Non-controlled and over-the-counter drugs of abuse

March 23, 2015, 10:41 pm

 

★★½☆☆

Abuse of Medications That Theoretically Are Without Abuse Potential. Reeves RR et al. South Med J 2015 Mar;108:151-157.

Abstract

This review of noncontrolled prescription and over-the-counter drugs that can be and have been abused for non-medical or recreational purposes is rather sketchy and anecdotal (as the authors admit,) but nevertheless contains some useful information.

Classes of drugs discussed include:

  • Cold & Cough products: pseudoephedrine, ephedrine, oxymetazoline, dextromethorphan
  • Anticholinergics: diphenhydramine, benztropine, trihexyphenidyl (Artane)
  • Antipsychotics: quetiapine, olanzapine
  • Antidepressants: tricyclics, bupropion, fluoxetine, venlafaxine
  • Anitconvulsants: pregabalin, gabapentin
  • Muscle relaxants: carisoprodol, cyclobenaprine (Flexeril,) baclofen

Among the more interesting take-home lessons from tis paper :

  • bupropion is sometimes abused by nasal insufflation (snorting), thus bypassing first-pass metabolism and enhancing its cocaine-like effect at high doses [as the clip above shows, bupropion is also abused by injection]
  • dextromethorphan in large doses has dissociative and  hallucinogenic effects similar to theses of phencyclidine (PCP) or ketamine
  • gabapentin and quetiapine have been reported to enhance the effects of Suboxone (buprenorphine/naloxone)

2 Comments:

  1. Jay Says:

    Above it mentions Oxymetazoline as a drug of abuse. How can Visene Be abused. Am not going to use this drug in a non-medical way, I’m just curious as to how this can be???

  2. Leon Says:

    Jay:

    Good question. The article states: “Although less notable, decongestants with stimulant properties such as ephedrine and oxymetazoline possess abuse potential if used in large doses.”

    The authors reference the following article to support that statement: “Clinical characteristics of cough mixture abusers referred to three substance abuse clinics in Hong Kong : a retrospective study” Tang AK et al East Asian Arch Psychiatry 2012 Dec;22:154-9. Unfortunately, the abstract does not mention oxymetazoline specifically and the full text is not available from my university library system.