An apparent increase in 'doctor shopping' in the years before heroin-related death may reflect the increasing misuse of prescription drugs, but also an increasing need for help, according to research published in the current issue of The Medical Journal of Australia.

Co-author of the research, Dr Raymond Martyres, from the Melbourne Division of General Practice, said identification of a pattern of escalating doctor shopping could save lives.

The research aimed to identify prescription drug-seeking behaviour patterns among young people who subsequently died of heroin-related overdose.

The research linked Medicare, Pharmaceutical Benefits Scheme (PBS) and Coroner's Court records from Victoria of 202 people aged 15-24 years who died of heroin-related overdose between 6 January 1994 and 6 October 1999.

Researchers examined patterns of use of medical services and prescription drugs listed on the PBS in the years before death, and use of all drugs just before death.

Polydrug use was reported in 90 per cent of toxicology reports, and prescription drugs were present in 80 per cent of subjects.

Subjects accessed medical services six times more frequently than the general population aged 14-24 years, and more than half of all prescribed drugs were those prone to misuse, such as benzodiazepines and opioid analgesics.

A pattern of drug seeking behaviour in the years before death was identified, with doctor-visitation rates, number of different doctors seen and rates of prescriptions peaking in the year before death.

"The extent to which this behaviour predicts heroin-related death requires further investigation," Dr Martyres said.

"Lifestyle characteristics typical of many young heroin users (such as homelessness, itinerancy, poverty and poor diet) may increase both the use of different doctors and the rate at which doctors are seen, as well as vulnerability to fatal overdose.

"Further research into increasing drug-seeking behaviour by young heroin users may identify individuals at overdose risk and provide an important or critical window of opportunity for intervention," Dr Martyres said.

CONTACT                 Dr Raymond Martyres  0414 891 675 / 03 9387 3040

                              Judith Tokley, AMA                 0408 824 306 / 02 6270 5471