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Citation
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Lalic S, Jokanovic N, Ilomäki J, Gisev N, Lloyd B, Lubman DI, Bell JS. Res. Social Adm. Pharm. 2019; 15(8): 925-935. |
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Affiliation
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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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Abstract
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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.
Copyright © 2018. Published by Elsevier Inc.
Language: en |