A Hidden Pandemic? Abuse of Gabapentinoids: A Brief Review of Recent Studies.

BACKGROUND: Gabapentin and pregabalin were developed for epilepsy and neuropathic pain. They work via voltage-gated calcium channels and are used for broad-spectrum diagnoses, e.g., epilepsy, neuropathic pain, other chronic pain syndromes, anxiety disorders, alcohol-drug withdrawal syndromes, agitation, insomnia, etc. Especially in a world dealing with the opioid crisis, gabapentinoids were considered safer alternatives to opioid analgesics. METHODS: This review aims to comprehensively search and summarize recent studies concerning the abuse of gabapentinoids published between 2021 and 2022 from various regions around the world. RESULTS: Studies have highlighted that a history of substance use disorder is a significant risk factor for gabapentinoid abuse. Concurrent abuse of gabapentinoids with illicit drugs can exacerbate drug-related damages. Drug screening and postmortem toxicology tests have revealed an increase in gabapentinoid consumption. In response to the abuse potential, several countries have classified gabapentinoids as controlled substances. CONCLUSION: Gabapentinoids are highly abused molecules worldwide. Physicians should be aware of their abuse potential.

Could Telling Parents About Substance Use Decrease Involvement in Crime of Substance Users?

INTRODUCTION: Substance use disorder and criminal behaviors are increasing all over the world day by day. Factors that affect the involvement in crime among people with substance use disorders need to be examined more. This research aims to investigate the protective factors of substance users' involvement in crime and clarify the importance of telling parents about their substance use. METHOD: A total of 190 patients with substance use disorders were included. Patients were divided into two groups: those who told their families about their substance use (TP+) and those who did not tell (TP-). A sociodemographic data form, the short form of My Memories of Upbringing Scale for perceived parental attitudes, Experiences in Close Relationships Scale-Revised, and Emotional Autonomy Scale were used. RESULTS: Our study found that people in the TP+group were less involved in crime than TP-. Telling rates increased proportionally when individuals' anxious attachment and individuation levels rose. In the TP+group, criminal history was correlated positively with substance use duration. CONCLUSION: Telling their families that they are using substances can be a protective factor in itself against crime among drug users, especially in the early stages of addiction. Professionals in addiction psychiatry should encourage their patients to tell their substance use. Teaching and encouraging them to communicate with their relatives might play a key role for policymakers while dealing with substance use disorders and related outcomes.

OPRD1 rs569356 polymorphism has an effect on plasma norbuprenorphine levels and dose/kg-normalized norbuprenorphine values in individuals with opioid use disorder.

This study aimed to determine the effects of nine OPRM1, OPRD1 and OPRK1 polymorphisms on plasma BUP and norbuprenorphine (norBUP) concentrations and various treatment responses in a sample of 122 patients receiving BUP/naloxone. Plasma concentrations of BUP and norBUP were detected by LC-MS/MS. PCR-RFLP method was used to genotype polymorphisms. OPRD1 rs569356 GG had significantly lower plasma norBUP concentration (p = 0.018), dose- (p = 0.049) and dose/kg-normalized norBUP values (p = 0.036) compared with AA. Craving and withdrawal symptoms were significantly higher in OPRD1 rs569356 AG+GG relative to AA. There was a statistically significant difference between the OPRD1 rs678849 genotypes in the intensity of anxiety (13.5 for CT+TT and 7.5 for TT). OPRM1 rs648893 TT (18.8 ± 10.8) was significantly different to CC+CT (14.82 ± 11.3; p = 0.049) in view of the intensity of depression. This current study provides the first data on a prominent effect of the OPRD1 rs569356 variation on BUP pharmacology due to its metabolite norBUP.

Delirium Tremens and Central Pontine Myelinolysis in a Patient with Alcohol Use Disorder and Pneumonia: a Case Report and a Narrative Review.

INTRODUCTION: Delirium tremens (DT) is a serious condition occurring in alcohol withdrawal syndrome. Alcohol consumption may also cause additional health problems, such as respiratory infections or neuropsychiatric conditions such as central pontine myelinolysis. In this clinical scenario, managing DT can be expected to be more compelling and complex. Alcohol decreases coughing and mucociliary clearance and disrupts the immunity of the respiratory system. CASE: Here we report on a middle-aged man with alcohol use disorder who had developed DT due to alcohol withdrawal and comorbid pneumonia. DISCUSSION AND CONCLUSION: In this paper, DT, the relation between respiratory infections and alcohol intake, and the correlation of alcohol consumption and central pontine myelinolysis (CPM) are discussed. Also, the literature on alcohol consumption and the additional respiratory and neurologic problems resulting from it are presented.