Epidemiological study of opioid use disorder in French emergency departments, 2010–2018 from OSCOUR database

Gallien, Yves; Martin, A Garcia; Caserio-Schönemann, Céline; Strat, Yann Le; Thiam, Marie-Michèle

doi:10.1136/bmjopen-2020-037425

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Furthermore, studies have shown an involvement of depression and benzodiazepines in abuse/misuse-related hospitalisations [33,34]. Compared with Schifano et al who also examined EudraVigilance data, but with a shorter observation period and no restriction to European countries, benzodiazepine use was more common in our study, whereas other opioids but also recreational drugs such as alcohol or cannabis were coded far less often [13].…”

Section: Fentanyl Use In Musculoskeletal Disorders Comorbidity and Ou...contrasting

confidence: 65%

Abuse, dependence and withdrawal associated with fentanyl and the role of its (designated) route of administration: an analysis of spontaneous reports from Europe

Jobski

Bantel²,

Hoffmann

2022

Eur J Clin Pharmacol

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Purpose Fentanyl, a highly potent synthetic opioid used in cancer and non-cancer pain, is approved for various routes of administration. In Europe, fentanyl consumption increased substantially in the last decades but information on abuse, dependence and withdrawal associated with fentanyl is scarce, especially with respect to its different formulations. Methods We analysed case characteristics of spontaneous reports of suspected fentanyl-associated abuse, dependence or withdrawal from European countries recorded in the EudraVigilance database up to 2018 with respect to the (designated) routes of administration and potential indications. Results A total of 985 reports were included (mainly from France and Germany) with 43% of cases referring to transdermal fentanyl. Median age was 45 years (48.8% female) and 21.6% had musculoskeletal disorders. Only 12.6% of those using transdermal fentanyl had a cancer diagnosis compared to 40.2% and 26.8% of those using intranasal and oral transmucosal fentanyl, respectively. Depression was common (10.7%) and highest in cases with musculoskeletal disorders (24.9%) as was the use of benzodiazepines. Overall, 39.5% of reports resulted in a prolonged hospital stay and for 23.2% a fatal outcome was recorded. The respective proportions were especially high in cases with musculoskeletal disorders (56.3% with prolonged hospitalisation) and in those using transdermal fentanyl (35.2% fatalities). Conclusions In suspected cases of abuse, dependence or withdrawal, fentanyl was mainly used for non-cancer pain indications and most often as transdermal formulations. Depression and prolonged hospitalisations were common, especially in patients with musculoskeletal disorders, indicating a vulnerable patient group and complex treatment situations.

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Section: Fentanyl Use In Musculoskeletal Disorders Comorbidity and Ou...contrasting

confidence: 65%

Abuse, dependence and withdrawal associated with fentanyl and the role of its (designated) route of administration: an analysis of spontaneous reports from Europe

Jobski

Bantel²,

Hoffmann

2022

Eur J Clin Pharmacol

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“… 1 , 2 These disorders include the use of heroin, morphine, and synthetic opioids the morbidity and mortality of which has increased in the last few decades, more precisely during the last two years with the COVID-19 pandemic. 1 , 3 , 4 However, the therapeutic interest of OSTs is counterbalanced by various somatic consequences, including qualitative and quantitative sleep disturbances. 5 , 6 For instance, 75% to 84% of patients receiving MMT have been found to have poor sleep quality, defined in previous studies by a Pittsburgh Sleep Quality Index (PSQI) score of more than five.…”

Section: Introductionmentioning

confidence: 99%

Methadone Dose and Timing of Administration as Predictors of Sleep Apnea Syndrome During Methadone Maintenance Treatment: A Retrospective Cross-sectional Study

Guillet,

Endomba,

Aravantinos

et al. 2023

Addict Health

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Background: This study aimed to assess the association of sleep apnea syndrome (SAS) with methadone dose and timing of administration in patients receiving methadone maintenance treatment (MMT) for opioid use disorder (OUD). Methods: This retrospective cross-sectional study was conducted on adult patients receiving MMT who had a nocturnal respiratory polygraphy between November 2015 and December 2021. Data on methadone treatment and polygraph recording, including the apnea-hypopnea index (AHI) were collected. Findings: A total of 40 patients, mostly male (72.5%), with a mean age of 35±6.7 years and a mean body mass index (BMI) of 25.1±4.5 kg/m² were included. The daily dose of methadone was significantly associated with an AHI≥15 events/h as well as an AHI≥30 events/h, even after adjustment for age, gender, BMI, and benzodiazepine use. However, these associations were not preserved when the time of administration (day vs evening) was considered, while the evening administration was significantly associated with an AHI≥15 events/h. The best sensitivity and specificity for the prediction of AHI≥15 events/h and AHI≥30 events/h were obtained with daily methadone doses of≥72.5 mg and 77.5 mg, respectively. Conclusion: In this sample of MMT patients, methadone doses of 72.5 mg and 77.5 mg were the best cut-off values for predicting AHI≥15 and≥30 events/h, respectively, especially when taken in the evening. These results should draw clinicians’ attention to the importance of SAS screening, and further studies are needed, notably comparisons with buprenorphine.

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Using the near real-time effective reproduction number Rt as an early-warning tool for seasonal bronchiolitis and influenza-like illness epidemics

Gallien,

Paireau,

Paty

et al. 2024

American Journal of Epidemiology

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Background Yearly bronchiolitis and influenza-like illness epidemics in France often involve high morbidity and mortality, which severely impacts healthcare. Epidemics are declared by the French National Institute of Public Health based on syndromic surveillance of primary care and emergency departments (ED), using statistics-based alarms. Although the effective reproduction number (Rt) is used to monitor the dynamics of epidemics, it has never been used as an early warning tool for bronchiolitis or influenza-like illness epidemics in France. We assessed whether Rt is useful for detecting seasonal epidemics by comparing it to the tool currently used (MASS) by epidemiologists to declare epidemic phases. Methods We used anonymized ED syndromic data from the Île-de-France region in France from 2010 to 2022. We estimated Rt and compared the indication of accelerated transmission (Rt >1) to the MASS epidemic alarm time points. We computed the difference between those two time points, time to epidemic peak, and the daily cases documented at first indication and peak. Results Rt provided alarms for influenza-like illness and bronchiolitis epidemics that were, respectively, 6 days (IQR[4;8]) and 64 days (IQR[52;80]) - in median - earlier than the alarms provided by MASS. Conclusion Rt detected earlier signals of bronchiolitis and influenza-like illness epidemics. Using this early-warning indicator in combination with others to declare an annual epidemic could provide opportunities to improve healthcare system readiness.

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Epidemiological study of opioid use disorder in French emergency departments, 2010–2018 from OSCOUR database

Cited by 3 publications

References 30 publications

Abuse, dependence and withdrawal associated with fentanyl and the role of its (designated) route of administration: an analysis of spontaneous reports from Europe

Abuse, dependence and withdrawal associated with fentanyl and the role of its (designated) route of administration: an analysis of spontaneous reports from Europe

Methadone Dose and Timing of Administration as Predictors of Sleep Apnea Syndrome During Methadone Maintenance Treatment: A Retrospective Cross-sectional Study

Using the near real-time effective reproduction number Rt as an early-warning tool for seasonal bronchiolitis and influenza-like illness epidemics

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