Evaluation of discharge prescribing after rescheduling of gabapentin as a controlled substance

Purpose Gabapentin has increasingly been identified as a drug of abuse, especially when used concurrently with opioids. Rescheduling gabapentin as a schedule V controlled substance may strengthen monitoring and prescribing restrictions. The purpose of this study was to characterize the impact of rescheduling gabapentin from a nonscheduled to a schedule V substance in Virginia on discharge prescribing patterns in a health system. Methods This was a retrospective, pre-post, multicenter chart review conducted at 4 sites. Data from 3 months before gabapentin rescheduling (prerescheduling group) and 3 months after gabapentin rescheduling (postrescheduling group) were evaluated. The primary outcome was the percentage of newly prescribed gabapentin prescriptions upon discharge, which was compared between the pre- and postrescheduling groups. Results A similar percentage of gabapentin prescriptions were newly prescribed in the prerescheduling group as compared to the postrescheduling group (55.0% vs 50.0%, P = 0.479). Gabapentin prescribing characteristics did not differ between the groups for new gabapentin prescriptions (n = 55 in the prerescheduling group, n = 50 in the postrescheduling group). Concomitant discharge prescribing of benzodiazepines (5.5% vs 2.0%, P = 0.619) and opioids (45.5% vs 60.0%, P = 0.136) did not differ significantly between the postrescheduling group and prerescheduling group for new gabapentin prescriptions. However, fewer opioid prescriptions exceeded 90 daily morphine milligram equivalents (MME) in the postrescheduling group as compared to the prerescheduling group for new gabapentin prescriptions (36.0% vs 20.0%, P = 0.020). Conclusion Gabapentin prescribing practices did not differ before and after rescheduling of gabapentin as a controlled substance. There was a trend toward dosages with reduced daily MME for concomitant opioid prescriptions after rescheduling. However, additional investigation with larger studies over longer periods of time is needed to discover whether gabapentin rescheduling significantly changes prescribing practices.

Impacts of Abusing Drugs on Our Society

Alcohol, heroin, inhalants and similar are considered as drug of abuse in our society. These can ruin the lives of everyone. Infact these are slow poisons. Mostly teen agers are big victims of these drugs. They may be more likely to engage in harmful behavior. Alcohol, cigarettes, and crack cocaine are the most often consumed drugs by young people. Our objectives are to identify the effects of abusing drugs in our society and play a role to stop it. The study was done in the Faisalabad division by the interviews of people who were drug addicts through the questionnaire. This survey research was completed in March 2020 to June 2020. We interviewed about 450 drug addicts and we have found about six abusing drugs among those. The drugs were alcohol, heroin, marijuana, allergic injection, inhalant and opium and the percentage of addicts were 24, 30, 15, 14, 10 and 07 respectively. We also found 9% females and 91% males were involve and 25% were teen ager, 60% were between 20 to 40 years and 15% were above 40 years. It is concluded that authorities should play their role to stop this sin and it should be established a number of centers for treatment of the drug addicts.

Habitual khat chewing alters urinary inorganic profile in adult healthy males

Objectives Khat (Catha edulis) is a stimulant plant, and it is abusive to induce euphoria, alertness and activity. Concomitant use of medications and khat chewing predisposes to the appearance of drug interactions result in treatment failure or toxicity. This study determined the changes in the urinary inorganic profile in adult healthy males who are chewing khat compared with non-khat chewer males. Methods A total of 40 adult non-smoker healthy males (20 khat chewer and 20 non-khat chewer) aged 24–30 years were selected. Khat chewer samples were positive for cathinone and cathine and negative for other drug of abuse, while non-khat chewer samples were negative for drug of abuse include cathinone and cathine. Samples were selected according to their results in immunoassay and gas chromatography mass spectrometry (GCMS) analysis. Cathine and cathinone were confirmed using liquid chromatography mass spectrometry (LC-MSMS) analysis. Inorganic profile includes titanium (Ti), cobalt (Co), copper (Cu), zinc (Zn), cadmium (Cd), and lead (Pb) were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). Results The levels of Ti, Co, Zn, Cd, and Pb in urine were significantly higher among the khat chewer group compared with non-khat chewer. Ti, Cd, Co, Pb and Zn urine levels were 0.5-, 1.5-, 1.15-, 5-, and 8.2-fold higher in the khat chewer group compared to non-khat chewer, respectively. Conclusions We suggested that continuous khat chewing has a long term effect on metabolic pathway of therapeutic drugs that result in toxicity or failure of therapy.

Immune System and Methamphetamine: Molecular Basis of a Relationship

: Use of methamphetamine (Meth) as a drug of abuse is on the rise worldwide. Besides its effect on the function of the brain, Meth has detrimental effects on how the immune system functions. As documented in the literature, various experimental models (cellular, animal, mice, and non-human primates) have been used that have contributed to the overall knowledge about immune system impairments from Meth exposure. It has to be noted that while Meth is used in very few treatments, it affects a broad range of biological mechanisms, not only immune regulation, in a negative manner. Undoubtfully, the effect of Meth is highly complex; moreover, the initial molecular triggers remain unknown. Analyses of available literature suggests that the effect of Meth is not prompted by one underlying mechanism. Whether the effect of Meth is acute or long-lasting, the overall effect is negative. Further advancement of our knowledge on Meth’s specific actions will require systematic experimental approaches using all available models. In addition, bioinformatic analyses are necessary to build a comprehensive model as a needed tool to fill the gap in knowledge.

A review of common psychedelic drugs

Psychedelic substances have traditionally been used in medicine and religious rituals. Their use dates back thousands of years with fossil evidence as old as 10 000 years. Throughout the 1950s and 1960s psychedelics were used in clinical studies. These drugs then saw widespread use in hippie culture and were viewed as a drug of abuse with no medicinal value. Currently, psychedelics are being investigated as adjuncts to existing psycho therapeutic approaches including depression and addiction. This article will look at definitions, classifications, effects and basic pharmacokinetics and pharmacodynamics of these drugs. In this review I will refer to this group of drugs as psychedelics.