Smoking Crushed Hyoscine/Scopolamine Tablets as Drug Abuse

Abstract

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.

Keywords :

• hyoscine N-butyl bromide/scopolamine
• abuse
• smoking
• antimuscarinic agent

THE AUTHORS

Farzad Jalali, MD, MPH, is a researcher at Mashhad University of Medical Sciences, Iran. His areas of interest are substance abuse, addiction, prisoner's health, and smoking cessation. Currently, he holds the various positions, such as:

• Member of Mashhad Addiction Research Centre (ADRC)

• Manager of Mashhad Central Prison Triangular Clinic

THE AUTHORS

Reza Afshari, MD, MPH, MSc, PHD, is an associate professor and consultant toxicologist, Mashhad University of Medical Sciences, Iran.

His areas of interest are medical toxicology, substance abuse, and toxicoepidemiology.

Currently, Reza Afshari holds the various positions, such as:

• Founding member and Director; Addiction Research Centre (ADRC)• President; Asia Pacific Association of Medical Toxicology (APAMT)

• Editor in Chief; Future of Medical Education Journal (FMEJ)

• Editor in Chief; Asia Pacific Journal of Medical Toxicology (APJMT)

• Co-Founder; Medical Toxicology Research Centre (MTRC)

• Director; Medical Toxicology Centre (MTC) (Sept, 2012)

• Director; Education development Centre (EDC), (May, 2012

• Board Member; Iranian Society of Toxicology (IRANTOX)

• Member of Reference Group; World Health Organization (WHO)

• Young Affiliate of Academy of Sciences for the Developing World (TWAS)

• Founding member and Director; Imam Reza (p) Rehabilitation Centre

• Member of European Association of Poison Centers and Clinical Toxicologists (EAPCCT)

THE AUTHORS

Ali Babaei, MD, is manager of Educational and Research Centre, District XI of State Prisons, Mashhad, Iran, Islamic Republic of Iran. His areas of interest are harm reduction, prisoner's health, health policy, and health promotion.