Prescription drug misuse: Is technology friend or foe? SUZANNE NIELSEN 1 & MONICA JANE BARRATT 2 1 Clinical Research, Turning Point Alcohol and Drug Centre, Melbourne, Australia, and 2 National Drug Research Institute, Curtin University of Technology, Perth, Australia Abstract Introduction and Aims. Prescription drug misuse and related harms have been increasing considerably over the past decade. At the same time, there has also been rapid growth in the use of online and Internet technologies.Thus, it is important that we understand the role online and Internet technologies play in prescription drug misuse. Design and Methods. Published work addressing the role of technology in prescription drug misuse is explored.Topics include: Internet supply, online monitoring of prescription drug use trends and electronic prescription monitoring. Results. Little is known about the prevalence of acquiring prescription drugs from online pharmacies. Prescription drugs are easily accessible through vendor websites, and ‘rogue’ no-prescription websites have proven difficult to control.There has so far been limited application of real-time monitoring to prevent overuse of prescription medications. Online monitoring of drug use trends may also prove to be a useful and timely source of information about new methods of ‘off-label’ prescription drug use. Discussion and Conclusions. Technology has the potential to play a more prominent role in facilitating drug acquisition, while also enhancing the monitoring and prevention of prescription drug misuse. As technology becomes more ubiquitous in everyday life, the continued investigation of its relationship with prescription drug misuse becomes even more important. [Nielsen S, Barratt MJ. Prescription drug misuse: Is technology friend or foe? Drug Alcohol Rev 2009;28:81–86] Key words: prescription drug misuse, drug trend monitoring, online discussion groups, online pharmacies, electronic prescription monitoring, Internet. Introduction Misuse of prescription drugs has risen over the past decade, especially in the USA where prescription misuse has been described to be at epidemic levels [1,2]. In Australia, morphine prescription per person among 15–54 year-olds almost doubled from 1995 to 2003 [3]. Considerable harms accompany this misuse, with mortality associated with pharmaceutical opioids exceeding that documented with heroin or cocaine [4]. Emergency room mentions of psychotropic drugs in the USA also doubled from 1994 to 2001, with large increases in mentions of hydrocodone and oxycodone products [5]. Over the past decade, Internet use has also increased considerably. Over the period from 1998 to 2006/2007, the percentage of Australian households with access to the Internet increased from 16% to 64%, with over 85% of Australians aged between 15 and 34 years having accessed the Internet at any location within the year 2006/2007 [6]. Teenagers and young adults now report the Internet as their primary source of general information [7,8], and 75% of a large American sample of youth had used the Internet at least once to find health information, including information on alcohol and drugs [7]. There is an enormous amount of information avail- able about illicit drugs online [9,10]. Much information available online is not available from traditional sources, including information about new drugs and novel drug practices [9–11], thus some researchers have developed methods of using the Internet as part of early warning drug trend monitoring systems [12–14]. Reviews of the accuracy of drug websites have mixed findings, with some describing the content as mislead- ing and inaccurate [9,15] and others evaluating it as Suzanne Nielsen BPharmBPharmSc(Hons), Research Fellow, Monica Jane Barratt BSc(Psych)(Hons), PhD Student. Correspondence to Dr Suzanne Nielsen, Turning Point Alcohol and Drug Centre, 54-62 Gertrude Street, Fitzroy,Vic. 3065, Australia. Tel: +61(0)3 8413 8413; Fax: +61(0)3 9416 3420; E-mail: suzin@turningpoint.org.au Received 5 February 2008; accepted for publication 10 August 2008. Drug and Alcohol Review (January 2009), 28, 81–86 DOI: 10.1111/j.1465-3362.2008.00004.x © 2009 Australasian Professional Society on Alcohol and other Drugs