Psychotropic drugs evaluated in the context of narcotic drugs according to the new Turkish criminal law

Abstract

Aim: The new Turkish Criminal Law, numbered 5237, has been legislated and implemented in 2004. The 188th article of this Act is entitled "Production and commerce of narcotic and stimulative material." The content of the 6th paragraph of this article is a new approach in the Turkish Penal system, in which "every kind of material which is produced under the permission of public authority or is sold by prescription written by an authorized physician and shows narcotic or stimulative effect may be evaluated as a listed drug." Legal investigations concerning some sedative, anxiolytic, or psychotropic medicines, which were previously marketed as 'legal highs or legal narcotics,' started with the implementation of the Act. In this context, the expert opinion of the 5th Expert Board of the Council of Forensic Medicine about these medications has been asked by concerned prosecutors or courts. In our study, we evaluated the files that were sent to the 5th Expert Board for expert opinion about this subject. The aim was to determine the physical and chemical characteristics of medications that were seized to determine whether they fell within the scope of the 6 th paragraph of the 188th article. Materials and Method: The files, which were sent to 5th Expert Board of The Council of Forensic Medicine between January 1, 2008 and December 31, 2009 for expert opinion as to whether the seized drugs were within the scope of the 6 th paragraph of the 188th article of the Turkish Penal Law,number 5237, were investigated retrospectively. The files were examined in terms of the name and location of the legal organisation sending the file, the content, form, and amount of drugs, and also whether there were any other narcotic materials present within the drugs (as a mix) or as a separate dosage form in the same prosecution. Results: Benzodiazepines were the most common medications (82.3%) among the drugs evaluated in scope of the 6th paragraph of the 188th article of the Turkish Penal Law, numbered 5237. The most frequently seized drugs in each of the two years were clonazepam, biperiden, diazepam, alprazolam, phenobarbital, ketamine, lorazepam, and zopiclone, respectively. The total number of files reduced 43% in 2009 with respect to the previous year. In more than half of the files (67%) only medications were seized and no other narcotic or stimulant materials were involved. Twenty seven percent of the files included an internationally listed drug (mostly marijuana) beside medications and the remaining six percent were confiscated together with other medically active substances, which had either stimulative or narcotic effect. The seized substances were mostly in tablet form. Although the number of tablets seized were ≤10 in 53% of the seizures, the number was greater than 1000 in four seizures (2.8 %). MDMA, an internationally listed narcotic and stimulative substance, was confiscated in two seizures together with phenobarbital and ketamine tablets. In one of the seizures, 8 different active substances were found within the ingredients of one tablet. Conclusion: In many countries, the prescription of some medicines, that are not internationally listed drugs, is limited in order to prevent their abuse, because of their narcotic or stimulative effects beside their therapeutic effects. In Turkey there are green and red prescription regulations on this subject. However in daily life, it seems that these drugs are prescribed by various physicians for short intervals and in more than required quantities. They are also sold by various pharmacies. As there is no national computerized data base, these drugs cannot be accounted for, especially when the cost of the prescription is directly paid by the buyers. In addition, it is difficult for physicians to make a decision in a brief clinical interview as to whether the complaints of a patient are real or not. Our results have demonstrated that a certain portion of these drugs were smuggled in rather than prescribed. When the misuse of these medicines, which have addiction and abuse potential, is determined by a forensic investigation, evaluating them within the scope of 188/6 of the Turkish Penal Law has been very helpful to reduce the demand for them as narcotics. The law may also have played a role in the great reduction in the number of seizures of these materials in the second year of our study.