Olanzapine 10 mg street value

Olanzapine 10 mg street value DEFAULT

Is Seroquel Developing an Illicit Reputation for Misuse/Abuse?

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Sours: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848462/

Inspired by the principles of crowdsourcing, StreetRx is a one-of-a-kind program that identifies and tracks the street value of prescription and illicit drugs. StreetRx gathers user-submitted data to map the street price of a variety of drugs across the country.

StreetRx users can anonymously post, view, and rate submissions, shedding new light onto the often muddy waters of the black market. By providing invaluable information about the preferences of users, health communication specialists can adapt the outreach efforts to the local needs of their community.

XANAX

A Brief History of Xanax

Xanax is a brand name for the medication alprazolam, a benzodiazepine used to treat anxiety disorders. Originally developed in Kalamazoo, Michigan, in the late 1960s by Upjohn Laboratories, alpraxolam was patented in 1971 and approved for medical use in the United States in 1981. Xanax was initially marketed as an antidepressant but was eventually promoted as a treatment for panic disorder in order to gain FDA approval. In an attempt to legitimize the use of an anti-anxiety medication, Upjohn Labs invested millions of dollars in studies that identified panic as a condition that necessitated medical treatment. In the United States, Xanax is classified as a Schedule IV controlled substance.

Xanax on the Street

With its high potential for physical and mental addiction, Xanax, the quick discontinuation of which can cause severe withdrawal symptoms, has a high risk of abuse. Xanax and other benzodiazepines are among the world’s most widely misused prescription drugs. The street value of Xanax varies depending on location and the dosage of the pill. The dosage of Xanax pills ranges from 0.25 milligrams to 3.5 milligrams. In order to better understand the underground market for this drug, StreetRx collects data on the street price of Xanax and has found that its average black-market price is approximately $7.30 per milligram.

FENTANYL

A Brief History of Fentanyl

Fentanyl is a powerful opioid developed in 1960 by the Belgian physician Paul Janssen. Approved for medical use in 1968, it has since become the most commonly used of all synthetic opioids. It is most often administered intravenously for acute pain management, but it also comes in a nasal spray, a lozenge, and a tablet, as well as in a patch, which is commonly prescribed to cancer patients with chronic pain. As a widely used analgesic, it is included in the World Health Organization’s list of essential medicines. In the United States, fentanyl is classified as a Schedule II controlled substance.

Fentanyl on the Street

Fentanyl is taken recreationally in a number of ways, including smoking, swallowing, snorting, and injection, as well as through patches and lollipops. Because of its high potency, recreational use of fentanyl is extremely dangerous, even for users with a tolerance to opiates.

Fentanyl is approximately one hundred times stronger than morphine, and some of its analogues are estimated to be hundreds of times stronger than heroin. Because of this, and because the street price of fentanyl is considerably lower than that of heroin, heroin dealers have been known to cut lower-quality product with it. This type of adulteration has resulted in fentanyl becoming one of the leading causes of overdose deaths in the United States.

The street value of fentanyl varies depending on which of the various forms it is being purchased in. According to data collected by StreetRx, the street price of fentanyl tablets is approximately $195 per milligram.

LORTAB

Lortab at a Glance

Lortab is a brand-name medication of a hydrocodone/acetaminophen combination. It is typically used for the treatment and management of moderate to severe pain. Like all drugs containing hydrocodone/acetaminophen combos, Lortab is classified by the FDA as a Schedule II drug requiring a valid prescription.

Lortab on the Street

Today, Lortab is primarily used as an alternative painkiller in place of Vicodin or Percocet. As with many other opiate analgesics (painkillers), there are risks associated with Lortab, especially when it is misused. It is the misuse that has caused the FDA to place restrictions on the legal procurement of Lortab, driving many people to buy it on the street or otherwise acquire it through the black market. In order to build a better understanding of the underground market for this drug, StreetRx collects data on the street price of Lortab and has found that the average street price of Lortab is approximately $1.20 per milligram.

METHADONE

A Brief History of Methadone

First developed in Germany in 1937, methadone offers patients longer and more potent analgesic effects than many other painkillers. First introduced to the U.S. market in 1947 by Eli Lilly and Company, methadone is approved as a reliable and effective analgesic (painkiller). In the United States, methadone is also used to treat opioid dependency because of its ability to block the euphoric highs of drugs like heroin or morphine. Due to the drug’s potency and long-lasting effects, methadone is listed as a Schedule II controlled substance by the FDA.

Methadone on the Street

Despite the regulations implemented by the United States government, methadone is still a widely used drug for the treatment of pain and opioid dependency. When a person is unable to procure methadone through traditional channels, he or she may turn to the black market. In order to develop a better understanding of the underground market for this drug, StreetRx collects data on the street price of methadone and has found that the average street price of methadone is approximately $1.00 per milligram.

MORPHINE

A Brief History of Morphine

First isolated from opium in 1804 by the German pharmacist Friedrich Serturner, morphine is a potent opiate analgesic most often used to manage pain before and after major surgery.

Morphine was first distributed by Serturner in 1817; however, it wasn’t until 1827 that the pharmaceutical company Merck began selling the drug commercially. After the invention of the hypodermic needle in 1857, morphine became the gold standard in opiate analgesics due to its ability to relieve even the most severe pain. Despite its benefits, morphine has a high potential for addiction and dependency.

Morphine on the Street

The feeling of euphoria that opium induces in the user is the leading reason for the abuse and misuse of this controlled substance. For this reason, the United States government classified morphine as a controlled substance under the Harrison Narcotics Tax Act of 1914, making the possession of morphine without a prescription a criminal offense. In order to obtain morphine, many people turn to illegal distributors and the black market. In order to better understand the underground market for this drug, StreetRx collects data on the street price of morphine and has found that the average street price of morphine is approximately 55¢ per milligram.

OXYCODONE

A Brief History of Oxycodone

Developed in Germany in 1916, oxycodone was one of several semi-synthetic opioids created to improve upon the existing selection of opioids. Scientists hoped that oxycodone, which is derived from thebaine, would become a viable treatment alternative while maintaining the analgesic effects of morphine and heroin without the dependence. One year after the drug was developed by German scientists Martin Freund and Edmund Speyer, oxycodone made its clinical debut. After its introduction to the U.S. market in May 1939, oxycodone became widely used to treat acute postoperative pain. After two decades, the United States government classified oxycodone as a Schedule II narcotic. It was the government’s hope that these new restrictions would aid in the fight against improper use and abuse of oxycodone. Today, oxycodone is an active ingredient in a number of brand-name pharmaceutical products, including Percodan, Endodan, Roxiprin, Percocet, Endocet, Roxicet, and OxyContin.

Oxycodone on the Street

Today, oxycodone is widely used to treat pain resulting from cancer treatments, major surgery, and more. While oxycodone has proven effective in the treatment of acute pain, it has been found that a dependency may occur in some patients. As such, the government has implemented certain restrictions, which in some cases may compel those who cannot obtain oxycodone through proper channels to seek the drug on the black market. In order to better understand the underground market for this drug, StreetRx collects data on the street price of oxycodone and has found that the average street price of oxycodone is approximately $1.40 per milligram.

PERCOCET

A Brief History of Percocet

Percocet, which contains oxycodone and acetaminophen, is used to relieve moderate to severe pain. Originally produced in Germany in 1916, oxycodone was used as an alternative to morphine as a treatment for acute and chronic pain. In the 1950s, pharmacists began mixing oxycodone with acetaminophen (aspirin) under the name Percodan, which became the most heavily prescribed painkiller in the United States at the time. Due to the fact that Percodan could not be used for postoperative pain, it was replaced by Percocet, which then became the leading painkiller in the country, in 1974. While Percocet was proven to be effective in treating pain, it became widely overprescribed. In 1995, the US Food and Drug Administration (FDA) recommended that Percocet be sold in limited amounts, as it had been found to be associated with liver damage. In 2000, an FDA study revealed the misuse of Percocet was the cause of almost 400 deaths per year due to overdose and liver damage. This caused the FDA to classify Percocet alongside other opiate-based painkillers as a Schedule II narcotic, tightening restrictions on availability.

Percocet on the Street

Despite government attempts to control and monitor the use of Percocet, it is still widely misused and abused. For those unable to procure Percocet from a physician, the alternative is often to find the popular painkiller on the street. The street market for prescription drugs like Percocet comprises a large underground economy that is poorly understood and has been studied very little. This gap in knowledge has allowed the prescription drug black market to expand and thrive. In order to better understand the underground market for this drug, StreetRx collects data on the street price of Percocet and has found that the average street price of Percocet is approximately $1.75 per milligram.

TRAMADOL

A Brief History of Tramadol

Tramadol was first developed in the laboratories of Grünenthal GmbH, a German pharmaceutical company, in the late 1970s. Since then, there have been over 55 different brand names for tramadol worldwide, including Ralivia, Ryzolt, Tramal, and Ultram. Tramadol is widely used for the relief and management of moderate to severe pain. Despite tramadol being classified as an opiate, the Food and Drug Administration (FDA) does not consider it to be a controlled substance in the United States. Because of this, one may obtain tramadol with a standard prescription. It is even possible to obtain tramadol from an online pharmacy as long as the pharmacy is properly licensed in the United States. As a synthetic agent, tramadol is less addictive than some other opioid analgesics and it is unlikely that a dependency will occur when the drug is used for an extended amount of time. This makes tramadol a good solution for many people with pain from an injury, illness, or operation.

Tramadol on the Street

While tramadol is not a controlled substance and is widely available, there is still a considerable black-market demand for the drug. In order to better understand the underground market for this drug, StreetRx collects data on the street price of tramadol and has found that the average street price of tramadol is approximately 12¢ per milligram.

VICODIN

About Vicodin

First introduced to the United States in 1978 by the German pharmaceutical company Knoll, Vicodin has become a common treatment for those suffering from mild to severe pain. A combination opioid-narcotic drug, Vicodin contains both acetaminophen and hydrocodone. Vicodin is an intermediate-strength Schedule II analgesic, approximately twice as potent as morphine when taken orally.

Vicodin on the Street

Since its introduction, Vicodin has been used to treat both acute and chronic pain. The FDA has classified Vicodin as a Schedule II drug with the hope that the restriction will limit the misuse or abuse of the drug. For those looking to obtain Vicodin without seeing a physician, the alternative is often to look toward the black market. The street market for prescription drugs like Vicodin comprises a large underground economy that is poorly understood and has been studied very little. The mission of StreetRx is to elucidate this underground drug market and use the knowledge obtained to aid in the reduction of prescription drug abuse. For this reason, StreetRx collects information on the street price of Vicodin and has found that the average street price of oxycodone is approximately $1.45 per milligram.

CANNABIS

Cannabis goes by many names, including weed, pot, marijuana, and more. The drug is derived from the hemp plant, Cannabis sativa, and is made from the dried flowers, leaves, stems, and seeds of the plant. Dried cannabis can be smoked, although it is often added to food or beverages, as well. Legalization in several states has made cannabis more accessible for medical and/or recreational purposes. Cannabis is a psychoactive drug that can be both a stimulant and a depressant. It often causes a euphoric feeling, or high. Ongoing use can cause respiratory problems, heart attack, and mental health issues like anxiety and depression.  

COCAINE

Derived from the coca plant, this drug comes in many forms, most commonly powder and crystal. Also referred to as coke, this stimulant creates a brief but intense high punctuated by feelings of euphoria related to the release of dopamine in the brain. In powder form, cocaine is typically snorted, although it can also be dissolved and injected. The crystal form of cocaine is known as crack, and it is smoked. Cocaine use can cause problems like nosebleeds and increased heart rate, as well as more serious concerns like hypertension, heart attack, stroke, and death.  

MDMA

More commonly known by street names like molly and ecstasy, MDMA is a synthetic stimulant and hallucinogen that typically comes in pill form, but can also be powdered and snorted or dissolved and injected. This drug affects brain chemistry in several ways, stimulating the release of dopamine, norepinephrine, and serotonin. This results in feelings of euphoria, increases energy, and alters social behavior, such that users experience heightened feelings of trust and empathy. Nausea, dizziness, and sweating are common side effects, as are increased heart rate and blood pressure. Anxiety, depression, and sleeplessness are common after using MDMA.  

GHB

Gamma-hydroxybutyrate (GHB), also known simply as G, is a central nervous system depressant that is used as a treatment for narcolepsy and cataplexy. It is also used illicitly as a recreational drug and has been associated with instances of date rape because one of the common side effects is amnesia. It is a white powder that is usually mixed into a liquid, where it becomes odorless and tasteless, for consumption. The effects of GHB include intoxication, disinhibition, and euphoria. Nausea, dizziness, and drowsiness are common side effects, although unconsciousness and even death are possible. Effects can last up to several hours, depending on the amount consumed.  

KRATOM

Mitragyna speciosa, or kratom, is a tropical evergreen tree native to Indonesia, Malaysia, Myanmar, Papua New Guinea, and Thailand. It is part of the coffee family and is known to produce opioid-like effects when ingested. The leaves are typically chewed, added to food, or brewed into tea, and it has long been used in traditional medicines in its native regions. In small doses, kratom acts as a stimulant, but in larger doses it becomes a depressant. Effects can last up to several hours. Nausea, vomiting, and constipation are common side effects, and respiratory issues, liver damage, psychosis, and seizures are possible with continued use.  

LSD

Lysergic acid diethylamide (LSD), often simply called acid, is a hallucinogenic chemical derived from the ergot fungus, which grows on rye and related grains. The major effect of this drug is sensory hallucination. Users often believe they see, hear, and feel things that are not present. Altered thoughts and feelings are also common. The effects can last several hours, and side effects typically include dilated pupils, dry mouth, sweating, and increased heart rate and blood pressure. Some users experience paranoia, delusions, and anxiety that may continue after the initial effects of the drug have worn off, and some people experience flashbacks later on.  

MESCALINE

Mescaline, often referred to as peyote, is a hallucinogenic substance derived from several different cacti, most famously the Lophophora williamsi, or peyote cactus. Peyote buttons are cut away from the roots and dried for consumption. The plant can be eaten, but it has a bitter flavor, which is why it is more often brewed into a tea or ground into powder to create capsules. Mescaline has a long history of use in Native American ceremonies, and although it is an illicit drug in the United States, it may still legally be used in specific ceremonies registered by a Native American church.  

METHAMPHETAMINE

This powerful but short-lived stimulant is extremely addictive and causes significant damage with long-term use. Meth, crystal, or crystal meth, as it’s commonly called, is made by mixing pseudoephedrine, a decongestant found in many cold medicines, with a variety of other chemicals, many of them toxic. The powder can be ingested, snorted, smoked, or injected. The effects are similar to what users might experience with other stimulants, such as cocaine. Over time, continued use of methamphetamines can cause weight loss, oral health problems, and skin sores, along with mental-health concerns like paranoia, anxiety, insomnia, and even delusions and hallucinations.  

PCP

Originally developed in the 1950s as an intravenous anesthetic, phencyclidine (PCP), also known as angel dust, was discovered to cause significant neurotoxic side effects, leading to the discontinuation of medical development and usage. The white, crystalline powder has since become a recreational drug that is typically smoked, snorted, ingested in a capsule, or dissolved in liquid, such as alcohol. PCP reacts with a variety of receptors in the brain, including NMDA, glutamate, dopamine, opioid, and nicotinic receptors. It can cause hallucinations, numbness and loss of motor function, feelings of strength and invincibility, amnesia, hostility, violence, and psychoses similar to schizophrenia, among other effects. Seizures, coma, and death are possible.  

PSILOCYBIN

This psychedelic substance occurs naturally in certain types of mushrooms, and produces hallucinogenic and other effects when the mushrooms are consumed. Often, users simply eat them as is, but mushrooms can also be added to food or brewed into a tea. Referred to as magic mushrooms or just shrooms, psilocybin mushrooms can alter perception of time, produce feelings of euphoria, and cause users to see, hear, and feel things that aren’t real. During use, it is common to experience side effects like dilated pupils, nausea, and vomiting. Continued use may cause ongoing or worsening side effects such as panic attacks and even psychosis.  

SALVIA

Although salvia is not currently classed as an illicit drug in the United States, it has hallucinogenic properties and is used as a recreational drug. Native to a specific region of Mexico, salvia is a plant in the mint family that contains opioid-like compounds. Leaves can be brewed as a tea, but many users simply chew or smoke the leaves. It takes only a few minutes for the drug to take effect, producing changes in mood, emotions, and sensory perception, particularly sight and touch. Many users claim to experience a trancelike state, which may explain its long history of use by Mazatec shamans during spiritual ceremonies. Little research has been conducted on the potential long-term effects of salvia.
Sours: https://streetrx.com/
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Abuse of second-generation antipsychotics: What prescribers need to know

References

1. Hussain MZ, Waheed W, Hussain S. Intravenous quetiapine abuse. Am J Psychiatry. 2005;162:1755-1756.

2. Morin AK. Possible intranasal quetiapine misuse. Am J Health Syst Pharm. 2007;64:723-725.

3. Waters BM, Joshi KG. Intravenous quetiapine-cocaine use (“Q-ball”). Am J Psychiatry. 2007;164:1.-

4. Reeves RR, Brister JC. Additional evidence of the abuse potential of quetiapine. S Med J. 2007;100:834-836.

5. Murphy D, Bailey K, Stone M, et al. Addictive potential of quetiapine. Am J Psychiatry. 2008;165:7.-

6. Fischer BA, Boggs DL. The role of antihistaminic effects in the misuse of quetiapine: a case report and review of the literature. Neurosci Biobehav Rev. 2009;34:555-558.

7. Pierre JM, Shnayder I, Wirshing DA, et al. Intranasal quetiapine abuse. Am J Psychiatry. 2004;161(9):1718.-

8. Sansone RA, Sansone LA. Is seroquel developing an illicit reputation for misuse/abuse? Psychiatry (Edgemont). 2010;7(1):13-16.

9. Tarasoff G, Osti K. Black-market value of antipsychotics antidepressants, and hypnotics in Las Vegas, Nevada. Am J Psychiatry. 2007;164:350.-

10. Keltner NL, Vance DE. Biological perspectives: incarcerated care and quetiapine abuse. Perspect Psychiatr Care. 2008;44(3):202-206.

11. Lai CH. Olanzapine abuse was relieved after switching to aripiprazole in a patient with psychotic depression. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(7):1363-1364.

12. Reeves RR. Abuse of olanzapine by substance abusers. J Psychoactive Drugs. 2007;39(3):297-299.

13. The Vaults of Erowid. Available at: . Accessed April 1 2011.

14. Hanley NJ, Kenna GA. Quetiapine: treatment for substance abuse and drug of abuse. Am J Health Syst Pharm. 2008;65:611-618.

15. Tcheremissine OV. Is quetiapine a drug of abuse? Reexamining the issue of addiction. Expert Opin Drug Saf. 2008;7:739-748.

16. Kuroki T, Nagao N, Nakahara T. Neuropharmacology of second-generation antipsychotic drugs: a validity of the serotonin-dopamine hypothesis. Prog Brain Res. 2008;172:199-212.

17. Smith JM. Abuse of the antiparkinson drugs: a review of the literature. J Clin Psychiatry. 1980;41(10):351-354.

18. Land W, Pinsky D, Salzman C. Abuse and misuse of anticholinergic medications. Hosp Community Psychiatry. 1991;42:580-581.

• Antipsychotics have been abused and misused by inpatients and outpatients.

• Most published case reports of antipsychotic abuse involve quetiapine, although some describe misuse of other agents, including olanzapine.

Serotonin, histamine, and α-adrenergic neurotransmitter systems may play a role in second-generation antipsychotics’ abuse potential.

• Although individuals have misused quetiapine and olanzapine, evidence indicates that these drugs may be effective for treating substance use disorders.

Mr. Z, age 27, seeks treatment for substance abuse at a mental health clinic. He has a 7-year substance use history and his last urine drug screen 1 month ago was positive for marijuana, opiates, and benzodiazepines. Mr. Z reveals that he purchases prescription drugs on the street, including hydrocodone, diazepam, and quetiapine. He states that when he takes a 100-mg dose of quetiapine, he feels happy, relaxed, and “drunk without the mind-numbing effects that you get with alcohol.” Mr. Z often takes quetiapine while smoking marijuana. He sleeps well with this and does not experience a hangover effect.

Although clinicians always are vigilant about patients’ misuse of psychoactive substances, recent case reports have described abuse of antipsychotics, particularly second-generation antipsychotics (SGAs). A PubMed and PsycINFO literature search revealed several case reports of quetiapine abuse (Table)1-6 and 2 case reports of olanzapine misuse.

ReferencePatientSettingDescription of abuse
Hussain et al, 20051Woman, age 34, with history of polysubstance abuse, depression, and borderline personality traitsPrisonCrushed tablets dissolved in water and injected intravenously
Morin, 20072Woman, age 28, with history of schizoaffective disorder, polysubstance abuse, and personality disorder not otherwise specifiedHospitalTablets crushed with aspirin and inhaled intranasally
Waters et al, 20073Man, age 33, with history of polysubstance abuseOutpatientCrushed tablets dissolved in water and injected intravenously
Reeves et al, 20074Man, age 49, with history of alcohol dependence and benzodiazepine abuseOutpatientMisuse without psychiatric symptoms or a diagnosed psychiatric disorder
Man, age 23, with history of benzodiazepine dependenceOutpatientMisuse without psychiatric symptoms or a diagnosed psychiatric disorder
Man, age 39, with history of bipolar disorderOutpatientOral use in doses more than the prescribed amount
Murphy et al, 20085Man, age 29, with unclear history of schizophreniaPsychiatric walk-in clinicMalingering psychiatric symptoms to obtain an oral dose and overnight stay
Fischer et al, 20096Man, age 53, with history of depressive symptomsCourt-mandated outpatient clinicMalingering psychiatric symptoms to obtain higher oral doses

Methods of quetiapine misuse include ingesting pills, inhaling crushed tablets, and injecting a solution of dissolved tablets.1-7 In case studies, patients report abusing quetiapine for its sedative, anxiolytic, and calming effects.1,2,4-7 One patient reported snorting crushed quetiapine tablets combined with cocaine for “hallucinogenic” effects.3 Street names for quetiapine include “quell,” “Susie-Q,” and “baby heroin,” and “Q-ball” refers to a combination of cocaine and quetiapine.8 Quetiapine tablets have a street value of $3 to $8 for doses ranging from 25 mg to 100 mg.9 Although outpatient misuse of quetiapine is common, abuse in correctional settings also is becoming more frequent.10 Residents of jails and prisons misuse quetiapine for reasons similar to those cited by outpatients: sedation, relief of anxiety, and hallucinogenic effects or “getting high.”1,2,10 Clinicians must differentiate inmates who have legitimate psychiatric symptoms that require antipsychotic treatment from those who are malingering to obtain the drug. Efforts to treat inmates for substance use disorders may be thwarted by the easy availability of drugs in correctional settings.10

The incidence of misuse of olanzapine and other SGAs is more difficult to ascertain. Only 2 case reports describe olanzapine abuse, both in outpatient settings. One describes a patient treated for depression with psychosis who was using increasingly higher doses of olanzapine to obtain euphoric effects.11 Switching to aripiprazole effectively treated her illness and addressed her olanzapine misuse.

In the other case, a patient with bipolar disorder was able to obtain olanzapine, 40 mg/d, by complaining of worsened manic symptoms.12 He described the experience of misusing olanzapine as getting a “buzz,” feeling “very relaxed,” and blunting the negative jitteriness he felt when he used cocaine.12 This patient stated that he had observed others abusing olanzapine, both orally and intravenously.

Although the literature lacks reports on the risks of antipsychotic abuse, numerous Web sites purport to sell these drugs without a prescription and some describe the experience of illicit use of drugs such as haloperidol, risperidone, quetiapine, and olanzapine and ways to “enhance” the experience by combining drugs.13 Reported experiences with risperidone tend to be negative, citing extrapyramidal side effects and feeling “numb,” whereas olanzapine and quetiapine users describe feeling “drunk without the bad effects of alcohol” and “really happy, calm.” These sites also describe hallucinogenic effects of these agents.13

References

 

1. Hussain MZ, Waheed W, Hussain S. Intravenous quetiapine abuse. Am J Psychiatry. 2005;162:1755-1756.

2. Morin AK. Possible intranasal quetiapine misuse. Am J Health Syst Pharm. 2007;64:723-725.

3. Waters BM, Joshi KG. Intravenous quetiapine-cocaine use (“Q-ball”). Am J Psychiatry. 2007;164:1.-

4. Reeves RR, Brister JC. Additional evidence of the abuse potential of quetiapine. S Med J. 2007;100:834-836.

5. Murphy D, Bailey K, Stone M, et al. Addictive potential of quetiapine. Am J Psychiatry. 2008;165:7.-

6. Fischer BA, Boggs DL. The role of antihistaminic effects in the misuse of quetiapine: a case report and review of the literature. Neurosci Biobehav Rev. 2009;34:555-558.

7. Pierre JM, Shnayder I, Wirshing DA, et al. Intranasal quetiapine abuse. Am J Psychiatry. 2004;161(9):1718.-

8. Sansone RA, Sansone LA. Is seroquel developing an illicit reputation for misuse/abuse? Psychiatry (Edgemont). 2010;7(1):13-16.

9. Tarasoff G, Osti K. Black-market value of antipsychotics antidepressants, and hypnotics in Las Vegas, Nevada. Am J Psychiatry. 2007;164:350.-

10. Keltner NL, Vance DE. Biological perspectives: incarcerated care and quetiapine abuse. Perspect Psychiatr Care. 2008;44(3):202-206.

11. Lai CH. Olanzapine abuse was relieved after switching to aripiprazole in a patient with psychotic depression. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(7):1363-1364.

12. Reeves RR. Abuse of olanzapine by substance abusers. J Psychoactive Drugs. 2007;39(3):297-299.

13. The Vaults of Erowid. Available at: . Accessed April 1 2011.

14. Hanley NJ, Kenna GA. Quetiapine: treatment for substance abuse and drug of abuse. Am J Health Syst Pharm. 2008;65:611-618.

15. Tcheremissine OV. Is quetiapine a drug of abuse? Reexamining the issue of addiction. Expert Opin Drug Saf. 2008;7:739-748.

16. Kuroki T, Nagao N, Nakahara T. Neuropharmacology of second-generation antipsychotic drugs: a validity of the serotonin-dopamine hypothesis. Prog Brain Res. 2008;172:199-212.

17. Smith JM. Abuse of the antiparkinson drugs: a review of the literature. J Clin Psychiatry. 1980;41(10):351-354.

18. Land W, Pinsky D, Salzman C. Abuse and misuse of anticholinergic medications. Hosp Community Psychiatry. 1991;42:580-581.

Sours: https://www.mdedge.com/psychiatry/article/64323/addiction-medicine/abuse-second-generation-antipsychotics-what-prescribers
How to use Olanzapine? (Zyprexa, zydis, zypadhera) - Doctor Explains

Do Not Be an Oblivious Drug Dealer: Part 2

Diphenoxylate/Atropine is another prescription medication that has recreational abuse potential. Diphenoxylate/Atropine is a combination medication that is used to treat diarrhea, with 2.5 mg of diphenoxylate and 0.025 mg of atropine within each pill. Diphenoxylate is a centrally-acting phenylpiperidine opioid that exhibits its pharmacologic activity by slowing the motility of the intestinal tract.6 Diphenoxylate is metabolized in the body to difenoxin, another opioid derivative that is 250-400 times the strength of diphenoxylate. Diphenoxylate has the potential to cross the blood-brain barrier and therefore has the potential to become habit-forming. The atropine and the diphenoxylate together produce unpleasant anticholinergic effects, nausea, and vomiting when taken in higher than recommended amounts and deter from abuse. The euphoria gained from abusing diphenoxylate/atropine is said to mimic the effects of more highly-regulated medications such as heroin and oxycodone. Usually dosed at a total of 5 mg of diphenoxylate by mouth 3-4 times daily, toxicity can begin at 75-100 mg per day.5 Overdosing on diphenoxylate/atropine can have serious side effects of seizure, flushing, drowsiness, respiratory depression and coma, particularly if combined with other respiratory depressants. A common dose of atropine, when used alone, 1 mg. This means that abusers can take up to 40 tablets of diphenoxylate/atropine, according to the atropine dose, without gaining appreciable anticholinergic effects.

Clonidine

Clonidine is an alpha-2 agonist used as an antihypertensive agent. Individuals abuse clonidine to self-treat opioid withdrawal and for its psychoactive potential. Particularly patients use clonidine with methadone to “boost” the central nervous system effects. Patients will appear to be drunk on this combination, yet will have no measurable blood alcohol concentrations. Other individuals abuse clonidine for its sedating properties. The average dose for abuse reported is 0.6 mg, significantly higher than the dose used to manage hypertension. Clonidine is often chosen as a drug of abuse due to its relative easiness to acquire.7

Parkinson’s drugs

Many drugs to treat Parkinson’s disease affect the dopamine receptors. Apomorphine is a D2 receptor agonist. This can generate psychiatric symptoms that patients describe as pleasant sensations of awakening, activating, and hypersexuality.8 Levodopa is another commonly abused drug. A case report reported that 2 patients increased their levodopa dosage to 1500-2000 mg/day to achieve euphoria despite side effects such as hyperkinesis and hallucinations.9 The dopamine pathway is associated with the reward effect. Therefore, the addiction potential for these drugs is great. However, a small minority of patients with Parkinson ’s disease have considered or have increased their medication to feel good.10

Pharmacists have a particularly important role in combatting abuse in that oftentimes they are the frontline in providing essential counseling and other tools to the community. We can make the largest impact in identifying and helping individuals with substance abuse.

Pharmacists can help by knowing the resources available in your community, and utilizing prescription drug monitoring programs for drug abuse prevention. With each new medication that reaches the market, there is the potential for great therapeutic interventions in the community, but there underlies an opportunity to abuse its effects. Understanding the pharmacology of each new agent keeps pharmacists ahead of drug abusers, thus limiting the amount of adverse drug events and death experienced within each community.

References

1. Fluoxetine [2017].

In: DRUGDEX® System (Micromedex 2.0). [AUHSOP Intranet]. Greenwood Village, CO: Truven Health Analytics Inc. [updated 2017, cited 2017 Apr 10]. Available from:

http://www.micromedexsolutions.com/micromedex2/librarian/

2.

Klein L, Bangh S, Cole JB Intentional Recreational Abuse of quetiapine compared to other second-generation antipsychotics. West J Emerg Med.

2017 Feb;18(2):243-250. doi: 10.5811/westjem.2016.10.32322. Epub 2016 Dec 6.

3. Sansone RA, Sansone LA. Is seroquel developing an illicit reputation for misuse/abuse? Psychiatry (Edgmont). 2010;7(1):13-16.

4.

Seroquel abuse [Internet]. Integrated treatment of substance abuse & mental illness; c2016 [cited 2017 Apr 5]. Available from:.

http://www.dualdiagnosis.org/seroquel-abuse/

5.

Quetiapine [2017]. Olanzapine [2017], Loperamide [2017], Lomotil [2017]. In: DRUGDEX® System (Micromedex 2.0). [AUHSOP Intranet]. Greenwood Village, CO: Truven Health Analytics Inc. [updated 2017, cited 2017 Apr 5]. Available from: http://www.micromedexsolutions.com/micromedex2/librarian/

6.Lomotil Addiction [Internet]. Elements Behavioral Health Drug Addiction Treatment. c2013 [cited 2017 Apr 10]. Available from:http://www.drugaddictiontreatment.com/types-of-addiction/prescription-drug-addiction/lomotil-addiction/

7. Beuger M, Tommasello A, Schwartz R, Clinton M. Clonidine use and abuse among methadone program applicants and patients. J Subst Abuse Treat. 1998;15(6):589-93.

8. Téllez C, Bustamante M, Toro P, Venegas P. Addiction to apomorphine: a clinical case-centred discussion. Addiction [serial online]. November 2006;101(11):1662-1665. Available from: Academic Search Premier, Ipswich, MA. Accessed March 22, 2017.

9. Spigset, O. and von Scheele, C. (1997), Levodopa dependence and abuse in parkinson's disease. Pharmacotherapy: J Human Pharmacol Drug Therapy. 17: 1027—1030. doi:10.1002/j.1875-9114.1997.tb03794.x

10. Mursaleen LR, Stamford JA. Drugs of abuse and Parkinson's disease. Prog Neuropsychopharmacol Biol Psych. 2016;64:209-17.

Sours: https://www.pharmacytimes.com/view/dont-be-an-oblivious-drug-dealer-part-2

Mg olanzapine street value 10

The street value of prescription drugs

Background: Although most physicians are aware of the potential for abuse and resale of prescribed medications, little has been done to document it. The purpose of this study was to determine which prescription drugs have street value, what that value is and why these drugs are used.

Methods: A descriptive cross-sectional survey using a semistructured interview technique was carried out on 2 weekdays (Mar. 10 and Apr. 1, 1997) in Vancouver's Downtown Eastside. A total of 58 users and dealers of prescription sedative/hypnotic and narcotic drugs were approached. Information collected included the demographic characteristics of those interviewed, the common street names of the drugs of interest, and their value and method of use.

Results: Thirty-two people agreed to participate in the study (participation rate 55%), 7 of whom were dealers. The range in price of sedative/hypnotic drugs was $0.10 to $2. For narcotic drugs the range was much greater, at $0.25 to $75. Descriptive analysis identified the minimum and maximum price and the mode of each preparation. Among the weak narcotic drugs the index drug (highest in demand on the street) was Tylenol No. 3 and among the more potent narcotics, MS Contin 30 mg.

Interpretation: A wide variety of prescription sedative/hypnotic and narcotic drugs are available on the street. The mark-up from pharmacy cost can be considerable. Factors influencing pricing include the relative inexperience of the buyer, the availability of illicit narcotics, the current street supply of prescription medications and the time of the month (before or after issue of social assistance cheques).

Sours: https://pubmed.ncbi.nlm.nih.gov/9700324/
Addicts Using This 'Safe' Medication To Get High

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