DOCSLIB.ORG

OFF-LABEL USE of FDA APPROVED DRUGS RX503.001 Bluereview POSTED DATE: 11/17/2003 EFFECTIVE DATE: 2/27/2004 ______

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
OFF-LABEL USE of FDA APPROVED DRUGS RX503.001 Bluereview POSTED DATE: 11/17/2003 EFFECTIVE DATE: 2/27/2004 ______ OFF-LABEL USE OF FDA APPROVED DRUGS RX503.001 BlueReview POSTED DATE: 11/17/2003 EFFECTIVE DATE: 2/27/2004 _____________________________________________________________________________ COVERAGE: Off-Label use of FDA approved drugs as prescribed by a physician to treat chronic, disabling, or life-threatening illnesses may be covered when meeting the criteria outlined below: · Has been approved by the FDA for at least one indication · Is in one of the standard reference compendia for the off-label indication, Standard reference compendia means: 1. The United States Pharmacopoeia Drug Information; 2. The American Hospital formulary service Drug Information OR · Is supported by clinical research that appears in peer-reviewed literature specific for the indication in question. Peer-reviewed literature means a published scientific study including a trial that is preferably large, multi-centered and prospective, double blinded and randomized. Peer-reviewed medical literature does not include publications or research studies that are sponsored to a significant extent by a pharmaceutical company or financially interested parties. Coverage of a drug that meets the coverage criteria shall also include medically necessary services associated with the administration of the drug. Off-Label use of FDA approved drugs is considered non covered when the FDA has determined its use to be contraindicated for treatment of the condition for which coverage is requested. Exception: If there is an HCSC medical policy or position statement regarding a specific drug that provides a coverage position for off- label use(s) of that drug, such medical policy or position statement supersedes use of this Off-Label Use policy. Note: Medical policies or position statements on specific drugs are reviewed for consideration of change when valid new scientific literature emerges. Use of an orphan drug is considered medically necessary when used to treat rare diseases and disorders as defined by the Orphan Drug Act of Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company* Southwest Texas HMO, Inc.* d/b/a HMO BlueÒ Texas * Independent Licensees of the Blue Cross and Blue Shield Association OFF-LABEL USE OF FDA APPROVED DRUGS RX503.001 BlueReview POSTED DATE: 11/17/2003 EFFECTIVE DATE: 2/27/2004 _____________________________________________________________________________ the U.S. Food and Drug Administration. An Orphan Drug is defined in the 1984 amendments of the Orphan Drug Act as “a drug intended to treat a condition affecting fewer than 200,000 persons in the United States or will not recover development cost, plus a reasonable profit, within 7 years following FDA approval. The Orphan Drug Act was signed into law on January 4,1983.” ______________________________________________________________________ DESCRIPTION: Off-label or “unlabeled” drug use is the use of a drug approved by the U.S. Food and Drug Administration (FDA) for other uses or in treatment regimens or patient populations that are not included in approved labeling. Unproved or unlabeled uses of drugs include a variety of situations ranging from completely unstudied to thoroughly investigated drug uses where the FDA has not been asked for approval, whereas approved uses of drugs have been proved to be safe and effective by the FDA after the review of adequate and controlled clinical trials that have documented their uses. ______________________________________________________________________ RATIONALE: The FDA approves drugs for specific indications that are included in the drug’s labeling. When a drug is used for an indication other than those specifically included in the labeling, it is referred to as an off-label use. Many off-label uses are effective, well-documented in the literature, and widely used. Texas legislative mandate requires coverage of Off-Label use of FDA approved drugs when meeting the criteria as outlined in the coverage section of this policy. Illinois department of Insurance has a mandate on Cancer Off-Label Drugs that requires “If a policy provides prescription drug benefits, it must also provide benefits for any drug that has been prescribed for the treatment of a type of cancer, even if the drug has not been approved for that specific cancer by the FDA. The drug must be approved by the FDA and must be recognized for treatment of the specific cancer for which it has been prescribed by an established reference compendium”. This applies to group insurance policies and individual and group HMO contracts. ______________________________________________________________________ PRICING: None Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company* Southwest Texas HMO, Inc.* d/b/a HMO BlueÒ Texas * Independent Licensees of the Blue Cross and Blue Shield Association OFF-LABEL USE OF FDA APPROVED DRUGS RX503.001 BlueReview POSTED DATE: 11/17/2003 EFFECTIVE DATE: 2/27/2004 _____________________________________________________________________________ ______________________________________________________________________ REFERENCES: · Legislature of the State of Texas. Section 1. Subchapter E, Chapter 21, Insurance Code. Article 21.53H "Coverage for Off-Label Uses of FDA Approved Drugs" · “Off-Label Drug Use." BCBSA Consortium Health Plan Medical Policy Reference Manual (2002 July 12) Prescription Drug: 5.01.01 · Illinois Mandated Benefits, Cancer Off-Label Drugs 215 ILCS 5/37Or, 215 ILCS 125/4-6.3 ______________________________________________________________________ DISCLAIMER: State and federal law, as well as contract language, including definitions and specific inclusions/exclusions, takes precedence over Medical Policy and must be considered first in determining coverage. The member’s contract benefits in effect on the date that services are rendered must be used. Any benefits are subject to the payment of premiums for the date on which services are rendered. Medical technology is constantly evolving, and we reserve the right to review and update Medical Policy periodically. HMO Blue Texas physicians who are contracted/affiliated with a capitated IPA/medical group must contact the IPA/medical group for information regarding HMO claims/reimbursement information and other general polices and procedures. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company* Southwest Texas HMO, Inc.* d/b/a HMO BlueÒ Texas * Independent Licensees of the Blue Cross and Blue Shield Association .
Load more

Recommended publications
  • Trends in Stimulant Dispensing by Age, Sex, State of Residence, and Prescriber Specialty — United States, 2014–2019☆
    HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Drug Alcohol Manuscript Author Depend. Author Manuscript Author manuscript; available in PMC 2021 December 01. Published in final edited form as: Drug Alcohol Depend. 2020 December 01; 217: 108297. doi:10.1016/j.drugalcdep.2020.108297. Trends in stimulant dispensing by age, sex, state of residence, and prescriber specialty — United States, 2014–2019☆ Amy R. Boarda,b,*, Gery Guyb, Christopher M. Jonesc, Brooke Hootsb aEpidemic Intelligence Service, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S106-8, Atlanta, GA, 30341-3717, United States bDivision of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S106-8, Atlanta, GA, 30341-3717, United States cOffice of the Director, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S106-8, Atlanta, GA, 30341-3717, United States Abstract Background: Stimulant medications are commonly prescribed for the treatment of attention- deficit/hyperactivity disorder; however, they also have high potential for diversion and misuse. We estimated national stimulant dispensing trends from 2014 to 2019 and differences in dispensing by age, sex, state, prescriber specialty, payor type, patient copay, and stimulant type. Methods: We calculated rates of stimulant dispensing using IQVIA National Prescription Audit (NPA) New to Brand, NPA Regional, and NPA Extended Insights data, which provide dispensing estimates from approximately 49,900 pharmacies representing 92 % of prescriptions dispensed in the United States. Average annual percent change (AAPC) from 2014 to 2019 was analyzed using Joinpoint regression. Results: From 2014 to 2019, the national annual rate of stimulant dispensing increased significantly from 5.6 to 6.1 prescriptions per 100 persons.
    [Show full text]
  • Exemption and Exclusion from Certain Requirements of the Drug Supply Chain Security Act During the COVID-19 Public Health Emergency
    Contains Nonbinding Recommendations Exemption and Exclusion from Certain Requirements of the Drug Supply Chain Security Act During the COVID-19 Public Health Emergency Guidance for Industry April 2020 U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research Center for Biologics Evaluation and Research Contains Nonbinding Recommendations Preface Public Comment This guidance is being issued to address the Coronavirus Disease 2019 (COVID-19) public health emergency. This guidance is being implemented without prior public comment because the Food and Drug Administration (FDA or the Agency) has determined that prior public participation for this guidance is not feasible or appropriate (see section 701(h)(1)(C) of the Federal Food, Drug, and Cosmetic Act (FD&C Act) (21 U.S.C. 371(h)(1)(C)) and 21 CFR 10.115(g)(2)). This guidance document is being implemented immediately, but it remains subject to comment in accordance with the Agency’s good guidance practices. Comments may be submitted at any time for Agency consideration. Submit written comments to the Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. Submit electronic comments to https://www.regulations.gov. All comments should be identified with the docket number FDA- 2020-D-1136 and complete title of the guidance in the request. Additional Copies Additional copies are available from the FDA webpage titled “COVID-19-Related Guidance Documents for Industry, FDA Staff, and Other Stakeholders,” available at https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/covid-19-related- guidance-documents-industry-fda-staff-and-other-stakeholders and from the FDA webpage titled “Search for FDA Guidance Documents” available at https://www.fda.gov/regulatory- information/search-fda-guidance-documents.
    [Show full text]
  • FDA Regulation of Cannabidiol (CBD) Products
    June 12, 2019 FDA Regulation of Cannabidiol (CBD) Products Cannabidiol (CBD) is promoted as treatment for a range of and hemp-derived compounds, including CBD. However, conditions, including epileptic seizures, post-traumatic the farm bill explicitly preserved FDA’s authority under the stress disorder, anxiety, and inflammation—despite limited Federal Food, Drug and Cosmetic Act (FFDCA, 21 U.S.C. scientific evidence to substantiate many of these claims. In §§301 et seq.) and Section 351 of the Public Health Service the United States, CBD is marketed in food and beverages, Act (PHSA, 42 U.S.C. §262), including for hemp-derived dietary supplements, and cosmetics—products that are products. According to FDA, “because the 2018 Farm Bill regulated by the Food and Drug Administration (FDA). did not change FDA’s authorities, cannabis and cannabis- CBD is also the active ingredient in an FDA-approved pharmaceutical drug, Epidiolex®. CBD is a plant-derived derived products are subject to the same authorities and substance from Cannabis sativa, the species of plant that requirements as FDA-regulated products containing any includes both hemp and marijuana, but from different plant other substance, regardless of whether the products fall varieties or cultivars. CBD is the primary nonpsychoactive within the definition of ‘hemp’ under the 2018 Farm Bill.” compound in cannabis, whereas tetrahydrocannabinol (THC) is cannabis’s primary psychoactive compound. FDA Regulation of CBD Products FDA, under the FFDCA, regulates many of the products Regulation of CBD Products marketed as containing cannabis and cannabis-derived Hemp and marijuana have separate definitions in U.S. law compounds, including CBD.
    [Show full text]
  • Prescription Drug Abuse See Page 10
    Preventing and recognizing prescription drug abuse See page 10. from the director: The nonmedical use and abuse of prescription drugs is a serious public health problem in this country. Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and Prescription older) have used prescription drugs for nonmedical reasons at least once in their lifetimes. Young people are strongly represented in this group. In fact, the National Institute on Drug Abuse’s (NIDA) Drug Abuse Monitoring the Future (MTF) survey found that about 1 in 12 high school seniors reported past-year nonmedical use of the prescription pain reliever Vicodin in 2010, and 1 in 20 reported abusing OxyContin—making these medications among the most commonly abused drugs by adolescents. The abuse of certain prescription drugs— opioids, central nervous system (CNS) depressants, and stimulants—can lead to a variety of adverse health effects, including addiction. Among those who reported past-year nonmedical use of a prescription drug, nearly 14 percent met criteria for abuse of or dependence on it. The reasons for the high prevalence of prescription drug abuse vary by age, gender, and other factors, but likely include greater availability. What is The number of prescriptions for some of these medications has increased prescription dramatically since the early 1990s (see figures, page 2). Moreover, a consumer culture amenable to “taking a pill for drug abuse? what ails you” and the perception of 1 prescription drugs as less harmful than rescription drug abuse is the use of a medication without illicit drugs are other likely contributors a prescription, in a way other than as prescribed, or for to the problem.
    [Show full text]
  • The Controlled Substances Act: Regulatory Requirements
    The Controlled Substances Act: Regulatory Requirements Brian T. Yeh Legislative Attorney December 13, 2012 Congressional Research Service 7-5700 www.crs.gov RL34635 CRS Report for Congress Prepared for Members and Committees of Congress The Controlled Substances Act: Regulatory Requirements Summary This report highlights certain non-criminal regulatory requirements of the Controlled Substances Act (CSA). The CSA and its implementing regulations establish a framework through which the federal government regulates the use of controlled substances for legitimate medical, scientific, research, and industrial purposes, and prevents these substances from being diverted for illegal purposes. The CSA assigns various plants, drugs, and chemicals (such as narcotics, stimulants, depressants, hallucinogens, and anabolic steroids) to one of five schedules based on the substance’s medical use, potential for abuse, and safety or dependence liability. Schedule I contains substances that have no currently accepted medical use and cannot safely be made available to the public under a prescription, while Schedules II, III, IV, and V include substances that have recognized medical uses and may be manufactured, distributed, and used in accordance with the CSA. The order of the schedules reflects substances that are progressively less dangerous and addictive. To restrict access to chemicals used in the illicit manufacture of certain controlled substances, the CSA also regulates 40 “listed chemicals.” Furthermore, the CSA regulates controlled substance “analogues,” which are substances that are not controlled but are structurally or pharmacologically similar to substances found in Schedule I or II and have no accepted medical use. Unless specifically exempted by the CSA, any person who handles controlled substances or listed chemicals (such as drug manufacturers, wholesale distributors, doctors, hospitals, pharmacies, and scientific researchers) must register with the Drug Enforcement Administration (DEA) in the U.S.
    [Show full text]
  • Lyrica CR® (Pregabalin ER)
    Drug Therapy Guidelines Lyrica CR® (pregabalin ER) Applicable Medical Benefit Effective: 1/1/21 Pharmacy- Formulary 1 x Next Review: 9/21 Pharmacy- Formulary 2 x Date of Origin: 6/18 Pharmacy- Formulary 3/Exclusive x Review Dates: 3/18, 6/18, 9/18, 9/19, 9/20 Pharmacy- Formulary 4/AON x I. Medication Description Pregabalin is a structural analogue of gamma-aminobutyric acid (GABA) and has anxiolytic, analgesic, and antiepileptic properties. Pregabalin does not show direct GABA-mimetic effects, but increases neuronal GABA levels as well as produces a dose-dependent increase in glutamic acid decarboxylase activity. Pregabalin reduces neuronal calcium currents by binding to the alpha-2-delta subunit of calcium channels, and this particular mechanism may be responsible for effects in seizure control, neuropathic pain, anxiety, and other pain syndromes. Pregabalin may also interact with descending noradrenergic and serotonergic pathways in the brainstem that modulate pain transmission in the spinal cord. II. Position Statement Coverage is determined through a prior authorization process with supporting clinical documentation for every request. III. Policy Formulary 1: See Sections A, B, C, and E Formulary 2: See Sections A, B, C, and E Formulary 3: See Sections A, B, D, and E Formulary 4/AON: See Sections A, B, C, and E Coverage of Lyrica CR is available for the following conditions when the listed criteria are met: Neuropathic pain associated with diabetic peripheral neuropathy (DPN) in adults: A. The member has a documented diagnosis of DPN B. When requesting coverage of a brand medication for which an A/B rated generic is available, coverage will be provided when there is sufficient evidence that the use of the A/B rated generic equivalent has resulted in inadequate results C.
    [Show full text]
  • Commonly Abused Prescription Drugs National Institutes of Health Visit NIDA at U.S
    Commonly Abused Prescription Drugs National Institutes of Health Visit NIDA at www.drugabuse.gov U.S. Department of Health and Human Services Substances: Category and Name Examples of Commercial and Street Names DEA Schedule*/How Administered Intoxication Effects/Health Risks Depressants Barbiturates Amytal, Nembutal, Seconal, Phenobarbital: barbs, reds, red birds, phennies, II, III, IV/injected, swallowed Sedation/drowsiness, reduced anxiety, feelings of well-being, lowered inhibitions, tooies, yellows, yellow jackets slurred speech, poor concentration, confusion, dizziness, impaired coordination and memory/slowed pulse, lowered blood pressure, slowed breathing, tolerance, Benzodiazepines Ativan, Halcion, Librium, Valium, Xanax, Klonopin: candy, downers, sleeping IV/swallowed withdrawal, addiction; increased risk of respiratory distress and death when pills, tranks combined with alcohol Sleep Medications Ambien (zolpidem), Sonata (zaleplon), Lunesta (eszopiclone) IV/swallowed for barbiturates—euphoria, unusual excitement, fever, irritability/life-threatening withdrawal in chronic users Opioids and Morphine Derivatives** Codeine Empirin with Codeine, Fiorinal with Codeine, Robitussin A-C, Tylenol with II, III, IV/injected, swallowed Pain relief, euphoria, drowsiness, sedation, weakness, dizziness, nausea, impaired Codeine: Captain Cody, Cody, schoolboy; (with glutethimide: doors & fours, loads, coordination, confusion, dry mouth, itching, sweating, clammy skin, constipation/ pancakes and syrup) slowed or arrested breathing, lowered pulse
    [Show full text]
  • Prescription Stimulants (Canadian Drug Summary)
    www.ccsa.ca • www.cclt.ca June 2016 Canadian Drug Summary Prescription Stimulants Key points The use of prescription stimulants among the Canadian general population is about 1% and has remained relatively stable since 2008. In Canada, the rate of prescription stimulant use is highest among youth. There is little Canadian data available on the harms associated with prescription stimulant use and misuse. Introduction Stimulants are a broad category of substances that act to increase the level of activity of the central nervous system. The category includes commonly used substances such as caffeine and nicotine, over-the-counter decongestants (e.g., pseudoephedrine), illegal drugs (e.g., cocaine, methamphetamine), and prescription medications. Although the category of stimulants includes many substances, this drug summary focuses on prescription stimulants. The most common use of prescription stimulants is to treat individuals diagnosed with attention deficit hyperactivity disorder (ADHD). Other medical uses for prescription stimulants include the treatment of narcolepsy and other sleep disorders. Table 1 lists examples of the generic, trade and street names for some common prescription stimulants. Table 1. Common generic, trade and street names for stimulants Generic name Trade name Street names Methylphenidate Ritalin®, Concerta®, Biphentin® Vitamin R, skippy, rids, uppers Dextroamphetamine Dexedrine® bennies, black beauties, hearts Amphetamine and dextroamphetamine Adderall® Beans, dexies, amps Lisdexamfetamine dimesylate Vyvanse® Vanies Prescription stimulants are normally taken in pill form for medical uses, but some people tamper with the pills to obtain euphoric effects from them. Such tampering can cause complications, such as blockage of small blood vessels due to insoluble fillers in the tablets, infections at the injection site, and rapid onset of effects that can cause blood pressure and heart rate to spike.
    [Show full text]
  • Prescription Drug Benefit Manual Chapter 7 – Medication Therapy Management and Quality Improvement Program
    Prescription Drug Benefit Manual Chapter 7 – Medication Therapy Management and Quality Improvement Program Table of Contents (Rev. 11, 02-19-10) Transmittals for Chapter 7 10 – Medication Therapy Management and Quality Improvement Program 10.1 Introduction 10.2 Definition of Terms 20 – Quality Assurance Requirements 20.1 – General Rule 20.2 – Compliance With State Standards 20.3 – Concurrent Drug Utilization Review (DUR) 20.4 – Retrospective Drug Utilization Review (RDUR) 20.5 – Medication Error Identification and Reduction (MEIR) 20.6 – Medwatch Reporting 20.7 – CMS Performance Measures 20.8 – Information for Quality Improvement Organizations (QIOs) 30 – Medication Therapy Management Program (MTMP) 30.1 – General Rule 30.2 – Targeted Beneficiaries 30.3 – MTM Services 30.4 – Use of Experts 30.5 – Considerations in MTMP Fees 30.6 – MTMP Application 30.7 – MTMP Approval Considerations 30.8 – Mid–Year MTMP Changes 30.9 – MTMP Reporting 30.10 - Claims Processing for MTM Services 40 – Consumer Satisfaction Surveys 40.1 – General Rule 40.2 – Part D Sponsor Follow-up Responsibilities 50 – Electronic Prescription Program (E-prescribing) 50.1 – General Rule 50.2 – State Law Preemption 50.3 – Standards for E-Prescribing 50.4 – Exemptions 50.5 – Promotion of Electronic Prescribing by MA-PD Plans 60 – Drug Utilization Management Program 60.1 – General Rule 60.2 – Over-the-Counter Drugs as Part of Utilization Management Programs 60.3 – Exception for Private Fee-for-Service MA Plans 60.4 – Drug Utilization Management Disclosure Requirements 60.5 – Web site Posting Requirements 60.6 – Revision of Utilization Management Criteria Requirements 70 - Part D Complaints Processing 70.1 – General Rule 70.2 – Timeframes for Complaints Processing Appendix A – Chapter 7 Related Web Sites 10 – Medication Therapy Management and Quality Improvement Program (Rev.
    [Show full text]
  • Using Type 9 NDA Designation to Accelerate Multiple Approvals for Your Drug Product
    Using Type 9 NDA Designation to Accelerate Multiple Approvals for Your Drug Product Authors: Elaine B. Taylor and Vibha Kumar INTRODUCTION Often companies submit their original New Drug Application (NDA) and wait for approval of that original NDA before submitting a supplemental NDA with data to support a new indication or claim. This sequential process results in a delay of at least six months (if expedited review) or longer depending on the time for review of the original NDA. The United States Food and Drug Administration (FDA) has a process whereby you can submit more than one original NDA for the same drug product, alleviating the need to wait for approval of the original NDA. One type of NDA that allows for submission prior to approval to the original NDA is the Type 9 NDA. Figure 1 depicts an actual timeline for approval of two NDAs using the Type 9 NDA process and a theoretical timeline to show potential delay if second NDA had been submitted after approval of first NDA. Figure 1: Rozlytrek – comparison of actual Type 9 NDA and theoretical sequential submission Months after Submission Source: Drugs@FDA A Type 9 NDA allows a sponsor to submit an NDA for a new indication or claim for a drug product while that drug product is currently being reviewed under a different original NDA (the ‟parent NDA”), and the applicant does not intend to market this drug product under the separate NDA after approval. A Type 9 NDA can be submitted on the same day as the original NDA or months later.
    [Show full text]
  • Guidance Document: Gabapentin Prescribing and Dispensing
    CONTROLLED SUBSTANCES BOARD 4822 Madison Yards Way Doug Englebert PO Box 8366 Chairperson Madison WI 53708 Alan Bloom Email: [email protected] Vice Chairperson Voice: 608-266-2112 FAX: 608-251-3032 Yvonne M. Bellay Secretary GUIDANCE REGARDING THE DESIGNATION OF GABAPENTIN AS A MONITORED PRESCRIPTION DRUG Background Facts Gabapentin is a prescription medication approved by the U.S. Food and Drug Administration for the treatment of neuropathic pain and epileptic disorders. In recent years, however, Gabapentin has been increasingly encountered by law enforcement, documented in national crime lab reports, reported to poison control centers, and diverted for illicit use. The Researched Abuse, Diversion and Addiction – Related Surveillance (RADARS) System indicates an increase in Gabapentin diversion. The Drug Abuse Warning Network (DAWN) indicates a rise in emergency department visit rates for Gabapentin. The Wisconsin Controlled Substances Board (CSB) and the Prescription Drug Monitoring Program (PDMP) staff have received requests by health care practitioners and law enforcement to have Gabapentin included in the PDMP. Prescribers have indicated it is beneficial to be aware of a patient having a prescription for Gabapentin prior to prescribing an opioid because, when combined with opioids, there is an increased risk of respiratory depression and opioid-related mortality increases significantly. Gabapentin is sought after for illicit use due to its potentiating opioid effect. Action Taken In response to the facts above, the CSB has adopted Clearinghouse Rule 20-080 relating to designating Gabapentin as a prescription drug having a substantial potential for abuse, and therefore a monitored prescription drug pursuant to Wis. Stat. § 961.385 (1) (ag).
    [Show full text]
  • Psychoactive Prescription Drug Use Disorders, Misuse and Abuse Pharmacoepidemiological Aspects
    Psychoactive prescription drug use disorders, misuse and abuse Pharmacoepidemiological aspects Micaela Tjäderborn Division of Drug Research Institution of Medical and Health Sciences Linköping University Linköping, Sweden 2016 Psychoactive prescription drug use disorders, misuse and abuse © Micaela Tjäderborn 2016 [email protected] ISBN: 978-91-7685-770-0 ISSN: 0345-0082 Printed in Linköping, Sweden 2016 Liu-Tryck AB ii All the passionate work I put into this thesis is dedicated to my parents, who always emphasized the importance of knowledge and of caring for the less fortunate. iii iv Psychoactive prescription drug use disorders, misuse and abuse Pharmacoepidemiological aspects Micaela Tjäderborn Division of Drug Research Institution of Medical and Health Sciences Linköping University, Linköping, Sweden Background: There is a widespread and increasing use of psychoactive prescription drugs, such as opioid analgesics, anxiolytics, hypnotics and anti-epileptics, but their use is associated with a risk of drug use disorder, misuse and abuse. Today, these are globally recognised and emerging public health concerns. Aim: The aim of this thesis is to estimate the occurrence and prevalence of psychoactive prescription drug use disorders, misuse and abuse, and to investigate the association with some potential risk factors. Methods: A study using register data from forensic cause of death investigations analysed and described cases of fatal unintentional intoxications with tramadol (Study I). Based on register data on spontaneously reported adverse drug reactions (ADRs) reported cases of tramadol dependence were scrutinized and summarised (Study II). In a study in suspected drug-impaired drivers with a toxicology analysis confirming intake of tramadol, diazepam, flunitrazepam, zolpidem and zopiclone, the prevalence of non-prescribed use was assessed and associated factors were investigated (Study III).
    [Show full text]