Prescribing Psychotropics: Misuse, Abuse, Dependence, Withdrawal and Addiction

Abstract

Recently, the growing use of prescription drugs for recreational purposes has been reported widely in the literature. However, the true extent and nature of such use is not completely understood. Some medications are already known to be misused. For instance, opioids, Central Nervous System (CNS) depressants (including tranquilizers, sedatives, and hypnotics) and stimulants (e.g. Attention-Deficit/Hyperactivity Disorder-medications). However, for a range of remaining molecules there have been anecdotal reports of misuse and diversion, but more needs to be understood. ‘Pharming’; ‘pharm-parties’; and ‘doctor-shopping’ attitudes, involving high-/ mega-dosage prescription drugs’ intake, are new trends which are increasingly being reported among young adult populations. Increasing levels of access to the web over the past 15 years or so may have boosted the current scenario of prescribed drugs’ misuse and abuse, with social networks playing a role in prescription drugs’ aggressive marketing/ distribution from rogue ‘pharmacy’ websites. Consistent with this, the current Research Topic will cover the assessment of the misuse, abuse, dependence, withdrawal, diversion and addiction potential of prescribing drugs. Most of these drugs are not scheduled, and there is little or no indication of these putative misusing issues in their accompanying medication package. Furthermore, some of these medications are made available over-the-counter in a range of countries. Prescribing drugs, which are the focus of this Research Topic, include but are definitely not limited to: gabapentinoids, antidepressants, antipsychotics, Z-drugs, beta-agonists, and over-the-counter medications (e.g., codeine phosphate; loperamide, dextromethorphan, promethazine, etc). The Research Topic would welcome empirical papers, systematic reviews, meta-analysis, reviews, and brief reports. Special consideration will be given to: • Pre-marketing considerations on how to identify the possible CNS drugs’ addictive liability levels • Post-marketing surveillance and pharmacovigilance strategies able to detect early signals of drug abuse (e.g., monitoring of drug utilization, anonymous tracking of users’ posts on social media, analysis of international Adverse Drug Reactions’ databases entries) • Clinical data • Methods for optimal reduction strategies to come off prescribing psychotropics, including antidepressants • Analysis of the current measures adopted to reduce drug diversion