Effects of prescription drug diversion, misuse and abuse on the health system in eThekwini District, KwaZulu-Natal, South Africa: Key stakeholders’ perceptions

Abstract

Background: Prescription drug diversion, misuse and abuse is a growing health threat negatively impacting the health care system and individuals globally. Most research has been conducted in high-income-countries. Little is known about prescription drug diversion, misuse and abuse to support anecdotal reports in resource-limited settings. Purpose: The main objective of this study is to determine prescription drug diversion, misuse and abuse practices in eThekwini district from the perspective of the health care providers, law enforcement, pharmacists, drug users and people living with HIV. Methods: Semi-structured in-depth-interviews were conducted between June-December 2018 among key stakeholders who were purposively sampled in eThekwini district. Thematic analysis was used to identify emergent themes around practices of prescription drug diversion, misuse and abuse. Results: Five main themes emerged during the interviews: manifestation of drug diversion; consumer’s attitude and behaviour; availability of medicines; gaps in the health care system; and lastly challenges and barriers to drug abuse treatment. Accidental addiction, health system gaps and consumer’s attitude and behaviours were perceived as significant contributing factors to the problem therefore negatively impacting health care providers and consumers. Conclusion: The study highlights the emerging practices of prescription drug diversion, misuse and abuse as a serious growing problem occurring through legal and illegal channels to anyone since the addictive medicines are readily available and easily accessible. We recommend a collaborative approach to address prescription drug diversion since the prescriber, dispenser, consumer and law enforcement are involved in the cycle to drug usage.