@article{ref1,
title="Harms associated with extramedical use of prescription opioid analgesics in Australia: a scoping review",
journal="Research in social and administrative pharmacy",
year="2019",
author="Lalic, Samanta and Jokanovic, Natali and Ilomäki, Jenni and Gisev, Natasa and Lloyd, Belinda and Lubman, Dan I. and Bell, J. Simon",
volume="15",
number="8",
pages="925-935",
abstract="BACKGROUND: Evidence is accumulating globally on harms from extramedical prescription opioid analgesic (POA) use. <br><br>OBJECTIVE: The aim of this scoping review was to explore harms and documented risk factors associated with extramedical POA use in Australia. <br><br>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. <br><br>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. <br><br>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.<br><br>Copyright © 2018. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="1551-7411",
doi="10.1016/j.sapharm.2018.07.001",
url="http://dx.doi.org/10.1016/j.sapharm.2018.07.001"
}