Nalbuphine hydrochloride dependence in anabolic steroid users

Nalbuphine hydrochloride, a nonscheduled apioid agonist/antngonist analgesi c, is currently approved for the treatment of pain. Recently, nalbuphine de pendence was reported in three anabolic steroid users in Britain. To furthe r document this phenomenon, we conducted interviews on eleven subjects who reported nalbuphine use. Eight subjects were clinically dependent on nalbup hine, and seven of the subjects who were asked about tolerance and withdraw al with nalbuphine acknowledged these symptoms. Eight subjects, who had nev er used drugs intravenously before, reported using nalbuphine by th is rout e, Nalbuphine-related morbidity was extensive and included medical complica tions and Psychiatric symptoms. Nalbuphine users also exhibited a high rate of comorbid Axis I disorders, including other substance misuse. Virtually all subjects described widespread nalbuphine use in the gymnasiums they fre quented. these observations, together with the recent increase in nalbuphin e-related articles in the lay press, suggest that nalbuphine may represent a new drug of abuse among athletes, especially those using anabolic steroid s, and that nalbuphine's scheduling status may need to be re-evaluated.