Diversion and misuse of prescription opioid substitution treatment medications

• Author: European Monitoring Centre for Drugs and Drug Addiction (EU body or agency)
• Pages: 19-33

TECHNICAL REPORT | Balancing access to opioid substitution treatment with preventing diversion of medications

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funding to be earmarked for the next financial year would need to consider the individuals

already in treatment and a proportion of those out of treatment who may possibly access OST in

the future. This coverage calculation also allows the number in need who have not yet been

reached with OST to be determined.

Furthermore, data on the overall number of high-risk opioid users in any kind of drug treatment

are available for 11 countries (Figure 8). An analysis of the data of all high-risk opioid users in

any kind of treatment and in OST shows that OST is the treatment of choice in all countries.

Between 2 % and 17 % of all opioid users in treatment receive interventions not involving opioid

substitution (Figure 8). In addition, these data show that, in low OST coverage countries

(Cyprus, Lithuania and Latvia), but also in Italy, the overall treatment coverage beyond OST is

estimated to be low, with a significant proportion of high-risk opioid users not in drug treatment.

Figure 8. Overall estimated number of high-risk opioid users in treatment (in OST and other

treatments) as a percentage of the estimated number of high-risk opioid users in 2017 in selected

countries

Source: EMCDDA (2019c,d).

3. Diversion and misuse of prescription opioid substitution

treatment medications

The diversion and misuse of opioid substitution medications is of particular concern in Europe.

The demand for specialised treatment related to the misuse of OST medications and the

number of deaths associated with these medications have been increasing over the past

decade. This growing problem requires close monitoring and adequate interventions. For this

reason, it is important to describe and understand the national contexts, groups and drivers

behind these observed increases.

First, it is important to clarify the terminology pertinent to such analysis and to draw a distinction

between prescription opioids and prescribed opioids. Prescribed opioid medications, such as