Prescription opioid access and misuse amongst users from the USA, UK, Australia, and New Zealand: Results from the 2015 Global Drug Survey

Morley, Katherine, Winstock, Adam, Ferris, Jason and Lynskey, Michael (2015). Prescription opioid access and misuse amongst users from the USA, UK, Australia, and New Zealand: Results from the 2015 Global Drug Survey. In: Lisbon Addictions Conference, Lisbon, Portugal, (). 23-25 September, 2015.

Author Morley, Katherine
Winstock, Adam
Ferris, Jason
Lynskey, Michael
Title of paper Prescription opioid access and misuse amongst users from the USA, UK, Australia, and New Zealand: Results from the 2015 Global Drug Survey
Conference name Lisbon Addictions Conference
Conference location Lisbon, Portugal
Conference dates 23-25 September, 2015
Publication Year 2015
Sub-type Oral presentation
Language eng
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Background: Prescription of opioid analgesics has increased rapidly in the United States (USA) over the last two decades, accompanied by increasing rates of misuse and overdose. Prescription opioid use has also increased in other countries, such as the United Kingdom (UK) and Australia, but the increase in associated misuse and overdose has not been as substantial. Differences in prescribing practices and characteristics of the health services in these countries have been suggested as potential reasons for these differences. To explore this, we examined whether methods of access and misuse of prescription opioids differed between people residing in the USA, UK, Australia, and New Zealand (NZ). Methods: We used data from the 2015 wave of the Global Drug Survey, a purposive sample surveyed using an online questionnaire. The sample used includes participants from the USA (n=5,289), UK (n=6,269), Australia (n=3,479), NZ (n=2,919). Participants reported on past-year use, methods and ease of access, health-care provider interactions, and how they used these drugs. We used questions relating to opioids most commonly prescribed in the selected countries: codeine, hydrocodone, and oxycontin. Chi-squared tests and logistic regression were used to investigate bivariate and multivariate associations. Results: Overall, 30% of participants (n=5,387) had used at least one of the three prescription opioids in the past year, but use was lower in the UK (25.2% of participants) than other countries (all 32-34%). Almost 15% of American participants reported buying these opioids from a dealer, but less than 5% of other participants reported this. Few participants had purchased them via the internet (<2% for all countries). Most obtained these opioids via prescription (n=3,804), but this was more common amongst Australian and NZ participants (approximately 80%), compared to those from the UK and USA (62.2% and 67.2% respectively). Of those who received these drugs on prescription, UK participants were most likely to report discussing the risk of addiction to these medications with their doctor (51.3% compared to 41.2% from NZ, and 44% from Australia and USA). Analyses adjusted for age and sex showed that amongst participants who had received prescriptions, those from the USA were least likely to report that obtaining another prescription within seven days would “very easy” or “easy” (odds ratio (OR) 0.36, 95% confidence interval (CI) 0.29-0.44) compared to those from the UK. Misuse was more common amongst American participants, particularly taking more than prescribed (OR 1.83, 95% CI 1.44-2.33), sharing with friends (OR 1.74, 95%CI 1.36-2.23), and mixing with other drugs to enhance effects (OR 1.70, 95%CI 1.33-2.45). Misuse did not differ substantially between UK, Australia, and NZ participants. Conclusion: Participants from the USA who obtained opioids on prescription were more likely to report misuse than those from the UK, Australia, and NZ. Those from the UK were more likely to recall discussing the addictive potential of these drugs with their doctor, but only 40-50% of participants reported this across countries. For all countries, medical practitioners are the most common route of access to prescription opioids; enhancing patient education could substantially impact upon their misuse.

Document type: Conference Paper
Collection: Institute for Social Science Research - Publications
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Created: Mon, 07 Mar 2016, 10:21:59 EST by Jason Ferris on behalf of Institute for Social Science Research