Non-medical drug use among prescription drug users

Background The purpose was to study the link between the medical and non-medical use of prescription drugs which are known to have abuse potential, such as anxiolytics, sedatives and strong analgesics. We aimed to examine which proportion of those using these prescription drugs for legitimate medicinal purposes also use them non-medically, and whether socio-demographics, binge drinking or the amount of drug prescriptions are associated with non-medical use among medical users. Furthermore, we aimed to study whether the non-medical use of prescription drugs differs by the type of drugs (anxiolytics, sedatives, strong analgesics) prescribed for medical purposes.

Methods Population-based Drug Surveys conducted in 2006, 2010 and 2014 in Finland were pooled into one dataset (N=8,537). The response rates varied between 55% and 48%. Respondents who reported having a doctor’s prescription for one or more groups of prescription drugs (anxiolytics, sedatives, strong analgesics) during the last 12 months were included in the study (n=1,602). Three mutually exclusive groups of prescription drug users were formed according to the non-medical use of prescription drugs and/or illicit drug use during the last 12 months: 1) medical use only (n=1,510), 2) medical and non-medical use of prescription drugs, but no illicit drug use (NMUPD, n=50), 3) illicit drug use in addition to medical and non-medical use of prescription drugs (IDU, n=42). A multinomial logistic regression analysis was used.

Results Six per cent of those having a legitimate prescription also reported using prescription drugs non-medically. Living alone or being a student, retired or other on their employment status was associated with NMUPD. Younger age, living in a large city, living alone and unemployment was associated with IDU. Frequent binge drinking was associated with both NMUPD and IDU, and so was the higher amount of drug prescriptions. There were no statistically significant associations between the types of prescribed drugs and NMUPD. However, those reporting IDU were more likely to have a prescription for sedatives, but less likely to have a prescription for strong analgesics (e.g. opioids).

Conclusions When prescribing medicines with abuse potential, physicians should follow up closely their patients’ use of these drugs in order to notice and prevent possible non-medical use. Furthermore, since the non-medical use of prescription drugs was associated with other substance use, physicians should assess patient’s alcohol and illicit drug use when prescribing medicines with abuse potential.