Over-the-counter and prescription medicine misuse in Cape Town--findings from specialist treatment centres

Abstract

Objective: To provide community-level public health surveillance information on over-the-counter (OTC) and prescription medicine misuse.

Methods: A retrospective study of OTC and prescription medicine misuse among 9,063 patients from 23 specialist substance abuse treatment centres in Cape Town, South Africa, between 1998 and 2000.

Results: OTC and prescription medicine misuse places a burden on health and social services in South Africa. This is evidenced through the constant demand for treatment for OTC/prescription medicine misuse. Benzodiazepines are the class of medicines for which users most often receive treatment, followed by analgesics. Analgesic misuse is most often accounted for by the use of codeine-containing medicines, many of which are available over the counter. Patients using OTC/prescription medicines as their primary drug of abuse are significantly more likely to be female, and aged over 40 years. In contrast, patients using OTC/prescription medicine as an additional drug of abuse tend to be male and over 40 years of age.

Conclusions: This study points to the need to develop primary health care protocols for detection, management and referral of patients misusing OTC/prescription drugs and the need to debate the re-scheduling of codeine as a prescription-only substance. The study also points to the need for further community-based research on the nature and extent of OTC/prescription drug misuse among the general population.