South Asia: UNODC presents exploratory study on the misuse of prescription drugs in the region

Pharmaceutical drugs are used for the prevention, diagnosis and treatment of various diseases and disorders. While some of them can be procured without any restrictions (over-the-counter drugs), others require a physician's prescription (prescription drugs). Certain narcotic and psychotropic prescription drugs, eg - opiate pain killers like morphine and some anti-cancer drugs, are under strict regulatory controls. However, many such prescription drugs, such as opioids, depressants and stimulants often reach the user without prescription.

In this regard, the last decade has seen a substantial rise in the recreational use of prescription drugs across South Asia. Easy access, affordability and high purity of narcotic and psychotropic prescription drugs make them attractive substitutes for illicit drugs. According to Dr Rajat Ray, Chief of the National Drug Dependence Treatment Centre, India and a WHO Collaborating Centre on Substance Abuse, this is a fairly serious and emerging problem in South Asia. He explains, "From my clinical experience, it appears that many ex-heroin/opiate users start abusing pharmaceuticals/prescription drugs in an effort to quit heroin/opiate consumption. However, some are initiated into drug use directly through pharmaceuticals/prescription drugs. Some others may have been prescribed these drugs for a genuine illness; however, self-use or abuse continued as these drugs can induce euphoria".

According to Dr Ray, the unavailability of street opioids, the lax control on sale of the pharmaceutical drugs without prescription and sale of these drugs by unscrupulous chemists who are driven by profit motives are some of the key factors for this problem. The health consequences of prescription drug abuse can be varied, depending on the drug being abused. For instance, chronic use of diazepam causes drowsiness, while those used as injections can additionally lead to the spread of HIV and hepatitis. Abuse of some other drugs such as stimulants can cause serious health damage, brain damage and irritability.

In the absence of national surveys, there is little data available on the use of pharmaceuticals in South Asia. Concerned by the health impact of illicit pharmaceutical drug use, during 2009, UNODC brought together policy makers and experts from the fields of drug law enforcement, drug treatment and representatives of the pharmaceutical industry in South Asia, with the objective of assessing in each country (Bangladesh, Bhutan, India, Maldives, Nepal, Sri Lanka) the nature and extent of pharmaceutical use, the manner in which pharmaceuticals are sourced illegally, and the legal, regulatory and enforcement gaps. A series of seminars and brain storming sessions were organised in each of the six countries, where experts discussed and assessed various aspects of the issue. Subsequently, they formulated recommendations on ways in which prescription drug abuse can be curtailed, taking into account that some of the drugs play an essential role in pain management and other areas of medical treatment.

Consolidating the conclusions of the seminars along with additional research, UNODC published the report 'Misuse of Prescription drugs - A South Asia Perspective' which provides an exploratory assessment of the nature and extent of the problem in the region in the context of drug use in general. Focussing on each of the countries mentioned above, the report addresses demand and supply issues, the importance of a proper assessment of the licit requirement of pharmaceuticals, legal and enforcement gaps, strengthening organizational capacities, the need for greater awareness among various stakeholders, the need for enhancing treatment and outreach services and most importantly highlighting the role of the pharmaceutical trade and industry to address this issue.

This UNODC publication and the above mentioned seminars were possible thanks to support from the Government of India.

Click here to read the report 'Misuse of Prescription Drugs: A South Asia Perspective'