The background pattern of drug usage in Australia.
The pattern of drug usage by urban populations has been studied in two typical Australian cities: Traralgon, Victoria, and Sydney, New South Wales. The study, lasting 1 year, involved questioning of 10% of the residents in households selected by random sampling and records of pharmacists. The questions related to state of health, recurrent or chronic disability, and drug exposures during 2 wk preceding the interview. Figures obtained from the Pharmaceutical Benefit Scheme (a system of partial federal subsidy) and the Morbidity Survey of the Royal Australasian College of General Practitioners showed Australians to be near the top of the world's drug takers, in comparison for example with Americans: between 6 and 7 prescriptions per capita in Australia and between 4 and 5 prescriptions in the United States in 1973. The consumption of over-the-counter drugs (OTC) was estimated from the Commonwealth Statistician's figures by subtracting the expenditure for prescription drugs from the total annual chemist sales--$A450,000,000. This represents a cost of $A33.85 for every man, woman, and child. Of this amount $A19.07 was spent for OTC drugs, analgesics and cough suppressants being the two largest items. Roughly 60% of Australians average two or more doses of analgesics per day, with some patients consuming 12 or more doses a day. An association between this high consumption of analgesics and an alarming incidence of iatrogenic disease--analgesic nephropathy and gastrointestinal hemorrhage--is postulated. It is concluded that this level of drug usage must be symptomatic of underlying stresses and pressures of urban society in that country, along with a cultural factor of ready acceptance of the social use of drugs.