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Non-medical use of baclofen: A case series and review of the literature
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  • Jean Marc Pelerin,
  • Lisa Fristot,
  • Valérie Gibaja,
  • Bruno Revol,
  • Pierre Gillet,
  • Juliana Lima-Tournebize
Jean Marc Pelerin
CHRU de Nancy

Corresponding Author:[email protected]

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Lisa Fristot
CHRU de Nancy
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Valérie Gibaja
CHRU de Nancy
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Bruno Revol
Centre Hospitalier Universitaire Grenoble Alpes
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Pierre Gillet
University Hospital of Nancy
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Juliana Lima-Tournebize
CHRU de Nancy
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Abstract

Aims: Baclofen is widely used for spastic disorders, and most recently for addictive disorders. The first signals of baclofen abuse occurred in the last decade. This study aims to assess the motives, diversion sources and routes of administration associated with the non-medical use of baclofen and examine health problems related to the non-medical use of baclofen. Methods: Spontaneous reports of baclofen abuse reported to the addictovigilance center of East France were analyzed. A literature search was simultaneously conducted using PubMed®, Web of Sciences®, and Google Scholar® databases. Both searches were performed in February 2021 without a time limit. Results: Forty-six cases were analysed (33-from the literature review and 13-from addictovigilance base). Baclofen’s non-medical use mainly affected male subjects with addictive history, but cases of primary abuse in subjects without any substance abuse history were also observed. Euphoria search was the most common reason for misuse. Route of administration included oral, snorting and sublingual use. Physicians were a common source for misused baclofen, but cases involving illegal sources were also observed. Most of the patients misusing baclofen presented serious complications, mainly represented by neurological and respiratory disturbances. Physical and psychological dependence to baclofen was observed in three persons. Conclusion: Although baclofen abuse remains relatively infrequent or (most likely) underestimated, this study helped to confirm the intrinsic abuse potential of baclofen and make visible the baclofen-abuse-related health harms. Careful consideration and benefit-risk analysis should be employed when prescribing baclofen, and emergency departments should be aware of baclofen dangers in abuse situations.