Non-controlled and over-the-counter drugs of abuse
March 23, 2015, 10:41 pm
Abuse of Medications That Theoretically Are Without Abuse Potential. Reeves RR et al. South Med J 2015 Mar;108:151-157.
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)