Smoking crushed hyoscine/scopolamine tablets as drug abuse.
BACKGROUND
Hyoscine N-butyl bromide/scopolamine (H/S) is a type of anticholinergic agent that is commonly used as an antispasmodic drug. We have evaluated the effects of crushed H/S smoking in prisoners who illicitly abused this drug.


METHODS
All imprisoned cases with at least a 3-month history of HS were evaluated from April 2012 to September 2012. Demographic information, history, and clinical findings were studied.


RESULTS
In total, 36 male cases with a mean (SD, min-max) age of 33.3 (3.6, 27-42) years were included. All subjects were cigarette smokers with a history of substance abuse and were under Methadone Maintenance Therapy (MMT). The majority (75%) of participants smoked H/S tablet with pin, and others used aluminum foil. Hallucinations were the most common neurological features. Amnesia (88%), insomnia (83%), palpitation (86%), flushing (86%), irritability (94%), and inability to concentrate (91%) were the most common findings. Among them, auditory (61%), visual (72%), and tactile (72%) hallucinations were reported.


CONCLUSIONS
This is the first case study of hyoscine smoking abuse. We found that H/S acts similar to other hallucinogens. Concurrent abuse of H/S in cases under MMT could be a future trend of abuse. Clinicians should be aware of abuse potential of H/S in treatment of some patients for drug overdose.
1Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
Farzad
F
Jalali
Reza
R
Afshari
Ali
A
Babaei
D000328:Adult; D000647:Amnesia / Q000209:etiology; D018680:Cholinergic Antagonists; D005260:Female; D005483:Flushing / Q000209:etiology; D006212:Hallucinations / Q000209:etiology; D006801:Humans; D008297:Male; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000150:complications / Q000628:therapy; D011329:Prisoners / Q000706:statistics & numerical data*; D012601:Scopolamine; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*
D018680:Cholinergic Antagonists; D012601:Scopolamine