Seeking drugs or seeking help? Escalating "doctor shopping" by young heroin users before fatal overdose

Med J Aust. 2004 Mar 1;180(5):211-4.

Abstract

Objective: To identify prescription drug-seeking behaviour patterns among young people who subsequently died of heroin-related overdose.

Design: Linkage of Medicare and Pharmaceutical Benefits Scheme and Coroner's Court records from Victoria.

Subjects: Two hundred and two 15-24-year-olds who died of heroin-related overdose between 6 January 1994 and 6 October 1999.

Main outcome measures: Patterns of use of medical services and prescription drugs listed on the Pharmaceutical Benefits Scheme in the years before death, and use of all drugs just before death.

Results: Polydrug use was reported in 90% of toxicology reports, and prescription drugs were present in 80% of subjects. Subjects accessed medical services six times more frequently than the general population aged 14-24 years, and more than half of all prescribed drugs were those prone to misuse, such as benzodiazepines and opioid analgesics. A pattern of increasing drug-seeking behaviour in the years before death was identified, with doctor-visitation rates, number of different doctors seen and rates of prescriptions peaking in the year before death.

Conclusions: An apparent increase in "doctor shopping" in the years before heroin-related death may reflect the increasing misuse of prescription drugs, but also an increasing need for help. Identification of a pattern of escalating doctor shopping could be an opportunity for intervention, and potentially, reduction in mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Clinical Pharmacy Information Systems
  • Drug Overdose / mortality
  • Drug Prescriptions / statistics & numerical data*
  • Family Practice*
  • Female
  • Health Services Misuse*
  • Heroin / poisoning*
  • Heroin Dependence / mortality
  • Heroin Dependence / prevention & control*
  • Hotlines
  • Humans
  • Male
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies
  • Victoria / epidemiology

Substances

  • Heroin