Harms associated with extramedical use of prescription opioid analgesics in Australia: A scoping review.


Journal

Research in social & administrative pharmacy : RSAP
ISSN: 1934-8150
Titre abrégé: Res Social Adm Pharm
Pays: United States
ID NLM: 101231974

Informations de publication

Date de publication:
08 2019
Historique:
received: 30 03 2018
accepted: 02 07 2018
pubmed: 5 8 2018
medline: 24 3 2020
entrez: 5 8 2018
Statut: ppublish

Résumé

Evidence is accumulating globally on harms from extramedical prescription opioid analgesic (POA) use. The aim of this scoping review was to explore harms and documented risk factors associated with extramedical POA use in Australia. MEDLINE, EMBASE, PsycINFO and CINAHL were searched for original studies published between January 2000 and February 2018. Studies were eligible for inclusion if: 1) POA use was explicitly reported, 2) extramedical use was evident 3) harm was explicitly reported, 4) data were collected in/after 2000, 5) conducted in adults and 6) undertaken in Australia. We identified 560 articles and 16 met the inclusion criteria. Harms reported from extramedical POA use included: increased health service utilization (n = 5), non-fatal overdose (n = 6), fatal overdose (n = 5), injection-related injuries or diseases (n = 4), engagement in crime (n = 2), loss of employment (n = 1), and foreign body pulmonary embolization (n = 1). Multiple drug toxicity was reported as the cause of death in up to 83% of fatal overdose cases. Risk factors for harm included being male, aged 31-49 years, a history of chronic non-cancer pain, mental health disorders and/or substance abuse, and concomitant use of benzodiazepines, antidepressants or other centrally-acting substances. Extramedical use of POAs is associated with a range of harms, including fatal and non-fatal overdose. Polysubstance use with other centrally-acting substances was often implicated. No published studies used linked data sources to provide a comprehensive overview of the extent of POA use or harm in Australia. Future research should focus on undertaking longitudinal cohort studies with linked data sources.

Sections du résumé

BACKGROUND
Evidence is accumulating globally on harms from extramedical prescription opioid analgesic (POA) use.
OBJECTIVE
The aim of this scoping review was to explore harms and documented risk factors associated with extramedical POA use in Australia.
METHODS
MEDLINE, EMBASE, PsycINFO and CINAHL were searched for original studies published between January 2000 and February 2018. Studies were eligible for inclusion if: 1) POA use was explicitly reported, 2) extramedical use was evident 3) harm was explicitly reported, 4) data were collected in/after 2000, 5) conducted in adults and 6) undertaken in Australia.
RESULTS
We identified 560 articles and 16 met the inclusion criteria. Harms reported from extramedical POA use included: increased health service utilization (n = 5), non-fatal overdose (n = 6), fatal overdose (n = 5), injection-related injuries or diseases (n = 4), engagement in crime (n = 2), loss of employment (n = 1), and foreign body pulmonary embolization (n = 1). Multiple drug toxicity was reported as the cause of death in up to 83% of fatal overdose cases. Risk factors for harm included being male, aged 31-49 years, a history of chronic non-cancer pain, mental health disorders and/or substance abuse, and concomitant use of benzodiazepines, antidepressants or other centrally-acting substances.
CONCLUSION
Extramedical use of POAs is associated with a range of harms, including fatal and non-fatal overdose. Polysubstance use with other centrally-acting substances was often implicated. No published studies used linked data sources to provide a comprehensive overview of the extent of POA use or harm in Australia. Future research should focus on undertaking longitudinal cohort studies with linked data sources.

Identifiants

pubmed: 30076092
pii: S1551-7411(18)30284-5
doi: 10.1016/j.sapharm.2018.07.001
pii:
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

925-935

Informations de copyright

Copyright © 2018. Published by Elsevier Inc.

Auteurs

Samanta Lalic (S)

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; Pharmacy Department, Austin Health, Melbourne, Australia. Electronic address: Samanta.Lalic@monash.edu.

Natali Jokanovic (N)

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; Pharmacy Department, Alfred Health, Melbourne, Australia.

Jenni Ilomäki (J)

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

Natasa Gisev (N)

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.

Belinda Lloyd (B)

Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Box Hill, Australia.

Dan I Lubman (DI)

Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Box Hill, Australia.

J Simon Bell (JS)

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.

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