Non-medical prescription drug
Non-medical prescription drug use is a common cause of emergency department (ED) visits in the United States for medication-related harm, but data on the effects of non-medical use of pharmaceuticals are limited. Using nationally representative public health surveillance data to characterize US ED visits for damage caused by non-medical prescription drug use, investigators at the CDC and FDA report in the American Journal of Preventive Medicine that over half of these visits are by young adults under 35, and over 40 percent of patients arrive unconscious or after cardio respiratory failure. They include recommendations to guide prevention efforts.
Non-medical prescription drug use, generally defined as use without a prescription or for reasons other than the medication is intended, is a global concern. The increase in morbidity from prescription opioids has been called an epidemic, and overdoses from prescription and illicit opioids led the US Department of Health and Human Services (HHS) to declare a public health emergency in 2017.
Previous studies have shown that prescription opioids and benzodiazepines are commonly misused (by 11.5 million and 5.6 million individuals in the US, respectively, in 2016). However, since the discontinuation of the Drug Abuse Warning Network after 2011, detailed national data describing morbidity from non-medical use of pharmaceuticals are limited.
The data showed that in the US in 2016, there were an estimated 358,247 ED visits for harm from the non-medical use of medications.
• Two-fifths (41 percent) of these ED visits resulted in hospitalization, and nearly one-quarter (22.6 percent) of visits involved unresponsive patients or had experienced cardio respiratory failure.
• One-half (50.9 percent) of these visits involved patients younger than 35. Only one in twenty (4.9 percent) visits involved older adults (aged 65 or more years old).
• Benzodiazepines were the most commonly implicated medication (47 percent), followed by prescription opioids (36 percent).
• Other substances such as alcohol, heroin, cocaine, and other illicit substances or medications were involved in 85 percent of benzodiazepine cases and 69 percent of prescription opioid patients.
About 275 million people worldwide, roughly 5.6 percent of the global population aged 15–64, used drugs at least once during 2016. Initial estimations suggest that, globally, 13.8 million young people aged 15–16 years used cannabis in the past year, equivalent to a rate of 5.6 percent. Some 31 million people who use drugs suffer from drug use disorders, meaning that their drug use is harmful to the point where they may need treatment. Roughly 450,000 people died as a result of drug use in 2015, according to WHO. Of those deaths, 167,750 were directly associated with drug use disorders (mainly overdoses). The rest were indirectly attributable to drug use and included deaths related to HIV and hepatitis C acquired through unsafe injecting practices.
Opioids continued to cause the most harm, accounting for 76 percent of deaths where drug use disorders were implicated. PWID — some 10.6 million worldwide in 2016 — endured the most significant health risks. More than half of them live with hepatitis C, and one in eight live with HIV.
