Early signal of diverted use of tropicamide eye drops in France

Abstract

These results represent the first early warnings of a tropicamide diverted use in France. Tropicamide abusers would seek euphoria or hallucinations. The high doses involved in intravenous administration could lead to serious complications.

The Misuse and Abuse of Ophthalmic Preparations: a Scoping Review of Clinical Case Presentations and Extant Literature

“…Cognitive impairment and weight loss are common (Bersini et al 2015). IV injections of tropicamide were reported in heroin users to intensify the effect and when self-medicating to delay withdrawals (Spagnolo et al 2013;Bersani et al 2013;Bozkurt et al 2014;Kuliev 2014, 2015;Bersani et al 2015;Otiashvili et al 2016;Ponté et al 2017). These injections are concerning, particularly given the clinical outcomes such as psychosis, dependence, injecting harms, and cardiovascular toxicity Kuliev 2014, 2015).…”

“…Early warning reports and mini-reviews have highlighted the issue of recreational and selfmedicating misuse of these drugs (Kadri et al 2010;Bersini et al 2013;Prilutskaya and Kuliev 2014;Bersini et al 2015). Most commonly reported ophthalmic preparations are those containing anticholinergics, antihistamines, and/or decongestants, such as tropicamide, cyclopentolate, naphazoline, and antazoline (Darcin et al 2011;Wazaify et al 2016;Ponté et al 2017). Other ophthalmic drugs liable for abuse are the topical anaesthetic drugs (TADs), such as proparacaine, lidocaine, benoxinate (oxybuprocaine), cocaine and tetracaine, and topically applied non-steroidal anti-inflammatory drugs (NSAIDs) (Rapuano 1990;Flach 2001;Erdem et al 2013;Sharifi et al 2013).…”

Addictovigilance contribution during COVID-19 epidemic and lockdown in France

“…Detecting and identifying signals are a cornerstone for addictovigilance actors: they need to be able to label a piece of information received as a signal [5,10,20,25,[31][32][33]. Signals suggesting a public health risk are collected and analysed in continuous manner in a surveillance process implemented by watchdog or public health structures, in a perspective of alert, anticipation and early action.…”

“…As a reminder, OSIAP is one of the national program implemented by the French addictovigilance network in the 1990s to record all falsified prescriptions presented to a network of community pharmacies located all over the country [11,12]. This monitoring program has been useful to identify addictovigilance signals or characterize the abuse potential of prescription drugs [32,[39][40][41]. Usually, OSIAP are periodically collected each year (in May and November) on a voluntary basis by sentinel pharmacies [12].…”

Identification and tracking of addictovigilance signals in general practice: which interactions between the general practitioners and the French addictovigilance network?

“…Over time, this monitoring system has developed as a network of regional centers with the aim to collect as well as analyze cases of abuse and pharmacodependence in the French context, thus providing scientific knowledge and pharmacological expertise to the national and regional French health authorities . For more than 25 years, this specific and original safety monitoring system has been able (i) to identify problematic use of diverted drugs, such as propofol , (ii) to early identify deleterious outcomes of illicit or not well‐known psychoactive substances, such as acute vascular events with cannabis , (iii) to identify signals before the first appearance of clinical or psychiatric complications of drug use, such as with methylphenidate or tropicamide , (iv) or to define new patterns of drug use . The word ‘Addictovigilance’ is the contraction of the terms ‘addiction’ and ‘vigilance’.…”