Skeletal Muscle Relaxant Guideline

Today’s post is a repost of an article I wrote previously about Skeletal Muscle Relaxants (SMRs). Concurrent with this article, I have added a Sample Guideline on prescribing Skeletal Muscle Relaxants to the Guideline Section of JailMedicine. Personally, I think that skeletal muscle relaxers like cyclobenzaprine, methocarbamol and chlorzoxazone are over prescribed for acute and […]

Sample Guidelines

JailMedicine Sample Clinical Guidelines These clinical guidelines are intended to be used as templates to help clinicians and administrators to create their own policies. These sample guidelines must be modified to make them applicable to each unique correctional facility. These guidelines are not intended to apply to all patients. Practitioners should use their clinical judgement […]

Medications at High Risk for Diversion and Abuse In Correctional Facilities

The practice of Correctional Medicine has many strange differences from medicine outside the walls. It took me a couple of years to get comfortable with the various aspects of providing medical care to incarcerated inmates. Of all of these differences, one that stands out in importance is the fact that many seemingly benign medications are […]

Skeletal Muscle Relaxers Do Not Relax Skeletal Muscles!

Today’s post is an opinion piece. Personally, I think that skeletal muscle relaxers like cyclobenzaprine, methocarbamol and chlorzoxazone are over prescribed for acute and chronic musculoskeletal pain, both in the outside world but especially in corrections. The main reason for this, I think, is that prescribers misunderstand what muscle relaxers do. Contrary to their name, […]

Patient Satisfaction? In a Jail?

I think everybody would agree that in the wide world of medicine outside of jails and prisons, patient satisfaction is critically important.  Partly this is because patients are not just patients, they are also business clients.  If they are not happy, they will go to some other doctor and some other hospital.  Many studies have […]

Three Cases (and Three Causes) of Rhabdomyolysis

Rhabdomyolysis is one of those diseases, like acute alcohol withdrawal, that I have seen much more commonly in my jails than I ever did when I worked in the emergency department. Rhabdomyolysis occurs when skeletal muscle cells die and rupture, releasing the protein myoglobin into the blood stream.  The kidneys attempt to clear the myoglobin, […]