BackgroundNonmedical prescription drug use (NMPDU) refers to the self-treatment of a medical condition using medication without a prescriber’s authorization as well as use to achieve euphoric states. This article reports data from a cross-national investigation of NMPDU in five European Countries, with the aim to understand the prevalence and characteristics of those engaging in NMPDU across the EU.MethodsA parallel series of self-administered, cross-sectional, general population surveys were conducted in 2014. Data were collected using multi-stage quota sampling and then weighted using General Exponential Model. A total of 22,070 non-institutionalized participants, aged 12 to 49 years, in 5 countries: Denmark, Germany, Great Britain, Spain, and Sweden. Lifetime and past-year nonmedical use of prescription medications such as stimulants, opioids, and sedatives were ascertained via a modified version of the World Health Organization’s Composite International Diagnostic Interview. Information about how the medications were acquired for NMPDU were also collected from the respondent.ResultsLifetime and past-year prevalence of nonmedical prescription drug use was estimated for opioids (13.5 and 5.0 %), sedatives (10.9 and 5.8 %), and stimulants (7.0 and 2.8 %). Germany exhibited the lowest levels of NMPDU, with Great Britain, Spain, and Sweden having the highest levels. Mental and sexual health risk factors were associated with an increased likelihood of past-year nonmedical prescription drug use. Among past-year users, about 32, 28, and 52 % of opioid, sedative, and stimulant nonmedical users, respectively, also consumed illicit drugs. Social sources (sharing by friends/family) were the most commonly endorsed methods of acquisition, ranging from 44 % (opioids) to 62 % (sedatives). Of interest is that Internet pharmacies were a common source of medications for opioids (4.1 %), stimulants (7.6 %), and sedatives (2.7 %).ConclusionsNonmedical prescription drug use was reported across the five EU countries we studied, with opioids and sedatives being the most prevalent classes of prescription psychotherapeutics. International collaborations are needed for continued monitoring and intervention efforts to target population subgroups at greatest risk for NMDU.

NMU of ADHD prescription stimulants were low compared with other prescription medications. While prevalence of NMU was higher for immediate-release than extended-release ADHD medications, absolute rates for prescription stimulants were low.

Prescription stimulant NMU was low compared with other prescription medications among individuals assessed for substance abuse problems, with little difference among specific products.

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ObjectiveTo examine rates of nonmedical use (NMU) of prescription extended-release (ER) amphetamines and ER methylphenidate, relative to availability.MethodsPrescribing data were acquired from IMS Health. Data relevant to ER amphetamine and ER methylphenidate were collected from two studies in the RADARS® (Researched Abuse, Diversion and Addiction-Related Surveillance) System (Q3 2007-Q2 2009). First, the Drug Diversion System provides a law enforcement perspective based on surveys of diversion investigators throughout the US. Second, the Poison Center System provides data on exposures to prescription drugs based on spontaneous calls. RADARS System data are presented as rates per 1,000 Unique Recipients of Dispensed Drug (URDD) to account for drug availability.ResultsFrom July 2007-June 2009, 18,315,404 prescriptions were filled for ER amphetamines, 26,674,152 for ER methylphenidate. RADARS System Drug Diversion trends nearly overlap for ER amphetamine and ER methylphenidate, relative to URDD (running average of 0.042 vs. 0.024 drug diversion reports per 1,000 URDD). Similarly, trends in RADARS System Poison Center calls are generally similar for ER amphetamine and ER methylphenidate, although ER amphetamine trends slightly lower (running average of 0.15 vs. 0.22 intentional exposures per 1,000 URDD).ConclusionsTrends from the US RADARS System, which controls for utilization rates, suggest diversion and poison center call rates are similar for ER amphetamine and ER methylphenidate.Supported by funding from Shire Development Inc.

were not significantly different on MDD-related outpatient services (least-squares mean difference[95% CI] for number of outpatient visits: 0.31[-0.01, 0.64]; OR[95% CI] for having ≥ 2 outpatient visits: 1.04[0.82, 1.32] for SNRI vs SSRI). ConClusions: Chinese physicians seem more likely to choose SNRI than SSRI for the treatment of severely-ill MDD patients, as suggested by the patients' higher likelihood of being treated at mental hospitals and having more MDD-related outpatient visits premedication initiation. Although SNRI initiators may be more severely-ill at medication initiation, they were not found to differ from SSRI initiators on outpatient and inpatient service use for MDD in the year following medication initiation.

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