Diversion of prescribed opioids by people living with chronic pain: Results from an Australian community sample

April 2014
Citation: 
Belcher J, Nielsen S, Campbell G, Bruno R, Hoban B, Larance B, Lintzeris N, Degenhardt L (2013). Diversion of prescribed opioids by people living with chronic pain: Results from an Australian community sample. Drug and Alcohol Review. DOI: 10.1111/dar.12084.

There has been an increase in prescription of opioids for chronic non-cancer pain in Australia and concern exists over possible diversion of prescription opioids to the illicit marketplace. Media coverage has suggested that elderly patients sell their prescribed opioids for additional income. Researchers used data from an existing cohort from the POINT study to test these specific claims. (POINT is a national prospective cohort that will follow 1,500 chronic pain patients newly prescribed opioids over two years). They found that very few people who are prescribed opioids for chronic non-cancer pain divert their opioids to others. Those that did were younger and displayed other aberrant behaviours.

Participants living with chronic non-cancer pain and who had been prescribed opioids for their pain were recruited as part of the POINT study. Just under 1,000 patients were interviewed.

Participants had been living with pain for 14.2 years on average and the most common conditions included chronic back/neck problems and arthritis/rheumatism. Just under half were currently prescribed one opioid, and slightly more than half had been prescribed between two and five opioids; the most common was oxycodone. Four per cent of participants reported ever supplying prescribed opioids to another person; one participant reported receiving payment.

Participants who supplied opioids to others were younger and engaged in a greater number of aberrant behaviours relating to their opioid medication including tampering with doses, taking opioids by alternative routes, seeing doctors to obtain extra opioids and refilling prescriptions early.

It appears that media reports of elderly patients selling their opioids to supplement their income may be reflective of exceptional cases. Future studies may investigate the extent to which other patient groups divert prescription opioids to the illicit marketplace.