Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida, USA.
Rocky Mountain Poison & Drug Center, Denver, Colorado.
Pharmacoepidemiol Drug Saf. 2019 May;28(5):700-706. doi: 10.1002/pds.4771. Epub 2019 Mar 25.
Systematic studies of the diversion of nonscheduled drugs, except for gabapentin, are not apparent. We searched diversion case reports of all other nonscheduled psychoactive prescription drugs in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System.
Case report data are drawn from a quarterly survey of prescription drug diversion completed by a national sample of law enforcement and regulatory agencies. Rates of diversion per 100 000 population were calculated for each year from 2002 to 2017 for prescription medications with greater than 400 reported cases during the period.
Cyclobenzaprine, quetiapine, and trazodone met criteria for analysis. We found a significant and steady increase in the diversion of each drug over the period. The 2017 annual rates of diversion per 100 000 population for the three medications range from 0.0428 to 0.0726. Although these rates of diversion are much lower than the rate for total opioid analgesics, they are all more than five times higher in 2017 compared with 2002. While diversion rates for opioids have decreased in recent years, rates for cyclobenzaprine, quetiapine, and trazodone have continued to increase.
A common attribute of the three nonscheduled drugs studied here is that all are used for the treatment and/or self-treatment of opioid withdrawal symptoms, and the increasing diversion of these drugs may be related to the ongoing opioid epidemic and to increasing levels of control over pharmaceutical opioid availability in the United States. Prescribers need to be aware of illicit markets for these medications and prescribe to their patients with appropriate caution.
除加巴喷丁外，目前尚无关于非管制药物滥用转移的系统研究。我们检索了研究滥用、转移和成瘾相关监测系统（RADARS）中所有其他非管制精神活性处方药物的滥用转移病例报告。
病例报告数据来自于一项针对处方药物滥用转移的季度调查，该调查由全国执法和监管机构的一个样本完成。计算了 2002 年至 2017 年期间每年每 10 万人中每种药物的滥用转移率，这些药物在该期间的报告病例数超过 400 例。
环苯扎林、喹硫平和曲唑酮符合分析标准。我们发现，这三种药物的滥用转移在这一期间呈显著且稳定的增长趋势。这三种药物 2017 年的年滥用转移率分别为每 10 万人 0.0428 至 0.0726。尽管这些滥用转移率远低于总阿片类镇痛药的转移率，但与 2002 年相比，2017 年的转移率都高出五倍以上。虽然近年来阿片类药物的滥用转移率有所下降，但环苯扎林、喹硫平和曲唑酮的滥用转移率仍在继续上升。
这里研究的三种非管制药物的一个共同特点是，所有这些药物都用于治疗和/或自我治疗阿片类药物戒断症状，这些药物的滥用转移率不断增加可能与阿片类药物流行以及美国对药物类阿片供应控制水平的提高有关。处方医生需要了解这些药物的非法市场，并谨慎为患者开处方。
