The sources of pharmaceuticals for problematic users of benzodiazepines and prescription opioids
Nielsen, S and Bruno, R and Degenhardt, L and Stoove, MA and Fischer, JA and Carruthers, SJ and Lintzeris, N, The sources of pharmaceuticals for problematic users of benzodiazepines and prescription opioids, Medical Journal of Australia, 199, (10) pp. 696-699. ISSN 0025-729X (2013) [Refereed Article]
Objectives: To describe benzodiazepine and prescription opioid use by clients of drug treatment services and the sources of pharmaceuticals they use.
Design: Structured face-to-face interviews on unsanctioned use of benzodiazepines and prescription opioids were conducted between January and July 2008.
Participants: Convenience sample of treatment entrants who reported regular (an average of ≥ 4 days per week) and unsanctioned use of benzodiazepines and/or prescription opioids over the 4 weeks before treatment entry.
Setting: Drug treatment services in Victoria, Queensland, Western Australia and Tasmania.
Main outcome measures: Participant demographics, characteristics of recent substance use, substance use trajectories, and sources of pharmaceuticals.
Results: Two hundred and four treatment entrants were interviewed. Prescription opioids were predominantly obtained from non-prescribed sources (78%, 84/108). In contrast, medical practitioners were the main source for benzodiazepines (78%, 113/144). Forging of prescriptions was extremely uncommon. A mean duration of 6.3 years (SD, 6.6 years) for benzodiazepines and 4.4 years (SD, 5.7 years) for prescription opioids was reported between first use and problematic use — a substantial window for intervention.
Conclusions: Medical practitioners are an important source of misused pharmaceuticals, but they are not the main source of prescription opioids. This has implications for prescription drug monitoring in Australia: current plans (to monitor only Schedule 8 benzodiazepines and prescription opioids) may have limited effects on prescription opioid users who use non-prescribed sources, and the omission of most benzodiazepines from monitoring programs may represent a lost opportunity for reducing unsanctioned use of benzodiazepines and associated harm.