Quetiapine abuse

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Quetiapine (often branded as Seroquel) is an antipsychotic drug used for schizophrenia and bipolar disorder. It’s also prescribed off-license in the UK for anxiety. That means that a fair few people with alcohol and other drug dependence end up on it. Recent experience makes me wonder if prescribers are as aware of the risks as they […]

Gabapentin and pregabalin misuse

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  Gabapentin and pregabalin misuse are problems that are not going to go away. My post on gabapentin is one of the most-read on this site. While these are useful medicines, workers in drug treatment and support see patients regularly on gabapentin or pregabalin who have misused the drugs or who are misusing them. Guidance is […]

Benzodiazepine Guidance

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SMMGP has published guidance for using benzodiazepines and benzo-like drugs in primary care. It’s a comprehensive 60+ page document which covers most (but not all) of the bases and reinforces the need for caution when prescribing the drugs. The guidance is so long in coming because consensus could not be reached. Benzo prescribing is an […]

Stopping benzos – not as hard as you’d think?

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Nobody wants to come off benzos – right? Too hard, too unpleasant and no willingness. But hang on a minute… DB Recovery Resources links to a study that used a structured intervention (the gorgeously named BAMP) to help folk come off benzodiazepines and what do you know, 70% were tapered or discontinued. That said the researchers […]

Naloxone is not enough

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I’m a fan of Take Home Naloxone (THN). I’ve also wondered about how our naloxone programmes might be recovery-focused. Dr Judith Craven wrote a personal piece touching on this a while back. Jason Schwarz picks up on how our expectations might be greater than the impact the drug can actually make. He quotes Andrew Kolodny, from Phoenix […]

Poor performance: sexual dysfunction on ORT

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Opiates seem to reduce the libido, it’s a common complaint in opiate users and those on replacement treatment. They seem to do this through suppressing testosterone and other key hormones. SMMGP reviews a couple of papers on the association between opioid replacement therapy (ORT) and sexual dysfunction. In the first, relatively small, Indian study, 60 sexually active men […]

Faith in pharmacology

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Holy grails are few and far between. Pharmaceutical holy grails are no different. They are as rare as a moderate position in the Scottish independence debate. We have a few prescription drugs licensed to treat addiction and some make things significantly better, some have modest impacts, and some appear to have little impact. Regardless of […]

Gabapentin abuse

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Gabapentin can be addictive. Search for gabapentin abuse or pregabalin abuse on Google Scholar and you’ll turn up 18,000 entries in less than a second. Pubmed is a little more specific finding 249 papers related to the subject. Vaults of Erowid has over 100 gabapentin and pregabalin ‘experiences’ detailed by users. I wrote a while back […]

Do opioids work for chronic pain? Sorry, we haven’t a clue

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Jason Schwartz highlights a Keith Humphreys post on the challenges of assessing opioids for long term non-cancer pain. With millions of people in the UK prescribed regular opiates on repeat prescriptions for chronic pain and these drugs fraught with dependence dangers, you’d think there would have to be a solid evidence base that they work. Not a bit […]