Diversion, Misuse and Abuse of Prescription Drugs in Upper-Middle-Income Countries: Narrative Literature Review

Globally, the diversion, misuse, and abuse of prescription drugs is a growing public health problem. This narrative review focused on factors influencing this problem in Upper-Middle-Income Countries. The literature reports that factors related to health systems and health providers such as retail pressure, insufficient consultation time, lack of screening tools, ineffective monitoring and surveillance systems, poor implementation of regulatory policies, lack of strict enforcement of prescribing policies as well as lack of specialized training perpetuate the problem. Evidence suggests that consumers with lack of appropriate knowledge about medication use, lack of awareness regarding potential risks, and poor attitude toward medication usage were more likely to engage into drug diversion and misuse. Based on a critical reflection of the literature, we propose a framework that outlines interventions needed to halt factors influencing drug diversion, misuse and abuse through a collaborative approach that will enable behavioural change and reduce the risk of harmful health outcomes.