HARCP Archives

Browse by article

Browse by volume

Heroin Addiction and Related Clinical Problems: 2015, 17, 2-3 (pages: 25 - 34)

The extent of misuse and diversion of medication for opioid substitution treatment: a review and expert opinions

Alho H., D'Agnone O., Krajci P., McKeganey N., Maremmani I., Reimer J., Roncero C., Somaini L., Wright N., and Littlewood R.

Summary: Introduction: Opioid dependence is a major global problem associated with negative health, social and economic outcomes. Opioid Substitution Treatment (OST) is the prescription of opioid-containing medicines as a substitution for illicit opioid drugs. OST, as an intervention for opioid dependence, reduces illicit drug use and is proven to improve outcomes by preventing harm and mortality. Provision of access to OST is associated with the misuse and diversion of opioid-containing medications. This misuse and diversion is a serious public health problem; it results in worsening outcomes with an increased risk to the individual's health, a lack of progression in recovery and an increase in criminal activity. Aim: The aim of this paper is to describe the extent of misuse and diversion of OST medication. Methods: An assessment of the scale of the problem was made based on a defined process including analysis of evidence from a systematic review of published literature and experts' practice. Results: Results describe rates of misuse of OST medication ranging from 18 to 81%; diversion occurs in 23 to 39% of cases. Misuse and diversion of OST is common and is associated with negative outcomes for individuals and society. Conclusion: Greater understanding of the extent and impact of misuse and diversion will assist in the development of strategies to reduce this problem and its significant consequences. As part of ensuring appropriate care for those with opioid dependence, addressing misuse and diversion must be considered an important priority.