What Are Psychoactive Drugs?

Psychotropic drugs refer to drugs that directly act on the central nervous system to excite or suppress them, and continuous use can produce dependence ^[1] . According to the dependence of the human body on psychotropic drugs and the degree of harm to human health, it is divided into one and two types of psychotropic drugs ^[2] .

Chinese name: Psychotropic drugs
Foreign name: Spirit Drug

Category: Controlled drugs
Act directly on: Central Nervous System

Catalogue of Psychotropic Drugs

(2013 edition) ^[3]

the first sort

Brolamfetamine
Cathinone
3. Diethyltryptamine 3- [2- (Diethylamino) ethyl] indole
4. Dimethoxyamphetamine (±) -2,5-Dimethoxy-alpha-methylphenethylamine
5. (1,2-dimethylheptyl) hydroxytetrahydromethyldiphenylpyran 3- (1,2-dimethylheptyl) -7,8,9,10-tetrahydro-6,6,9-trimethyl- 6Hdibenzo [b, d] pyran-1-ol
6. Dimethyltryptamine 3- [2- (Dimethylamino) ethyl] indole
7. Dimethoxyethyl amphetamine (±) -4-ethyl-2,5-dimethoxy--methylphenethylamine
8. Eticyclidine
9. Etryptamine
10. Hydroxyphenamine (±) -N- [alpha-methyl-3,4- (methylenedioxy) phenethyl] hydroxylamine
11. Ergot Diethylamine (+)-Lysergide
12. Ethylphenamine (±) -N-ethyl-alpha-methyl-3,4- (methylenedioxy) phenethylamine
13. Dimethylene oxyamphetamine (±) -N, alpha-dimethyl-3,4- (methylene-dioxy) phenethylamine
14. Mescaline
15. Methcathinone
16. Krabi Rees 4-Methylaminorex
17. Methoxyphenamine 5-methoxy--methyl- 3,4- (methylenedioxy) phenethylamine
18. 4-Methylthioamfetamine
19. Parahexyl
20. Paramethoxyamphetamine P-methoxy-alpha-methylphenethylamine
21. Silo New Psilocine
22. Psilocybine
23. Rolicyclidine
24. 2,5-Dimethoxy-alpha, 4-dimethylphenethylamine
25. Tenamfetamine
26. Tenocyclidine
27. Tetrahydrocannabinol
28. Trimethoxyamphetamine (±) -3,4,5-Trimethoxy-alpha-methylphenethylamine
29. Amfetamine
30. Amineptine
31. 2,5-dimethoxy-4-bromophenethylamine 4-Bromo-2,5-dimethoxyphenethylamine
32. Dexamfetamine
33. Dronabinol
34. Fenetylline
35. Levamfetamine
36. Levomethamfetamine
37. Mecloqualone
38. Metamfetamine
39. Metafetamine Racemate
40. Methaqualone
41. Methylphenidate * Methylphenidate
42. Phencyclidine
43. Fenmetrazine Phenmetrazine
44. Secobarbital
45. Ziproprol
46. Amfepramone
47. Benzylpiperazine
48. Buprenorphine * Buprenorphine
49. 1-Butyl-3- (1-naphthoyl) indole 1-Butyl-3- (1-naphthoyl), indole
50. Catha edulis Forssk
51. 2,5-Dimethoxy-4-iodophenethylamine
52. 2,5-Dimethoxyphenethylamine
53. Dimethylamfetamine
54. Etaqualone
55. [1- (5-fluoropentyl) -1H-indol-3-yl] (2-iodophenyl) methanone (1- (5-Fluoropentyl) -3- (2-iodobenzoyl) indole)
56. 1- (5-fluoropentyl) -3- (1-naphthoyl) -1H-indole
57. -hydroxybutyrate * Gamma-hydroxybutyrate
58. Ketamine * Ketamine
59. Mazindol
60. 2- (2-methoxyphenyl) -1- (1-pentyl-1H-indol-3-yl) ethanone indol-3-yl) ethanone
61. Methylenedioxypyrovalerone
62. 4-Methylethcathinone
63. 4-Methylmethcathinone
64. 3,4-Methylenedioxy-methanone
65. Modafinil
66. 1-pentyl-3- (1-naphthoyl) indole 1-Pentyl-3- (1-naphthoyl) indole
67. Tapentadol
68. Triazolam

Second category

Isoprene barbitur * Amobarbital
Butalbital
3. Northephedrine Cathine
4. Cyclobarbital
5. Flunitrazepam
6. Glutethimide *
7. Pentazocine * Pentazocine
8. Pentobarbital * Pentobarbital
9. Alprazolam * Alprazolam
10. Aminorex
11. Barbital
12. Benfetamine Benzfetamine
13. Bromazepam
14. Brotizolam
15. Butobarbital
16. Camazepam
17. Chlordiazepoxide
18. Clobazam
19. Clonazepam * Clonazepam
20. Clorazepate
21. Clothiazepam
22. Cloxazolam
23. Delorazepam
24. Diazepam * Diazepam
25. Estazolam * Estazolam
26. Ethchlorvynol
27. Ethinamate
28. Ethyl Loflazepate
29. Etilamfetamine
30. Fencamfamin
31. Fenproporex
32. Fludiazepam
33. Flurazepam * Flurazepam
34. Halazepam
35. Haloxazolam
36. Ketazolam
37. Rifetamine Lefetamine
38. Loprazolam
39. Lorazepam * Lorazepam
40. Lormetazepam
41. Medazepam
42. Mefenorex
43. Meprobamate * Meprobamate
44. Mesocarb
45. Methylphenobarbital
46. Methyprylon
47. Midazolam * Midazolam
48. Nimetazepam
49. Nitrazepam * Nitrazepam
50. Nordazepam
51. Oxazepam
52. Oxazolam
53. Pemoline * Pemoline
54. Bendimetrazine
55. Phenobarbital * Phenobarbital
56. Phentermine
57. Pinazepam
58. Pipradrol
59. Prazepam
60. Pyrovalerone
61. Secbutabarbital
62. Temazepam
63. Tetrazepam
64. Vinylbital
65. Zolpidem * Zolpidem
66. Allobarbital
67. Buprenorphine Transdermal patch
68. Butorphanol and its injection *
69. Caffeine
70. Caffeine Sodium Benzoate
71. Dexfenfluramine
72. Dezocine and Its Injection
73. Ergotamine and Caffeine Tablet
74. Fenfluramine
75. Furfennorex
76. Nalbuphine and its injection
77. Paracetamol and Hydrocodone Bitartrate Tablet
78. Bingjijun Propylhexedrine
79. Tramadol
80. Zaleplon
81. Zopiclone

Note: 1. The above varieties include their possible salts and unilateral preparations (unless otherwise specified).

2. The above varieties include their chemical isomers (unless otherwise specified).

3. Psychotropic substances listed in the product list are the products produced and used in China.

Psychotropic drug production department

Psychotropic drugs are produced according to the plan by the production unit designated by the state. No other unit or individual may engage in the production of psychotropic drugs. The raw materials of psychotropic drugs and the production units of first-class psychotropic drugs are determined by the Ministry of Health in conjunction with the State Pharmaceutical Administration. The production units of the second category of psychotropic drug preparations shall be determined by the health administration departments of the provinces, autonomous regions and municipalities directly under the Central Government, together with the pharmaceutical administration departments at the same level.

Psychotropic Drug Supply Agency

The raw materials of psychotropic drugs and the first class of psychotropic drugs are uniformly allocated or purchased by the Ministry of Health in conjunction with the business unit designated by the State Pharmaceutical Administration; The operating unit shall not operate any other unit or individual.

Instructions for the use of psychotropic substances

Doctors should use psychotropic substances reasonably according to their medical needs, and abuse is strictly prohibited. Except for special needs, the prescription of the first type of psychotropic drugs should not exceed three daily dosages, and the prescription of the second type of psychotropic drugs should not exceed seven daily dosages. The prescription should be kept for two years for reference.

Problems with psychotropic drugs

In recent years, the State has successively introduced the "Regulations on the Administration of Narcotic Drugs and Psychotropic Substances" (hereinafter referred to as the "Regulations"), "Regulations on the Administration of Narcotic Drugs in the Medical Institutions, Type I Psychotropic Drugs" (hereinafter referred to as the "Regulations"), and "Prescription Management Methods "(Hereinafter referred to as the" Measures ") and a series of laws and regulations. These laws and regulations have effectively promoted the management of narcotic drugs and psychotropic drugs, but some practical problems have also been found in the implementation process, which need to be improved ^[4] .

Psychotropic medical records instead of "Dedicated Cards for Narcotic Drugs"

Article 21 of the Measures stipulates that: "If patients suffering from cancer pain in outpatient (emergency) and patients with moderate or severe chronic pain require long-term use of narcotic drugs and first-class psychotropic drugs, the first-visit physician shall personally inspect the patient and establish Corresponding medical records require the signing of the "Informed Consent Form." Only copies of the diagnosis and identification documents of the hospitals at level 2 or higher are required to be kept in the medical records. Compared with the previous application of the "Special Card for Narcotic Drugs", it is indeed more user-friendly, making it easier for patients to use narcotic drugs and first-class psychotropic drugs. However, it is easy for criminals to take advantage of such management loopholes, establish multiple medical records in different hospitals, and prescribe and purchase narcotic drugs multiple times. There is a hidden danger that narcotic drugs will flow into illegal channels. Because the current information management systems used by different hospitals are different, the information between the hospitals is not compatible, and patients can easily prescribe medicines in multiple hospitals and repeat prescriptions; or because the hospital's medical record management model has loopholes, it may even be You can get different prescriptions in the same hospital.

Where to use psychotropic injections

Article 21 of the "Provisions" stipulates: "Injectable narcotic drug formulations are limited to use in medical institutions or by medical staff to the patients' homes;" Article 22 of the Measures states: "Except for the long-term use of anesthesia Except for outpatient (emergency) cancer pain patients and patients with moderate or severe chronic pain, drugs and first-class psychotropic drugs, narcotic injections are limited to use in medical institutions. "Article 26 of the Measures states:" Pipeline hydrochloride Tiperidine prescription is a commonly used amount and is limited to use in medical institutions. "By restricting the place of drug use and directing medication to patients by medical staff, reducing intermediate links, the main purpose is to reduce the chance of narcotic drugs flowing into illegal channels. However, in the implementation process, we encountered practical difficulties. Due to the serious condition of most advanced cancer patients, it is impossible to require them to return to the hospital or stay in the hospital multiple times a day. It is also unrealistic to require medical staff to visit the patient's home multiple times a day. There are problems such as personnel, vehicles, and increased financial burden on patients. Secondly, the article also has doubts. The provisions of the Measures can be interpreted as patients with cancer pain and patients with moderate to severe chronic pain who need to use such drugs for a long time. They can be taken home after purchasing narcotic drugs and first-class psychotropic drugs. use.

Recall of empty ampoules and scraps of psychotropic substances

Article 27 of the "Provisions" stipulates: "When patients use narcotic drugs, first-class psychotropic drugs injections or patches, they should be required to return the empty ampoules or used patches of the original batch when they are redistributed. And record the number of empty ampoules or scraps that are recovered. "But during the execution of our pharmacists, we often encounter situations that cannot be recovered, such as patients who only use one injection or patch, or patients who have long-term medications, such as cancer, no longer use them. Due to the lack of a recovery mechanism, patients or family members generally do not actively return empty ampoules and scraps. If the pharmacist enforces it violently, it will easily lead to doctor-patient disputes and cause complaints from patients or family members.

Recovery of Psychotropic Drugs

Article 30 of the "Provisions" stipulates: "When patients no longer use narcotic drugs and first-class psychotropic drugs, medical institutions shall require patients to return the remaining narcotic drugs and first-class psychotropic drugs to medical institutions without compensation. Dispose of according to regulations. "During the use of narcotic drugs, due to the needs of patients, individualized injections were implemented, and the drugs remained ^[5] . From the perspective of patients and their families, it is difficult to understand and accept that they have spent money on medicines and returned them without compensation. The hospital is not binding on patients and their families. They want to return it, and they do not want to return it to the hospital. In addition, non-refund of drug fees may lead to doctor-patient disputes and reduce hospital patient satisfaction. Therefore, the hospital pharmacy is practical It is difficult for patients to return without compensation during operation ^[6] .

Problems with the rational use of psychotropic drugs

The "Measures" stipulates the dosage of prescriptions. Among them, the 23rd regulation: "Each prescription for narcotic drugs and first-class psychotropic drugs for outpatient (emergency) patients is a commonly used amount; controlled-release formulations, Each prescription shall not exceed the commonly used amount for 7 days; for other dosage forms, each prescription shall not exceed the commonly used amount for 3 days. "Article 24 of the Measures stipulates:" For patients with outpatient (emergency) cancer pain and moderate to severe chronic Prescriptions for narcotic drugs and first-class psychotropic drugs for patients with pain should not exceed the usual amount of 3 days per prescription; for controlled release preparations, each prescription should not exceed the usual amount of 15 days; for other dosage forms, each prescription should not exceed 7 days. "The above provisions do not clearly specify how much to use once or daily, the maximum limit for a single dose, the interval between medications, what are the special circumstances, the time that can be appropriately extended, etc. The pharmacist brought a lot of difficulties when adjusting the prescription, and could not guarantee the rational use of medicines. At the same time, there was a lot of flexibility in prescription medicines, which gave lawbreakers an opportunity. In addition, because morphine had no "ceiling effect", the country There have been relevant regulations on the use of morphine preparations for patients with cancer pain not subject to the extreme limits of the Pharmacopoeia. Is the use of morphine preparations in accordance with the Measures?

Registration of psychiatric drugs

Article 20 of the "Provisions" stipulates: "Medical institutions shall register a register of narcotic drugs and first-class psychotropic drugs, which shall include the name of the patient (agent), gender, age, identification number, medical record number, Disease name, drug name, specifications, quantity, prescription physician, prescription number, date of issue, drug issuer, reviewer. "Article 51 of the Measures stipulates:" Medical institutions shall be based on narcotic drugs and psychotropic drugs Prescriptions are registered in accordance with the types and specifications of narcotic drugs and psychotropic substances. The registration content includes the date of issue, the name of the patient, and the number of medications. "At present, the registration of narcotic drugs and psychotropic substances in hospitals is registered. They are different. Some hospitals register items according to the old "Regulations", while others follow the new "Measures."

Psychotropic Drug Problems

Establish a dedicated outpatient medical record and network information system for psychotropic drugs

For outpatients who require a long-term use of narcotic drugs and first-class psychotropic drugs for diagnosis, a special outpatient medical record should be established and kept in the hospital for unified management. In order to avoid the use of repetitive medical records to set up medicines for criminals, a computer network information system for anesthesia and psychotropic drugs should be established, which can cover all aspects of information from public security departments, health authorities, designated distributors, medical institutions and patients to achieve information The closed loop operation system of the shared circulation of anesthesia and psychotropic drugs ^[7] , thus effectively avoiding fraud and arbitrage.

Humanized service of psychotropic drugs , establishment of injection injection mechanism

Further enhance the humanized service concept. For patients diagnosed with long-term use of narcotic drugs and first-class psychotropic drugs, the location of use should be determined according to the patient's condition and in accordance with the principles of convenience and safety. The implementation of territorial management, the patient chooses the nearest hospital, and it is clear that the hospital is responsible for the distribution of such drugs. Establish and improve the out-patient mechanism for narcotic injections, include it in the government's special budget for the government, provide relevant financial support, and systematically guarantee manpower and material resources so that regulations can be truly implemented. It not only meets the needs of patients, but also reduces potential hidden dangers, which is beneficial to the management of anesthetic drugs.

Establish a mechanism for the recovery of empty ampoules, scraps and surplus medicines

The state should strengthen the legal education for patients and their families, vigorously publicize the legal consequences of illegally holding narcotic drugs or causing narcotic drugs to flow into illegal channels, and recommend that you sign an informed consent before use, and clearly inform that empty ampoules and waste stickers should be returned after use. And the remaining drug obligations, and make relevant punishments for violations to strengthen binding force. In addition, to establish a sound compensation mechanism for drug withdrawal, the state should take appropriate compensation measures, and provide appropriate financial compensation or rewards to the family members of patients who consciously hand over the remaining drugs, so as to effectively prevent such drugs from flowing into illegal channels. And because some narcotic drugs are expensive, can they be reused instead of simply destroyed to save social resources on the premise of ensuring the safety of medication.

Strengthen training of psychotropic drugs and rational use of drugs

The health department should strengthen the training of medical staff on the use of narcotic drugs and psychotropic substances, strengthen the drug education for patients and their families, and reduce the ideological burden on medical staff and patients. The "Three-step Pain Relief Program for Cancer Pain" recommended by WHO was further promoted, in accordance with the five principles, namely: the preferred non-invasive route of administration, step-wise administration, timely administration, dose individualization, and attention to specific details. When it is clear that morphine is used by patients with cancer pain, doctors should implement individualized administration according to the condition of the cancer patient and the physical tolerance of the patient. There is no limit on the use of morphine, and reasonable use of narcotic drugs and psychotropic drugs is provided to prevent cancer patients from pain.

Enforcement Rules and Regulations for Psychotropic Drugs

The relevant state departments should refine the statutory provisions that have doubts or ambiguous regulations, and combine years of experience in implementation to formulate relevant implementation rules to strengthen the operability and effectiveness of implementation. Otherwise, even if there are relevant regulations, if Without good implementation, the effect will be greatly reduced ^[4] .