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Gharaibeh L, Alameri MA, Al-Kabariti AY, Alsa'd AA, Abed A, Karameh N, Aldeeb ID. Practices, perceptions and trust of the public regarding online drug purchasing: a web-based survey from Jordan. BMJ Open 2023; 13:e077555. [PMID: 37890969 PMCID: PMC10619020 DOI: 10.1136/bmjopen-2023-077555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVES Online purchasing, including drugs, increased dramatically in the last decade especially through the COVID-19 pandemic. The aim of this study was to investigate the frequency and attitudes of consumers concerning online drug purchasing and assess their perceptions regarding the benefits and disadvantages. DESIGN A web-based survey conducted through a self-administered questionnaire that was approved by the Institutional Review Board (IRB) committee, ethical approval number: IRB/Al-Ahliyya Amman University/3/13/2021-2022. Cronbach's alpha for the attributes of benefits and disadvantages was 0.608 and 0.744, respectively. Primary outcome measures were extent of trust of the public in online drug purchasing using Likert scale. Multivariate linear regression was used to assess predictors of the trust score. SETTINGS Hashemite Kingdom of Jordan. PARTICIPANTS Inclusion criteria; residents of the Hashemite Kingdom of Jordan 18 years or older. The questionnaire was distributed through snowball effect via different social media. RESULTS A total of 428 participants filled the questionnaire, their average age was 29.7±11.2. Almost all participants, 419 (98.6%) use the internet daily but only 79 (18.6%) participants shop online regularly. Fifty participants (11.8%) purchased drugs online and they had higher benefits score of online purchasing compared with those who did not buy drugs online, 12.5±3.7 and 10.9±3.1, respectively, p=0.002. Participant who purchased drugs online had an increase in trust score of 0.847 compared with those who did not purchase drugs online, p<0.001. In the multivariate model, participants with education level of high school or higher than high school, compared with those with education lower than high school had an increase in trust score of 1.336 (p=0.026) and 1.137 (p=0.039), respectively. CONCLUSION The public recognises the risks in buying drugs online. Awareness campaigns and regulations that control and monitor online drug purchasing should be implemented.
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Affiliation(s)
- Lobna Gharaibeh
- Biopharmaceutics and Clinical Pharmacy Department, Al-Ahliyya Amman University, Amman, Jordan
| | | | - Aya Y Al-Kabariti
- Biopharmaceutics and Clinical Pharmacy Department, Al-Ahliyya Amman University, Amman, Jordan
| | - Alhareth A Alsa'd
- Biopharmaceutics and Clinical Pharmacy Department, Al-Ahliyya Amman University, Amman, Jordan
| | - Anas Abed
- Biopharmaceutics and Clinical Pharmacy Department, Al-Ahliyya Amman University, Amman, Jordan
| | - Nida Karameh
- Biopharmaceutics and Clinical Pharmacy Department, Al-Ahliyya Amman University, Amman, Jordan
| | - Ibrahim D Aldeeb
- Biopharmaceutics and Clinical Pharmacy Department, Al-Ahliyya Amman University, Amman, Jordan
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Kim SY, Cho NW, Yoo MS, Han SY, Oh JW. Narcotics information management system in South Korea: system development and innovation. BMC Health Serv Res 2023; 23:73. [PMID: 36694145 PMCID: PMC9872055 DOI: 10.1186/s12913-023-09060-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND As the misuse and abuse of medical narcotics are increasing in South Korea, an information system for the integrated information management of medical narcotic drugs across the nation is needed. This paper presents the development process of the Narcotics Information Management System (NIMS) for the monitoring of medical narcotics usage and the results of its implementation. METHODS As the NIMS enforces that all narcotics handlers digitally report all information on handling medical narcotic drugs, the functional requirements of the NIMS have been identified in accordance with the Narcotics Control Act. In addition to the functional requirements, the non-functional requirements of the NIMS have been elicited by major narcotics handlers and their associations. The non-functional requirements include privacy, availability, connectivity, interoperability, and data integrity. The system design with entity-relationship diagrams and its implementation processes have been presented. RESULTS The NIMS encompasses all narcotic handlers, which comprise exporting, importing, and pharmaceutical companies; wholesalers; hospitals and clinics; and pharmacies, collecting over 120 million cases annually. It enables transparent monitoring throughout the life cycle, from manufacturing, sales, purchase, and disposal of narcotics. As a result, the number of prescriptions for medical narcotics has been reduced by 9.2%. CONCLUSIONS To the best of our knowledge, the NIMS is the world's first system to manage all information on the total life cycle of medical narcotics, including imports, production, distribution, use, and disposal of drugs. This system has enabled the safety management and monitoring of medical narcotic drugs. Additionally, it provides consistent and transparent information to physicians and patients, leading to the autonomous safety management of narcotics. The successful development of the NIMS can provide guidelines for implementing a narcotics management system in other countries.
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Affiliation(s)
- Sang-Yoon Kim
- Korea Institute of Drug Safety & Risk Management, 5Th Fl., 30, Burim-Ro 169 Beon-Gil, Dongan-Gu, Anyang-Si, Gyeonggi-Do, Republic of Korea.,Department of Industrial Information Systems, Seoul National University of Science and Technology Graduate School of Public Policy and Information Technology, 232 Gongneung-Ro, Nowon-Gu, Seoul, 139-743, Republic of Korea
| | - Nam-Wook Cho
- Department of Industrial Information Systems, Seoul National University of Science and Technology Graduate School of Public Policy and Information Technology, 232 Gongneung-Ro, Nowon-Gu, Seoul, 139-743, Republic of Korea
| | - Myung-Sik Yoo
- Korea Institute of Drug Safety & Risk Management, 5Th Fl., 30, Burim-Ro 169 Beon-Gil, Dongan-Gu, Anyang-Si, Gyeonggi-Do, Republic of Korea.
| | - Soon-Young Han
- Korea Institute of Drug Safety & Risk Management, 5Th Fl., 30, Burim-Ro 169 Beon-Gil, Dongan-Gu, Anyang-Si, Gyeonggi-Do, Republic of Korea
| | - Jeong-Wyan Oh
- Korea Institute of Drug Safety & Risk Management, 5Th Fl., 30, Burim-Ro 169 Beon-Gil, Dongan-Gu, Anyang-Si, Gyeonggi-Do, Republic of Korea
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Long CS, Kumaran H, Goh KW, Bakrin FS, Ming LC, Rehman IU, Dhaliwal JS, Hadi MA, Sim YW, Tan CS. Online Pharmacies Selling Prescription Drugs: Systematic Review. PHARMACY 2022; 10:pharmacy10020042. [PMID: 35448701 PMCID: PMC9031186 DOI: 10.3390/pharmacy10020042] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/09/2022] [Accepted: 03/18/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction: The patronage of online pharmacies is rapidly growing, driven by the convenience and cheaper costs of purchasing prescription drugs electronically, especially under the lockdown situation. However, there are issues regarding the quality of the prescription drugs sold online and the legitimacy of online pharmacies. The use of prescription drugs without the supervision of a licensed health care practitioner may potentially harm consumers. Objectives: This systematic review was conducted to improve the body of knowledge on three main aspects of online pharmacies: (1) type and characteristics of the online pharmacies selling drugs; (2) the quality of pharmaceutical drugs purchased online; and (3) the characteristics of consumers of online pharmacies. Methods: Based on a pre-defined search strategy, PubMed and Scopus were utilised to search articles written in the English language published between January 2009 and February 2020. Studies focusing on the sale of prescription drugs were included. The terms used for the literature search were “online pharmacy”, “internet pharmacy”, “e-pharmacy”, “prescription”, “quality”, “medication safety”, and “counterfeit medicine”. These terms were used alone and in combination with Boolean operators. The institutional webpages including the World Health Organization (WHO) and the United States Food and Drug Administration (USFDA) were also examined for any additional studies. No methodological limitations in terms of study design were applied. A standardised data collection form was used to compile the data. Results: Based on the inclusion and exclusion criteria, a total of 46 articles were eligible and included in the final analysis. There were 27 articles on types and characteristic of online pharmacies, 13 articles on the quality of prescription drugs sold from online pharmacies, and 11 articles on consumers purchasing prescription drugs from online pharmacies. Readers should note that five articles discussed both the types and characteristics of online pharmacies, and the quality of the drugs sold from the outlets. The response rate (products received out of the number of orders) ranged from 20% to 100%, whereas the proportion of consumers buying prescription drugs online ranged from 2.3% to 13%. Reasons for online purchase of prescription drugs include the difficulty of obtaining a prescription for certain medications such as opioid analgesics, cheaper cost, since the costs associated with seeing a physician to obtain a prescription are reduced, and the need to obtain drugs such as opioid analgesics and benzodiazepine for misuse. Conclusions: Almost half of the online pharmacies are not properly regulated and fraudulent issues were uncovered. To address this issue, stricter regulation by World Health Organization and implementation should be carried out together with frequent monitoring of the licensure system and pharmacy verification on every online pharmacy, this would reduce the number of illegal or illegitimate online pharmacy.
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Affiliation(s)
- Chiau Soon Long
- Faculty of Computing and Engineering, Quest International University, Ipoh 30250, Malaysia;
| | - Harshily Kumaran
- School of Pharmacy, KPJ Healthcare University College, Nilai 71800, Malaysia; (H.K.); (F.S.B.)
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai 71800, Malaysia;
| | - Faizah Safina Bakrin
- School of Pharmacy, KPJ Healthcare University College, Nilai 71800, Malaysia; (H.K.); (F.S.B.)
| | - Long Chiau Ming
- PAP Rashidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE1410, Brunei; (L.C.M.); (J.S.D.)
| | - Inayat Ur Rehman
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan 23200, Pakistan;
| | - Jagjit Singh Dhaliwal
- PAP Rashidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE1410, Brunei; (L.C.M.); (J.S.D.)
| | - Muhammad Abdul Hadi
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
| | - Yee Wai Sim
- Faculty of Computing and Engineering, Quest International University, Ipoh 30250, Malaysia;
- Correspondence: (Y.W.S.); (C.S.T.)
| | - Ching Siang Tan
- School of Pharmacy, KPJ Healthcare University College, Nilai 71800, Malaysia; (H.K.); (F.S.B.)
- Correspondence: (Y.W.S.); (C.S.T.)
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Abstract
Morbidity and mortality attributable to opioid use and misuse among adolescents and young adults are evident. Although recent trend data suggest a decrease in both opioid misuse and opioid use disorder among adolescents and young adults in the last few years, overdose cases continue to rise. The opioid epidemic among this population is complex and has a different profile compared to adults, with family facilitating exposure to opioids more often than other sources. Additionally, despite recommendations by experts to initiate medications for opioid use disorder, few initiate treatment. The recent COVID-19 pandemic has impacted many facets of daily life and its effects on the opioid crisis are largely unknown. Stay-at-home mandates resulting in online schooling and limited social interaction has had deleterious consequences for adolescents, especially their mental health. This viewpoint attempts to explore the effects of the pandemic on the opioid crisis in this vulnerable population.
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Affiliation(s)
- Romina A Romero
- Department of Emergency Medicine, University of California, Irvine, CA, USA
| | - Sean D Young
- Department of Emergency Medicine, University of California, Irvine, CA, USA.,University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine, CA, USA
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Chiappini S, Schifano F, Martinotti G. Editorial: Prescribing Psychotropics: Misuse, Abuse, Dependence, Withdrawal and Addiction. Front Psychiatry 2021; 12:688434. [PMID: 33995156 PMCID: PMC8119768 DOI: 10.3389/fpsyt.2021.688434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 01/16/2023] Open
Affiliation(s)
- Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Giovanni Martinotti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
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6
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Lee H, Yang K, Palmer J, Kameg B, Clark L, Greene B. Substance Use Patterns Among Adolescents: A Latent Class Analysis. J Am Psychiatr Nurses Assoc 2020; 26:586-594. [PMID: 31253067 DOI: 10.1177/1078390319858658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND: Substance use among adolescents remains a major public health concern, which is correlated with mortality. AIMS: The purpose of this study was to (1) examine risk factors predisposing adolescents to substance use and (2) identify patterns of simultaneous drug exploration among adolescents. METHOD: Data (N = 15,624; collected in 2015) were drawn from the Centers for Disease Control and Prevention, National Youth Risk Behavior Survey, which is a national school-based survey of 9th- to 12th-grade students to monitor health risk behaviors. Substance use was assessed using self-reported questionnaires, and latent class analysis and logistic regression were used for data analysis. RESULTS: Five latent patterns of substance use were identified: (1) abstinent (64%); (2) 1st-step social experimenter (25%) (i.e., used alcohol, e-cigarettes, and/or marijuana); (3) 2nd-step social experimenter (6%) (i.e., used alcohol, cigarettes, e-cigarettes, marijuana, synthetic marijuana, and/or prescription pills); (4) pill experimenter (4%), (i.e., used prescription pills); (5) full experimenter (2%) (i.e., likely to use all assessed substances). Gender, race, grade, and depressive mood were strong predictors of membership in a particular substance use class. CONCLUSION: Adolescents presenting for care may possess symptoms associated with various substances beyond those being managed. Mental health nurses can leverage these results in reducing adolescent substance use through primary and secondary prevention. A longitudinal study of not only substance use patterns but also the progression to substance use disorders among adolescents is warranted.
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Affiliation(s)
- Heeyoung Lee
- Heeyoung Lee, PhD, PMHNP-BC, CRNP, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kyeongra Yang
- Kyeongra Yang, PhD, MPH, RN, CNE, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Joshua Palmer
- Joshua Palmer, BSN, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brayden Kameg
- Brayden Kameg, DNP, PMHNP-BC, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lin Clark
- Lin Clark, DNP, PMHNP-BC, Community House Mental Health Agency, Seattle, WA, USA
| | - Brian Greene
- Brian Greene, EdD, University of Pittsburgh, Pittsburgh, PA, USA
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Cunliffe J, Décary-Hêtu D, Pollak TA. Nonmedical prescription psychiatric drug use and the darknet: A cryptomarket analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:263-272. [PMID: 30772109 PMCID: PMC6900283 DOI: 10.1016/j.drugpo.2019.01.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/04/2018] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
Background Nonmedical prescription psychiatric drug use (NMPDU) is an increasing global health problem, with recent concern focusing on darknet cryptomarkets as sources of procurement. There is a shortage of evidence regarding comparative worldwide NMPDU trends, due in part to data collection difficulties. This problem is particularly marked for non-opioid drugs, particularly those psychiatric drugs which act on the central nervous system (CNS) and have high misuse potential and are associated with high levels of dependency and fatal overdose. This paper therefore has two goals: 1) to report on the kinds of psychiatric prescription drugs available on cryptomarkets, and 2) to use this data to uncover temporal and geographical trends in sales of these products, potentially informing policy regarding NMPDU more generally. Method Digital trace data collected from 31 cryptomarkets in operation between September 2013 and July 2016 was analysed by country of origin descriptively and for trends in the sales for 7 psychiatric drug groupings, based on their main indication or intended use in psychiatric practice. Results Sedatives (such as diazepam and alprazolam) and CNS stimulants (mainly Adderall, modafinil and methylphenidate) had the greatest share of sales, but usage and trends varied by location. The UK has high and rising levels of sedative sales, whilst the USA has the greatest stimulant sales and increasing sedative rates. Sales of drugs used in the treatment of opioid dependency are also substantial in the USA. The picture is less clear in mainland Europe with high sales levels reported in unexpected Central and Northern European countries. There is evidence of a move towards the more potent sedative alprazolam – already implicated as a source of problematic NMPDU in the USA – in Australia and the UK. Sales of drugs such as antidepressants, antipsychotics, mood stabilisers and antidementia drugs – all drugs with limited abuse potential – were negligible, indicating minimal levels of online cryptomarket procurement for self-medicating mental health problems. Conclusion Predominantly, psychiatric drugs with potent sedative, stimulant or euphoriant effects are sold on cryptomarkets and this varies by country. With some caveats regarding the limitations of cryptomarket digital trace data taken into account, the study of trends of these products sold online over time may offer a novel and increasingly important window onto wider drug purchasing habits.
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Affiliation(s)
- Jack Cunliffe
- School of Social Policy, Sociology and Social Research, University of Kent, United Kingdom.
| | | | - Thomas A Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Carretta CM, Burgess AW, Dowdell EB, Caldwell BA. Adolescent Suicide Cases: Toxicology Reports and Prescription Drugs. J Nurse Pract 2018. [DOI: 10.1016/j.nurpra.2018.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hulme S, Bright D, Nielsen S. The source and diversion of pharmaceutical drugs for non-medical use: A systematic review and meta-analysis. Drug Alcohol Depend 2018; 186:242-256. [PMID: 29626777 DOI: 10.1016/j.drugalcdep.2018.02.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/18/2018] [Accepted: 02/20/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The non-medical use (NMU) of pharmaceutical drugs is an increasing public health concern. This systematic review consolidates current knowledge about how pharmaceutical drugs are obtained for NMU and the processes and people involved in diversion. METHODS Peer-reviewed and grey literature databases were searched for empirical studies published between 1996 and 2017 that examined the source or diversion of pharmaceutical opioids, sedatives or stimulants for NMU in countries with reported misuse problems. Pooled prevalence meta-analyses using random effects models were used to estimate the prevalence of medical and non-medical sourcing reported by end-users, and gifting, selling and trading by various populations. RESULTS This review synthesizes the findings of 54 cross-sectional studies via meta-analyses, with a remaining 95 studies examined through narrative review. Pharmaceutical drugs are primarily sourced for NMU from friends and family (57%, 95% CI 53%-62%, I2 = 98.5, n = 30) and despite perceptions of healthcare professionals to the contrary, illegitimate practices such as doctor shopping are uncommon (7%, 95% CI 6%-10%, I2 = 97.4, n = 29). Those at risk of diversion include patients displaying aberrant medication behaviors, people with substance use issues and students in fraternity/sorority environments. Sourcing via dealers is also common (32%, 95% CI 23%-41%, I2 = 99.8, n = 25) and particularly so among people who use illicit drugs (47%, 95% CI 35%-60%, I2 = 99.1, n = 15). There is little to no organized criminal involvement in the pharmaceutical black market. CONCLUSION Pharmaceutical drugs for NMU are primarily sourced by end-users through social networks. Future research should examine how dealers source pharmaceutical drugs.
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Affiliation(s)
- Shann Hulme
- National Drug and Alcohol Research Centre, 22-32 King St, Randwick, NSW, 2031, Australia.
| | - David Bright
- School of Social Sciences, UNSW Australia, High Street, Kensington, NSW, 2052, Australia
| | - Suzanne Nielsen
- National Drug and Alcohol Research Centre, 22-32 King St, Randwick, NSW, 2031, Australia
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