METHODS: The study consisted of an anonymous online survey distributed by direct contact and via the internet between June-November 2021 to the general population living in Italy. Descriptive statistics were reported, and regression analyses were performed to identify risk factors for lifetime misuse of OTC. The study was approved by the University of Hertfordshire (aLMS/SF/UH/02951).
RESULTS: A number of 717 subjects responded to the survey and were included in the study. Sample was mainly represented by female (69.3%) students (39.9%) in the 20-25 years age group (30.0%). Based on the survey responses, study participants were divided into two groups according to the presence/absence of OTC abuse/misuse (127 versus 590), which were compared for possible predictors of OTC diversion. Concomitant substances used with OTC were alcohol (8.8%), prescription medicines (6.1%), other OTC (4.7%), and cannabis (2.6%). Multivariate regression showed that the strongest predictor of OTC abuse/misuse was knowledge of the effects of OTC [odds ratio/OR of 2.711, 95% Confidence Interval/CI 1.794-4.097, p<0.001). The probability of OTC abuse/misuse almost doubled when individuals purchased OTC without indication [OR = 1.54, 95% CI 1.02–2.34, p = 0.042]. Finally, education was negatively correlated with OTC abuse/misuse [OR = 0.695, 95% CI 0.58–0.94, p = 0.016].
CONCLUSION: Although, according to our data, the phenomenon of OTC abuse appeared to be limited, increasing attention is needed because of its possible underestimation and high-risk outcomes. Preventive strategies, including a simplified access to information, may play a key role in the limitation of OTC drugs misuse.
- over-the-counter drugs
- drug misuse
- drug diversion