title: Changes in non-opioid substitution treatment episodes for pharmaceutical opioids and heroin from 2002 to 2011.
abstract: BACKGROUND
  There has been a well-documented increase in the non-medical use of pharmaceutical opioids (PO) worldwide. However, there has been little detailed examination of treatment demand, or the characteristics of those presenting for treatment, particularly for treatments other than opioid substitution.
  
  
  METHODS
  Data from closed drug and alcohol treatment episodes from the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS-NMDS, representing non-opioid substitution treatment) in Australia for 2002-2003 to 2010-2011 were examined. In the four jurisdictions where detailed data were available, episodes where heroin was the principal drug of concern were compared to episodes for the four most frequently reported pharmaceutical opioids (morphine, codeine, fentanyl and oxycodone).
  
  
  RESULTS
  In 2002-2003, most (93%) opioid treatment was related to heroin with seven percent of all opioid treatment episodes reporting a PO as the principal drug of concern. In 2010-2011, 20% of all opioid treatment episodes were attributed to POs. Distinct changes over time were observed for different opioids. There was an increase in the average age at the start of treatment for heroin and oxycodone episodes, and a reduction in the proportion of females for codeine episodes, with 67% in 2002-2003 compared with 44% in 2010-2011. Codeine and oxycodone episodes had the lowest current or past injection rates.
  
  
  CONCLUSIONS
  Clear differences were observed over time and between different opioids. Monitoring these emerging patterns will be important to inform treatment needs, particularly in light of different patterns of poly drug use, different routes of administration and changing demographic characteristics.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales 2052, Australia; Drug and Alcohol Services, South Eastern Sydney Local Health District, 591 South Dowling St, Surry Hills 2010, Australia. Electronic address: suzanne.nielsen@unsw.edu.au.
authors.forename: S
authors.initials: S
authors.lastname: Nielsen
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales 2052, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Roxburgh
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales 2052, Australia; School of Medicine, University of Tasmania, Level 1, Medical Science 1, 17 Liverpool Street, Hobart 7000, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Bruno
authors.affiliation: Drug and Alcohol Services, South Eastern Sydney Local Health District, 591 South Dowling St, Surry Hills 2010, Australia; University of Sydney, Department of Addiction Medicine, Missenden Road, Camperdown 2006, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Lintzeris
authors.affiliation: Tobacco, Alcohol and Other Drugs Unit, Australian Institute of Health and Welfare, 1 Thynne Street, Fern Hill Park, Bruce 2617, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Jefferson
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales 2052, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001315:Australia; D005260:Female; D003932:Heroin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000639:trends*; D009293:Opioid-Related Disorders / Q000628:therapy*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D003932:Heroin
keywords: Codeine; Fentanyl; Oxycodone; Prescription opioid; Treatment