Drug interactions between common illicit drugs and prescription therapies.
OBJECTIVE
The aim was to summarize the clinical literature on interactions between common illicit drugs and prescription therapies.


METHODS
Medline, Iowa Drug Information Service, International Pharmaceutical Abstracts, EBSCO Academic Search Premier, and Google Scholar were searched from date of origin of database to March 2011. Search terms were cocaine, marijuana, cannabis, methamphetamine, amphetamine, ecstasy, N-methyl-3,4-methylenedioxymethamphetamine, methylenedioxymethamphetamine, heroin, gamma-hydroxybutyrate, sodium oxybate, and combined with interactions, drug interactions, and drug-drug interactions. This review focuses on established clinical evidence. All applicable full-text English language articles and abstracts found were evaluated and included in the review as appropriate.


RESULTS
The interactions of illicit drugs with prescription therapies have the ability to potentiate or attenuate the effects of both the illicit agent and/or the prescription therapeutic agent, which can lead to toxic effects or a reduction in the prescription agent's therapeutic activity. Most texts and databases focus on theoretical or probable interactions due to the kinetic properties of the drugs and do not fully explore the pharmacodynamic and clinical implications of these interactions. Clinical trials with coadministration of illicit drugs and prescription drugs are discussed along with case reports that demonstrate a potential interaction between agents. The illicit drugs discussed are cocaine, marijuana, amphetamines, methylenedioxymethamphetamine, heroin, and sodium oxybate.


CONCLUSIONS
Although the use of illicit drugs is widespread, there are little experimental or clinical data regarding the effects of these agents on common prescription therapies.


CONCLUSIONS
Potential drug interactions between illicit drugs and prescription drugs are described and evaluated on the Drug Interaction Probability Scale by Horn and Hansten.
Department of Pharmacy Practice, Drug Information and Learning Resource Center, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA. wtl0001@auburn.edu
Wesley T
WT
Lindsey
David
D
Stewart
Darrell
D
Childress
D002986:Clinical Trials as Topic; D004347:Drug Interactions; D006801:Humans; D013287:Illicit Drugs / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000633:toxicity; D055553:Prescription Drugs / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D019966:Substance-Related Disorders / Q000150:complications*
D013287:Illicit Drugs; D055553:Prescription Drugs