Yes, Soma (carisoprodol) is still prescribed in the United States, but far less frequently than it once was. It remains FDA-approved for short-term relief of acute musculoskeletal pain, and it is classified as a Schedule IV controlled substance by the DEA. However, its well-documented potential for abuse and dependence has pushed most prescribers toward safer alternatives, and the European Union pulled it from the market entirely in 2008.
Why Soma Is Harder to Get Than It Used to Be
Soma was once easy to obtain and inexpensive, which contributed to widespread misuse. In 2012, the DEA placed carisoprodol on Schedule IV of the Controlled Substances Act, putting it in the same regulatory category as drugs like Xanax and Valium. That means every prescription is tracked, refills are limited, and pharmacies face stricter dispensing rules.
Many doctors now view Soma as a last resort. The American Pain Society and the American College of Physicians recommend over-the-counter pain relievers as first-line treatment for acute back pain, with muscle relaxants reserved as an alternative. Among muscle relaxants, guidelines from the American Academy of Family Physicians single out carisoprodol (along with diazepam) as drugs that should be reserved for last-line therapy because of their abuse potential and lack of superiority over other options.
What Makes Soma Riskier Than Other Muscle Relaxants
The core issue is what happens after you swallow the pill. Your liver breaks carisoprodol down into meprobamate, an older sedative that was itself a widely abused drug in the 1950s and 60s. Meprobamate acts on the same brain receptors targeted by benzodiazepines and alcohol, producing sedation and a sense of relaxation that can feel rewarding. With repeated use, your brain adjusts to that constant sedation, building tolerance and, eventually, physical dependence.
Soma also carries a specific danger when combined with opioids and benzodiazepines. This combination, sometimes called the “Holy Trinity” in substance-misuse circles, creates a synergistic effect: each drug amplifies the others’ ability to suppress breathing. The result is a dramatically higher risk of fatal respiratory depression. Current opioid prescribing guidelines warn against combining opioids with benzodiazepines, though they don’t always flag carisoprodol as an additional risk factor, which some researchers consider a gap in the guidance.
How Long a Prescription Lasts
The FDA label is clear: Soma should only be used for two to three weeks. There is no evidence supporting longer use, and the conditions it treats, such as acute muscle spasms from a strain or injury, are generally expected to resolve within that window. Doctors who do prescribe it typically write for a short course and avoid renewals.
If you stop taking Soma abruptly after using it for longer than directed, withdrawal symptoms can include insomnia, vomiting, abdominal cramps, headache, tremors, muscle twitching, anxiety, and in severe cases, hallucinations or psychosis. A gradual taper under medical supervision is the standard approach for anyone who has been taking it regularly.
Soma Is Banned in Europe
In 2007, Norway announced plans to pull carisoprodol from its market after new data highlighted rising rates of abuse, addiction, and poisoning. That triggered a review by the European Medicines Agency, which concluded that the risks of carisoprodol outweighed its benefits. The agency recommended suspending marketing authorizations across the EU, and the drug was removed from markets in countries including the UK, Spain, Italy, Sweden, Finland, and Denmark. It is no longer available anywhere in Europe.
What Doctors Prescribe Instead
No single muscle relaxant has been proven clearly superior to the others for treating muscle spasms. But two alternatives come up most often in practice: cyclobenzaprine and tizanidine. Cyclobenzaprine is the most studied of the group and is effective across a range of musculoskeletal conditions. Tizanidine works through a different mechanism and, like cyclobenzaprine, has sedative properties that can help when muscle spasms are disrupting sleep. Neither is free of side effects (drowsiness is common with both), but neither carries the same addiction risk as Soma.
Choice between these alternatives usually comes down to side-effect profiles, potential drug interactions, and how well a patient tolerates the medication. For many people with acute back or neck pain, a short course of an anti-inflammatory drug combined with physical therapy is enough without adding a muscle relaxant at all.
The Bottom Line on Getting a Soma Prescription
You can still legally receive a Soma prescription in the United States, but the circumstances where a doctor will write one have narrowed considerably. Most providers will try other muscle relaxants first, limit prescriptions to a few weeks, and monitor closely for signs of misuse. If you’re currently taking Soma and wondering about its safety, the key factors are how long you’ve been on it, whether you’re taking other sedating medications, and whether your underlying pain has been addressed through other means like physical therapy or anti-inflammatory drugs.