The consequences of drug misuse on post-marketing surveillance

Over the past decade, the ‘traditional’ drug scenario has shown significant changes because of the emergence of a range of molecules, e.g. the novel psychoactive substances (NPS), which are either already existing or newly created
molecules [1]. A range of prescribed medications are currently being used as NPS [1]. Overall, the misuse and diversion of medications is a significant and increasing public health concern [2], with 5.4% of British respondents aged 16–19 years old having abused a prescription drug in the past 12 months [3]. It
is a matter of concern that, for a range of prescribing molecules (e.g. gabapentinoids), the formal pre-marketing processes had not been able to appropriately identify their potential for abuse, a potential which has however emerged overtime [4,5]. Similarly, drugs such as benzodiazepines and
z-hypnotics were considered ‘safe’ for many years before their
addictive liability levels were identified.

Hence, in this article, we aimed at commenting on the different factors relating to pre- and post-marketing prescription drugs’ abuse liability assessment; issues likely to be complicated by recent changes in drug scenarios.