TY - JOUR PY - 2019// TI - Harms associated with extramedical use of prescription opioid analgesics in Australia: a scoping review JO - Research in social and administrative pharmacy A1 - Lalic, Samanta A1 - Jokanovic, Natali A1 - Ilomäki, Jenni A1 - Gisev, Natasa A1 - Lloyd, Belinda A1 - Lubman, Dan I. A1 - Bell, J. Simon SP - 925 EP - 935 VL - 15 IS - 8 N2 - 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

LA - en SN - 1551-7411 UR - http://dx.doi.org/10.1016/j.sapharm.2018.07.001 ID - ref1 ER -