Glossary

• Author: European Monitoring Centre for Drugs and Drug Addiction (EU body or agency)
• Pages: 39-40

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

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necessary and proportionate to ensure the effectiveness of the treatment and its security to third

parties, and that authorities should ensure that treatment is paid for and that healthcare

professionals are duly remunerated.

The implementation of effective anti-diversion strategies while maintaining adequate access to

effective treatment requires accurate evaluation of the individual and systemic determinants of

the phenomenon in each country. Importantly, some European countries still need to improve

access to OST to those in need in order to achieve adequate coverage levels. The development

of responses should include all stakeholders involved in the provision of OST and in the

prevention of diversion and misuse, as well as patients, with the ultimate goal of reducing the

harmful use of opioids, improving overall access to and the quality of OST, and reducing drug-

related deaths.

Glossary

Accessibility: the degree to which a medicine is obtainable for those who need it at the

moment of need with the least possible regulatory, social or psychological barriers.

Affordability: the degree to which a medicine is obtainable for those who need it at the moment

of need at a cost that does not expose them to a risk of serious negative consequences, such

as not being able to satisfy other basic human needs.

Availability: the degree to which a medicine is present at distribution points in a defined area

for the population living in that area at the moment of need.

Benzodiazepine: a class of drugs that have a hypnotic and sedative action; they are prescribed

mainly as tranquillisers to control symptoms of anxiety, but are also used for recreational

purposes.

Controlled medicines: medicines containing controlled substances, namely the substances

listed in the international drug control conventions.

Diacetylmorphine (the principal psychoactive constituent of heroin): a short-acting opiate

agonist. Illicit (‘street’) heroin may be smoked or solubilised with a weak acid and injected.

Diversion: the act of redirecting a prescription medication (e.g. an OST medication) from

legitimate sources to illegitimate or illegal sources.

Doctor shopping: the practice of visiting multiple physicians to obtain multiple prescriptions.

Essential medicines: those medicines that are listed in the World Health Organization model

list of essential medicines. This list presents a list of minimum medicine needs for a basic

healthcare system, listing the most efficacious, safe and cost-effective medicines for priority

conditions.

Misuse of medications (including OST medications): the use medications outside legitimate

therapeutic guidance.

Morphine: a naturally occurring alkaloid extracted from opium; it is a powerful narcotic

substance with a strong analgesic (painkilling) action and it has other significant effects on the

central nervous system.