ve been in pain management since 2006 and have asked for my dosage to be increased exactly once. This month the woman in front of me at the pharmacy was informed it was too early for her Xanax (but not Suboxone). She gave some long speech about how her ID was stolen and it must have been filled at CVS around the corner because someone knew she had a prescription and called it in using her ID. Then she spent 5 minutes talking about what a nightmare it will be to unravel everything.

I finally get up to the counter and we all started laughing at her. You see, pharmacists and techs (other patients, too) can spot an addict from a mile away. I get respect from my doctor and pharmacy team because I’ve never tried to refill early, don’t ask for dosage increases, have never failed a urine screen, only use one pharmacy, etc.

It’s assholes like you that ruin it for legitimate patients like me.

Go back under your rock and wait out the withdrawals rather than trying to belittle DOCTORS of Pharmacy for being underachievers.

Also, I never even heard of Soma until I started reading TAP. Is it really that commonly prescribed with narcs?

Comment by Jesse on 2014-02-12 06:29:21 -0800 #

Whoops, hit the reply above your comment rather than below.

The above from me applies to you.

Comment by Jesse on 2014-02-12 06:29:50 -0800 #

And I’ve obviously replied to the wrong comment.

Whoops, sorry!

Comment by GN on 2014-02-27 06:19:03 -0800 #

I have had Soma one time and it made me see double, I could barely move. It was awful! Never again…

Comment by Hayden on 2014-03-07 04:01:54 -0800 #

I’m to worried to get anything filled after reading this website, I never want to make someones life differcult, I’m one of those people that never complains, is patient, friendly, and as far as prescriptions go I never refil early. I really don’t want to be judged. I think I’ll just stop my current medications.

Comment by Anon on 2014-04-13 14:42:21 -0700 #

Unfortunately, it’s now Daddy Meth, Grandma and Grandpa Meth, and all of the above at my store.

Most of the backorders dropped off and it was no-holds-barred run for the finish line. Daily Focalin XR (bordering on max dose) + adderall “as needed for daytime sleepiness” – oh, and of course, they’re driving themselves up there to drop it off and pick it up. Mhmm.

Hundreds of Adderall “as needed for focus”. In a non-student aged adult. Seemingly unemployed.

It’s like doctors and patients alike have realized pain medication is in the national spotlight and decided to swap from downers to uppers to try to stay ahead of ‘the man’.

It’s freaking D.O. family practitioners who’ve literally never written it before too. One office has gotten so bad in the course of a year that if you ever see a non-C2 script come out of it, it’s still on the C2 pad. Why? It’s all they keep in the office. From 0 C2s, everything referred to Psychiatrists (if not Psychiatric speciality for juvenile patients) to everything in-house in little over a year.

This is the next wave of doom and gloom substance abuse. And it can’t get here fast enough.

Comment by Bob on 2014-10-09 18:06:56 -0700 #

Hate to say it but, flexeril sucks and soma works as intended, so, give me soma every time. It must suck to have to deal with the druggies, but, as a patient that’s had 6 sinus surgeries (ugly ones culminating in a full frontal obliteration) and now a third neck operation, a posterior fusion of c5-7 after the frontal c5 art disc broke its screws and the fusion below didn’t…I can tell you horror story one after the other of what serious fucking unrelenting pain is like and putting up with all the bullshit regs which have only served to criminalize all of us that actually need this shit while doing zero to curb the problem..

Comment by Sulanda on 2014-10-09 21:53:23 -0700 #

I seriously believe pharmacists after counting drugs all day long (and many do not wear gloves) are getting many, accumulated traces of what they are counting into their systems through their pores. If you just read through these rants, and have any contact with these folks you will understand my statement very clearly!