Jennifer Fass

Synthetic Cathinones (Bath Salts): Legal Status and Patterns of Abuse

Objective: To review the current legal status and patterns of abuse of bath salts. Data Sources: A literature search was conducted through MEDLINE (1950-December 2011), PubMed (1966–December 2011), EMBASE (1966-December 2011), and International Pharmaceutical Abstracts (1970-December 2011) using the search terms bath salts, mephedrone, and methylenedioxypyrovalerone to identify articles on the legal status of bath salts and on studies focusing on patterns of abuse of bath salts. The GovTrack.us Web site was searched to determine the status of federal bills regarding bath salts. The National Association of Boards of Pharmacy and Drug Enforcement Administration Web sites and the Federal Registerwere also examined to identify legislation on bath salts. Study Selection and Data Extraction: Case reports and studies regarding bath salts were examined. Federal laws involving bath salts were also evaluated. Data Synthesis: The Department of Justice issued a final order in the Federal Register, temporarily placing the 3 synthetic stimulants, mephedrone, methylenedioxypyrovalerone, and methylone, under Schedule I of the Controlled Substances Act. Literature evaluated included case reports, retrospective studies, surveys, toxicology data, and chemical analyses studies. Information in the literature demonstrated that bath salts are highly abused, and common adverse effects include hypertension, tachycardia, and psychiatric symptoms. Conclusions: Psychoactive substances recently sold as bath salts have been placed in Schedule I of the Controlled Substances Act. Pharmacists can play an important role in raising awareness on the dangers of bath salts abuse through patient counseling and community outreach programs. The evidence on legal status and patterns of abuse clearly demonstrates that bath salts contain dangerous substances that should be permanently controlled.

Carisoprodol Legal Status and Patterns of Abuse

Objective: To review the current legal status and patterns of abuse of carisoprodol. Data Sources: A literature search was conducted through MEDLINE (1950-August 2010), PubMed (1966-August 2010), EMBASE (1966-August 2010), and International Pharmaceutical Abstracts (1970-August 2010) using the search terms carisoprodol and abuse. In addition, reference citations from publications identified were reviewed. State laws and regulations were accessed through NABP LAW Online (2010) using the search term carisoprodol. Federal proposed rules were accessed through the Federal Register (1995 Volume 59-2010 Volume 75) using the search term carisoprodol. Study Selection and Data Extraction: State laws and federal proposed rules regarding carisoprodol were examined. Case reports and studies involving carisoprodol abuse were evaluated. Data Synthesis: Carisoprodol is not federally scheduled under the Controlled Substances Act (CSA). However, carisoprodol is scheduled in 36% (n = 18) of states of the US. The Drug Enforcement Administration issued a Notice of Proposed Rulemaking in the Federal Register on November 17, 2009, to place carisoprodol into schedule IV of the CSA, with a deadline to submit written comments by December 17, 2009. Case reports, retrospective studies, and national reports, including reports from the American Association of Poison Control Centers and results from the Monitoring the Future national survey on drug use, have identified carisoprodols abuse potential. Conclusions: Carisoprodol should be placed in schedule IV of the CSA based on its abuse potential and current state laws and regulations. Federally scheduling carisoprodol would lead to uniformity among the states and hopefully assist in preventing prescription drug abuse. Larger, well-designed studies evaluating carisoprodol abuse should be performed.

Physician-assisted suicide: Ongoing challenges for pharmacists

The pharmacist on duty at a community pharmacy in Oregon receives a phone call from a local physician who says he intends to write a prescription for a lethal dose of secobarbital to end a patient’s life. The physician says that in his oncology practice, patients occasionally request physician-

Prescription drug take-back programs

![Figure][1] The Office of National Drug Control Policy (ONDCP) and the Food and Drug Administration (FDA) created a federal guidance that provides a list of 27 medications recommended for disposal by flushing, since the risk of ingestion outweighs the environmental risk.[1][2],[2][3] FDA and

Legal Requirements for Drug Information Resources Maintained by Pharmacies

Drug information (DI) resource requirements differ between states and practice setting or specialty. The objective of this study was to determine each states legal requirements for maintaining DI resources in a pharmacy according to general or specialty practice. All 50 states in the United States, the District of Columbia, and Puerto Rico were targeted to identify their mandated DI resources. General resources were required by 50 boards of pharmacy (or jurisdictions) (96.2%), whereas 43 (82.6%) specified site- or practice-specific resources. Minnesota and South Dakota (3.8%) required print references. Forty (76.9%) required current laws or regulations. Other specifications include allowances for journals (7.7%), requirements for herbal medicine information (7.7%), and a resource in support of immunization administration (5.8%). This study details DI references mandated in the United States. Pharmacists should be aware that their state and area of practice may dictate which DI resources they must maintain to be in compliance with relevant laws.

Comment: Effect of Scheduling Tramadol as a Controlled Substance on Poison Center Exposures to Tramadol:

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New Practitioners Forum

Journal clubs have been in existence since the 1870s, when Sir William Osler, a physician, began the process of systematically reviewing research articles for the purpose of medical education.[1][1] A journal club is a meeting of people to analyze the strengths and weaknesses of research published

New Practitioners Forum: Strategies for reinventing journal club.

Journal clubs have been in existence since the 1870s, when Sir William Osler, a physician, began the process of systematically reviewing research articles for the purpose of medical education.[1][1] A journal club is a meeting of people to analyze the strengths and weaknesses of research published

Strategies for reinventing journal club

Journal clubs have been in existence since the 1870s, when Sir William Osler, a physician, began the process of systematically reviewing research articles for the purpose of medical education.[1][1] A journal club is a meeting of people to analyze the strengths and weaknesses of research published