INFORMATION LINE 1300 85 85 84
April 29, 2019
Use of pharmaceuticals is a major public health concern in Australia, with widespread non-prescribed use resulting in a range of harms.
Non-prescribed use (NPU) of pharmaceutical drugs is the use of a prescription or over-the-counter drug for non-medicinal purposes or other than directed by a registered healthcare professional.1 This includes:
Non-prescription use can be accidental or deliberate. Sometimes people use pharmaceutical drugs to:
There are many types of pharmaceuticals that are used in this way, including steroids, nonbenzodiazepines, some anti-psychotics and codeine.
Pharmaceutical drugs with the highest non-prescribed use in Australia are opioids and sedatives, specifically benzodiazepines.4 These drugs are listed as Essential Medicines by the World Health Organisation, and when used as advised by health professionals, can be effective and safe.5
The likelihood of developing a dependency on or tolerance of pharmaceutical drugs depends on the type of drug. Risk of harm, such as overdose or dependency, increases with length of use and dosage. Non-prescribed use of opioids in Australia, Canada, the United States and some parts of Europe exceeds use of all illicit drugs except for cannabis.4,6-8
Many people underestimate the potential risks associated with non-prescription use of pharmaceutical drugs and believe them to be “safer” than illicit drugs.9 However, more people die from overdose of pharmaceuticals than all illicit drugs combined. Approximately 1 in 8 people (12.8%) will engage in non-prescribed use of a pharmaceutical drug over their lifetime.
Some people who use pharmaceuticals report feeling dependent or unable to reduce or eliminate their use. 10.7% of recent users of ‘painkillers/analgesics and opioids’ and 8.0% of recent users of tranquillizers/sleeping pills said that they could not stop or cut down their use, even if they wanted to.
Some people are at higher risk of non-prescribed use of pharmaceutical drugs, overdose and dependency. Individuals with complex health needs or mental health issues, an existing dependence on other drugs or alcohol, and people living in rural or remote areas may be at elevated risk of developing a dependency on pharmaceutical drugs.10
Use of pharmaceuticals is related to the availability and use of illicit drugs. The rise in non-prescription use of benzodiazepine and opioids is partly attributable to the decrease in availability of heroin.11,12 It’s also been shown that 39% of people who engaged in non-prescribed use of pharmaceuticals also used illicit drugs.4 Therefore, strategies to reduce the non-prescribed use of pharmaceuticals should be developed in conjunction with policies and interventions to reduce the potential harms associated with illicit drug use.
There are a number of harm reduction measures in place to reduce the risk of overdose, dependence and non-prescribed use of pharmaceuticals. For example, SafeScript was recently introduced to help doctors and pharmacists to identify when a patient may be at risk of non-prescribed use or receiving high-risk pharmaceuticals beyond medical need and prompt a discussion about alternative treatments with patients.13
Other strategies could include:
DrugInfo or 1300 85 85 84
Interested to find out more?
Read this related article from the ADF Library.