Estimating the proportion of prescription opioids that is consumed by people who inject drugs in <scp>A</scp>ustralia

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction and Aims.</jats:title><jats:p>To estimate the contribution that people who inject drugs (<jats:styled-content style="fixed-case">PWID</jats:styled-content>) make to population‐level use of prescription opioids in <jats:styled-content style="fixed-case">A</jats:styled-content>ustralia.</jats:p></jats:sec><jats:sec><jats:title>Design and Methods.</jats:title><jats:p>Data on prescriptions of oxycodone, morphine and methadone tablets were obtained for <jats:styled-content style="fixed-case">N</jats:styled-content>ew <jats:styled-content style="fixed-case">S</jats:styled-content>outh <jats:styled-content style="fixed-case">W</jats:styled-content>ales, <jats:styled-content style="fixed-case">V</jats:styled-content>ictoria, <jats:styled-content style="fixed-case">T</jats:styled-content>asmania and <jats:styled-content style="fixed-case">Q</jats:styled-content>ueensland, and time series analyses used to characterise the trends from 2002 to 2010. Estimates of the number of <jats:styled-content style="fixed-case">PWID</jats:styled-content> were combined with data on their levels, frequency and typical doses of morphine, methadone tablet (only prescribed in <jats:styled-content style="fixed-case">A</jats:styled-content>ustralia for pain) and oxycodone from 2004 to 2010. Estimated consumption per 1000 <jats:styled-content style="fixed-case">PWID</jats:styled-content> and per 1000 persons aged 20–69 years was contrasted and the proportion of total consumption accounted for by <jats:styled-content style="fixed-case">PWID</jats:styled-content> estimated.</jats:p></jats:sec><jats:sec><jats:title>Results.</jats:title><jats:p>Morphine prescribing declined; oxycodone prescribing increased. <jats:styled-content style="fixed-case">PWID</jats:styled-content> had far higher rates of prescription opioid consumption (defined daily doses per 1000) than the general population. Tasmania had highest use of prescribed opioids. <jats:styled-content style="fixed-case">PWID</jats:styled-content> contribution to morphine consumption in Tasmania increased to 28% (range 22–37%) in 2010; elsewhere, <jats:styled-content style="fixed-case">PWID</jats:styled-content> contribution was lower (midpoints of 2–12%, 2010). Methadone tablet use was less elevated compared with the general population. With the exception of Tasmania, <jats:styled-content style="fixed-case">PWID</jats:styled-content> were estimated to consume less than 5% of oxycodone.</jats:p></jats:sec><jats:sec><jats:title>Discussion and Conclusions.</jats:title><jats:p><jats:styled-content style="fixed-case">PWID</jats:styled-content> use prescription opioids at high levels and can account for a significant proportion of consumption. Increased oxycodone prescribing in <jats:styled-content style="fixed-case">A</jats:styled-content>ustralia has not been driven by <jats:styled-content style="fixed-case">PWID</jats:styled-content>. Opioid substitution therapy and other effective treatments need to be more available and attractive to <jats:styled-content style="fixed-case">PWID</jats:styled-content>. <jats:italic>[Degenhardt L, Gilmour S, Shand F, Bruno R, Campbell G, Mattick RP, Larance B, Hall W. Estimating the proportion of prescription opioids that is consumed by people who inject drugs in Australia. </jats:italic>Drug Alcohol Rev<jats:italic> 2013;32:468–474]</jats:italic></jats:p></jats:sec>