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Sedating pills

I have divided the drugs with abuse potential into categories based on their primary psychoactive effect. Trazadone, for example, can be either a sedative or a euphoric, depending on how it is used.

The risk for a particular drug also can vary depending on the particular correctional facility you happen to be in.

You might be having major problems with a drug in your facility that has not presented much of a hassle in my jails! There is little difference (in my opinion) between Lyrica and gabapentin in both use for neuropathic pain or for abuse potential.

These are drugs commonly sought—and prescribed—as sleeping aids. Their use should be uncommon, prescribed for acute muscular conditions only, and limited to 7 days or less. Abuse potential ( ) Remeron is a sedating antidepressant–so sedating, in fact, that it works as a sleeping pill. Amitriptylline is the most sedating of the cyclic antidepressants. Doxepine is sedating due to high anticholinergic properties. Albuterol is an essential drug for the treatment of asthma and COPD. When sought illegitimately, it is usually requested as a psychiatric drug or headache medication. However, second generation antihistamines such as loratidine (Claritin) and cetirizine (Zyrtec) have less abuse potential and often can be substituted.

Does the drug have a ready substitute with less abuse potential? If you find yourself scratching your head and wondering, “How in the world can that be abused? Bentyl is prescribed for Irritable Bowel Syndrome and abdominal cramps, but achieves its antispasmodic effects as an anticholinergic. DM should not be prescribed nor should DM be available on commissary due to its high abuse potential and minimal legitimate effect. These medications are abused for reasons other than their psychiatric effects. Since many benign fiber products available, psyllium should not be used in jails or prisons. It is an essential drug for those few who have hepatic encephalopathy. Non-stimulant laxatives are preferable in most cases. In fact, in my experience, acute tramadol withdrawal tends to be more severe than withdrawal from many other narcotics.

Like all correctional physicians, I myself have wrestled with the problems these drugs cause.

Some have little therapeutic value and so are not such a big problem—I just don’t prescribe them.

But these drugs are, in fact, abused and diverted in jails and prisons.