The misuse and trafficking of prescription drugs is growing fast worldwide and is set to become as big a problem as illicit drugs, a report by the International Narcotics Control Board warns. Governments need to step up efforts to stem the problem, it says.
The diversion and misuse of narcotic drugs in the form of pharmaceutical preparations, however, also continues to be under-reported, it says.
The board recommends that all governments should “promote the rational use of narcotic drugs and psychotropic substances,” in accordance with the recommendations of the World Health Organization.
The report by the independent, quasi-judicial body, which monitors the implementation of UN drug control conventions, points out that in the past decade consumption of opioid analgesics increased by more than 100% in more than 50 countries.
It says that in the United States “the gradual abuse in the use of sedatives, tranquillisers and narcotic drugs other than heroin among the general population has resulted in prescription drugs becoming the second most abused class of drugs after cannabis.”
Such prescription drugs have effects, it says, similar to those of illicit drugs when taken in inappropriate quantities and without medical supervision.
The number of Americans who misused controlled prescription drugs “nearly doubled from 7.8 million in 1992 to 15.1 million” in 2003, it notes. The misuse of prescription drugs such as fentanyl, hydrocodone, and oxycodone, it says, has led to a rising number of deaths in North America and Europe.
Large scale diversions of buprenorphine, an analgesic that is prescribed for substitution treatment of drug dependency, have also been reported in India and in European countries such as France where it is widely used in the treatment of heroin addicts.
During 2001-5 the global consumption of buprenorphine more than tripled from 420 million daily doses to 1.5 billion daily doses. Illicit preparations of buprenorphine have been found to be misused in Iran, Pakistan, the United Arab Emirates, the Czech Republic, Finland, Georgia, and Mauritius, among other countries.
In the United Kingdom the misuse of methadone alone or in combination with other drugs, says the study, “was implicated in 173 drug related deaths in 2005.”
Misuse of fentanyl through pharmacy theft, fraudulent prescriptions, and illicit distribution by patients, doctors, and pharmacists is also a growing problem in North America, Europe and Russia, where it is sold by traffickers as an imitation of illicit drugs such as heroin.
The report says that since 2000 the global consumption of fentanyl for medical purposes has more than tripled.
The misuse of prescription drugs is exacerbated by the higher volumes of drugs in the unregulated market and the rapid growth of internet pharmacies, which in some countries are not subject to national drug control regulations. And, despite the closure of thousands of illegal internet pharmacies, “there are an increasing number of such internet sites selling medicines containing opioids and stimulants without prescription.”
The substances most commonly traded over the internet, it says, were psychotropic substances, benzodiazepines, and stimulants.
Philip Emafo, the board's president, says that activities of the unregulated market “expose patients to serious health risks.”
The board concludes that WHO should consider the development of “a guide on best practices in dealing with the unregulated market, to be compiled and widely distributed.”
The 2006 annual report of the International Narcotics Control Board is available at www.incb.org.