The State Food and Drug Administration, the Ministry of Public Security, and the National Health Commission issued an announcement on adjusting the list of psychotropic drugs, including dextromethorphan, diphenoxylate-containing compound preparations, nalfuraphine, and lorcaserin in the list of Class II psychotropic drugs; The midazolam API and injection were adjusted from Class II psychotropic drugs to Class I psychotropic drugs, and other unilateral preparations of midazolam remained Class II psychotropic drugs. It will be officially implemented on July 1.
Now let's review the knowledge of these drugs~
Dextromethorphan
Dextromethorphan is generally referred to as dextromethorphan hydrobromide cough suppressant. Once dextromethorphan is overdosed, it is easy to become addictive for a long time. In extreme cases, the person taking the drug may die due to respiratory depression. Long-term abuse can cause brain damage and mental confusion.
As a result, dextromethorphan is at risk of abuse in life, and the abuse is mainly adolescent. Prior to this, dextromethorphan had undergone a regulatory upgrade from over-the-counter to prescription drugs.
Diphenoxylate-containing combinations
Diphenoxylate-containing combination preparations (i.e., diphenoxylate in the drug composition) are used for the treatment of enteritis, used for acute and chronic functional diarrhea and chronic enteritis. Its main ingredient, diphenoxylate, is an odorless white crystalline powder, which has a similar effect to morphine on the intestine, and promotes the absorption of intestinal water by inhibiting intestinal mucosal receptors. Combined with anticholinergic drug atropine, synergistically strengthens the inhibitory effect of intestinal peristalsis.
Diphenoxylate is a derivative of meperidine (demerol), which is a synthetic opioid receptor agonist, belonging to a phenypiperidine derivative, is a synthetic analgesic for clinical application, with central nervous system inhibition, antispasmodic and analgesic effect, large doses can bring euphoria, long-term use can form dependence.
Nalfuraphine
Nalfuraphine, commonly referred to as nalfuraphine hydrochloride oral disintegrating tablets in mainland China, is often used to improve pruritus in hemodialysis patients (only if the response to existing treatments is not satisfactory).
The mechanism of action of nalfuraphine hydrochloride is mainly to activate opioid kappa receptors, thereby inhibiting the release of neurotransmitters and inhibiting pain signaling. Clinical trials have found that some typical kappa agonists produce hallucinogenic and anxiety and sedative adverse effects.
Locarcelin
Locaserin is an orally effective and selective serotonin 2C receptor agonist that has been used to treat obesity. However, it can also bring serious physical discomfort, such as headache, dizziness, fatigue, nausea, serotonin syndrome (a series of symptoms caused by hyperfunction of serotonin in the nervous system, including anxiety, tremors, confusion, etc., and in severe cases, it can be life-threatening).
Midazolam
Midazolam is a short-acting benzodiazepine sedative-hypnotic drug, which is mainly used to treat insomnia, and can also be used to induce sleep before surgery or diagnostic examination, which can improve the analgesic effect of anesthetics.
The drug mainly works with the central inhibitory neurotransmitter y-aminobutyric acid (GABA) to produce a central inhibitory effect, and exert hypnotic and sedative effects. In addition, the drug has anxiolytic, anticonvulsant and muscle relaxant effects.
Possible adverse effects of long-term use of the drug include psychiatric abnormalities (confusion, mood abnormalities), depression (pre-existing depressive symptoms may recur during drug use, and older people are more likely to have such reactions), physiological dependence (withdrawal may produce withdrawal symptoms rebound, including rebound insomnia, mood changes, anxiety and agitation), and may also produce psychological dependence.
In addition, the Ministry of Public Security, the National Health Commission and the National Medical Products Administration jointly issued the Announcement on Listing 46 Substances such as Bromine Coffee in the Supplementary Catalogue of Controlled Varieties of Non-medical Narcotic Drugs and Psychotropic Substances, and decided to add 46 new psychoactive substances such as bromine to the list, which will come into force on July 1, 2024.
Non-medical narcotic drugs and psychotropic substances
Supplementary Catalogue of Controlled Varieties
Reminder
Drug abuse addiction is very harmful, it will cause physical and psychological trauma to us, make our social function deteriorate, family relations are seriously damaged, if not treated or not properly treated, it is easy to embark on the road of drug abuse and even theft and other illegal crimes, affecting social stability.