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Pain Management board


Dear BilboCameron,

I am not particularly well-versed in pharmacology, but I am aware that doctors (in a general sort of way) have become increasingly wary when it comes to the prescribing of Soma. I have used Soma in the past, and it was--by far--the most effective muscle relaxant I have ever used.

I live in Florida, and Soma was moved from a non-controlled substance to a Schedule IV (the same level as most benzodiazapines, like Xanax and Valium). Soma may have become a Schedule IV in all 50 states, but I don't want to say so when I am not completely sure. Maybe this is why some of the doctors have become more "careful" in Rx'ing Soma. In the Physicians' Desk Reference (PDR), it states that Soma "does not directly relax tense skeletal muscles in man". However, this statement has been there for at least a decade.

The only other muscle relaxant that provided relief for me was Norflex. It has been so long, I am not even sure that it is made any longer. But, it is worth looking into.

I'm one of those people who makes a distinction between dependency and addiction. I wholeheartedly believe that we become dependent on many of our pain medicines--as they allow us to live a normal life. Since I have to live regularly, I really don't find fault with dependence. Years ago, I worked in a Physician's office where an alarming amount of Adderall was Rx'd by one particular doctor. It always amazed me that so many patients "lost" their Adderall. Or, they had it "stolen". Or, this. Or, that. BEFORE ANYONE JUMPS ON ME--I REALIZE THINGS LIKE THIS HAPPEN. HOWEVER, IT JUST SEEMED TO OCCUR WAY, WAY TOO OFTEN TO THE SAME PEOPLE! In fact, less than a year ago, a relative (I'm 99% sure), stole my Actiq, Dilaudid, Duragesic, and Fioricet. So, I know things like this happen. I had a rather enjoyable month, by the way, and I am sure I was a thrill to live with! My poor family--they certainly earned some extra points in Heaven for living with me during that time.

I assume that you are going to Pain Management for the long haul, like most of us do. So, maybe you and/or your doctor shouldn't worry about the dependence issue. Frankly, the Xanax you mentioned is a Schedule IV--not the most potently addictive substance compared to the opiates many of us regularly consume! For instance, I use Duragesic 75 mcg, Actiq (made of fentanyl, also), and Dilaudid. Yes, I'm positive that I am dependent on these medications, which allow me to live a better and more comfortable life. Certainly, if I were to stop these medications immediately--I would go through some terrible withdrawal symptoms...some of the worst agony I can't comprehend, I'm sure.

So, am I an "addict"? Really, I don't think so. I don't go from doctor to doctor just to obtain medication in order to get "high". Am I dependent? I offer a resounding "YES!!" I don't mean to go off the subject too much, but I hope your doctor will see that the so-called "mind-altering psychotic" effects of Soma are the actions that help your muscles relax in a therpeutic manner!! And, I hope he realizes that you aren't using Soma to get high.

Your "short version" asked for suggestions of alternative muscle relaxants. My suggestion is Norflex (if it is still available). My other suggestion--if it is feasible--is to find a different doctor. I realize that this isn't always a possibility in the PM realm, but I thought I would bring it up anyway.

The two previous posts offer appropriate insight concerning this subject!

BilboCameron, we all wish you the best. Please keep us informed.

Sincerely,
Conductor (Jon)
You know, its funny because soma was a drug they used to throw at us by the handfuls in the 'olden days' of PM. It has gotten a reputation for being highly addictive, I think a largely undeserved one, like Jon said, dependancy yes, addiction no. Soma also worked very well for me for a long time, but almost no doctor will prescribe it anymore for long term use and it is even difficult to find a doctor willing to use it for short term. This is not the case in many other countries, some of which actually sell it as an OTC medication. I have no idea what doctors were told about soma to scare them off it, but it must have been a doozy. You can try to reason with your doctor if you think it will help or you could try something like atavan or valium, those are both muscle relaxers and it may be as simple as changing your xanex script to atavan. I was switched to baclofen too, and it does work for me, but I still think the soma worked better. maybe Shore or someone can let us know why and what the differences are, I would also like to know why soma went from being a favorite tool of most doctors to being almost reviled by them, if anyone knows. have a nice evening all! ~ Fabby :wave:
Excellent point fabby. I would like to know also. My GP will prescribe it without hesitation. 350mg up to 4 times a day. However, since I signed a contract with the PM Dr, I dont think it would br wise to switch back through my GP. I didnt get a copy of the contract so I dont know if it pertains to just narcotics or all meds he prescribes.

While having Soma will not save me from all my issues, it will do a lot more than the useless crud I take now.

Quote from Fabrashamx:
You know, its funny because soma was a drug they used to throw at us by the handfuls in the 'olden days' of PM. It has gotten a reputation for being highly addictive, I think a largely undeserved one, like Jon said, dependancy yes, addiction no. Soma also worked very well for me for a long time, but almost no doctor will prescribe it anymore for long term use and it is even difficult to find a doctor willing to use it for short term. This is not the case in many other countries, some of which actually sell it as an OTC medication. I have no idea what doctors were told about soma to scare them off it, but it must have been a doozy. You can try to reason with your doctor if you think it will help or you could try something like atavan or valium, those are both muscle relaxers and it may be as simple as changing your xanex script to atavan. I was switched to baclofen too, and it does work for me, but I still think the soma worked better. maybe Shore or someone can let us know why and what the differences are, I would also like to know why soma went from being a favorite tool of most doctors to being almost reviled by them, if anyone knows. have a nice evening all! ~ Fabby :wave:
I believe that my contract just states narcotics as I do take other meds that are Rxed by my primary as well as the CIIs that are from my PM.but if your pm stated he did not want you on it,it could be a problem?don't know.my primary rxes my lexapro my robaxin and my valium.I suppose you could concievably have your primary Rx it for you and not mention anything to your PM,but that could also come back to haunt you in some way too.But the way my situation is,I can go to my primary and pretty much ask for what I think I may need,we discuss it and if he agrees,it is done.i don't talk to my PM clinic at all about anything before i am Rxed something from my primary.i think as long as it is not an actual narcotic of any sort it isn't any sort of an issue,at least in my case anyway.i mean really,my PM is not my main healthcare provider,they are just treating my pain.you do have the right to have other meds Rxed that have no connection to your PM doc,ya know what I mean?The only problem that I can really see here in your particular case is that your PM stated he did not want you on it.maybe if you sat down and spoke with your primary about this and just see what his thoughts are on this and how he would feel about Rxing it for you despite what the PM told you.he IS your primary doc afterall.if your primary feels that you should be on this,this would be HIS call,you know what I mean?i doubt that your PM could really say anything about it if your primry feels that this med would be in your best interest.then this would be a situation between your two docs and not you.Just a thought.only 'we' really know just what works the best for us and our pain.if this med truely works that well for you,then i would think that you have every right to be able to stay on it thru your primary if he agrees.good luck,marcia
Sounds like we have the exact same setup. My GP scripts me Lexapro, Ambien CR and 1mg Xanax. As long as it not narcotic then he will do it. My PM Dr saw Soma on the list of meds I wrote down on my chech-in paperwork. He stopped right there and suggested I should take something else and then went on to tell me how its not a muscle relaxer. I didnt realize how well it worked until it was gone. I always pick my battles to build rapport and trust so when I ask for a bump up in BT meds I dont look like someone who wants it all. Its a strategy that seems to have worked so far.

Since my GP Rx'd it before and the PM Dr "asked" me to switch I am really thinking that there shouldnt be a problem just asking my GP to auth it. Im going to call into the Pharmacy and ask for a refill which will prompt them to send a request to my GP. His PA usually handles all of it anyway. Its just a slight risk and one that is easy to justify my actions. After all, the agreement was for the PM to Rx the narcotics and my GP does the rest.

I could ask my PM for Soma but since he seems to be so against it he would probably say no. At that point, if I went and got it from my GP, then that would look pretty bad. When my PM Rx'd the baclophen he didnt say "no more soma" and prior to that is was understood that my GP would Rx everything but the narcotics.

Thanks for your insight.



Quote from feelbad:
I believe that my contract just states narcotics as I do take other meds that are Rxed by my primary as well as the CIIs that are from my PM.but if your pm stated he did not want you on it,it could be a problem?don't know.my primary rxes my lexapro my robaxin and my valium.I suppose you could concievably have your primary Rx it for you and not mention anything to your PM,but that could also come back to haunt you in some way too.But the way my situation is,I can go to my primary and pretty much ask for what I think I may need,we discuss it and if he agrees,it is done.i don't talk to my PM clinic at all about anything before i am Rxed something from my primary.i think as long as it is not an actual narcotic of any sort it isn't any sort of an issue,at least in my case anyway.i mean really,my PM is not my main healthcare provider,they are just treating my pain.you do have the right to have other meds Rxed that have no connection to your PM doc,ya know what I mean?The only problem that I can really see here in your particular case is that your PM stated he did not want you on it.maybe if you sat down and spoke with your primary about this and just see what his thoughts are on this and how he would feel about Rxing it for you despite what the PM told you.he IS your primary doc afterall.if your primary feels that you should be on this,this would be HIS call,you know what I mean?i doubt that your PM could really say anything about it if your primry feels that this med would be in your best interest.then this would be a situation between your two docs and not you.Just a thought.only 'we' really know just what works the best for us and our pain.if this med truely works that well for you,then i would think that you have every right to be able to stay on it thru your primary if he agrees.good luck,marcia
I have been taking soma now for about 2 years. I have severe tmj and suffered terrible muscle spasms in my face, neck, upper back and temples. Soma is the only med that got that totally under control. My gosh, when I tried things like Flexeril and those types I was so drugged I couldn't function. Soma has been a God-send for me. I don't know what I would do if my dentist took me off of it. I take it and I also take the soma compound, that too is a wonderful med. It has the soma, aspirin and condeine in it. It can really attack those awful, painful muscle spasms. I wonder why dr's think it is NOT a muscle relaxer? I mean it is the only med I have ever tried that stopped my muscle spasms. For me it worked better than valium!

Karen