| アブストラクト | BACKGROUND: While data from USA and Canada demonstrate an opioid overdose epidemic, very little nation-wide European studies have been published on this topical subject. METHODS: Using a nationally representative sample of the French Claims database (>700,000 patients), the exhaustive nationwide hospital discharge database, and national mortality registry, all patients dispensed at least one prescription opioid (PO) in 2004-2017 were identified, to describe trends in PO analgesic use, shopping behaviour, opioid-related hospitalizations and deaths. Annual prevalence of PO use and shopping behaviour (>/=1 day of overlapping prescriptions from >/=2 prescribers, dispensed by >/=3 pharmacies) was estimated. RESULTS: In 2004-2017, the annual prevalence of weak opioid use codeine, tramadol and opium rose by 150%, 123%, and 244%, respectively (p < 0.05). Strong opioid use increased from 0.54% to 1.1% (+104%, p < 0.05), significantly for oxycodone (+1950%). Strong opioid use in chronic noncancer pain rose by 88% (p < 0.05) and 1180% for oxycodone. Opioid shopping increased from 0.50% to 0.67% (+34%, p < 0.05), associated with higher mortality risk HR = 2.8 [95% confidence interval (CI): 1.2-6.4]. Opioid-related hospitalizations increased from 15 to 40 per 1,000,000 population (+167%, 2000-2017), and opioid-related deaths from 1.3 to 3.2 per 1,000,000 population (+146%, 2000-2015). CONCLUSIONS: This study provided a first European approach to a nationwide estimation with complete access to several national registries. In 2004-2017 in France, PO use excluding dextropropoxyphene more than doubled. The increase in oxycodone and fentanyl use, and nontrivial increasing trend in opioid-related morbidity-mortality should prompt authorities to closely monitor PO consumption in order to prevent alarming increases in opioid-related morbidity-mortality. SIGNIFICANCE: In 2004-2017, prescription opioid use in France at least doubled and oxycodone use increased particularly, associated with a nontrivial increase in opioid-related morbidity-mortality. Although giving no indication for an 'opioid epidemic,' these findings call for proper monitoring of opioid use. |
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| ジャーナル名 | European journal of pain (London, England) |
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| Pubmed追加日 | 2018/7/28 |
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| 投稿者 | Chenaf, C; Kabore, J-L; Delorme, J; Pereira, B; Mulliez, A; Zenut, M; Delage, N; Ardid, D; Eschalier, A; Authier, N |
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| 組織名 | Universite Clermont Auvergne, CHU Clermont-Ferrand, Inserm, Neuro-Dol, Service de;Pharmacologie medicale, Centres Addictovigilance et Pharmacovigilance, Centre;Evaluation et Traitement de la Douleur, Delegation a la Recherche Clinique et a;l'Innovation, F-63001, Clermont-Ferrand, France.;Observatoire Francais des Medicaments Antalgiques (OFMA)/French Monitoring Centre;for Analgesic Drugs, CHU Clermont-Ferrand, Universite Clermont Auvergne, F-63001,;Clermont-Ferrand, France.;Institut Analgesia, Faculte de Medecine, BP38, F-63001, Clermont-Ferrand, France. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30051548/ |
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