Misc benzonotate, remeron, seroquil

[livinginahaze]

ive got all these random scripts in my house that no one uses. remeron and seroquil are anti pyschotics i think and i dont even know about benonotate i think its for coughing or something. anyways do any of these things have any recreational value or no? i doubt it but figured it couldnt hurt to make sure before i toss them

 

[Kittycat5]

Not really. Remeron is an antidepressant and used for sleep. Benzonatate is indeed a cough suppressant but of no recreational value. Ive read prisoners try and use Seroquel to get high but have no idea if this is just urban legend and highly recommend not trying it.

 

[SKL]

No recreational value there (and stop raiding people's medicine cabinets, kiddo.) Remeron and Seroquel (in low doses) are good for sleep though.

Seroquel rec use in prison and institutional settings is a real thing, as unlikely as it may seem. I guess folks just will take anything that they can get. I guess it sort of zonks you off baseline and makes you not give a fuck but that's hardly anything that could be considered a high but ... it is even injected as a "Q-ball" (wtf?)

Intravenous Quetiapine-Cocaine Use ("Q-Ball")
BRIAN M. WATERS, M.D. and KAUSTUBH G. JOSHI, M.D.
San Antonio, Tex.
To the Editor: We have noted recent reports of quetiapine diversion and misuse among inmates in correctional settings where it is also called "quell" or "baby heroin" (1, 2). It is used orally, intranasally, and intravenously for its potent sedative and anxiolytic properties (1, 2). Inmates obtain quetiapine for illegitimate use by malingering of psychotic symptoms or obtaining it from other inmates. The high prevalence of substance use disorders in corrections and the secondary gain of serving out "easy time" with pharmacological assistance contribute to an underground economy of diverted psychoactive medications (3). Anecdotal reports from colleagues—as well as online testimonials—support the existence of quetiapine diversion and misuse in noncorrectional settings as well (4). The following case is an example of prescription medication diversion with concomitant illicit substance use seen in the local county hospital emergency room.


A 33-year-old married Caucasian male with a history of polysubstance dependence (cocaine, heroin, alcohol, benzodiazepines) reported to the local county hospital emergency room requesting assistance with drug detoxification and rehabilitation. The patient endorsed daily use of intravenous cocaine mixed with 400 mg–800 mg of quetiapine. Quetiapine was surreptitiously diverted from his wife’s prescription. He reported crushing the quetiapine tablets and mixing the resulting powder with cocaine and water. He subsequently heated the mixture and drew the supernatant through a cotton swab into a syringe to administer intravenously. When asked why he engaged in this drug mixture, he stated that it achieved desired "hallucinogenic" effects.

Combining prescription medications and/or illicit drugs is a common practice to synergistically heighten the intoxication from the substances while potentially reducing undesirable side effects. The combination of intravenous heroin and cocaine (also known as "speedball") is a well-known strategy to both maximize the cocaine "rush," while mitigating its "crash" (5). It may be hypothesized that quetiapine was substituted for heroin in our case (to form a "Q-ball") because the sedative/anxiolytic effects of quetiapine may mitigate the dysphoria associated with cocaine withdrawal and to possibly provide a "hallucinogenic" effect.

The case presented highlights the unknown effects (such as a "hallucinogenic" experience) of combining substances with different pharmacological properties and subsequently circumventing first-pass metabolism through intravenous administration. Individuals who use oral medications intravenously have the potential to develop significant pulmonary complications secondary to the deposition of medication binders in lung parenchyma. Furthermore, the cardiovascular and arrhythmogenic properties of cocaine may be amplified in combination with quetiapine (which has a risk of QTc prolongation). Physicians should remain cognizant of potential medication diversion and misuse in noncorrectional settings.

Hallucinogenic effects? WTF? There's no way. Some kind of delirium maybe but nothing pleasant. And combining with cocaine is just nuts, only going to give as they say cardiac risk and attenuate all that's good about cocaine.

(OP plz don't try for it)

Quetiapine Addiction?
EMIL R. PINTA, M.D.
Columbus, Ohio and ROBERT E. TAYLOR, M.D.
Cambridge, Ohio
To the Editor: Quetiapine is not a controlled substance and is not considered addictive. Yet there are several reports describing abuse among inmates in jails and prisons (1, 2).

The pharmaceutical formulary for the Ohio correctional system contains three second-generation antipsychotics, but quetiapine is not one of them. It may be prescribed with special authorization for patients with serious mental disorders who have not responded to formulary agents. However, inmates entering prison on quetiapine for other conditions, such as sleep and anxiety disorders, must have it tapered and discontinued.

The authors have treated a number of inmates who have engaged in drug-seeking and sometimes illegal behavior to obtain this medication. The following case is illustrative:


A 39-year-old incarcerated male with hepatitis C and a history of opiate abuse was treated for generalized anxiety disorder. When seen by the prison psychiatrist, he was receiving quetiapine 800 mg and clonidine 0.9 mg at bedtime.
The psychiatrist was concerned about the risks of prescribing an antipsychotic medication for a patient with hepatitis without a serious mental disorder. The patient refused to discuss other treatment alternatives stating, "I need my Seroquel." Efforts to enlist his cooperation for a quetiapine taper were unsuccessful. He abruptly left a treatment team meeting and informed staff that he would purchase quetiapine illegally from other inmates and had done this before.


We have treated other prisoners who have threatened legal action and even suicide when presented with discontinuation of quetiapine. We have not seen similar drug-seeking behavior with other second-generation antipsychotics of comparable efficacy. Emil R. Pinta, M.D. has worked as a prison consultant for 35 years and can only recall similar behavior to obtain controlled substances.

Hussain et al. suggest that quetiapine abuse may be more prevalent among prisoners because commonly abused drugs are less readily available (2). Another reason may be that quetiapine treats anxiety and sleeplessness associated with substance use withdrawal—with prisoners having high rates for these disorders (3). However, an internet search yielded a number of self-reports by individuals who believe they have become addicted to this agent (4). There is a popular rap song in which "seroquel" is included in a long list of addictive substances (5). In street jargon, quetiapine is known as "quell" and "Susie-Q."

Our experience indicates the need for additional studies to explore the addiction-potential of quetiapine. Quetiapine is an effective medication for treatment of schizophrenia, bipolar disorder, and related illnesses. We believe clinicians should be extremely cautious when prescribing this medication for nonserious mental disorders and for individuals with histories of substance abuse.

Prisoners and my patients abuse all kinds of stuff. They will deliberately act up to get i.m. Ativan but even like getting shot up with Thorazine which I can scarcely believe. Some of them seek out Cogentin, too, which I find odd although it is a tropane it has none of the reinforcing properties of one...