Learning unit: Misuse of drugs


Impact of the learning unit:

Falsification, misuse, abuse of medicines are ways of using a drug in breach of legal or medical
recommendations and regulations. It is well known in drugs inducing substance dependence, but it
also relates to other drug groups. Substances enhancing performance form a specific category of
misused drugs – doping in sport. Not only physicians in acute medicine should have general
knowledge about misused drugs, reasons for their misuse, and medical complications that could
emerge. Every health professional needs to know how this undesirable use of medicines is regulated.

Relevant terms

misuse of drugs

                reasons for the misuse

                               effects on mood, mind, consciousness, „sensation seeking“ misuse

                               improvement of intellectual performance, cognitive functions,
concentration

                               stress relief, anxiolysis, calming

                               substance dependence

                               eating disorders

                examples of misused drug groups

psychiatric medication and drugs affecting CNS

                               opioids

                               anti-obesity agents and laxatives

doping

                definitions

                ways of testing

                therapeutic use exception

examples of banned substances in sport

                               β-sympathomimetic and β-sympatolytic agents

                                               performance-enhancing effects

                                               adverse effects and risks

                               anabolic steroids

performance-enhancing effects

                                               adverse effects and risks


regulations of drug misuse

list of dependency-producing substances

prescription and dispensation of medicines

reports for the state regulatory authority (SÚKL)


falsified medicines

definition and sources of falsified medicines

protection of patients and health professionals by regulations (labelling of medicines)


Learning outcomes

Student gives an overview of frequently misused drug groups and explains for what biological effect
are they misused. Student describes the regulation of prescription, dispensing and clinical use of
these substances and can adequately respond to the illegal offer on the internet. Student is aware
that medicines may be falsified and briefly describes the system of protection against such
products.

Study materials

Rang & Dale's Pharmacology, 8th edition, 2016, chapter 58, pp. 703-707 (Lifestyle drugs and drugs
in sport)


Doping: https://www.wada-ama.org/sites/default/files/prohibited_list_2018_en.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2439523/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3465038/

Misused drugs in the EU – overview: https://www.ncbi.nlm.nih.gov/pubmed/22572594

http://www.emcdda.europa.eu/best-practice/briefings/addressing-misuse-medicines_en

Misuse of drugs – legislation in the Czech Republic:

Act No. 167/1998 Coll., on Dependency Producing Substances

Order of the Government No. 463/2013 Coll., regarding the lists of dependency producing substances

Act No. 378/2007 Coll., on pharmaceuticals (§ 39, 81a, 82, 83, 84)


Falsified medicines:

http://europa.eu/rapid/press-release_MEMO-11-91_en.htm?locale=en

https://ec.europa.eu/health/medicinal_products/videos_en

https://ec.europa.eu/health/human-use/falsified_medicines_en


Exam questions

General pharmacology:  2. Types of pharmacotherapy, rules of rational and safe pharmacotherapy. The
question of drug misuse