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Well it's doubtless HC/APAP is addictive if left unmonitored; how Brett Farve (the QB) ended up taking them like candy, for months and months, until he himself realized he was addicted, and had the courage to kick his habit and warn the public, took a lot of guts.

But this media frenzy hurts innocent patients on a variety of notorious drugs, and their doctors, by making them so fearful the doctor doesn't want to prescribe it and the patient doesn't want to take it.

The Pt. would do much better on OxyContin T. 1 daily in the AM; we all know analgesia on a scheduled, rather than PRN basis is less likely to lead to problems down the road. (Or do we?) Or the lowest dose of the Duragesic patches.

As far as the carisoprodol goes, I can say on my own behalf it does work, as does methcarbamol, but I don't believe I've ever taken either for more than a month. Pt. exhibits greatly improved range of motion, functionality, and less pain and spasm when on the drug than when not taking it; he doesn't exhibit drug seeking behaviors at all, and generally has to be reminded to take his meds.

Every NSAID through the COX-2 inhibitors have been ineffective and poorly tolerated; cyclobenzeprine was the predictable nightmare; tramadol was poorly tolerated and not effective; propoxyphene and Talwin received similarly poor reviews.

SL buprenorphine worked extremely well, and 1 dose in the morning managed the pain all day for the pt; on a very rare day he might need 1/2 T. hs in addition.

So I guess you answered my question- carisoprodol seems to be a prize drug of abuse, and that's why there's some hesitancy to presribe it. Maybe it does work chiefly through CNS depressant effects, but, it does work. It's a shame.

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