Smoking crushed hyoscinescopolamine tablets as drug abuse.
Hyoscine N-butyl bromidescopolamine (HS) is a type of anticholinergic agent that is commonly used as an antispasmodic drug. We have evaluated the effects of crushed HS smoking in prisoners who illicitly abused this drug. All imprisoned cases with at least a 3-month history of HS were evaluated from April 2012 to September 2012. Demographic information, history, and clinical findings were studied. In total, 36 male cases with a mean (SD, min-max) age of 33.3 (3.6, 27-42) years were included. All subjects were cigarette smokers with a history of substance abuse and were under Methadone Maintenance Therapy (MMT). The majority (75%) of participants smoked HS tablet with pin, and others used aluminum foil. Hallucinations were the most common neurological features. Amnesia (88%), insomnia (83%), palpitation (86%), flushing (86%), irritability (94%), and inability to concentrate (91%) were the most common findings. Among them, auditory (61%), visual (72%), and tactile (72%) hallucinations were reported. This is the first case study of hyoscine smoking abuse. We found that HS acts similar to other hallucinogens. Concurrent abuse of HS in cases under MMT could be a future trend of abuse. Clinicians should be aware of abuse potential of HS in treatment of some patients for drug overdose.