Carisoprodol legal status and patterns of abuse.

OBJECTIVE: To review the current legal status and patterns of abuse of carisoprodol. DATA SOURCES: A literature search was conducted through MEDLINE (1950-August 2010), PubMed (1966-August 2010), EMBASE (1966-August 2010), and International Pharmaceutical Abstracts (1970-August 2010) using the search terms carisoprodol and abuse. In addition, reference citations from publications identified were reviewed. State laws and regulations were accessed through NABPLAW Online (2010) using the search term carisoprodol. Federal proposed rules were accessed through the Federal Register (1995 Volume 59-2010 Volume 75) using the search term carisoprodol. STUDY SELECTION AND DATA EXTRACTION: State laws and federal proposed rules regarding carisoprodol were examined. Case reports and studies involving carisoprodol abuse were evaluated. DATA SYNTHESIS: Carisoprodol is not federally scheduled under the Controlled Substances Act (CSA). However, carisoprodol is scheduled in 36% (n = 18) of states of the US. The Drug Enforcement Administration issued a Notice of Proposed Rulemaking in the Federal Register on November 17, 2009, to place carisoprodol into schedule IV of the CSA, with a deadline to submit written comments by December 17, 2009. Case reports, retrospective studies, and national reports, including reports from the American Association of Poison Control Centers and results from the Monitoring the Future national survey on drug use, have identified carisoprodol's abuse potential.
CONCLUSIONS: Carisoprodol should be placed in schedule IV of the CSA based on its abuse potential and current state laws and regulations. Federally scheduling carisoprodol would lead to uniformity among the states and hopefully assist in preventing prescription drug abuse. Larger, well-designed studies evaluating carisoprodol abuse should be performed.