Mail-Order (Veterinary) Drug Dependence

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Abstract
To the Editor.— Carisoprodol (Rela, Soma) is marketed as a musculoskeletal pain reliever and is not classified as a controlled substance. However, its primary metabolite is meprobamate (Equanil, Miltown),1 a drug with high potential for abuse and addiction. We report a case of carisoprodol dependence. One case has been reported previously.2 Because carisoprodol is not legally classified as a drug of abuse, it is available over-the-counter through veterinary mail-order catalogs. Report of a Case.— A 46-year-old woman, a breeder of cats, was admitted to the emergency department in a stupor. The serum drug screen revealed carisoprodol, 23.6 mg/L, and meprobamate, 72.8 mg/L. With supportive care, she improved and admitted to the ingestion of approximately 100 carisoprodol tablets (350 mg each). Fortyeight hours after ingestion, she displayed symptoms of meprobamate withdrawal, including anxiety, disorientation, hallucinations, insomnia, and tremors.3 These resolved with a tapering dose schedule of meprobamate, and

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