Tailored treatment needed for prescription drug misuse, says ACMD

pillsPrescription-only drugs are being widely diverted to supplement the use of illegal substances, according to a new report from the Advisory Council on the Misuse of Drugs (ACMD). However, diversion and illicit supply remains a ‘much smaller problem’ than in the US, it states.

Diverted prescription drugs are supplementing, rather than replacing, the use of street drugs like heroin, it says – either as a way of complementing their effects or to ‘tide over’ users until they can access illicit drugs.

More people are now seeking treatment for addiction to prescription drugs, it states, and there is growing anecdotal evidence from treatment services of clients whose opioid-dependency developed through use of over-the-counter codeine products. Use of diverted medicines can also increase the risk of overdose, it adds, while ‘unethical’ online sales of prescription drugs via unregistered pharmacies are also increasing, with some people using prescription drugs to manage the comedown from stimulants like cocaine. Alongside prescription opioids, the most commonly diverted drug types are benzodiazepines and ‘Z drugs’, as well as pregabalin, gabapentin and anti-psychotics.

The report wants to see the development of tailored treatment for people who are dependent on prescription or over-the-counter drugs, as well a ‘watch list’ of medicines that could potentially be misused. It also calls on prison healthcare commissioners to ‘embed responsibility’ for the issue into healthcare provider specifications.

‘The diversion of prescription-only medicine damages patient-doctor relationships and can create an atmosphere of distrust,’ said ACMD chair Professor Les Iversen. ‘The use of medicines supplied illicitly is dangerous – it is essential that tailored treatment is developed for users who have become dependent on prescription or over-the-counter medicines.’

The government has also announced that Owen Bowden-Jones, consultant in addiction psychiatry at Imperial College and clinical adviser to PHE, will take over the role of ACMD chair from January. ‘The ACMD plays a hugely important role in ensuring the government has the evidence it needs to tackle the misuse of drugs, and I am confident Dr Bowden-Jones will continue to drive this work forward as we strive to prevent the harms caused by drug misuse,’ said minister for vulnerability, safeguarding and countering extremism, Sarah Newton.

Diversion and illicit supply of medicines at www.gov.uk