Dr Bryan Betty: General Practice NZ chair on research revealing more Kiwis are using prescription drugs for recreational purposes

A new survey out of Massey University has sparked concerns surrounding the number of Kiwis using prescription drugs recreationally.

One out of four survey respondents reported using pharmaceuticals for non-medicinal purposes in the previous six months.

General Practice NZ chair Dr Bryan Betty says pain medications, sedatives like benzodiazepines, gabapentin and ADHD medications are most likely to be abused.

"Most GPs are aware of the issue - and are very careful when prescribing these medications."

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Episode Transcript

Speaker 1 (00:00):
Brian Bridge.

Speaker 2 (00:01):
Survey from Massi University has sparks concerns that people using
prescription drugs are using them for recreational use. One in
four surveyed reported using pharmaceuticals for non medical purposes in
the previous six months. But how easy is it for
someone to actually become addicted to this kind of medication?
Chair of General Practice, New Zealand, doctor Brian Betty is

(00:21):
with me this evening, Brian, good evening.

Speaker 1 (00:24):
Well, good evening, Ryan, nice to be here, great to
have you.

Speaker 2 (00:28):
Are you worried? One in four? Well, first of all,
does that sound right to you? One in four?

Speaker 1 (00:33):
Oh, look, it sounds very high. I've got to say. However,
we know there has been issues around about an appropriate
use of medication and the potential for addiction with certain medications,
and the illicit use of some medication. So this has
been something that's been around for a while, and I
suppose it is worth highlighting that there are issues around

(00:54):
certain medications. We do prescribe.

Speaker 2 (00:56):
What drugs do people like?

Speaker 1 (00:59):
Yeah? Look, question? I suppose the ones we think of
often are pain medications, things like opioids, scentives, s, benzodiazepines
in particular, and something called gabapentins, which are a particular
medication that can be used for pain or epilepsy. The
other one that is around is ADHD medication, so that

(01:21):
can be abused and that can actually be addictive. And
there are instances where where medications dot methylphenidate, which is
used for a DHD can be crushed and used intravenously
or snorted to give a high because in high doses
or very fast release, it can give a very high

(01:43):
addictive property which people like. And those are the other
medications where diversion as we call it can occur.

Speaker 2 (01:50):
How easy is it for a GP to prescribe the
drugs that you just outlined.

Speaker 1 (01:56):
Look varies, So things like opioids an ADHD have to
be prescribed monthly, so they are described every month, not
three monthly lots, and so there is restriction in terms
of how they used. And in fact opioids are prescribed
generally every ten days, so there is restricted access to them.

(02:18):
And we use opioids often in palliative care or pain medication.
And these medications, all of them, when used appropriately, are
very very beneficial and have a real role to play.
So there are restrictions and how they are used, and
most gps are very careful with how they prescribe these
medications and will often do things like say prescribed ten

(02:40):
daily or if I've got concerns, we'll only give three
days worth at once if something is happening. But we
do know that there are appalled to patients who have
addictive who are addicted to medication, who do doctor shop
and look for amount of these medications to accumulate, So
it can be a problem, but most gps are aware

(03:01):
of the issue and are very careful when prescribing these medications.

Speaker 2 (03:05):
What impact do these men like you talked about the
opioids in particular, what impact do they have on your body?
If you're if you're using them at the dose that
your doctor has prescribed, does that mean num impact on
the body, And only if you go over that does
it start to affect you long term?

Speaker 1 (03:22):
Yeah, we need to be very careful about why the
medication is being used. So for instance, where a lot
of these medications are used as actually im palliative care
end of life, and where they're being used for pain,
there is really no risk of addiction to the person
they've been used with, and we need to be very
very clear on that where they used for the purposes

(03:44):
of pain and palliative care, they're not addictive and they
are totally appropriate. They can be titraded, and they need
to be used where the problem arises. We know that,
particularly things like opioids, where they are used inappropriately, that
is the weare they're not used for the persevere pain,
so in a pallie of care situation, they do can
give you for a very addictive type property when they're

(04:07):
not used for pain, and it's in that that people
can become very addicted to them. And in fact, opioids
have a very very strong addictive property. So when they
used outside of their indication, which in this case is
for severe pain, there is certainly a problem in terms
of what they do to the body and the potential
for addiction.

Speaker 2 (04:26):
But is the problem that you would take the dose
and double it and that affects your body, or could
you actually take a prescribed dose that a doctor would
give you for pain for the rest of your life
and actually experience no side effects on your body.

Speaker 1 (04:43):
Well, but that potentially happens. But again I go back
to the basic premise that if you are being prescribed
it for pain, for a say cancer, for instance, then
it's absolutely appropriate and we don't get too concerned about
addictive properties in those situations.

Speaker 2 (04:59):
Oh totally.

Speaker 1 (05:00):
It's when it's been diverted outside of that that that's
the way the problem starts to arived.

Speaker 2 (05:04):
I mean, for good to say, if you've got cancer,
the last thing you've worried about it is whether you're
addicted to some medicine. Do you know what I mean?

Speaker 1 (05:09):
And we have to be very careful of that that
the message that goes out that these medications do have
an absolute role to play. They are incredibly beneficial in
certain circumstances. Do you worry you need to be used
to the right place?

Speaker 2 (05:22):
Do you worry sometimes that the more we talk about this,
that we might start regulating medicines like this and take
them away from people who need them.

Speaker 1 (05:32):
Look, I think this is always a balancing act between
how much regulation do you put in place because there
is perceptional there is an actual problem versus you know,
denying people who actually need access to these medications. I mean,
the other one I interested was ADHD medication that is
incredibly beneficial for patients who do suffer from ADHD, and

(05:54):
it is an incredibly important medication for those patients. But
again when it's used in appropriate greatly, it becomes a problem.
So yes, that's always this balancing act between how much
restriction versus making sure we do give access to these
medications to those that need it.

Speaker 2 (06:10):
Brian, thank you. Great to have you on the show,
Doctor Brian Biddy, Chair of General Practice, and his Dylan.
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