Gabapentin is the single biggest problem drug of abuse in many correctional systems. Some folks consider the word "narcotic" synonymous w/ any mind altering substance. Narcotic is more of a law enforcement word than a medical one. It is subject to the Controlled Substance Act (some people feel this defines narcotic) I believe it is a schedule 4 drug which is a lower abuse potential drug classification.It unfortunately is often not recognized as a potential drug of abuse in the medical community at large. Depending on how it is abused, trazodone can be primarily sedating or primarily euphoric. Wellbutrin is an antidepressant with many acceptable substitutes such as venlafaxine (Effexor) and duloxetine (Cymbalta). Imodium is a commonly prescribed diarrheal treatment with opioid receptor activity. Duloxetine (Cymbalta) has been shown to be a superior drug for use in treating neuropathic pain. Trazadone is a poor antidepressant and can easily be replaced with many others. Due to its high abuse potential, it should be rarely used. Imodium’s abuse potential should be considered when prescribing it, especially since most cases of mild diarrhea do not need any treatment. Even if a particular inmate doesn’t care about getting high himself, he can still profit by selling these drugs to others who are.
Trazodone is a poor antidepressant and can easily be replaced with other, better antidepressants that have much less abuse potential. Many better medications for nasal complaints are available and so decongestants rarely need be prescribed. These drugs are used to get a euphoric “high.” Gabapentin (Neurontin). Gabapentin is commonly prescribed off label for neuropathic pain and other chronic pain syndromes. Effexor is an antidepressant with many substitutes such as Cymbalta and the SSRIs. If you are addicted, or even if you just like to get high once in a while, and you can’t obtain your preferred drugs of abuse because you are incarcerated, these are the drugs that can serve as an alternative in a pinch.It is critically important for medical professionals in corrections to know which seemingly benign drugs have the potential to be abused and diverted.The practice of Correctional Medicine has many strange differences from medicine outside the walls.It took me a couple of years to get comfortable with the various aspects of providing medical care to incarcerated inmates.