RESUMO
PURPOSE: Gamma-hydroxybutyrate (GHB) withdrawal is a life-threatening condition that does not always respond to standard treatment with benzodiazepines. Baclofen has potential utility as a pharmacological adjunct and anecdotal reports suggest that it is being used by drug users to self-manage GHB withdrawal symptoms. Here, we investigate current patterns of use and the online availably of baclofen. METHODS: Data triangulation techniques were applied to published scientific literature and publicly accessible Internet resources (grey literature) to assess the use of baclofen in GHB withdrawal. An Internet snapshot survey was performed to identify the availability of baclofen for online purchase and the compliance of retailers with the UK regulations. Data were collected according to pre-defined criteria. RESULTS: A total of 37 cases of baclofen use in GHB withdrawal were identified in the scientific literature, as well as 51 relevant discussion threads across eight Internet forums in the grey literature. Baclofen was available to purchase from 38 online pharmacies, of which only one conformed to the UK regulations. CONCLUSIONS: There is limited published evidence on the use of baclofen in GHB withdrawal, but both scientific and grey literature suggests clinical utility. Online pharmacies are readily offering prescription-only-medication without prescription and due to inadequate regulation, pose a danger to the public.
Assuntos
Baclofeno/uso terapêutico , Agonistas dos Receptores de GABA-B/uso terapêutico , Internet , Padrões de Prática Médica , Psicotrópicos/toxicidade , Oxibato de Sódio/toxicidade , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Animais , Baclofeno/economia , Baclofeno/normas , Baclofeno/provisão & distribuição , Pesquisa Biomédica/métodos , Tráfico de Drogas/economia , Agonistas dos Receptores de GABA-B/economia , Agonistas dos Receptores de GABA-B/normas , Agonistas dos Receptores de GABA-B/provisão & distribuição , Humanos , Internet/economia , Internet/ética , Disponibilidade de Medicamentos Via Internet/economia , Disponibilidade de Medicamentos Via Internet/ética , Disponibilidade de Medicamentos Via Internet/normas , Medicamentos sob Prescrição/economia , Medicamentos sob Prescrição/normas , Medicamentos sob Prescrição/provisão & distribuição , Medicamentos sob Prescrição/uso terapêutico , Mídias Sociais/economia , Mídias Sociais/ética , Reino UnidoRESUMO
The online, direct-to-consumer (DTC) medical marketplace is proliferating more rapidly than regulation is evolving to ensure proper patient safety and public health controls. Along with this growing body of unrestrained medical testing and pharmaceuticals offered DTC online, most types of insulin and insulin administration products may now be purchased without prescriptions or physician guidance. Given the relatively significant risks of insulin use, the abuse potential, the high prevalence of diabetes mellitus, and the rising population of uninsured and underinsured, it is imperative to reform the online DTC medical marketplace to ensure that patient safety and public health are protected.