Pulverizing medication as a harm reduction and intentional drug overdose prevention strategy: Two case studies

• Main Authors: Mitsui, N. (Author), Okazaki, D. (Author), Takanobu, K. (Author), Tanaka, T. (Author), Watanabe, S. (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Inc 2021
• Subjects: adult; alprazolam; Article; auditory hallucination; automutilation; brotizolam; case report; clinical article; delusion; depression; disorientation; drug overdose; Drug Overdose; female; Female; follow up; harm reduction; Harm Reduction; hospital discharge; human; Humans; impulse control disorder; impulsiveness; insomnia; intelligence quotient; levomepromazine; medication compliance; mental disease; motivation; non prescription drug; off label drug use; patient compliance; perception disorder; powder; prodromal symptom; Prospective Studies; prospective study; pulverization; risk reduction; risperidone; schizophrenia; suicidal ideation; suicide; Suicide; suicide attempt; suicide attempted; suicide prevention; Suicide, Attempted; tablet; tranquilizer; trazodone; valproic acid; Wechsler adult intelligence scale; young adult; zolpidem
• Online Access: View Fulltext in Publisher
• ISBN: 2574173X (ISSN)
• DOI: 10.1002/npr2.12189

Aims: We explored the use of pulverized medication as a new method to prevent intentional drug overdose. Methods: This case study presents data obtained from the medical records of two female patients, aged 19 and 27 years, who presented with schizophrenia and neurodevelopmental disorder, respectively. Both patients provided written informed consent. Medication was administered to the two patients in powdered form, as opposed to in tablet form, in an attempt to prevent intentional drug overdose. Results: This administration method successfully prevented intentional drug overdose for 3 and 5 years in each case, respectively. However, case-control or prospective cohort studies are needed to rule out biases, including cognitive bias. Conclusion: Pulverizing medication is a simple and effective means of preventing intentional drug overdose by restricting access to the means of suicide, regardless of the type of mental disorder. © 2021 The Authors. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Neuropsychopharmacology.