Methylphenidate disintegration from oral formulations for intravenous use by experienced substance users

Bjarnadottir, Gudrun; Jóhannsson, Magnús; Magnússon, Andrés; Rafnar, Bjarni O.; Sigurðsson, Engilbert; Steingrímsson, Steinn; Ásgrímsson, Valþór; Snorradóttir, Ingibjörg; Bragadóttir, Helga; Haraldsson, H. Magnús

doi:10.1016/j.drugalcdep.2017.04.028

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Given that use of intravenous route is frequent in France [14,44], this pattern suggests that a part of methylphenidate obtained by doctor shopping may be used by intravenous route, because methylphenidate OROS is the least preferred substance for intravenous route in drug‐abusing subjects [13]. Interestingly, OROS technology increases the time for preparing and the viscosity of the preparation, which may be the reason for this preference [45].…”

Section: Discussionmentioning

confidence: 99%

Doctor shopping for methylphenidate as a proxy for misuse and potential abuse in the 67 million inhabitants in France

Soeiro

Frauger

Pradel

et al. 2020

Fundamemntal Clinical Pharma

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Doctor shopping enables subjects to receive more than the prescribed dose out of any medical management, which suggests a search for high doses and makes doctor shopping a relevant proxy for misuse and potential abuse. Therefore, this study aimed to identify and characterize profiles of subjects with doctor‐shopping behavior for methylphenidate in the entire French population. This study is a cross‐sectional study of doctor‐shopping behavior for methylphenidate in France, in 2016, using the Système national des données de santé, and accounting for overlapping prescriptions. Subjects who obtained >840 mg by doctor shopping were defined as subjects with heavy doctor‐shopping behavior, and subjects who obtained >0 mg and ≤840 mg by doctor shopping were defined as subjects with light doctor‐shopping behavior. A total of 63 739 subjects were included, and received 339.6 kg of methylphenidate. Among them, 216 (0.3%) subjects had heavy doctor‐shopping behavior, and 313 (0.5%) subjects had light doctor‐shopping behavior. Compared with subjects with light doctor‐shopping behavior, subjects with heavy doctor‐shopping behavior were older (64% of 30‐ to 49‐year‐old subjects vs. 77% of ≤17‐year‐old subjects; P < 0.001), received more concomitant dispensings of antipsychotics (37% vs. 26%; P = 0.008) and opioid maintenance treatments (50% vs. 6%; P < 0.001), and had more prescribers (4 [IQR = 2‐5] vs. 2 [IQR = 2–3]; P < 0.001). In the French context where prescription and dispensing of methylphenidate are highly regulated and methylphenidate is much less used than in other countries, these results are a warning signal to avoid trivializing methylphenidate in adults.

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Section: Discussionmentioning

confidence: 99%

Doctor shopping for methylphenidate as a proxy for misuse and potential abuse in the 67 million inhabitants in France

Soeiro

Frauger

Pradel

et al. 2020

Fundamemntal Clinical Pharma

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“…Given that the use of intravenous route for methylphenidate is frequent in France (79)(80)(81), this pattern also suggests that a part of methylphenidate obtained by doctor shopping may be used by intravenous route, because methylphenidate OROS is the least preferred drug for intravenous route in drug-abusing patients (82). Interestingly, OROS increases the time for preparing due to the viscosity of the preparation, which may be the reason for this preference (83).…”

Section: Recovering Pharmacological Determinants Of Abusementioning

confidence: 99%

Early Detection of Prescription Drug Abuse Using Doctor Shopping Monitoring From Claims Databases: Illustration From the Experience of the French Addictovigilance Network

et al. 2021

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Opioid analgesics and maintenance treatments, benzodiazepines and z-drugs, and other sedatives and stimulants are increasingly being abused to induce psychoactive effects or alter the effects of other drugs, eventually leading to dependence. Awareness of prescription drug abuse has been increasing in the last two decades, and organizations such as the International Narcotics Control Board has predicted that, worldwide, prescription drug abuse may exceed the use of illicit drugs. Assessment of prescription drug abuse tackles an issue that is hidden by nature, which therefore requires a specific monitoring. The current best practice is to use multiple detection systems to assess prescription drug abuse by various populations in a timely, sensitive, and specific manner. In the early 2000's, we designed a method to detect and quantify doctor shopping for prescription drugs from the French National Health Data System, which is one of the world's largest claims database, and a first-class data source for pharmacoepidemiological studies. Doctor shopping is a well-known behavior that involves overlapping prescriptions from multiple prescribers for the same drug, to obtain higher doses than those prescribed by each prescriber on an individual basis. In addition, doctor shopping may play an important role in supplying the black market. The paper aims to review how doctor shopping monitoring can improve the early detection of prescription drug abuse within a multidimensional monitoring. The paper provides an in-depth overview of two decades of development and validation of the method as a complementary component of the multidimensional monitoring conducted by the French Addictovigilance Network. The process accounted for the relevant determinants of prescription drug abuse, such as pharmacological data (e.g., formulations and doses), chronological and geographical data (e.g., impact of measures and comparison between regions), and epidemiological and outcome data (e.g., profiles of patients and trajectories of care) for several pharmacological classes (e.g., opioids, benzodiazepines, antidepressants, and methylphenidate).

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“…11 Einnig kom í ljós að neytendur kjósa ákveðin lyfjaform metýlfenídat fram yfir önnur og neyslumynstrið einkennist af mjög tíðum sprautun um í nokkurra daga törnum með hléum á milli. 13,14 Tilgangur rannsóknar var að skoða komur einstaklinga sem nota vímuefni í aeð á bráðamóttökur og innlagnardeildir Landspít ala yfir tveggja ára tímabil Til að meta þjónustuþunga voru komur, innlagnir og innlagnardagar taldir. Til að skilja betur heilbrigðis vanda hópsins á Íslandi voru komuástaeður greindar og gerður samanburður milli þeirra sem notuðu mest metýlfenídat og annarra.…”

Section: áLyktununclassified

Intravenous drug users in Iceland: Use of emergency departments, hospital admissions and mortality

Rafnar

Bjarnadottir

2021

LBL

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INTRODUCTION: Drug abuse is a significant contributor to premature disease and mortality. Drug users are less likely to attend traditional Primary Health Care and more likely to present to Emergency Departments with their problems. Drug users often present late for treatment and find difficult ot engage and follow through treatment in standard models of health services. Materials and methods: The study is retrospective. 108 intravenous drug users were identified upon admission to one of three intpatient addiction treatment centres in Iceland in the years 2012-2013. Case notes for the two years leading to admission were examined. Results: The study group had significantyl more contacts with Emergency Departments than a matched sample from the community (p<0.001). Mean number of visits for the study group per year was 4.8 (median 3.5) and 43% had four or more visits in a year. Majority of visits were for pshychiatric symptoms with a third considered serious. The two main medical reasons were infections from injecting and accidents/violence. There was no significant difference in study parameters between those who mainly use methylphenidate vs other substances. Mortality rate for the study group compared to the general population of same age was 26.4 (CI 16.7-41.5, p<0,001).

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Methylphenidate disintegration from oral formulations for intravenous use by experienced substance users

Cited by 4 publications

References 24 publications

Doctor shopping for methylphenidate as a proxy for misuse and potential abuse in the 67 million inhabitants in France

Doctor shopping for methylphenidate as a proxy for misuse and potential abuse in the 67 million inhabitants in France

Early Detection of Prescription Drug Abuse Using Doctor Shopping Monitoring From Claims Databases: Illustration From the Experience of the French Addictovigilance Network

Intravenous drug users in Iceland: Use of emergency departments, hospital admissions and mortality

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