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Patterns of prescription drug misuse presenting to provincial drug clinics.

AIM
To survey new patients, presenting to three drug clinics, on the patterns, usage and costs of prescription pharmaceuticals.


METHOD
Consecutive patients seen by the medical staff for assessment had a 7-day history recorded for prescription drug (PD) usage, and the associated costs of these from street sources.


RESULTS
There were 37 patients (26 males) with a mean age of 34 years (21-51). Ten reported using only intravenous (IV) morphine, at a median dose of 105 mg/day (40-600), at a mean cost of 56 cents/mg. Another 12 reported methadone as their sole opioid at a median dose of 50 mg/day (27-70), at a mean cost of 81 cents/mg. A further 11 used a mixture of opioids, predominantly morphine and methadone but also dihydrocodeine (3), oxycodone (1), tramadol (1) and codeine (2). Seventeen reported also using hypnosedatives, but did not report high doses of these. The overall weekly expenditure on PDs was $367/week (0-2100).


CONCLUSIONS
Morphine and methadone remain the predominant street opioid PDs in this region. Street prices have reduced, perhaps reflecting greater drug availability in accordance with increased national prescribing of opioids. There is continuing diversion of PDs to the street which is an ongoing Public Health issue requiring coordinated responses, including improved prescribing training, pain guidelines, drug clinic policy and actions by Medsafe, Police and regulatory bodies to contain this problem.