UK survey of non-medical use of prescription drugs (NMURx) as a valuable source of general population illicit drug use data

Amioka

et al. 2019

There is concern in the UK about nonmedical use (NMU) of alprazolam (Xanax). We investigated the epidemiology of alprazolam NMU compared with diazepam using data from the Survey of Non-Medical Use of Prescription Drugs (NMURx) programme (collected 28 September-1 December 2017). The survey included 10 019 respondents and was weighted by age, sex and region to represent 52 927 659 UK adults. The estimated national prevalence of lifetime NMU of alprazolam was 0.32% (95% confidence interval: 0.19-0.46), and 1.30% (1.06-1.54) for diazepam.The prevalence of NMU in the last 90 days was significantly different when split by age category for alprazolam (P < .001), but not for diazepam (P = .262) with alprazolam NMU being more common among younger adults (age 16-24 years: 0.37%; age 25-34 years: 0.14%; 35 years or older: 0.01%). Further research is needed to fully understand the motivations of alprazolam NMU and to monitor whether the popularity of alprazolam will rise.

Section: Methodsmentioning

confidence: 99%

Nonmedical use of alprazolam in the UK: Results from a nationally representative survey

Amioka

et al. 2019

“…The NMURx programme is part of the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS) system methodology, which has been described in detail elsewhere. 14,15 Data used in this analysis were collected from an online survey between 23 March and 23 April 2018. Poststratification weights were applied the survey population based on region, sex and age to be representative of the demographic distribution of the adult UK population.…”

Section: Methodsmentioning

confidence: 99%

Nonmedical use of benzodiazepines and Z‐drugs in the UK

Haynes

et al. 2020

Self Cite

To estimate prevalence of last 12-month nonmedical use (NMU) of benzodiazepines and Z-drugs (the nonbenzodiazepine hypnotics zaleplon, zolpidem and zopiclone) in the UK. Methods: Data were collected using the Non-Medical Use of Prescription Drugs survey with poststratification weighting applied to be representative of the UK population (≥16 years). Participants were questioned about whether they had nonmedically used benzodiazepines and/or Z-drugs in the last 12-months and from where they had obtained the drug (including via a prescription, or illicitly from a friend/family member, a dealer or via the internet). Additional questions were asked about last 12-month use of illicit drugs (cannabis, cocaine, 3,4-methylenedioxymethylamphetamine [MDMA], non-pharmaceutical amphetamine, crack cocaine and/or heroin). Results: The study included 10 006 eligible participants representing approximately 52 927 000 UK adults. The estimated prevalence of past 12-month NMU of any benzodiazepine and/or Z-drug was 1.2% (95% confidence interval: 1.0-1.5) corresponding to approximately 635 000 adults; amongst this group only an estimated 4.6% (1.2-8.0) had NMU of both a benzodiazepine and a Z-drug. The highest prevalence of NMU for only Z-drugs was among those who had used heroin in the last 12-months (5.4%, 2.7-10.5), whilst the highest prevalence of NMU for only benzodiazepines was among those who had used illicit stimulants in the last 12-months: cocaine (5.9%, 3.8-8.9), amphetamine (5.6%, 3.1-10.0) and MDMA (5.2%, 3.1-8.8). The drug non-medically used was more commonly acquired without than with a prescription for both only benzodiazepines (70.2%, 59.4-81.1 compared to 51.3%, 41.5-64.6) and only Z-drugs (75.6%, 61.6-89.7 compared to 33.9%, 16.9-51.0). Conclusion: There is little overlap between benzodiazepine and Z-drug NMU suggesting distinct nonmedical use of the drugs; future studies need to explore whether this relates to personal preference, drug availability or other factors. A significant proportion are acquiring these drugs for NMU without a prescription, so without guidance and monitoring from a medical practitioner. While the dangers of mixing benzodiazepines and heroin/other opioids are well documented, there is a The authors confirm that the PI for this paper is Paul I. Dargan and that he had direct clinical responsibility for patients.

“…The methodology of this program has been described elsewhere. 16,17 The countries included in this study are the five most populous located entirely within Europe: Germany, the United Kingdom (UK), France, Italy and Spain. 18 Recruitment and data collection are delivered to countrybased members through a global survey panel company, in the native language of the country where it is undertaken and in English, and targeted at the age group from 15 years (Spain), 16 years (UK) and 18 years (France, Germany, Italy) and older.…”

Section: Study Design and Populationmentioning

confidence: 99%

“…needle exchanges, homeless shelters). Therefore, the survey was not representative of the general population even though the goal was to produce population-based estimates and post-stratification weights were applied to represent national demographics and substance use characteristics.The major strength of this study is that it is representative of the national populations; the UK version of the survey has been shown to be comparable to the national Crime Survey of England and Wales (CSEW) cohort, in terms of illicit drug use 17. The main limitation with this study, as with all online surveys, is the reliance on participants providing honest, accurate answers.…”

mentioning

confidence: 99%

Non‐medical use of benzodiazepines and GABA analogues in Europe

Amioka

et al. 2020

We investigated the prevalence of non-medical use (NMU) of benzodiazepines and GABA analogues in Europe. Methods: Data were collected using the online Non-Medical Use of Prescription Drugs (NMURx) survey from France, Germany, Italy, Spain and the UK. Results: The study included 55 223 eligible surveys which, after post-stratification weights were applied, represented approximately 260 million European adults. Lifetime NMU of benzodiazepines was highest in Spain (6.5%, 95% CI: 6.07.0) and lowest in Germany (1.7%, 1.52.0). Lifetime NMU of GABA analogues was highest in Germany (5.4%, 5.05.7) and lowest in France (2.2%, 1.92.5) and the UK (2.2%, 1.92.6) While no notable difference was observed for France or the UK, there was a higher prevalence of last 12-month NMU of benzodiazepines compared to GABA analogues in Italy (2.4 times higher) and Spain (3.0 times higher) and a higher prevalence of NMU of GABA analogues compared to benzodiazepines in Germany (2.6 times higher). Conclusion: This study shows that there is variation in NMU of benzodiazepines and GABA analogues among countries. Of particular interest is the high incidence of GABA analogue NMU in Germany and benzodiazepine NMU in Spain. Further research to identify factors and motivations responsible for the higher prevalence observed are essential to inform public health policies in those countries. K E Y W O R D S addiction, drug abuse, public health 1 | INTRODUCTION Non-medical use (NMU) of prescription medicines is a global issue and, while much of the attention is focused on NMU of prescription opioids, there are other drug classes that warrant investigation. 1,2 A previous study by Novak et al. investigating NMU of prescription drugs in Denmark, Germany, Great Britain, Spain and Sweden found that, while opioids were the most commonly reported medication for lifetime NMU (13.5% of respondents after weighting, compared to 10.9% for sedative drugs [benzodiazepines and tranquilisers]), sedative drugs were most commonly reported for past-year NMU (5.8% compared to 5.0% for opioids). 3 Benzodiazepines have been widely used for their sedative and anxiolytic properties globally for decades, while more recently the