Prescription Drug Abuse in Canada and the Diversion of Prescription Drugs into the Illicit Drug Market

By Haydon, Emma; Rehm, Jürgen et al. | Canadian Journal of Public Health, November/December 2005 | Go to article overview
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Prescription Drug Abuse in Canada and the Diversion of Prescription Drugs into the Illicit Drug Market


Haydon, Emma, Rehm, Jürgen, Fischer, Benedikt, Monga, Neerav, Adlaf, Edward, Canadian Journal of Public Health


ABSTRACT

Prescription drug abuse has received considerable attention in media reports in recent years. The purpose of this article is to describe the Canadian situation and context with regards to prescription drug abuse and the diversion of psychotropic prescription drugs into the illicit drug market, with a focus on the need for more data and interventions. Canada ranks within the top 10% of countries in the use of benzodiazepines, opioid prescriptions and stimulants. There are many ways that prescription drugs are diverted into the illicit market and varied reasons for use and abuse. Prescription drug abuse is further related to a number of negative consequences, including overdose. While seniors and women have been the primary focus for research in Canada on prescription drug abuse, adolescents and young adults have received less attention. Systematic epidemiological data specifically on prescription drug abuse in the Canada context are lacking and are needed in order to more clearly understand the reasons for the phenomenon and to develop and implement appropriate interventions.

MeSH terms: Prescriptions, drug; Canada; adolescents; drugs of abuse

RÉSUMÉ

L'abus des médicaments sur ordonnance reçoit beaucoup d'attention dans les médias depuis quelques années. Cet article décrit la situation canadienne à l'égard de ce type d'abus et du détournement des médicaments sur ordonnance vers le marché clandestin, en insistant sur le besoin de données et de mesures supplémentaires. Le Canada se classe parmi les 10 % des pays qui consomment le plus de benzodiazepines, de stimulants et d'opiacés sur ordonnance. Il existe de nombreux moyens de détourner les médicaments sur ordonnance vers le marché clandestin, et la consommation et l'abus des médicaments peuvent avoir des causes diverses. De plus, l'abus des médicaments sur ordonnance entraîne plusieurs conséquences négatives, dont les surdoses. Les études canadiennes sur l'abus des médicaments sur ordonnance portent principalement sur les personnes âgées et les femmes, mais beaucoup moins sur les adolescents et les jeunes adultes. On manque de données épidémiologiques systématiques sur l'abus des médicaments sur ordonnance au Canada; de telles données permettraient de mieux comprendre les raisons de ce phénomène et d'élaborer et de mettre en oeuvre des interventions appropriées.

Examinations of 'illicit drug use' typically focus on illegally produced substances like heroin and cocaine; however, a closer look suggests that the abuse of prescribed drugs plays a major role. The existence of the problem of prescription drug abuse in Canada is not new. In 1979, Wilson and Geekie1 called for more knowledge and better control of abuse of narcotic pharmaceuticals. Their call seems even more relevant today in light of media reports that have pointed to the continued high prevalence of the diversion and illicit use of specific prescription drugs.2,3 The purpose of this paper is to describe the available Canadian data, with a discussion of the implications for interventions.

Prescription drug abuse will be defined in this paper as use that occurs without a physician's prescription, in greater amounts than prescribed, more often than prescribed, and/or for other reasons than indicated by the prescribing physician.4 Further, this article will focus on particular groupings of psychotropic drugs: stimulants, benzodiazepines (sedativehypnotics), and opioids (narcotics).

Epidemiology of prescription drug use

The data on the extent of psychotropic prescription drug abuse in Canada are vague at best. Thus, quite often indirect indicators are used, such as internationally comparable figures on use. In such global statistics, Canada maintains a very high position for use (and possible abuse) of the psychotropic drugs of concern discussed in this paper: it is second highest in the list of all countries in the world for benzodiazepine use, fifth highest for prescription narcotics use, and within the top 15 countries for stimulant use.

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