Prescription pharmaceutical misuse on the rise


green and white antibiotics

Misuse of pharmaceuticals is now responsible for more deaths than illegal drugs, new data show

A new report from the Australian Institute of Health and Welfare, Non-medical use of pharmaceuticals: trends, harms and treatment: 2006-07 to 2015-6, shows that the number of Australians misusing pharmaceutical drugs is rising.

The report looks at two main types of pharmaceuticals: opioid analgesics, including morphine, codeine and tramadol; and benzodiazepines.

“Over the past decade, there has been a substantial rise in the number of deaths involving a prescription drug, with drug-induced deaths more likely to be due to prescription drugs than illegal drugs,” says AIHW spokesperson Matthew James.

In 2016 there were 1,808 drug-induced deaths in Australia, with benzodiazepines the most common single drug type, identified in 663 drug-induced deaths.

This is followed by 550 deaths from other opioids (including prescription painkillers such as oxycodone, morphine, and codeine).

The report shows that in 2016 about a million Australians (4.8% of the total population) aged 14 years or older had misused a pharmaceutical drug in the past 12 months. This was up from 3.7% in 2007.

In 2016, the non-medical use of pharmaceuticals was higher than all illegal drugs, except cannabis (10.4%).

The general trend is consistent with international observations: the AIHW singles out non-medical use of pharmaceuticals and resulting harms especially in the United States and Canada, where these are also rising.

The rate of dispensed prescriptions for opioids has risen by 24% —from 36,900 per 100,000 population in 2010–11 to 45,600 per 100,000 population in 2014–15, while prescriptions for benzodiazepines have remained fairly stable.

NSW Pharmacy Guild president David Heffernan told the AJP that while the data in the AIHW report pre-dates the introduction of MedsASSIST in March 2016, it supports later MedsASSIST data which show 98% of patients using OTC codeine were doing so correctly.

He says the AIHW report states that “misuse includes for non-medical purposes or in doses or frequencies other than those prescribed”.

“Misuse does not mean abuse,” Mr Heffernan says. “For example, it may mean a person accidentally took two instead of one Panadeine.

“The prescription death rate is concerning. The data suggests that some patients with a prescription addiction may have previously sought access to OTC medication before MedsASSIST.”

The report highlights the need for vigilance and better exchange of information between health professionals, he says.

“It also highlights the need for better post-hospitalisation reconciliation of medicine use—where many addictions arise.

“Above all, the report shows the need for mandatory national real time recording of medicines which are subject to abuse and dependence or cause harm.

“The real time recording must operate across pharmacies and doctors’ surgeries to be effective. As from February 1 there will be no real time monitoring system in place and there is no system in place to monitor prescription opioids.

“While the report mentions the announcement of a federal real time monitoring program, it is still just that—an announcement.”

Earlier this year, the AIHW’s 2016 National Drug Strategy Household Survey showed that Indigenous Australians were more than twice as likely to have recently used a pharmaceutical for non-medical purposes than non-Indigenous Australians.

The Survey also found people living in remote or very remote areas were almost twice as likely as those living in major cities to have recently used a pharmaceutical for non-medical purposes.

“This finding also held true for Australians living in the most disadvantaged socioeconomic areas, with 6% having recently misused pharmaceuticals compared with 4.2% of those in the most advantaged areas,” saiys Mr James.

Recent users of pharmaceuticals for non-medical purposes were also more likely than those who had not misused pharmaceuticals to experience mental illness (29% compared with 15.2%), chronic pain (15.9% compared with 10.3%), and high or very high levels of psychological distress (24.1% compared with 10.9%).

More people are seeking treatment for opioid analgesics, an increase from 56% in 2006–07 to 73% in 2015–16.

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