Slane Amelia, Robert Sophie, Rarrick Christine, Weeda Erin
Psychiatric Clinical Pharmacy Specialist, The Medical University of South Carolina, Charleston, South Carolina.
Assistant Professor, The Medical University of South Carolina College of Pharmacy, Charleston, South Carolina.
Ment Health Clin. 2022 Jun 10;12(3):199-204. doi: 10.9740/mhc.2022.06.199. eCollection 2022 Jun.
The abuse potential of opioids and other controlled substances is well-known; however, reports of noncontrolled prescription medication (NCPM) misuse deserves further attention. Whereas several studies investigate patterns, motivations, and biochemical mechanisms underlying the misuse potential of NCPM, the clinical significance of NCPM misuse is not well-understood. The primary objectives of this project were to identify prescriber perceptions of NCPM misuse and evaluate patient reported patterns of misuse through survey responses.
Adult patients admitted to psychiatry services and prescribers working in psychiatry or on a general medicine service during the study time frame were invited to participate. Surveys were collected anonymously for both patients and prescribers.
NCPM misuse was reported by 38.4% of patients. Trazodone (35%) and quetiapine (30%) were most commonly reported as being misused. Opioid (24.1% vs 4.3%; = .023) and cannabis use disorders (13.8% vs 0%; = .019) were reported more frequently in patients who misuse NCPM, whereas no difference was seen for other SUDs ( > .05). There was no difference between psychiatric and general medicine prescribers regarding familiarity with NCPM misuse (n = 21 [87.5%] vs n = 13 [81.3%]; = .668).
High rates of NCPM misuse were seen in this patient population. Our findings confirm previous reports of quetiapine misuse and also reveal that trazodone is frequently misused. Based on the observations in this study, the misuse of NCPM is identified as prevalent and noteworthy at our institution, warranting provider education and future studies.
阿片类药物和其他管制药物的滥用可能性是众所周知的；然而，非管制处方药（NCPM）滥用的报告值得进一步关注。尽管有几项研究调查了NCPM滥用可能性背后的模式、动机和生化机制，但NCPM滥用的临床意义尚未得到充分理解。本项目的主要目标是通过调查反馈确定开处方者对NCPM滥用的看法，并评估患者报告的滥用模式。
邀请在研究时间段内入住精神科的成年患者以及在精神科或普通内科工作的开处方者参与。患者和开处方者的调查问卷均为匿名收集。
38.4%的患者报告有NCPM滥用情况。曲唑酮（35%）和喹硫平（30%）是最常被报告滥用的药物。在滥用NCPM的患者中，阿片类药物使用障碍（24.1%对4.3%；P = 0.023）和大麻使用障碍（13.8%对0%；P = 0.019）的报告更为频繁，而其他物质使用障碍则无差异（P>0.05）。精神科和普通内科开处方者在对NCPM滥用的熟悉程度方面没有差异（n = 21 [87.5%]对n = 13 [81.3%]；P = 0.668）。
在该患者群体中发现了较高的NCPM滥用率。我们的研究结果证实了先前关于喹硫平滥用的报告，同时也表明曲唑酮经常被滥用。基于本研究的观察结果，NCPM滥用在我们机构被认定为普遍且值得关注，需要对医疗服务提供者进行教育并开展未来研究。
