TY - JOUR
T1 - Harms associated with extramedical use of prescription opioid analgesics in Australia
T2 - A scoping review
AU - Lalic, Samanta
AU - Jokanovic, Natali
AU - Ilomäki, Jenni
AU - Gisev, Natasa
AU - Lloyd, Belinda
AU - Lubman, Dan I.
AU - Bell, J. Simon
PY - 2019
Y1 - 2019
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.
AB - 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.
KW - Australia
KW - Drug overdose
KW - Extramedical use
KW - Harm
KW - Opioid analgesics
KW - Review
UR - http://www.scopus.com/inward/record.url?scp=85050701232&partnerID=8YFLogxK
U2 - 10.1016/j.sapharm.2018.07.001
DO - 10.1016/j.sapharm.2018.07.001
M3 - Article
AN - SCOPUS:85050701232
VL - 15
SP - 925
EP - 935
JO - Research in Social and Administrative Pharmacy
JF - Research in Social and Administrative Pharmacy
SN - 1551-7411
IS - 8
ER -