Misuse of prescription medicines is as prevalent as the use of recreational drugs and novel psychoactive substances in Singapore: an unrecognised public health issue?

Abstract

Introduction: Misuse of prescription medicines and the harms associated with such use are growing threats across the world. There is currently, however, limited data on the extent of prescription medicine misuse in Singapore and whether this is a current threat in the country. Methods: An online survey, limited to 1,000 individuals (aged 21 years and over) who were residents in Singapore, was administered through a survey panel company in September 2015. The survey collected information on participant demographics, and their awareness, selfreported lifetime and past-year misuse of commonly available prescription medicines in Singapore as well as the use of a range of recreational drugs and novel psychoactive substances (NPS). Results: Lifetime (6.7%) and past-year (4.8%) misuse of any prescription medicine was comparable to lifetime (6.0%) and past-year (3.0%) use of any recreational drugs/NPS. The top five prescription medicines for lifetime misuse were: diazepam (2.7%); codeine (2.3%); dhasedyl (promethazine, codeine and ephedrine; 1.6%); panadeine (paracetamol and codeine; 1.5%); and methylphenidate (1.2%). The top five drugs for past-year misuse were: diazepam (1.6%); codeine (0.9%); panadeine (0.7%); alprazolam (0.6%); baclofen (0.6%); and gabapentin (0.6%). Conclusion: Misuse of prescription medicine in Singapore was common, with prevalence comparable to the use of recreational drugs/NPS. A common source for misused drugs was physicians. Further studies are required to determine whether this is more widespread in Singapore and establish the different forms of drug diversion, so that appropriate prevention strategies can be implemented.

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.…”

“…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.…”

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

“…Due to the paucity of data on the prevalence of prescription medicine misuse in Singapore, we conducted two online internet surveys in 2015 [35] 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) identify the demographic characteristics of those reporting misuse.…”

Regional, national and international datasets: How they improve our understanding of the acute harms associated with prescription medicine misuse

“…[2][3][4][5] There is increasing recognition that the issues relating to prescription medicine misuse described in the United States are a global phenomenon, although until recently this has been less well researched and reported outside of the United States. [6][7][8][9][10][11] There is increasing awareness and concern about the potential harm to health in those who misuse prescription medicines. In a survey of 300 UK-based doctors and other prescribers working in primary care settings, around half of those surveyed felt that patients were not aware of the adverse health consequences of high dose combination codeine medicines and the majority (86%) thought that patients perceived over-the-counter codeine-containing medicines to be safe.…”

“…Data from a mosaic of information sources, including accesses and calls to poisons information services, population and sub‐population level surveys, monitoring of the street cost of prescription medicines, enrolment in drug treatment services and monitoring of internet discussions related to prescription medicines has provided detailed information on the prevalence of prescription medicine misuse and some of the associated harms with this misuse 2–5 . There is increasing recognition that the issues relating to prescription medicine misuse described in the United States are a global phenomenon, although until recently this has been less well researched and reported outside of the United States 6–11 …”