A report published today (Thursday, 15 December) by the government’s drug advisors has found prescription-only medicines are being used to supplement the use of other illicit drugs – like cocaine and heroin – but that at present we have a much smaller problem in this regard than the USA.
The Advisory Council on the Misuse of Drugs (ACMD) was tasked with investigating whether medicines are being taken by people they were not prescribed for - also known as diversion and illicit supply of medicines (DISM). It has also explored the potential medical and social harms by comparing the situation in the UK with the USA where the issue is well-established.
Diverted prescription drugs are not replacing traditional street drugs, the inquiry finds, but rather supplementing their use. Evidence suggests that prescription medicines are being widely used to complement the effects of illicit drugs such as heroin and cocaine or by users to ‘tide them over’ by alleviating withdrawal symptoms until they can access or afford Class ‘A’ drugs.
The use of diverted medicines leads to an increased risk of accidental overdose, infections and blood-borne viruses and illicitly supplied medicines may also be counterfeit. Furthermore, most prisons have reported issues of diverted medicines being used by inmates.
The ACMD’s report recommends health professionals and organisations support the development of tailored treatment for those who misuse or have become dependent on prescription or over-the-counter medicines and keep a watch list of prescribed medicines that could be abused. It also calls for prison health care commissioners, including NHS England, to embed responsibility for protecting against this into prison healthcare provider specifications. This requires action by prison governors to deliver improved safety in partnership.
Professor Ray Hill, chair of the Diversion and Illicit Supply of Medicines Inquiry, said:
We call on the Government and public health bodies to have increased awareness and policies in place to tackle the diversion and supply of prescription medicines, which has become of growing public concern across the globe in recent years.
Our inquiry has found misuse of prescribed medicine supplements the abuse of traditional illicit drugs - increasing the risk of accidental overdose, infections and blood-borne viruses.
We remain particularly concerned with the on-going trends of diversion of medications in the prison environment.
Professor Les Iversen, chair of the ACMD, said:
The diversion of prescription-only medicine damages patient-doctor relationships and can create an atmosphere of distrust.
The use of medicines supplied illicitly is dangerous - it is essential that tailored treatment is developed for users who have become dependent on prescription or over-the-counter medicines.
Other key findings of the study are:
- addiction clinics and therapists in the UK reported, anecdotally, that they sometimes see opioid-addicted clients who first developed a dependency on over-the-counter (OTC) codeine
- use of prescription medicines to manage the ‘come down’ from illicit stimulant drugs seems to involve purchase of the drugs from a ‘friend’ who may have obtained them by legitimate prescription
- the sale of prescription medicines is increasing online with many unregistered pharmacies supplying prescriptions and medicines unethically
- the number of people seeking treatment for addiction to prescription medicines has reportedly increased. As with other drug users those using prescription drugs often have other mental health problems to cope with