Objectives: There is growing concern among some Australian medical professionals about the potential for misuse of prescription opioids (such as morphine and oxycodone) following changes in prescribing legislation for these medications over the past five years. This paper presents data on patterns of use, misuse and diversion among sentinel injecting drug users in Australia. It also presents population level data on the harms associated with prescription opioids, such as hospital admissions, emergency department and drug treatment presentations. Data on the number of prescriptions for these medications are also presented.
Methods: Several data sources will be presented; data from the Illicit Drug Reporting System; data from the National Hospital Morbidity Database; data from the Alcohol and Other Drug Treatment Services National Minimum DataSet; data from the Drug Utilisation Sub-Committee; and data from the NSW Health Emergency Department Information System.
Results: There have been increases over time in some jurisdictions in the use of prescription opioids (particularly morphine) among regular injecting drug users in Australia, and use among this group is primarily of diverted (non-prescribed) opioids. There have also been increases in hospital presentations for opioid poisonings (morphine/oxycodone/codeine poisonings in particular) and in numbers presenting for treatment, particularly for oxycodone use.
Conclusions: While the IDRS provides good data on the diversion of prescription opioids among sentinel groups of injecting drug users, diversion in the broader community has not generally been well-documented. Continued monitoring of the trends in harms is warranted. Warnings about the dangers of these drugs are essential in order to reduce the harms associated with the misuse of prescription opioids. Medical practitioners need to continue to carefully assess patients requesting these medications, whilst ensuring access for those with genuine clinical need.