09 August 2011

Happy pills

Given the high incidence of mental and physical ills among people who end up incarcerated it is unsurprising that many self-medicate. The Australian Institute of Criminology has released 'Prescription drug use among detainees: Prevalence, sources and links to crime' (Trends and Issues in crime and criminal justice no. 423) by Catherine McGregor, Natalie Gately & Jennifer Fleming.

The six page report is described as -
the first of its kind in Australia to examine the self-reported use of illicit pharmaceuticals among a sample of police detainees surveyed as part of the Australian Institute of Criminology’s Drug Use Monitoring in Australia (DUMA) program. In all, 986 detainees were interviewed, of which 19 percent reported having recently used pharmaceutical drugs for non-medical purposes in the past 12 months — nearly five times as high as reported by the general Australian population.
The authors comment that -
Non-medical prescription drug use was found to be substantially higher in the detainee population by comparison with the general community. Among the detainees surveyed, more prescription drug users were unemployed, derived their income from welfare or benefits, considered themselves drug dependent, were currently on a drug-related charge and had been arrested or imprisoned in the previous 12 months by comparison with non-users.

Most pharmaceuticals were sourced from family and friends or from the person’s usual doctor and pharmacy. There was little support for the view that pharmaceuticals are commonly obtained through script forgery or over the internet. Benzodiazepines, followed by opioids, were the most commonly used pharmaceuticals for non-medical purposes in this sample of police detainees.

This paper provides policymakers with valuable information about the reasons for use and the methods by which pharmaceuticals are typically accessed for non-medical purposes. Further research to investigate the methods of obtaining illicit pharmaceuticals from within the general community is needed.
The research indicates that -
non-medical prescription drug use was found to be substantially higher in the detainee population by comparison with the general community. Among the detainees surveyed, more prescription drug users were unemployed, derived their income from welfare or benefits, considered themselves drug dependent, were currently on a drug-related charge and had been arrested or imprisoned in the previous 12 months by comparison with non-users. Most pharmaceuticals were sourced from family and friends or from the person’s usual doctor and pharmacy. There was little support for the view that pharmaceuticals are commonly obtained through script forgery or over the internet. Benzodiazepines, followed by opioids, were the most commonly used pharmaceuticals for non-medical purposes in this sample of police detainees. Further research to investigate the methods of obtaining illicit pharmaceuticals from within the general community is needed.
What sort of meds are being used? The authors indicate that -
Diazepam, followed by alprazolam, were the benzodiazepines used most frequently by prescription drug users. This pattern may reflect their availability at low cost on the pharmaceutical benefits scheme. In 2007, diazepam and alprazolam were respectively the most frequently dispensed benzodiazepines through the pharmaceutical benefits scheme. The relatively low use of flunitrazepam in this sample may reflect the difficulty of accessing this benzodiazepine since its rescheduling to an S8 drug in 1998. Of the opioids, morphine was most commonly used by prescription drug users in this sample. This again is consistent with other studies of Australian users. The low prevalence of other prescription drug use, including that of antipsychotics and antidepressants, probably reflects the lack of reinforcing properties of these drugs as they do not produce marked stimulating or sedative effects.
In commenting on demographics the report indicates that
Prescription drug use was higher in women, younger people, the unemployed and detainees who considered themselves drug dependent. Use was also associated with indicators of social disadvantage and offending behaviour. Specifically, more users had a current drugs-related charge, had been arrested in the previous 12 months and had been in prison in the previous 12 months. Prescription drug use appeared to have a specific purpose or function for most of the detainees using them. While a minority took pharmaceuticals for reasons of curiosity or availability, most took them to relieve negative emotional states, insomnia, pain or symptoms associated with drug dependence. Additionally, over one-quarter had taken prescription drugs for their reinforcing or hedonic properties.