Internet sourcing and UK end consumer trend interest in the controlled medicines (opioids, sedatives and GABA drugs) in pre and post COVID-19 timeframes

Whitfield, M; Germain, Jennifer; Hillis, Alyson; Halsall, Devina; McVeigh, Jim; Abbasi, Yasir; Hout, Marie Claire Van

doi:10.1016/j.etdah.2021.100027

Cited by 7 publications

(13 citation statements)

References 35 publications

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“…That said, similar warnings about designer benzodiazepines do not appear to have had the desired impact. COVID-19 could have played a part in the decreasing role of alprazolam in drug-related deaths, for example, by lockdown measures limiting access to illicit supplies ( Bergeron et al, 2020 ; Whitfield et al, 2021 ) or to prescribed benzodiazepines ( Carr et al, 2021 ), or reduced access to treatment ( Carr et al, 2021 ; Di Gessa et al, 2022 ) leading to self-medication with substitute drugs ( Zaami et al, 2020 ). Further investigation is warranted into the fall in alprazolam-related deaths.…”

Section: Discussionmentioning

confidence: 99%

Alprazolam-related deaths in Scotland, 2004–2020

et al. 2022

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Background: The benzodiazepine drug alprazolam, a fast-acting tranquiliser, cannot be prescribed on the National Health Service in the United Kingdom. Illicit alprazolam supply and consumption have increased. Concern about increasing numbers of alprazolam-related fatalities started circulating in 2018. However, statistics on this issue are very limited. This study examined patterns in such mortality in Scotland. Methods: Statistics on deaths where alprazolam was mentioned in the ‘cause of death’ were obtained from official mortality registers. Anonymised Scottish case-level data were obtained. Data were examined in respect of the characteristics of decedents and deaths using descriptive statistics. Results: Scotland registered 370 deaths in 2004–2020; 366 of these occurred in 2015–2020: most involved males (77.1%); mean age 39.0 (SD 12.6) years. The principal underlying cause of death was accidental poisoning: opiates/opioids (77.9%); sedatives/hypnotics (15.0%). Two deaths involved alprazolam alone. Main drug groups implicated: opiates/opioids (94.8%), ‘other benzodiazepines’ (67.2%), gabapentinoids (42.9%), stimulants (30.1%), antidepressants (15.0%). Two-thirds (64.2%) involved combinations of central nervous system (CNS) depressants. Discussion: Alprazolam-related deaths are likely due to an increasing illicit supply. The fall in deaths in 2019–2020 is partially due to increased use of designer benzodiazepines. Treatment for alprazolam dependence is growing. Clinicians need to be aware of continuing recreational alprazolam use. When such consumption occurs with CNS depressants, overdose and death risks increase. Conclusions: More awareness of alprazolam contributing to deaths, especially in conjunction with other CNS depressants, is needed by consumers and clinicians. Improved monitoring of illicit supplies could identify emerging issues of medicines’ abuse.

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Section: Discussionmentioning

confidence: 99%

Alprazolam-related deaths in Scotland, 2004–2020

et al. 2022

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“…The study formed part of a larger piece of research exploring online UK sourcing of drugs ( Whitfield et al, 2021 ). For this stage, stakeholders (such as policy makers, health care professionals, community workers or police) and individuals who source online (ISOs) and have purchased opioids, sedatives or GABA drugs, from North West England were recruited using purposive (participants selected on characteristics align-ing with the study criteria), snowball sampling (referrals from existing sample), and response-driven (similar to snowball sampling and led by specific themes emerging from the interviews) techniques.…”

Section: Sample and Recruitmentmentioning

confidence: 99%

“…In depth, semi-structured interviews were conducted with participants over Zoom video conference software by authors one and two. The interview schedules were informed by previous publications by the research team ( Whitfield et al, 2021 ). The schedule was tested within the research team and after each interview, the schedule was amended as required.…”

Section: Data Collectionmentioning

confidence: 99%

“…Ethical approval was obtained by Liverpool John Moores University Research Ethics Committee (reference: 20/PHI/024). The research team has considerable experience regarding the methodological and ethical implications of online methods in drugs research ( Van Hout, 2015 ;Van Hout and Hearne, 2017 ;Whitfield et al, 2021 ), qualitative research methodologies with hidden drug user populations, and surveillance systems and drug related death research. It included team members with professional expertise in medicines control, and treatment of drug use disorders.…”

Section: Ethical Approvalmentioning

confidence: 99%

“…Key pharmaceuticals under surveillance by the European Monitoring System for Drugs and Drug Addiction (EMCDDA), and the European Medicines Agency (EMA) early warning system include opioids; sedatives and gamma-amino butyric acid (GABA) drugs ( Casati et al, 2012 , European Monitoring Centre for Drugs andDrug Addiction, 2016 ). The 2021 World Drug Report highlighted the breadth and depth of online drug markets which operate across both the surface and dark web ( United Nations Office on Drugs and Crime, 2021 ) and the online presence and interest in pharmaceuticals has continued to flourish during and since the COVID-19 pandemic ( Whitfield et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Internet sourcing and unsafe use of controlled drugs (opioids, sedatives and GABA drugs) in the UK: An in depth case study of consumer dynamics during COVID-19

Hillis

Germain

Whitfield

et al. 2023

Emerging Trends in Drugs, Addictions, and Health

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Private prescribing of controlled opioids in England, 2014-2021: a retrospective observational study

Martus

MacKenna

Richards

2023

Preprint

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Background: Trends of opioid prescribing in the NHS has been well published, yet trends by private prescribers has not been established. Aim: To assess trends and geographical variation of controlled opioids dispensed by private prescribers in England. Design and setting: A retrospective observational study in English primary care. Methods: Data on schedule II and III controlled opioids was obtained from the NHS Business Services Authority (BSA) using freedom of information (FOI) requests between 01 January 2014 and 30 November 2021. Absolute counts and rates of the number of items dispensed per cumulative number of registered private prescribers and stratified over time, by opioid type, and geographical region. Results: 128,341 items of controlled opioids were dispensed by private prescribers in England between January 2014 and November 2021, which decreased by 50% from 23,339 items (4.09 items/prescriber) in 2014 to 11,573 items (1.49 items/prescriber) in 2020. Methadone (36%) was the most common controlled opioid dispensed privately, followed by morphine (18%), buprenorphine (16%), and oxycodone (12%). Prescriptions were highest in London (74%), followed by the South-East of England (7%). A proportion of items (n=462, 0.35%) were prescribed by unidentified doctors. Conclusions: Controlled opioids dispensed by private prescribers in England decreased and were primarily dispensed in London. To ensure patient safety, the monitoring and surveillance of controlled opioids dispensed privately should continue and items linked to unidentified doctors should be further investigated.

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Internet sourcing and UK end consumer trend interest in the controlled medicines (opioids, sedatives and GABA drugs) in pre and post COVID-19 timeframes

Cited by 7 publications

References 35 publications

Alprazolam-related deaths in Scotland, 2004–2020

Alprazolam-related deaths in Scotland, 2004–2020

Internet sourcing and unsafe use of controlled drugs (opioids, sedatives and GABA drugs) in the UK: An in depth case study of consumer dynamics during COVID-19

Private prescribing of controlled opioids in England, 2014-2021: a retrospective observational study

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