title: Estimating the proportion of prescription opioids that is consumed by people who inject drugs in Australia.
abstract: OBJECTIVE
  To estimate the contribution that people who inject drugs (PWID) make to population-level use of prescription opioids in Australia.
  
  
  METHODS
  Data on prescriptions of oxycodone, morphine and methadone tablets were obtained for New South Wales, Victoria, Tasmania and Queensland, and time series analyses used to characterise the trends from 2002 to 2010. Estimates of the number of PWID were combined with data on their levels, frequency and typical doses of morphine, methadone tablet (only prescribed in Australia for pain) and oxycodone from 2004 to 2010. Estimated consumption per 1000 PWID and per 1000 persons aged 20-69 years was contrasted and the proportion of total consumption accounted for by PWID estimated.
  
  
  RESULTS
  Morphine prescribing declined; oxycodone prescribing increased. PWID had far higher rates of prescription opioid consumption (defined daily doses per 1000) than the general population. Tasmania had highest use of prescribed opioids. PWID contribution to morphine consumption in Tasmania increased to 28% (range 22-37%) in 2010; elsewhere, PWID contribution was lower (midpoints of 2-12%, 2010). Methadone tablet use was less elevated compared with the general population. With the exception of Tasmania, PWID were estimated to consume less than 5% of oxycodone.
  
  
  CONCLUSIONS
  PWID use prescription opioids at high levels and can account for a significant proportion of consumption. Increased oxycodone prescribing in Australia has not been driven by PWID. Opioid substitution therapy and other effective treatments need to be more available and attractive to PWID.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; Melbourne School of Global and Population Health, University of Melbourne, Melbourne, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.forename: Stuart
authors.initials: S
authors.lastname: Gilmour
authors.forename: Fiona
authors.initials: F
authors.lastname: Shand
authors.forename: Raimondo
authors.initials: R
authors.lastname: Bruno
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Campbell
authors.forename: Richard P
authors.initials: RP
authors.lastname: Mattick
authors.forename: Briony
authors.initials: B
authors.lastname: Larance
authors.forename: Wayne
authors.initials: W
authors.lastname: Hall
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D063487:Prescription Drug Misuse / Q000639:trends; D011793:Queensland / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000175:diagnosis* / Q000453:epidemiology*; D013648:Tasmania / Q000453:epidemiology; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: chronic pain; heroin; injecting drug use; opioid substitution therapy; pharmaceutical opioid