Abuse Of Medicines Research Articles

Korean Integrated Care : Cooperation between Modern and Traditional Medicines

Introduction : In spite of widespread practice of modern (western) medicine, many local residents, especially the elderly still resort to traditional (oriental) medicine in a variety of range. It is necessary to review patient-centered integrated care of both sides of medicines to increase the therapeutic effect. Furthermore, the increasing trend of herbal drugs in recent years, there is a growing risk for abuse of medicines. Description of policy context and objective : To promote the introduction and diffusion of patient-centered integrated healthcare between modern and traditional medicines. Target population: Inpatients who experience collaborative medical treatments from modern and traditional medicines at a hospital Highlights(innovation, impact and outcomes) : 1. Improved patient satisfaction and treatment effectiveness: Preceding studies show that hyperthermia therapy, acupuncture treatment, and prescription of herbal medicine are effective in reducing side effects of radiotherapy and angiogenesis inhibition. 2. Decreased toxicity: Some herbal medicines reduce the toxicity of anti-estrogen drugs. 3. Hyperthermia and acupuncture are effective for pain relief: Injury or arthritis, especially in cold patterns where the pain naturally feels better with the application of heat. 4. Higher quality of care: Providing quality services by strengthening superior areas in both fields Comments on transferability : In countries where traditional medicine is used as treatment in operation, it can effectively manage treatments of people with chronic diseases. Conclusions : Typically, traditional medicine is used to provide an alternative way of treatment. Partly it was confirmed that the collaborative integrated care complement the shortcomings of each other and it improves the treatment effect. Although Korea's National Health Insurance does not accept such integrated cares yet, it should them into serious consideration by way of further research from a national perspective.

When religion opens the door: Despite the challenges, partnerships with religious and spiritual communities can address medical disparities and improve patients' wellbeing.

When religion opens the door: Despite the challenges, partnerships with religious and spiritual communities can address medical disparities and improve patients' wellbeing.

Non-prescription medicine misuse, abuse and dependence: a cross-sectional survey of the UK general population.

Non-prescription medicine misuse, abuse and dependence: a cross-sectional survey of the UK general population.

Nonfatal and fatal intoxications with pure caffeine – report of three different cases

Caffeine is not usually perceived as a drug by most people because it is found in many foods and drinks, including caffeinated energy drinks, as well as in over the counter analgesics and cold preparations. Recently in Poland it has become increasingly common to take pure caffeine, bought through online stores, as a psychoanaleptic. This creates a much higher risk of severe and even fatal poisoning in comparison with the risk associated with the abuse of food products and non-prescription medicines containing low doses of caffeine. This paper presents three different cases of poisoning that occurred when pure caffeine was taken as psychostimulant; in cases 1 and 2 poisoning was the result of a single overdose, while in the case 3 poisoning resulted from a cumulative overdose. In the case 1 there was a severe intoxication (persistent vomiting, hypotension, tremor), and the concentration of caffeine in the blood was found to be 80.16μg/mL. The patient was treated using hemodialysis, which caused a rapid decrease in blood levels of caffeine and relief of the clinical symptoms of poisoning. Cases 2 and 3 were fatal poisonings, and recorded levels of caffeine in post mortem blood samples were 140.64μg/mL and 613.0μg/mL. In case 2 the patient died 10min after admission to hospital as a result of sudden cardiac arrest, which was preceded by an attack of convulsions, and in case 3 death occurred in home and was also sudden in nature. Taking pure caffeine as a stimulant is associated with a high risk of overdose and the development of serious and even fatal poisoning, and those using pure caffeine are generally completely unaware of these risks. In such cases, death is usually sudden due to functional mechanisms.

Research for the Development of an OTC Medicine Dose/Treatment Guide Application for the Disadvantaged

Background: Information regarding a medicine printed on the packaging or dosage instructions is not being properly used as source of information sources by various users. This study aimed to revise and supplement the concept of the OTC medicine information deliverly system, which was proposed in the earlier study, to suit the information awareness features of the visually impaired and the elderly. Methods: The study developed an application by combining the NFC Tag and NFC Tag detection technology on a smart phone. The developed application consists of two parts: a writer application (Medi-writer) that allows for easily recording OTC medicine usage information using a smart phone, and a reader application (Medi-helper) that dictates the OTC medicine information to the user. The detailed operation of the application is as follows: first the basic OTC medicine information is recorded to a NFC Tag via the writer application, and the NFC Tag is attached to the label of the medicine. Next, the reader application is activated by the NFC Tag detection sensor on a smart phone. Results: To confirm the usefulness of the developed application, the study conducted a verification test with twelve visually impared people and ten elders on the convenience and availability of the application. The test results showed that all participants evaluated the developed application and found it to be very useful and helpful in using OTC medicine information, giving an average score greater than 90 out of 100. Conclusions: The dose guide application developed in this study was targeted to increase the understanding of dose information and reduce the danger of misuse and abuse of medicine by providing additional information on dose instructions by using audio and visual information for elders and children.

Drug Abuse and Psychosis: New Insights into Drug-induced Psychosis.

Addictive drug use or prescribed medicine abuse can cause psychosis. Some representative symptoms frequently elicited by patients with psychosis are hallucination, anhedonia, and disrupted executive functions. These psychoses are categorized into three classifications of symptoms: positive, negative, and cognitive. The symptoms of DIP are not different from the symptoms of schizophrenia, and it is difficult to distinguish between them. Due to this ambiguity of distinction between the DIP and schizophrenia, the DIP animal model has been frequently used as the schizophrenia animal model. However, although the symptoms may be the same, its causes are clearly different in that DIP is acquired and schizophrenia is heritable. Therefore, in this review, we cover several DIP models such as of amphetamine, PCP/ketamine, scopolamine, and LSD, and then we also address three schizophrenia models through a genetic approach with a new perspective that distinguishes DIP from schizophrenia.

Les aspects actuels de l’usage de l’ecstasy/MDMA en France

Methylenedioxymethamphetamine (MDMA), the active compound of ecstasy, has been used for several years, especially by young adults to benefit of psychostimulant properties. By raising the level of neuromodulators in the synapsis, MDMA can cause psychiatric and physical injuries. After reduced supplies in 2009 (number of ecstasy seizures equal to 10 percent of those recorded in 2002), judicial authorities now observed an increased availability (a half more part of seizures in 2012 than 2010). From its "Spontaneous Notifications" data base and "deaths in connection with the abuse of medicine and substances (DRAMES)", "observation of illegal drugs and misuse of psychotropic medications" (OPPIDUM), and "observation of drug dependencies in ambulatory medicine" (OPEMA) national inquiries, the French Addictovigilance network (CEIP-A) highlighted the increasing consumption of MDMA. The way of use appeared quite unchanged: users were mainly young men between 25 and 30 years; they favored an occasional use but mainly combined other products such as alcohol, cannabis and other stimulants. Severity of the clinical cases, based on hospital care and forensic data, could be consistent with the higher amounts of MDMA measured in pills.

From Rhetoric to Reality: Commentary on Flynn & Brown (2016)

Drs Flynn and Brownmake crucial points in their article, namely, the failings of treatment programs around the country to reflect the conceptualization of substance dependence as a chronic health condition; and the need for the best minds in the nation to put their collective muscle into the issue of substance abuse. I have never been more optimistic about the treatment of alcohol and drug dependence. The priority given to substance use in the Affordable Care Act (ACA) is unprecedented. It creates the opportunity for a long-isolated and marginalized substance-abuse treatment industry to become an integrated part of healthcare. The moment for the creation of an Institute of Medicine (IOM)-like platform to respond to substance use has never been better. Wemay finally be at a pointwhere public awareness, political will, and community need have reached the necessary criticalmass. Creating such a vehicle early in the implementation of the ACA allows for the best minds to bring shape to what will ultimately lead to a more pliable multisystem-involved response to substance abuse. This is happening at time when our communities are flooded with the highest-quality laboratory tested illegal drugs the world has ever produced. The businessmodel yields extraordinary profits, the distribution networks are incredibly sophisticated, and the production, sales and the consumer base are truly international. Let me set that optimism aside for a moment. There is a real chance that the medical field will not embrace this new responsibility; that this issue will be simply be seen as yet another mandate foisted on an already overburdened healthcare system – not the kind of pivotal issue that grossly affects health, healthcare outcomes and life trajectory, and bends the cost curve. With few exceptions, physicians, nurses, psychologists, social workers and a variety of other healthcare disciplines are not well prepared to respond to substance abuse, having received little training in the diagnosis and treatment of substance use disorders. The ACA provides the mandate to enlarge the scope of practice for these disciplines, it is up to academic, professional and healthcare leadership—all three—to push this change. Further, as ubiquitous and necessary as they are, it is always difficult for commissions, councils, institutes and the like to gather the needed politicalmomentum to enact their good ideas and avoid creating yet another advisory report collecting dust. In order to succeed, any IOM-like initiative must be extremely deliberate in the framing of its mission and goals, and in its selection of participants, work process, work products, governance, lead-in and rollout. To that end it will be crucial to create a platform that is structured to allow real movement toward action and productive engagement of external decision makers as the body moves through its work. This

Non-prescription medicine misuse, abuse and dependence: a cross-sectional survey of the UK general population.

Background Non-prescription medicines (NPMs) can be misused, abused or lead to dependence, but the prevalence of these problems within the UK general population was unknown. The aim of this study was to estimate the prevalence of self-reported misuse, abuse and dependence to NPMs. Methods A cross-sectional postal survey was sent to 1000 individuals aged � 18 randomly drawn from the UK Edited Electoral Register. Results A response rate of 43.4% was achieved. The lifetime prevalence of NPM misuse was 19.3%. Lifetime prevalence of abuse was 4.1%. Younger age, having a long-standing illness requiring regular NPM use and ever having used illicit drugs or legal highs were predictive of misuse/ abuse of NPMs. In terms of dependence, lifetime prevalence was 2% with 0.8% currently dependent and 1.3% dependent in the past. Dependence was reported with analgesics (with and without codeine), sleep aids and nicotine products. Conclusion Given the increasing emphasis on self-care and empowering the public to manage their health with NPMs, the findings highlight the need for improved pharmacovigilance of these medicines to maximize benefits with minimal risk. Healthcare providers need to be aware of the potential for misuse, abuse and dependence, particularly in patients with long-term illness.

Self-medications with potential abuse in the Middle East: a systematic literature review

Self-medication (SM) is highly prevalent in the Middle East. However, regulations in the Middle East are not always enforced and therefore many prescription medicines can be purchased as SM, resulting in potential abuse of many medicines. The aim of this article, therefore, was to undertake a comprehensive review to identify the different types of self-medications involved in abuse in the Middle East and to identify harms related to SM abuse. An extensive review of the published literature pertaining to the subject (1990–2015) was conducted using PubMed, Web of Science, Cochrane and Google Scholar databases for OTC medication abuse in the Middle East. Twenty two papers were identified. Medications involved in SM abuse included: psychoactive prescription-only medicines, codeine-containing products, tramadol, anabolic steroids, sedative antihistamines, decongestants and laxatives. Moreover, studies in the region rarely reported harms related to SM abuse and strategies to limit this abuse. Potential SM abuse involving a range of medicines is a public health problem in the Middle East. Future interventions and regulations should be applied to limit the expansion of SM use and potential abuse.

When cure becomes an illness-abuse of addictive prescription medicines.

When cure becomes an illness-abuse of addictive prescription medicines.

Gaining Policy Insight with a System Dynamics Model of Pain Medicine Prescribing, Diversion and Abuse

Misuse of pain medicine is a leading cause of accidental deaths in the USA—over 15 000 deaths annually. A system dynamics model was developed and used to study the impact of three types of policy interventions to reduce adverse outcomes. Besides medical usage, the model also includes the diversion of pain medicines and their nonmedical use. Model behavior compared favourably with historical data at multiple points in the system. A prescription drug monitoring program intervention reduced nonmedical overdoses through supply restriction, and an intervention to reduce popularity of nonmedical usage reduced nonmedical overdoses by curtailing demand. A tamper‐resistant drug formulation intervention resulted in decreased risk to individuals but increased overdose deaths. Key policy insights are that supply and demand must be carefully considered; that the feedback loops, which created the problem, can help to identify solutions; and that outcome metrics must be carefully chosen. Copyright © 2015 John Wiley & Sons, Ltd.

Pharmacists’ Knowledge, Attitudes and Beliefs Regarding Intervention for Prescription Medicines Abuse

Background: Abuse of medicines is becoming a serious problem in many parts of the world, with negative consequences ranging from addiction, psychosis, cardiovascular complications, and premature deaths from unintentional overdose. In Pakistan, prescription drugs, which are misused or abused by some patients, are often obtained from pharmacies. However, intervention for prescription drugs misuse has not been tested in this setting. Objectives: The objective of the study was to assess knowledge, perception and attitudes regarding interventions towards the abuse of prescription medicines (PM) among practicing pharmacists in Pakistan. Materials and Methods: This transversal study was conducted from June to September 2015 by adopting a pre validated questionnaire distributed to practicing pharmacists in different private and public sector hospitals of Karachi. Descriptive statistics were used to demonstrate participants’ demographic information and their response to the questionnaire items. Pearson’s chi-squared test was executed to evaluate the association of gender, age, organization, and experience of pharmacists with their response. A p value < 0.05 was considered as significant. Results: The study revealed that mass population 75% claimed that they had adequate knowledge of prescription medicine abuse. 81.25% perceived drug abuse as a problem and 88.10% considered that the role of pharmacist was very important in prevention of PM abuse. However pharmacists were not confident that patients would take their advice, respond positively and make needed behavior changes. Respondents also were not confident regarding the manner in which screenings and interventions should occur. Conclusion: Findings from this study will assist health authorities to formulate appropriate health promotion interventions to control and prevent abuse of prescription medicines. Actions directed at early intervention, capacity building, education, public health initiatives and law enforcements will hopefully curb the menace of PM abuse.

Awareness, Knowledge, Perception and Attitude towards Prescription Medicines Abuse among Medicines Prescribers and Dispensers in Nnewi Nigeria

Background: Abuse of medicines is becoming a serious problem in many parts of the world, with negative consequences ranging from addiction, psychosis, cardiovascular complications, and premature deaths from unintentional overdose. Objectives: The objective of this study is to assess awareness, knowledge, perception and attitudes toward the abuse of prescription medicines (PM) among medicines prescribers and dispensers in Nigeria. Design and Participants: A descriptive cross-sectional study was carried out among pharmacists, other pharmacy staff in retail pharmacies, licensed patent medicines vendors (chemical sellers), and medical doctors in Nnewi, Nigeria. Data were collected through self-completed questionnaire supervised by trained research assistants, between December 2013 and April 2014. Three hundred and seventy-five participants were recruited for this study. Data Analysis: The Statistical Package for the Social Sciences (SPSS) version 17 for windows was used for data analysis. Bivariate and multivariate analyses were carried out to evaluate differences and associations based on selected variables. Results: The perception was high 294 (78.4%) among respondents that PM abuse was a problem in the community. Knowledge of health problems associated with PM abuse was also high at 226 (60.3%). However the attitude of the respondents towards early detection of PM abuse among their patients/clients was discouraging. Education, educational status, work status and gender significantly predict good knowledge and positive attitude about PM abuse. Conclusion: Findings from this study will assist health authorities to formulate appropriate health promotion interventions to control and prevent abuse of prescription medicines. Actions directed at early intervention, capacity building, education, public health initiatives and law enforcements will hopefully curb the menace of PM abuse in Nnewi, Nigeria.

Comparison of Drug Abuse at Two Music Festivals and the Importance of Health Education

Among the countries of the European Union, Romania occupies the fourth place considering the consumption of ethno-botanical drugs with a psychotropic effect. In Targu-Mures town yearly it is organized the festival called “Peninsula Music Festival” where we examined the drug usage habits of young participants by applying a questionnaire. The data were compared with some data obtained at Sziget Festival (Budapest). It was concluded that a high number of participants tried out ethno-botanical drugs and cannabis derivatives, followed by the abuse of medicine with alcohol and amphetamines. The number of cannabis derivative consumers has been growing since 2002 and the number of ethno-botanical drug users increased suddenly since 2009. The practical use of the survey results contribute to underline the importance of the development of health education programs, drug- prevention strategies. The main goals are: 1. to maintain the sensitivity of the society, of local communities which should improve their problem-solving skills concerning the suppression of the drug-problem (community, cooperation); 2. to provide possibilities for the youth to become capable to form a productive lifestyle and to refuse drugs; 3. to help individuals and families who get in contact with drugs and those who fight with drug problems (social work, curing and rehabilitation); 4. to reduce the possibility of accessing drugs (cigarettes, alcohol, ethno botanicals and other psychoactive substances).

‘I can't be an addict. I am.’ Over-the-counter medicine abuse: a qualitative study

ObjectivesOver-the-counter (OTC) pharmacy medicines are considered relatively safe in contrast to prescribed and illicit substances, but their abuse and addiction potential is increasingly recognised. Those affected represent a hard to...

Drogas emergentes (II): el pharming

The use of medicines, with or without medical prescription, for recreational ends by the young population has received little attention from doctors. In the USA, one in five adolescents has used medicines for recreational purposes, and consultations in Emergency Departments for medicine abuse have exceeded those for illegal drugs. Although few data are available in Spain, such consumption is situated between 3.1 and 8.6% according to surveys. The medicines most used are dextromethorphan and methylphenidate. The former, on sale without prescription, presents a varied symptomatology, dosage and dependent metabolic action, ranging from euphoria to hallucinations. Methylphenidate, taken orally, nasally or intravenously, is used as a stimulant in substitution for cocaine and is one of the medicines most diverted onto the illicit market at the world level. In principle, other substances like modafinil and propofol present a limited incidence of non-medical use, but they have a probable abuse potential that should be borne in mind, above all in the health context. Finally, opiates like fentanyl, oxycodone and buprenorphine, with new pharmaceutical presentations, have recently become generalized in the therapeutic arsenal of many medical specialities; they are giving rise to phenomena of abuse, dependence and diversion towards the illicit market. Demands for detoxification treatment, their mixture with illegal substances, and cases of death should alert us to the abuse of these medicines.

Use of codeine-containing medicines by Irish psychiatric inpatients before and after regulatory limitations on their supply.

In recent years, concerns have been highlighted in several jurisdictions, including Ireland, regarding abuse of over-the-counter codeine-containing medicines. On the 1st of August 2010, national regulatory guidelines aimed at limiting the supply of these medicines in Ireland came into force. Aims To study the effects of the new regulations on the use of non-prescribed codeine-containing medicines by psychiatric patients admitted to an Irish university teaching hospital before (n = 117) the regulations came into effect and 6 months afterwards (n = 126). Participants completed a brief self-administered survey questionnaire about their use of over-the-counter codeine-containing medicines in the preceding 3 months. Compared with before the introduction of the new regulations, there was a large decline in the reported 'often' or 'regular' use of codeine-containing medicines in the 3 months before admission (33.3% v. 17.4%, χ 2 = 6.354, p = 0.01) and there was a reduction in the proportion of patients for whom others had expressed concerns about their frequency of use of such medications (15.5% v. 4.8%, χ 2 = 7.29, p = 0.03). There was also a decline in the proportion of patients who stated that they would use codeine-containing medicines for either a 'feel-good' effect or to curb cravings (15.9% v. 1.9%, p < 0.01, two-tailed Fisher's exact test). We conclude that tight regulations on the supply of non-prescription codeine-containing medicines have the potential to reduce the use and abuse of such medicines in patient populations availing of admission to psychiatry hospitals.

Prescription painkillers and controlled substances: an appraisal of drug information provided by six US pharmacies

BackgroundHealth literacy impacts health outcomes. Health literacy is a measure of a person’s competence to find, access, contextualize, and understand the information needed to make health decisions. Low levels of health literacy have been associated with poor health status. Health literacy can be enhanced by improving the readability of health literature. Misuse and abuse of prescription medicines and controlled substances is rising. It could be argued that improving the readability of the drug-information documents associated with these medicines could serve to alleviate this situation in a small, albeit incremental, manner. This paper provides a readability assessment of 71 such documents.MethodsThe readability of drug-information documents associated with 12 commonly misused and abused painkiller medicines and controlled substances published by the top six US pharmacies was assessed. The Flesch-Kincaid Grade Level, Flesch Reading Ease, and Simple Measure of Gobbledygook (SMOG) indices were used to assess the readability of these drug-information documents. One-way analysis of variance (ANOVA) was used to compare the readability of the documents.ResultsThe average Flesch-Kincaid Grade Level index score was found to be 11.16. The average Flesch Reading Ease index score was found to be 45.94. The average SMOG index score was found to be 13.60. Pharmacies C and E had the best average readability scores, whereas pharmacies A and B had the worst average readability scores.ConclusionAccess, contents, and formatting of the documents were qualitatively analyzed to make recommendations to improve readability. Pharmacies C and E were used as benchmarks to identify the seven best practices. Good drug-information documents should have: (1) clear purpose, (2) limited scope, (3) summary/brief review, (4) well-placed graphics, (5) informative illustrations, (6) clean layout and lucid formatting relevant to the media, and (7) focus on the intended users.

Surveillance and uncertainty: community pharmacy responses to over the counter medicine abuse

The sale of over-the-counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self-treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi-structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants' definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who might be affected, and a review of how pharmacists can have more information about patients to inform OTC medicine sales.