Non-Medical Pharmaceutical Use

Non-medical pharmaceutical use refers to consuming a prescription or over-the-counter drug for non-therapeutic purposes or other than directed by a registered healthcare professional (Larance et al., 2011).

Uses of Pharmaceutical Drugs

Pharmaceutical drugs may be used for a range of reasons including to induce euphoria, to enhance the effects of alcohol and other drugs, to self-medicate illness or injury, to mitigate the symptoms of withdrawal from alcohol and other drugs or to improve performance.

Non-medical use of pharmaceutical drugs is a public health problem in Australia. While the prevalence has recently decreased their associated harms are significant and include mortality due to toxicity. Lifetime rates of unsanctioned use of pharmaceutical drugs in Australia has decreased from 12.8 percent in 2016 to 11.7% in 2019. Interestingly, opioid analgesics were the most commonly misused class of pharmaceutical, making it the second most used illicit drug after cannabis and in 2019, it was the fourth most common (AIHW, 2019).

Who Uses Non-Medical Pharmaceuticals?

Non-medical use of pharmaceuticals is considered as acceptable by 28% of Australians, which is higher than the level of acceptability for use of other drugs such as cannabis or methamphetamine. In 2016, people living with a mental condition (29%) or chronic pain (16%) reported higher levels of non-medical use of pharmaceuticals than those without these conditions (AIHW, 2017). In the same year, Aboriginal and Torres Strait Islander persons were 2.3 times more likely to use pharmaceutical drugs as non-Indigenous people.

People who inject drugs also have higher rates of non-medical pharmaceutical use and many use these as substitutes for illicit drugs, such as heroin. The 2018 Illicit Drug Reporting System (Peacock et al., 2018) showed that respondents reported recent non-medical use of pharmaceutical opioids, including morphine (22%), buprenorphine (17%), oxycodone (14%) and fentanyl (7%).

Harms Associated With Non-Medical Use of Pharmaceuticals

The health harms associated with the non-medical use of pharmaceutical drugs includes overdose, falls, decreased cognitive function and memory loss, mental health problems (such as depression and anxiety), menstrual irregularities and sleep problems (Nicholas, Lee & Roche, 2011; NSW Ministry of Health, 2017).

In 2016–17, 59 per cent of drug-related hospital admissions were due to sedatives and hypnotics, such as benzodiazepines, and 87 per cent of these also involved alcohol (AIHW, 2018b).

Non-Medical Pharmaceutical Deaths

Between 2006 and 2016, deaths, where benzodiazepines or other opioids were present, rose by 168 per cent and 127 per cent, respectively. Of the 1,808 drug-induced deaths in 2016 (rate of 7.5 per 100,000 population) reported by the ABS, the most common substance present was a benzodiazepine (37%) followed by other opioids such as oxycodone, morphine and codeine (30%) (ABS, 2017). In over 96% of drug-induced deaths where benzodiazepines were present, they were taken in conjunction with other drugs including alcohol.

References

Australian Institute of Health and Welfare. (2017). National Drug Strategy Household Survey 2016: detailed findings [Drug Statistics series no. 31, Cat no. PHE 214]. Retrieved from https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-detailed/contents/table-of-contents