Correlates of Non-Medical Prescription Drug Misuse Among a Treatment-Seeking Population: A Comparison with Illicit Drug Users

Abstract

Prescription drugs (PD) undoubtedly help people with various physical or psychiatric ailments. Nevertheless, they are often diverted and misused (use without prescription or for purposes/in ways not intended by the prescriber). This study compared the sociodemographic and clinical correlates of those who misused PDs, used illegal drugs and co-ingested both, to identify those who were at a high risk of misusing these drugs. Retrospective analysis of the treatment outcome monitoring (TOM) data for the period of 2013–2017 identified 1369 subjects for the study; 295 patients presented with PD use disorder (PDUD alone), 811 with illegal drug use disorder (IDUD alone), and 263 had both PDUD and IDUD. The study sample included treatment seeking population (Singaporeans and permanent residents). TOM data included data collected through direct interviews (addiction severity, quality of life) and from the clinical case notes (diagnosis, co-morbidities, socio demographic information, etc.). The most commonly misused prescription and illegal drugs were benzodiazepines (63.1%) and heroin (63.4%), respectively. Those who co-ingested both PD and illegal drugs (PDUD+IDUD) had a significantly higher addiction severity score, lower quality of life and higher psychiatric co-morbidities than that of IDUD alone at baseline. When compared to Chinese patients, Malay and Indian patients had lower odds (p < 0.05) of PDUD alone and PDUD+IDUD than Chinese patients; divorcees had higher odds of PDUD+IDUD than those who were married. Those with primary and secondary qualifications had higher odds (2.1 and 2.9 times, respectively) of PDUD+IDUD than those with tertiary qualification and those in managerial or professional roles had higher odds of PDUD alone than those who were unemployed. Gender, ethnicity, marital status, education and occupational classes were associated with PDUD and IDUD. These characteristics can be helpful to identify those who are at the risk of PDUD and incorporate strict prescription monitoring to their care.

Misuse of medication in adult substance misuse services: a systematic review protocol

“…This is especially important where illicit substances are used alongside OTC and/or POMs because this may be associated with a lower quality of life and greater mental health issues. 43 It is, therefore, essential to be able to offer timely and effective interventions to reduce the risk of using other substances, experiencing more severe functional problems and riskier drug-related behaviours. 44 Additionally, substitute treatment used in SMS may also be used inappropriately and people who access SMS are more likely to experience comorbid mental health conditions, be prescribed psychotropic medication and for unlicensed indications.…”

Prescription medicine misuse in the Asia–Pacific region: An evolving issue?

“…40 The majority of these buprenorphine abusers were male (90%) with a mean age of 39.2 (SD 8.0) years; 52.5% were currently employed and 98% had at least 34 Those with primary and secondary education qualifications had higher odds (2.1 and 2.9 times, respectively) of misusing both prescriptions and illicit drugs than those with tertiary qualification and those working in managerial or professional roles had higher odds (4.4 and 7.4 times, respectively) of misusing prescription medicines only than those who were unemployed. 41 Due to the paucity of data on the prevalence of prescription medicine misuse in Singapore, we conducted 2 online internet surveys in 2015 42 and 2016. The aim of the studies was to determine: (i) whether survey respondents had heard of different prescription medicines; (ii) the prevalence of prescription medicine misuse in Singapore; and (iii) the demographic characteristics of those reporting misuse.…”

“…In another paper evaluating prescription medicine misuse among 2273 individuals who were seeking treatment for substance misuse in Singapore, 41 295 misused prescription medicines only, 811 used illicit drugs, and 263 misused a mixture of both prescription and illicit drugs; 904 were excluded from the study as they reported using alcohol only. It was found that those who were misusing prescription medicines were predominantly male (243, 82.4%) with a mean age of 41.2 (SD 11.4) years; 63.1% among this group ( n = 186) reported misusing benzodiazepines as their main drug and 18.6% ( n = 5) used codeine.…”

Prescription medicine misuse in the Asia-Pacific Region: an evolving issue?

“…61.6% (n=162) used heroin as their main drug, 14.1% (n=37) misused benzodiazepines, and 11.8% (n=31) used amphetamines. It was found that educational level and occupational status were associated with different types of misuse [34]. Those with primary and secondary education qualifications had higher odds (2.1 and 2.9 times, respectively) of misusing both prescriptions and illicit drugs than those with tertiary qualification and those working in managerial or professional roles had higher odds (4.4 and 7.4 times, respectively) of misusing prescription medicines only than those who were unemployed [34].…”

“…In another paper evaluating prescription medicine misuse among 2273 individuals who were seeking treatment for substances misuse in Singapore [34]. 295 misused prescription medicines only, 811 used illicit drugs, and 263 misused a mixture of both prescription and illicit drugs.…”