Prescription Drug Abuse Flashcards
3 most abusable benzos?
Alprazolam (Xanax)
lorezepam (Ativan)
triazolam (Halcion)
What 2 factors make a benzo subject to abuse?
High potency, short half-life
Review: To which receptor do benzos bind?
GABA-A
Most abused (non-cocaine) stimulant?
Methamphetamine
Demographic we’re most worried about in prescription pain killer abuse?
Adolescents / young adults.
5 ways people get painkillers for abuse?
Deceived physicians Dishonest physicians Genuine pain patients (diversion) Theft/diversion from pharmacies Internet <- easy, but not common
Typical narrative for escalation of painkiller abuse/dependence?
Take pills -> start snorting to get more effect +/- injecting -> get heroin because it’s cheaper and smoke it -> start injecting heroin.
Genetics in opioid addiction?
Probably plays a role. Not everybody gets euphoria from opiates - may be predictive of addiction.
3 aspects of the ideal treatment for opiate abuse?
Stops withdrawal
Reduces craving
Blocks high from abused opiates
How does methadone fall short of ideal?
Stops withdrawal and reduces craving, but doesn’t really block the high.
How does buprenorphine fall short of ideal?
It actually does all 3 things, but it has some abuse potential. (hence suboxone)
3 areas for prevention of prescription drug abuse?
Educate public.
Alter prescribing practices.
Make opioids less abusable.
4 ways to make opioids less abusable?
Combine with naloxone (so can’t inject).
Physical barriers (i.e. gel capsules so can’t be crushed and snorted).
Include naltrexone in center (where it won’t be absorbed unless crushed).
Prodrugs.
What is pseudo-addiction?
Looks its addiction/drug-seeking with the energy and time that people devote toward painkiller acquisition - but it’s all driven by uncontrolled pain.
