User Experiences of Prescription and Over-The-Counter Drug Abuse in Aden City, Yemen

Community pharmacists' experience of gabapentin misuse and abuse: A quantitative study from Jordan

Gabapentin is an anticonvulsant that has an abuse potential. The aim of this study was to investigate the misuse and abuse of gabapentin in Jordan from the perspective of community pharmacists. A cross-sectional survey using a self-reported structured questionnaire was used with a convenience sample of pharmacists employed by various independent and chain community pharmacies. An online technique was used in this study using Google forms. A total of 215 questionnaires were completed, with 200 respondents (93%) reporting awareness of cases of gabapentin abuse in their pharmacies. Less than half of the respondents (n = 94; 43.7%) indicated that gabapentin requests were not accompanied by prescriptions. Almost two-thirds of respondents (63.6%) noticed an increased pattern of gabapentin abuse/misuse during the last 6 months. The study underscores the need for regulatory efforts and pharmacovigilance to manage potential gabapentin abuse, along with pharmacist and patient education at the community pharmacy, regarding potential abuse of gabapentin.

Challenges in substance use treatment as perceived by professionals and Arabic-speaking refugees in Germany

BACKGROUND

Substance use (SU) and substance use disorders (SUDs) have been recently documented among forcibly displaced populations as a coping mechanism to migration and postmigration stressors. Although the literature exploring substance use among refugees has grown recently, little is known about SU among Arabic-speaking refugees and, more specifically, on the challenges and experiences in regards to SU treatment. This study investigates this topic from the perspectives of Arabic-speaking refugees and professionals in Germany.

METHODS

Design and participants To expand our knowledge on this topic, a qualitative approach was employed by conducting in-depth and semi-structured interviews among 26 participants (13 refugees and 13 professionals) in Germany during 2020-2021. Purposive sampling was used to recruit Arabic-speaking refugees in two rehabilitation centers in Berlin. Data and analysis Interviews were conducted with 26 participants of which 13 were refugees and 13 professionals. Refugees were interviewed individually in the rehabilitation centers, they ranged from 21 to 52 years of age, and their average time in Germany was 6.3 years. An open-ended survey was conducted among the professionals via the SoSci-survey platform, and they ranged from 22 to 66 years of age, with an average of 5 to 9 years of work experience. Data were analyzed using thematic analysis.

RESULTS

Three themes resulted from the thematic analysis: (1) The treatment is facilitated by institutional and emotional support; (2) The affected refugees struggle with complex contextual barriers to access SUD treatment; and (3) Individual and community preventive strategies are needed.

CONCLUSIONS

This study provides insight into the support and challenges of accessing effective SU treatment and prevention among Arabic-speaking refugees in Germany. Collaborative efforts by the community, professionals, and policymakers are needed to facilitate access to effective treatment and implement culturally and linguistically sensitive approaches for the treatment and prevention of SU among refugees.

Role and challenges of community pharmacists in managing mental health care in Indonesia: A mix-method study

This research aims to explore roles and challenges faced by Indonesian community pharmacists in mental healthcare management. A sequential mixed method study was conducted. This study found that drug counselling as a pharmaceutical care service that is often given to patients with mental disorder. Nonetheless, inadequate training and concern of psychotropic drug abused were identified as a major barrier hindering effective service delivery. These finding suggests that there is a need for pharmacists to gain additional education and training in mental health, as well as implement a system that integrates patient medical records across all healthcare settings.

Paracetamol: unconventional uses of a well-known drug

OBJECTIVES

To describe and map what is known about unconventional uses of paracetamol through a scoping review of published literature by adopting adopted a PRISMA systematic approach methodology.

KEY FINDINGS

Four themes for unconventional uses of paracetamol emerged: (a) use of paracetamol in sleep (a-1) positive effect of paracetamol on sleep (n = 9) or (a-2) neutral or negative effect of paracetamol on sleep (n = 9); (b) use of paracetamol in sport (n = 13); (c) mixing paracetamol with drinks, waterpipe and illicit drugs (n = 5); and (d) miscellaneous uses (n = 4). Forty records were reviewed and charted. Available literature supports concern around the potential of harmful or non-medical use of paracetamol, especially among patients with a history of substance use, parents of young children or athletes.

SUMMARY

Paracetamol (acetaminophen) is one of the most popular and widely used drugs for the treatment of pain and fever. It is considered remarkably safe if used within instructions. However, there is growing evidence that paracetamol, is sometimes used outside approved indications or abused (i.e. used for non-medical reasons). This review highlights the need for enhanced pharmacovigilance and surveillance of non-medical paracetamol use and raising general public awareness of its potential dangers especially in higher than recommended doses.

A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications worldwide and have analgesic, antipyretic and anti-inflammatory properties. Although NSAIDs are recognised as generally safe and effective, non-medical and extra-medical use of these products can occur. Unlike the use of illegal and many prescription drugs, which are subject to extensive research attention, inappropriate use of NSAIDs has been less well investigated. This scoping review collates and describes what is known regarding non-medical and extra-medical use of NSAIDs. In total, 72 studies were included in this scoping review. Three themes emerged from the review: (1) indicative profile of people who engage in non-medical or extra-medical use of NSAIDs; (2) antecedents for non-medical or extra-medical use; and (3) adverse health effects of non-medical and extra-medical use of NSAIDs. The review concluded that there is a need for enhanced patient education, including among sports people; pharmacovigilance in terms of clinician recognition of aberrance; and prescriber and pharmacist awareness of the potential for extra-medical and non-medical use and the related health harms.

A Non-cutaneous Form of Melanoma in a Goat during Meat Inspection: a Case Report

Malignant melanoma is a neoplasm that originates from melanocytes. This tumor is observed in cutaneous and non-cutaneous forms, and it is considered one of the most life-threatening types of cancers. Non-cutaneous melanoma is a complex of unique and malignant complications that are easily separable from cutaneous type. Since the ultraviolet radiation from the sun damages DNA and is an oxidative stress factor in melanoma and there are more melanocytes in the basal layer of skin than other parts of the body, the cutaneous form has more prevalence. Most of the time, non-cutaneous form is the result of cutaneous metastasis but both forms can occur primarily. Furthermore, non-cutaneous form usually happens in mucosal layers, intestines, and eyes; moreover, the main reasons are ectopic melanocytes or their unwanted regressive growing. Malignant melanoma can occur in all domestic animals; however, they seem to be rare in sheep and goats. Herein, we describe a rare case of the primary non-cutaneous form of malignant melanoma in a three-year-old indigenous female goat. During meat inspection procedures in a slaughterhouse in Tabriz, Iran, we encountered numerous round firm black masses on visceral surfaces and serous membranes of the abdominal and thoracic cavities. The liver and lungs were prominently affected. Samples were taken from involved parts, and malignant melanoma was confirmed in the histopathological examination due to pleomorphism and polymorphism and melanin pigments in cells with eosinophilic cytoplasm. According to what was stated in the "manual on meat inspection for developing countries", the carcass was not convenient for human use and condemned by the inspector.

An insight into the pharmaceutical sector in Yemen during conflict: challenges and recommendations

In our world today, we need to understand, measure, and respond to inequality. The conflict and siege in Yemen have caused serious repercussions and consequences for the pharmaceutical sector and health of the people. Hospital, health centres and facilities, medicines warehouses and pharmaceutical factories have been destroyed. Further, the conflict has aggravated the health situation with shortages of medicines, an increase in chronic illnesses, and multiple epidemics and casualties. This article aims to highlight the challenges faced by the pharmaceutical sector in Yemen. It will address the overall state of health of the Yemeni people, as well as focus on the past, current status and future development of the pharmaceutical sector. Further, it will focus on possible remedial actions to solve some of these problems. These problems can be tackled if the responsible parties have the political will to do so. Acknowledging the different classes of problems is undeniably very important to provide clarity on the future of Yemen's supposedly promising pharmaceutical landscape.

Evaluation of Nasal Decongestants by Literature Review

Over-the-counter drugs are medicines that are available to consumers without a prescription. The most common оver - the-counter preparations in self - medication are nasal decongestants that can be used systemically or locally in the form of drops or nasal sprays. The most common indications for nasal decongest-ants are viral infections and allergic conditions in order to alleviate the symptoms so it is necessary to inform the users about the type of drug, the active substance it contains and the correct dosage regimen. Given their availability and the prevailing safety precaution, these preparations can lead to numerous prolonged conditions and complications. The mechanism of action of nasal decongestants is based on the reduction of blood vessels’ swelling in the nose, which helps the opening of the airway. As a result, most nasal decongestants cause vasoconstriction (narrowing of blood vessels). There are nasal decongestants that block histamine and have a good effect on people who suffer from seasonal allergies.

Availability (free sale) and prolonged use of the decongestant lead to a decrease in the sensitivity of the alpha receptor, which leads to the need to increase the dose at shorter time intervals to achieve the same effect. As a consequence, patients use excessive, uncontrolled doses of nasal decongestants, which is a public problem and warns of the necessity of identification and the taking of measures to prevent their uncontrolled procurement and use.