Drugs of Abuse: A Clinical Reference Guide for Healthcare Professionals

This series is designed exclusively for educational and clinical awareness purposes. It follows the format used by pharmacology textbooks (Goodman & Gilman’s, KD Tripathi’s Essentials of Medical Pharmacology) and public health agencies (NIDA, WHO, NIMHANS) to educate healthcare professionals on substances commonly diverted for recreational misuse.

If you or someone you know is struggling with substance dependence, please contact NIMHANS (080-46110007) or the National Drug Helpline (1800-11-0031).

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How This Reference Is Organized

Each drug entry includes:

• INN / Salt Name (International Non-proprietary Name)
• Common Indian Brand Names
• Drug Class & Schedule (H / H1 / X / NDPS)
• Legitimate Medical Uses
• Mechanism of Action (why it produces psychoactive effects)
• Why It Is Abused (clinical context for healthcare providers)
• Side Effects & Dangers of Abuse
• Signs a Clinician Should Watch For (to identify patients diverting medications)

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📑 The Series by Drug Class

Class 1: Opioid Analgesics

• Part 1: Codeine, Tramadol, and Tapentadol Mild to moderate opioids commonly diverted from pain and cough prescriptions.
• Part 2: Morphine, Fentanyl, Pethidine, and Buprenorphine Strong opioids reserved for severe pain and palliative care.

Class 2: Benzodiazepines & Z-Drugs

• Part 3: Alprazolam, Diazepam, Lorazepam, and Clonazepam The most commonly abused sedative-hypnotics in India.
• Part 4: Zolpidem, Zopiclone, and Nitrazepam Non-benzodiazepine hypnotics and older sedatives.

Class 3: Gabapentinoids

• Part 5: Pregabalin and Gabapentin The rapidly emerging class of abused nerve-pain medications.

Class 4: Stimulants

• Part 6: Methylphenidate, Modafinil, and Amphetamines CNS stimulants used for ADHD and narcolepsy.

Class 5: Dissociatives

• Part 7: Ketamine, Dextromethorphan, and Nitrous Oxide NMDA antagonists and anesthetic gases diverted for recreational use.

Class 6: Anticholinergics & Antihistamines

• Part 8: Promethazine, Diphenhydramine, and Trihexyphenidyl OTC and prescription drugs abused for their deliriant and sedative effects.

Class 7: Muscle Relaxants & Miscellaneous CNS Depressants

• Part 9: Carisoprodol, Cyclobenzaprine, and Barbiturates Older sedatives and muscle relaxants with significant abuse potential.

Class 8: Anabolic Steroids & Performance-Enhancing Drugs

• Part 10: Nandrolone, Stanozolol, Testosterone, and hGH Substances diverted from medical use into gyms and athletics.

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🛡️ Important Notice for Readers

This reference exists because a doctor who cannot recognize diversion and abuse patterns cannot protect their patients. The clinical signs of a patient who is “doctor shopping” for benzodiazepines, or who is crushing and snorting their Pregabalin tablets, are specific and recognizable — but only if the clinician knows what to look for.

This series does NOT provide:

• Dosing information for recreational use
• Instructions on how to obtain these substances outside legal channels
• Encouragement of any form of substance misuse

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Last Reviewed: May 2026. Sources: NIDA (NIH), WHO, NIMHANS, KD Tripathi’s Essentials of Medical Pharmacology, Goodman & Gilman’s The Pharmacological Basis of Therapeutics.