Discussing the increasing misuse of medications like bupropion, quatypine, and gabapentinoids, and the need to address this national crisis. Exploring the misuse of prescription medications, addiction as a chronic brain disease, and the criteria for defining addiction. Focusing on the misuse and abuse potential of commonly prescribed medications, including bupropion. Exploring the differences in anticholinergic effects, the abuse potential of certain drugs, and the spectrum of altered mental states.
Misuse of uncontrolled medications, such as bupropion, quetiapine, and gabapentinoids, is a rising trend, contributing to increasing drug overdose deaths.
The definition of addiction has evolved to include behavioral and cognitive components, emphasizing brain circuitry and excessive drug self-administration.
Deep dives
Increase in misuse of uncontrolled medications
Misuse of uncontrolled medications, such as bupropion, quatypine, and gabapentinoids, is a new trend in medication misuse. Patients are taking these medications in excessive amounts, often through non-traditional routes like snorting, and co-administering them with other drugs of abuse. The misuse also includes malingering psychiatric symptoms to obtain prescription medications and the diversion of prescriptions for monetary gain or exchange. This rise in medication misuse contributes to the increasing number of drug overdose deaths, which is a national crisis.
Updated definition of addiction and its features
The definition of addiction has evolved, as per the American Society of Addiction Medicine, to include the inability to consistently abstain from drug use, impairment in behavioral control, cravings, diminished recognition of problems associated with drug use, and dysfunctional emotional responses. Addiction is no longer solely defined by physiological dependence or withdrawal. The updated definition emphasizes the brain's reward, motivation, memory, and related circuitry. Additionally, addiction is characterized by excessive drug self-administration and behavioral disinhibition. It does not solely rely on physiological dependence.
Misuse and abuse potential of specific medications
Certain medications have a higher potential for misuse and abuse. The podcast highlights three classes: antidepressants, antipsychotics, and gabapentinoids. Bupropion, an antidepressant, is known to be misused at high doses, sometimes referred to as 'poor man's cocaine,' due to its stimulating properties. Quetiapine, an antipsychotic, is misused for its sedative and calming effects, often through nasal insufflation or injection. Moreover, it is sometimes used to mitigate the effects of stimulant abuse. The misuse and abuse of these medications pose various risks, including seizures and toxic reactions.
There are many reasons why patients misuse medications. Today, Joseph Pierre shakes us out of our 1990s understanding of addiction and explains a new trend, misuse of uncontrolled medications like Bupropion, Quetiapine and the Gabapentinoids.
Chris Aiken, MD, and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
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