Oral Administration of Zolpidem Tartrate in an Abuse-deterrent Formulation Versus an Immediate Release Formulation in Beagle Dogs

Objective: The continuing rise of prescription drug abuse has greatly necessitated the development of an abuse-deterrent formulation. Geopolymers are a promising base for drug design as they allow for tuneable drug release and possess superior physical and chemical properties compared with conventional pharmaceutical excipients.Methods: Geopolymer pellets containing zolpidem tartrate were administrated orally to beagle dogs as a controlled-release formulation with the commercial immediate-release product, Stilnoct® tablets, as the control.Results: The administration of zolpidem tartrate as immediate-release tablets demonstrated an elevated immediate release plasma profile and the zolpidem tartrate in the geopolymers demonstrated a controlled-release plasma profile. The pharmacokinetic analysis demonstrated that immediate-release tablet administration generated much higher plasma concentration when compared with geopolymer pellets administration for zolpidem tartrate. On the other hand, the geopolymer formulation prolonged the time of drug release.Conclusion: Oral administration of zolpidem tartrate in geopolymer pellets demonstrated a controlled-release plasma profile.

Involvement of the dopaminergic system in the reward-related behavior of pregabalin

There has been an increase in cases of drug addiction and prescription drug abuse worldwide. Recently, pregabalin abuse has been a focus for many healthcare agencies, as highlighted by epidemiological studies. We previously evaluated the possibility of pregabalin abuse using the conditioned place preference (CPP) paradigm. We observed that a 60 mg/kg dose could induce CPP in mice and that pregabalin-rewarding properties were mediated through glutamate neurotransmission. Notably, the dopaminergic reward circuitry is also known to play a crucial role in medication-seeking behavior. Therefore, this study aimed to explore the possible involvement of dopaminergic receptor-1 in pregabalin-induced CPP. Mice were randomly allocated to receive saline or the dopamine-1 receptor antagonist SKF-83566 (0.03 mg/kg, intraperitoneal). After 30 min, the mice received either saline or pregabalin (60 mg/kg) during the conditioning phase. Among the control groups that received saline or SKF-83566, the time spent in the two conditioning chambers was not significantly altered. However, among the pregabalin-treated group, there was a marked increase in the time spent in the drug-paired chamber compared to the time spent in the vehicle-paired chamber. Notably, blocking dopamine-1 receptors with SKF-83566 completely prevented pregabalin-induced place preference, thus demonstrating the engagement of the dopaminergic system in pregabalin-induced reward-related behavior.

Early Detection of Prescription Drug Abuse Using Doctor Shopping Monitoring From Claims Databases: Illustration From the Experience of the French Addictovigilance Network

Opioid analgesics and maintenance treatments, benzodiazepines and z-drugs, and other sedatives and stimulants are increasingly being abused to induce psychoactive effects or alter the effects of other drugs, eventually leading to dependence. Awareness of prescription drug abuse has been increasing in the last two decades, and organizations such as the International Narcotics Control Board has predicted that, worldwide, prescription drug abuse may exceed the use of illicit drugs. Assessment of prescription drug abuse tackles an issue that is hidden by nature, which therefore requires a specific monitoring. The current best practice is to use multiple detection systems to assess prescription drug abuse by various populations in a timely, sensitive, and specific manner. In the early 2000's, we designed a method to detect and quantify doctor shopping for prescription drugs from the French National Health Data System, which is one of the world's largest claims database, and a first-class data source for pharmacoepidemiological studies. Doctor shopping is a well-known behavior that involves overlapping prescriptions from multiple prescribers for the same drug, to obtain higher doses than those prescribed by each prescriber on an individual basis. In addition, doctor shopping may play an important role in supplying the black market. The paper aims to review how doctor shopping monitoring can improve the early detection of prescription drug abuse within a multidimensional monitoring. The paper provides an in-depth overview of two decades of development and validation of the method as a complementary component of the multidimensional monitoring conducted by the French Addictovigilance Network. The process accounted for the relevant determinants of prescription drug abuse, such as pharmacological data (e.g., formulations and doses), chronological and geographical data (e.g., impact of measures and comparison between regions), and epidemiological and outcome data (e.g., profiles of patients and trajectories of care) for several pharmacological classes (e.g., opioids, benzodiazepines, antidepressants, and methylphenidate).

Physicians' Role in Curbing the Worst Drug Crisis in America: Prescription Opioid Abuse

Opioids have an important role in the management of acute, cancer, and chronic pain. However, their indiscriminate use in chronic pain has led, in part, to the epidemic of prescription drug abuse, resulting in a dramatic increase in morbidity and mortality in America. Most of this abuse originates from legitimate prescriptions by physicians. Prescribing opioids to chronic pain patients while restricting them to those who abuse them is very challenging, and physicians seek appropriate and unbiased prescribing guidelines. Our review, based on analysis of the available literature, focuses on striking a balance between overprescribing and underprescribing. The core concept of this strategy relies in using screening tools to identify patients who are at high risk for opioid abuse along with diligent monitoring using prescription monitoring programs and urine drug screens, while also limiting opioid doses. Hopefully, using these principles, physicians can more confidently prescribe opioids to those who would benefit from these powerful drugs and at the same time keep opioids away from those who could potentially be harmed. This review contains 3 figures, 4 tables, and 98 references. Key Words: abuse, addiction, chronic pain, dose limitation, misuse, monitoring, opioids, overdose, screening

Roles of Pharmacy Technicians in Preventing Prescription Drug Abuse

Objective: To provide and identify potential roles and strategies for pharmacy technicians to identify and prevent drug abuse within the pharmacy. Data Sources: Related materials were searched via PubMed and Google Scholar from 2000 to present using search terms: “pharmacy,” “technicians,” “prescription,” “drug,” and “abuse.” Articles describing statistics, warning signs, and prevention strategies for pharmacies were identified through databases and organizations’ sites. Portions of the Ohio Administrative Code on OARRS (Ohio Automated Rx Reporting System), and Pennsylvania prescription drug monitoring program information were also identified. Study Selection and Data Extraction: Relevant sections of the Ohio Administrative Code and OARRS were identified through the Ohio Board of Pharmacy website. Information regarding the Pennsylvania Prescription Drug Monitoring was identified via Pennsylvania’s Department of Health website. Sections of the Combat Methamphetamine Act of 2005 were identified through the Drug Enforcement Administration Diversion website. Resources on drug abuse and prevention statistics were obtained from Drug Abuse.gov and American Society of Health System Pharmacists. Information regarding warning signs were identified from the National Association of Boards of Pharmacy. Data Synthesis: The data provided for identification of potential roles for technicians within efforts to prevent prescription drug abuse, including evaluation of warning signs, involvement in the use of prescription monitoring programs, and in efforts to prevent methamphetamine abuse and diversion. Conclusions: After identifying potential roles for pharmacy technician involvement in the prevention of prescription drug abuse, it is evident that there is a need for further education and training on the subject specific to pharmacy technicians.