Misuse of medicines refers to the use of a psychoactive medicine for self-medication, recreational or enhancement purposes, with or without a medical prescription and outside accepted medical guidelines. It may occur in the context of polydrug use.
Concerns have been growing in many European countries about increasing misuse of medicines, particularly in the light of large increases in deaths from prescription opioid analgesics in the United States. However, there are considerable differences between Europe and the United States with respect to prescribing practices.
The groups of medications that have been associated with misuse include:
These medicines may be obtained by regular prescribing, doctor shopping or visits to multiple pharmacies, diversion of supplies onto the illicit market and internet purchases. One important driver of misuse of medicines is poor prescription practice — this can be over-prescription or, particularly in the case of OST medication, under-prescription, which can result in people seeking to self-medicate. Clinical good practice in the prescription of OST medications reduces diversion and the harms associated with misuse of these medications.
It is not clear if motivational interviewing can help to reduce benzodiazepine use.
Core objectives in this area include: