Carisoprodol Detox: Timelines, Symptoms & Effects

According to the National Survey on Drug Use and Health, more than two million Americans aged 12 and older have abused carisoprodol (trade name: Soma) at least once in their lifetime ¹.

Carisoprodol is a skeletal muscle relaxer used in combination with rest and physical therapy to relax muscles and relieve pain associated with injury, strain, or sprain. When taken recreationally in doses higher than prescribed, carisoprodol can cause sedation, drowsiness, and a short-lived, mild euphoria.

It is often abused by combining it with other substances such as alcohol, benzodiazepines, and opioids to enhance its effects. Though generally safe when taken therapeutically, those who abuse the drug can eventually become dependent on it and need assistance from an addiction treatment program to stop ^1,2,3.

Effects and Symptoms of Carisoprodol Withdrawal

The muscle relaxing effects of carisoprodol are achieved through its actions on the central nervous system as opposed to peripherally, or on the muscles themselves. Physiologic dependence may result from sustained use. Once dependence has formed, carisoprodol may elicit some withdrawal symptoms when its administration is abruptly halted. Due to the fact that carisoprodol is metabolized to a second addictive sedating substance – known as meprobamate – it may be associated with an even larger range of withdrawal symptoms than other drugs in the muscle relaxant class.

Common symptoms associated with carisoprodol withdrawal include ^1,3,8:

• Anxiety.
• Insomnia.
• Headache.
• Stomach cramping.
• Nausea.
• Vomiting.
• Confusion.
• Delirium.
• Tachycardia (increased heart rate).
• Ataxia (loss of muscle coordination).
• Muscle twitching.
• Tremors.

Although less common, withdrawal from carisoprodol may produce:

• Chills.
• Hallucinations.
• Seizures.

What is the Detox Timeline and Protocol?

Withdrawal symptoms may begin in as little as 12-48 hours after the last dose and typically continue for another 12-48 hours following onset ³. Severity and duration of symptoms will depend on the user’s dosage and length of use. Symptoms may endure longer in those who combine carisoprodol with other CNS depressants such as alcohol, opiates, and benzodiazepines ^2,3.

Detox programs may vary in their approaches to treatment. There are no approved medications approved to treat carisoprodol addiction; however, there are many residential detox programs that help patients taper off the drug slowly under the care and supervision of a physician. Also, medically assisted detox treatment programs will have nurses and/or doctors on staff to administer medications to address physical and psychological symptoms as they arise.

Many detox centers offer social detox programs. Social detox is a form of short-term, clinically managed, non-medical detox where the patient is provided support during withdrawal in a sober environment. Social detox programs usually include room and board, interpersonal support, and medical surveillance.

Continuing the Treatment Process

Following detox, many facilities will help the patient transition into an appropriate inpatient or outpatient rehab program where they can continue the treatment process ⁴.
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Do I Need a Detox Program?

It may be difficult for some people using carisoprodol to recognize that they may have a problem, as many begin taking it as prescribed by a doctor. However, there are certain indications that you may have a problem. Signs and symptoms of carisoprodol addiction may include ^1,2,3,5:

• Taking the drug in a way other than prescribed (combining with other drugs, increasing dosage, etc.).
• Taking for nonmedical reasons (to relax, get high, come down from stimulants, etc.).
• Spending a large portion of your time in obtaining or using the drug.
• Doctor shopping (visiting multiple doctors for prescriptions).
• Loss of interest in favorite activities.
• Social isolation (spending a lot of time alone).
• Neglecting responsibilities in favor of using.
• Experiencing mood swings.
• Physical symptoms of use (nausea, vomiting, appetite changes, restlessness, etc.).
• Frequent periods of illness and irritability (withdrawal in between doses).

If you’re experiencing the above signs of addiction, you may need to seek help to stop abusing carisoprodol. Doing so is especially important considering the long-term consequences of abuse. Side effects of carisoprodol abuse can include ³:

• Mood changes, such as depression.
• Slowed cognition.
• Paresthesia (odd skin sensations / tingling)
• Vertigo.
• Impaired visual acuity / loss of coordination.
• Pronounced sedation.
• Intermittent loss of consciousness.
• Increased risk of accident / bodily injury.

You also risk overdose when you abuse the drug, symptoms of which include ³:

• Shallow breathing / respiratory arrest.
• Somnolence.
• Clammy skin.
• Inability to control bodily movements.
• Seizure / convulsions.
• Very low blood pressure.
• Tachycardia / slowed heart rate.
• Obtundation / loss of consciousness.
• Coma.

Carisoprodol overdose can be fatal. Each day that you continue abusing this drug, your health risks may accumulate. Substance abuse recovery programs can help those struggling with compulsive carisoprodol use. 

How Does Supervised Detox Help?

Quitting carisoprodol can be incredibly difficult as withdrawal symptoms can be difficult to bear – both physically and psychologically. In some cases, carisoprodol withdrawal may be dangerous. The dangers of carisoprodol withdrawal are worsened when used in conjunction with substances like alcohol and other sedative medication. If you’ve been using carisoprodol at high doses or with other substances, it is important to detox in a safe environment with medically trained staff available to act in case of emergency.

Discontinuation of use can result in significant physiological and cognitive changes – potentially producing symptoms of anxiety, depression, social withdrawal, or aggression that may persist beyond the acute withdrawal period.

During supervised detox, a physician can help you slowly lower your dose of carisoprodol in order to increase comfort and minimize the intensity of withdrawal symptoms. In some cases, additional sedating medications will be carefully administered to mitigate serious withdrawal risks. Psychologists and counselors will be on hand to help you address any emotional or mental health issues that may arise during the withdrawal period as well.

It is not only important to undergo medically supervised detox during the initial withdrawal period, but also to continue addiction treatment to ensure that sobriety can be maintained and relapse prevented. Your detox facility will typically provide you with a plan to transition into ongoing treatment and aftercare ^3,6,7.

Finding a Treatment for Carisoprodol (Soma) Abuse

Treatment for carisoprodol addiction is available on both an inpatient and outpatient basis. Inpatient treatment is more intensive and takes place in a residential facility. Patients will reside in the facility full time for approximately 30-90 days (or longer) depending on the severity of addiction.

This immersive treatment environment provides recovering individuals a safe place to address the physical and psychological components of their addiction, free from the stressors of their daily life that may trigger them to want to use. Outpatient treatment takes place on a part-time basis and may be ideal for those with less severe addictions who want to maintain their personal and professional lives outside of treatment. Outpatient treatment is often less expensive and more likely to be covered by insurance plans ^6,7.

Whether outpatient or inpatient, a typical treatment program will likely include some combination of the following ^6,7:

• Medically assisted detox: Medically supervised detox involves slowly tapering your dose of carisoprodol, and/or administration of longer acting sedative medication under the supervision of a physician. Depending on the severity of the addiction, this may take place either on an outpatient basis, or in a controlled environment with full supervision until the detox is complete. Talk to your physician to discuss the safest, most appropriate option for you. Note that the completion of detox does not signal the completion of treatment, but rather the beginning. Components of addiction recovery like counseling and therapy are critical to the maintenance of sobriety.
• 12-step programs: 12-step programs are a form of support group that offer addicts a linear, step-by-step process to recovery amongst the support of others battling the same or similar addictions. Popular programs that may be applicable for carisoprodol addiction include Narcotics Anonymous (NA) and Pills Anonymous (PA).
• Individual therapy and counseling: Individual therapy and counseling can help recovering individuals address the emotional and psychological factors contributing to their addiction.
• Group counseling: Group counseling can involve other patients battling similar addictions as well as family members of the addicted person. Group therapy provides the added support and allows for participating members to support each other through their challenges and is an important aspect of the recovery process.
• Aftercare: To raise the chances of sustained sobriety, it is important that people recovering from carisoprodol addiction continue to attend aftercare programs such as support groups, outpatient visits, counseling, and therapy. Aftercare helps you respond to cravings and triggers in a healthy way and prevent relapse.

If you or someone you love is struggling with addiction to carisoprodol, you do not have to go through it alone. 

References

1. National Drug Intelligence Center. Soma: Fast Facts, Questions, and Answers.
2. U.S. National Library of Medicine. Carisoprodol. (August 1, 2010).
3. National Highway Traffic Safety Administration: Drug and Human Performance Fact Sheets. Carisoprodol (And Meprobamate)
4. SAMSHA. Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol.
5. NIH: National Institute on Drug Abuse. Signs of Drug Abuse and Addiction.
6. NIH: National Institute on Drug Abuse. (November 2014). Treating Addiction to CNS Depressants.
7. NIDA. (December 2012). Principles of Drug Addiction Treatment: A Research Based Guide.
8. Ni, K., Cary, M., & Zarkowski, P. (n.d.). Carisoprodol withdrawal induced delirium: A case study.