Safer use of prescription medications

Medications can treat and cure many health conditions and diseases, as well as help us manage pain and discomfort.

Some can be purchased over-the-counter at supermarkets and pharmacies – like paracetamol (Panadol) - while others need a prescription from a doctor.

But even though medications are commonly used by many Australians, they still carry some risk.

Understanding these risks can help you avoid or reduce any potential harms.

Here we look at some of the ways you can be safer when using medications.

Which medications have more risk?

Any type of medication can cause harm if you take too much, or if it interacts with another drug.

Some medications have a greater risk of harm – including overdose, dependence (addiction), or side effects.

Opioid (e.g. Codeine or Panadeine) and benzodiazepine (e.g. Valium or Temazepam) medications can lead to dependence. And they are two of the most common drugs involved in accidental overdoses in Australia.¹

Access to higher risk medications is generally more tightly controlled. For example, some medicines require a prescription from a doctor, psychiatrist or other health professional.

And some medications are only allowed to be prescribed for specific conditions, or for a short amount of time, to reduce the risk of harm.

For over-the-counter medications, such as paracetamol and ibuprofen, you don’t need a prescription. But even though they’re readily available, they still come with risks.

In 2020-21, non-opioid analgesics (including paracetamol and ibuprofen), were responsible for 8,213 hospitalisations – the fourth most of any drug over that period (including legal and illegal substances).¹

You can read more about how access to medications is regulated on the Therapeutic Goods Administration (TGA) website.

What are the risks of medications?

The risks of different pharmaceutical drugs vary.

You can experience negative side effects, adverse reactions (e.g. an allergic reaction), interactions (from using two or more medications) or an overdose.

Side effects can be more likely when a medication:

• is particularly strong
• interacts with an existing health issue
• is taken by someone other than the person it was prescribed for,  or taken differently than instructed on the packet (non-prescribed use)
• is mixed with alcohol, other medicines or illicit drugs.^2-4

Overdose

Prescription medicines cause more overdose deaths in Australia than illicit drugs.^{1, 5}

An overdose is when a toxic amount of a drug, or combination of drugs, causes a severe adverse reaction. Not all overdoses are fatal, and most overdoses in Australia are accidental.^{1, 5}

Accidental overdose means either the medicine was taken by mistake, too much was taken by mistake, or the medicine reacted with another medication or drug.

If you think you, or someone else, has taken an overdose, made an error with medicine or been poisoned, it’s best to dial triple zero (000) immediately. If you’re unsure, contact the Poisons Information Centre on 13 11 26 to speak with a poisons expert.

Reducing the risks

When taken as prescribed, medications are generally safe and effective.

And understanding how to take them safely can reduce your risk of harm.

Before taking, check that you know:

• what you’re taking and how it should help
• how and when to take the medicine (your doctor or pharmacist can explain this to you, and it’s often included on the packaging)
• how to safely store the medicine
• what the potential side effects are, and how to manage them
• if there are any possible long-term use impacts
• if it’s safe to take while driving, or operating machinery.^{6, 7}

Talk to a pharmacist, your doctor or call Medicines Line (1300 633 424) if you’re unsure.

Other things you can do to reduce risks include:

• Getting your medication needs reviewed regularly, at an appointment with your doctor or by speaking to a pharmacist.
• Keeping a list of the medications you take, including over-the-counter (like Panadol), prescribed, and any supplements.
• Telling your doctor, pharmacist or hospital staff what you take if being given/prescribed a new medication, to make sure there’s no risk of harmful interactions, or other things to be aware of.^{7, 8}

Reducing risk when combining medications

It’s important to know what medications can be taken together. Many hospitalisations and overdoses happen when different medications taken at the same time interact with each other.^{1, 5}

Alcohol can also interact with many medicines, causing both short and long-term effects.

Drinking can increase the effects, or side effects, of certain medications while some medicines increase the effects of alcohol, making you feel more intoxicated.⁶

Ask your doctor or pharmacist about any potential interactions before taking a new medicine, or call Medicines Line on 1300 633 424.

What is non-prescribed use of medicines?

Non-prescribed use is when someone uses a prescription or over-the-counter drug in a way other than it was intended. This includes:

• taking more than the prescribed amount or taking it more frequently
• using prescription-only medication when it was not prescribed for you
• sharing prescription medication with others
• combining your medication with other drugs, including alcohol
• using medication against medical advice, for example, while driving or using heavy machinery.⁹

Non-prescribed use can be accidental or on purpose. Sometimes people use pharmaceutical drugs to:

• feel happy or relaxed
• relieve pain or illness
• improve performance
• increase the effects of alcohol and other drugs
• help with symptoms of withdrawal from alcohol and other drugs.⁹

What are the risks of non-prescribed use?

Non-prescribed use of medication can lead to harmful impacts, including overdose and dependence.

The risk of harm is also increased if medications are mixed with other drugs.¹⁰

Some medicines can increase feelings of relaxation and euphoria, leading to an urge to use them again. If you are dependent on a pharmaceutical drug, not having it can also cause unpleasant withdrawal symptoms.¹¹

Reducing the risk of harm from non-prescribed use

If using medication in any other way than prescribed:

• research what the medication is, its potential effects and risky interactions
• if you’ve never used it before, start with a small amount and wait for effects
• avoid mixing with other drugs, including alcohol
• use around people you trust and in a safe environment
• if using opioids, keep naloxone handy for emergencies (naloxone temporarily reverses an opioid overdose)
• avoid activities that require mental and physical awareness - like driving, swimming or operating heavy machinery.^{12, 13}

Information and advice

For advice and information about any medication, talk to your doctor, a pharmacist, or contact:

• Medicines Line on 1300 633 424: for any general questions around medications and their effects, risks and how to use safely.
• Poisons Information Centre on 13 11 26: for advice if there’s been an error taking a medicine (too much taken, or the wrong medication).
• Triple zero (000): if you think you, or someone else, may have taken an overdose/is experiencing an overdose, call triple zero (000) and ask for an ambulance.

Help and support

If you’re worried about your own, or someone else’s, use of medication there’s help and support available:

• National Alcohol and Other Drug Hotline: 1800 250 015 
  A 24/7 telephone service where you can talk to a counsellor who can provide information, advice, support and referrals.
• Path2Help: the Alcohol and Drug Foundation’s free, online platform that helps you find alcohol or other drug support services near you.
• Counselling online: alcohol and other drug support – confidential, free and available 24/7.
• Health direct service finder: to locate a health service, including GP, near you.
• Reconnexion: information and support about benzodiazepine dependency and withdrawal, anxiety, insomnia, and depression.