Abuse of Prescription Drugs in the Context of Novel Psychoactive Substances (NPS): A Systematic Review
Recently, a range of prescription and over-the-counter drugs have been reportedly used as Novel Psychoactive Substances (NPS), due to their potential for abuse resulting from their high dosage/idiosyncratic methods of self-administration. This paper provides a systematic review of the topic, focusing on a range of medications which have emerged as being used recreationally, either on their own or in combination with NPS. Among gabapentinoids, pregabalin may present with higher addictive liability levels than gabapentin, with pregabalin being mostly identified in the context of opioid, polydrug intake. For antidepressants, their dopaminergic, stimulant-like, bupropion activities may explain their recreational value and diversion from the therapeutic intended use. In some vulnerable clients, a high dosage of venlafaxine (‘baby ecstasy’) is ingested for recreational purposes, whilst the occurrence of a clinically-relevant withdrawal syndrome may be a significant issue for all venlafaxine-treated patients. Considering second generation antipsychotics, olanzapine appears to be ingested at very large dosages as an ‘ideal trip terminator’, whilst the immediate-release quetiapine formulation may possess proper abuse liability levels. Within the image- and performance enhancing drugs (IPEDs) group, the beta-2 agonist clenbuterol (‘size zero pill’) is reported to be self-administered for aggressive slimming purposes. Finally, high/very high dosage ingestion of the antidiarrhoeal loperamide has shown recent increasing levels of popularity due to its central recreational, anti-withdrawal, opiatergic effects. The emerging abuse of prescription drugs within the context of a rapidly modifying drug scenario represents a challenge for psychiatry, public health and drug-control policies.
Item Type | Other |
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Uncontrolled Keywords | Drug abuse; Novel psychoactive substances; NPS; Pharmacovigilance; Prescribing drugs’ abuse |
Subjects | Neuroscience(all) |
Date Deposited | 26 Jul 2024 18:30 |
Last Modified | 26 Jul 2024 18:30 |
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- School of Life and Medical Sciences
- Department of Pharmacy, Pharmacology and Postgraduate Medicine
- Centre for Health Services and Clinical Research
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Unit
- Centre for Clinical Practice, Safe Medicines and Drug Misuse Research
- Department of Clinical and Pharmaceutical Sciences
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