We have used them for years (since 1998). We have one now. I know ranchers who have put over 200,000 miles on one. The exhaust brake is the best of any pickup. We have rancher friends who run Dodge and Ford and they tell us the exhaust brake on the Dodge is way better than on the Fords. Mr. FH used to add an exhaust brake before they came standard. He puts air bags on his as well because he hauls heavy loads. This last one he got with 4.10 gears and he likes that the best.
Don't be afraid to use it but be prepared for poor fuel mileage when hauling/pulling. They are pretty tough rigs. We have a CM flatbed on ours too.
I found a couple of pictures. The pickup was sitting in a bit of a hole, it never is squashed down like it looks here.
Hope this helps!!