Diversion of drugs for non-medical use (NMU)
This is blog 1 of 10 blogs on the topic of non-medical use of prescription medicines and overdose risks. This blog is part of the series on drug overdose awareness and overdose prevention inspired by International Overdose Awareness Day (2021).
This article discusses the risks and prevalence of NMU (non-medical use) of prescription pharmaceutical products.
These blogs series focusing on drug overdose prevention, including NMU of prescription medications, aims to focus attention on:
- the increasing number of overdose toxicity cases attending Emergency Rooms
- the rise in overdose toxicity fatalities caused by polydrug use (polysubstance use)
- the impact of the Covid-19 pandemic on substance use behaviours and overdose rates
- International Overdose Day and other overdose prevention efforts by the Penington Institute
Polydrug use (definition): Polydrug use (polysubstance use) means concurrent use of more than one drug substance, such as concurrent use of alcohol, prescribed medications, opioids, and/or other potent drugs. Polydrug use/polysubstance use overdoses tend to involve the intake of more than one toxic substance in a condensed period of time (e.g. several hours) where the effects of each individual substance are impacted by the presence of other substance(s) in the person’s bloodstream.
Download the latest Australian overdose statistics revealed in the Penington Institute’s 2021 Australian Overdose Report.*
Polysubstance use may include but is not limited to:
- concurrent intake of legal substances with illicit substances (for example, alcohol use with cocaine use, MDMA)
- mixing illicit drugs and/or alcohol with prescription medications
- prescription medications consumed for ‘non-medical use’ (NMU) with other substances of intoxication
The effects of intaking multiple toxic substances in a proximal period of time include detrimental drug-to-drug interactions and higher levels of toxicity, which can lead to seizures, permanent brain damage, and death. Non-medical use of prescription medicines (NMU), such as taking someone else’s prescriptions, can also prove deadly.
Unfortunately, concurrent consumption of toxic substances – and overdose risks related to polysubstance use – are at epidemic levels in society.
Polysubstance use harms and overdose risks
Why is polydrug use harmful?
When drugs interact with other drugs in a person’s bloodstream, this alters the drug’s expected effects. It often results in adverse drug-to-drug interactions.
Additionally, polydrug use/polysubstance use generally equates to higher levels of intoxication (blood toxicity) – which can prove fatal.
- High doses of ANY toxic product can result in an overdose scenario.
- So, too, can concurrently using alcohol with illicit drugs and/or prescription pharmaceuticals.
- Even ‘low doses’ of a toxic substance (the so-called ‘party drugs’ MDMA/Ecstasy), can lead to overdose-related harms, particularly as illegal drug supply chains are known to distribute highly contaminated products (containing paint thinners and deadly bacteria).
Emergency rooms are inundated with individuals who are experiencing overdose toxicity related to drugs.
In some cases, it ends up being fatal.
Mixing substances such as pain medicines, illicit drugs and alcohol – and/or excessive dosing of a single drug – can lead to:
- permanent brain damage (neurotoxicity to the serotonergic system in the brain)
- temporary psychosis/long-term psychiatric problems
- physical disabilities
- fatal levels of overdose toxicity
Note: this list is not inclusive of drug-related harms, such as injuries from accidents and drug-related violence, criminal charges/jail time, relationship breakdowns, institutionalisation and/or homelessness.
When is ‘drug overdose awareness day’?
- Drug overdose awareness day is held annually on August 31, 2021 (31 August 2021).
- It is a project led by the Penington Institute, a key driver of overdose awareness programs, prevention efforts, and drug-use safety campaigns.
Pharmaceutical industry support | overdose prevention efforts
As an industry, we can help reduce overdoses by a number of compliance measures.
- One of the articles in this blog series discusses how GMP compliance contributes to diversion prevention as well as proper packaging and labelling.
- Ensuring compliance with Good Manufacturing Practice (GMP) and GxP, including Good Distribution Practice (GDP) and Good Documentation Practice, are some of the ways we can assist our community in overdose prevention efforts.
- But we can also help by increasing community awareness of the dangers of non-medical use (NMU) of pharmaceutical products – and the dangers of mixing drugs (polysubstance use) such as mixing alcohol, opioid medications and certain types of prescriptions.
- And we can each do our part to participate in International Drug Overdose Awareness Day on the 31st of August 2021, and other prevention measures (such as supporting research efforts by the Penington Institute).
For additional information, read this entire series of blogs being published from 22 August 2021 through 31 August 2021 in support of polydrug-use overdose awareness and overdose prevention day.
Overdose Awareness and Prevention Resources and Research
Please support the Penington Institute.
This is the 1st of 10 articles/blogs discussing drug overdose statistics and polydrug use harms.
- You’ve just finished reading Blog 1 of 10 (non-medical use of prescription medications).
- Click here to read Blog 2 of 10 (factors contributing to the increase in overdose fatalities).
- Click here to read Blog 3 of 10 (the impact of the Covid-19 pandemic on substance use behaviours and overdose rates).
- Click here to read Blog 4 of 10 (synthetic opioid risks)
- Additional blogs 5 to 10 on Overdose Awareness resources and Prevention research are being published in late August 2021.