Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018

Pierce, Mimi; Amsterdam, Jan van; Kalkman, Gerard A.; Schellekens, Arnt; Brink, Wim van den

doi:10.1192/j.eurpsy.2021.2219

Cited by 80 publications

(55 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Opioids are involved in fatal overdose more often than any other drug [1]. The global opioid market is growing, and fatal overdoses related to illicit opioids such as heroin (diamorphine) and to the misuse of opioid painkillers have increased to record levels in the developed world [2]. The UK experiences the most opioid-related deaths of any European nation total and per head of population, with 3,256 deaths recorded in 2017 [3].…”

Section: Introductionmentioning

confidence: 99%

The Socio-Demographics and Health Service Use of Opioid Overdose Decedents in Wales: A Cross-Sectional Data Linkage Study

Fuller¹,

Jones²,

Bradshaw³

et al. 2022

Eur Addict Res

View full text Add to dashboard Cite

Background: Fatal opioid overdose is a significant public health problem with increasing incidence in developed countries. This study aimed to describe demographic and service user characteristics of decedents of opioid overdose in Wales to identify possible targets for behaviour modification and life-saving interventions. Methods: A retrospective cross-sectional analysis was conducted of a census sample of opioid overdose-related deaths recorded between January 01, 2012, and October 11, 2018, in Wales. UK Office for National Statistics, Welsh Demographic Service, and National Health Service datasets were linked deterministically. Decedents’ circumstances of death, demographic characteristics, residency, and health service use were characterized over 3 years prior to fatal overdose using descriptive statistics. Results: In total, 638 people died of opioid overdose in Wales between January 01, 2012, and October 11, 2018, with an incidence rate of 3.04 per 100,000 people per year. Decedents were predominantly male (73%) and middle aged (median age 50 years). Fatal overdoses predominantly occurred in the community (93%) secondary to heroin (30%) or oxycodone derivative use (34%). In the 3 years prior to death, decedents changed address frequently (53%) but rarely moved far geographically. The majority of decedents had recently visited the emergency department (83%) or were admitted to the hospital (64%) prior to death. Only a minority had visited specialist drug services (32%). Conclusions: Deaths from opioid overdose typically occur in middle-aged men living peripatetic lifestyles. Victims infrequently visit specialist drug services but often attend emergency medical services. Emergency department-based interventions may therefore be important in prevention of opioid overdose fatalities in the community.

show abstract

Section: Introductionmentioning

confidence: 99%

The Socio-Demographics and Health Service Use of Opioid Overdose Decedents in Wales: A Cross-Sectional Data Linkage Study

Fuller¹,

Jones²,

Bradshaw³

et al. 2022

Eur Addict Res

View full text Add to dashboard Cite

show abstract

“…However, the level of prescription opioid use [10] and opioid-related deaths in most European countries is still (much) lower than in the USA. For example, opioid-related mortality in the EU was 1.3 per 100,000 population in 2017 (US: 14.9 per 100,000) [11]. Although opioid-related harm appears limited in the EU as a whole, there are some EU (constituent) countries (e.g., Estonia and Scotland) that reported an opioid-related mortality rate similar to the USA [6].…”

Section: Introductionmentioning

confidence: 99%

Monitoring Opioids in Europe: The Need for Shared Definitions and Measuring Drivers of Opioid Use and Related Harms

et al. 2022

Self Cite

View full text Add to dashboard Cite

The past 20 years, the USA is facing a serious opioid crisis initiated by an increase in prescription opioid use. Europe has also seen an increase in prescription opioid use, but the extent of related harm is still largely unknown. Given the impact of the US opioid epidemic, it is important to closely monitor signs of emerging opioid-related problems to guarantee early warnings and timely actions. Shared and meaningful definitions for opioid use and related harms, and relevant information about specific drivers for opioid use and related problems are needed for an adequate policy response. In this commentary, we discuss these definitions, the need to know more about the specific drivers for increased opioid use, its related harm, and proposals for strategies to move forward. Policy recommendations include making a distinction between licit and illicit opioids when monitoring and reporting on opioid-related harm, and using oral morphine equivalents to quantify prescription opioid use in a clinically relevant and comparable manner. A major topic of further research is exploring unique and universal drivers of prescription opioid (mis)use across Europe, in particular the role of opioid diversion.

show abstract

“…However, two recent studies have suggested Ireland has relatively high opioid overdose mortality, and that prescribing of strong opioids has increased between 2010 and 2019. 6 , 7 With changing opioids prescribing, it is important to understand if changes are driven by higher prescribing rates or doses/potencies, and also how this fits within the context of other analgesic medications. The potential for inappropriate use and misuse of analgesics is not limited to opioids, with treatments for neuropathic pain, such as pregabalin and gabapentin, also of concern.…”

Section: Introductionmentioning

confidence: 99%

“…In Ireland, although codeine prescribing has been examined, 5 there has been little evidence on trends in opioid prescribing. However, two recent studies have suggested Ireland has relatively high opioid overdose mortality, and that prescribing of strong opioids has increased between 2010 and 2019 6,7 . With changing opioids prescribing, it is important to understand if changes are driven by higher prescribing rates or doses/potencies, and also how this fits within the context of other analgesic medications.…”

Section: Introductionmentioning

confidence: 99%

Opioid and analgesic utilization in Ireland in 2000 and 2015: A repeated cross‐sectional study

Moriarty¹,

Bennett²,

Fahey³

2021

Pharmacology Res & Perspec

View full text Add to dashboard Cite

In recent decades, opioid use has increased internationally and is a major public health concern. This study aims to characterize changes in opioid and other analgesic prescribing in Ireland over a 15‐year period (2000–2015). This is a repeated cross‐sectional study of administrative pharmacy claims data in 2000 and 2015. Individuals of all ages in Ireland's Eastern Health Board region who were eligible for the General Medical Services (GMS) scheme were included. This scheme covers 40% of the population, mostly those on lower incomes and older people. The primary outcome was dispensing of opioids, both prevalence of any use and rate per 1000 GMS eligible population (standardized to the 2015 population). Logistic regression was used to assess odds of opioid dispensing in 2015 versus 2000, controlling for demographic differences. The eligible study population was 364 436 in 2000 and 523 653 in 2015. In 2000, 19.4% of the eligible population had at least one opioid dispensing compared to 20.8% in 2015. The rate increased from 671 to 1098 dispensings per 1000 population. The increase was highest in the dispensing rates of codeine, tramadol, oxycodone, buprenorphine, and fentanyl. Compared to 2000, there was higher odds in 2015 of being dispensed a strong opioid (adjusted odds ratio 2.0, 95%CI 1.97–2.04) or long‐acting formulation (3.75, 95%CI 3.58–3.92). Increased prescribing of opioids, particularly strong opioids, between 2000 and 2015 is evident in Ireland. This is concerning due to the potential for misuse, and opioid‐related morbidity/mortality.

show abstract

Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018

Abstract: Authors' Contributions:MP conducted the data collection. WvdB, MP and JvA conducted the data analysis. MP created the figures. WvdB, MP, JvA, GK and AS interpreted the data and created the results. MP wrote the first draft of the report with critical input from WvdB, MP, JvA, GK and AS.

Cited by 80 publications

References 19 publications

The Socio-Demographics and Health Service Use of Opioid Overdose Decedents in Wales: A Cross-Sectional Data Linkage Study

The Socio-Demographics and Health Service Use of Opioid Overdose Decedents in Wales: A Cross-Sectional Data Linkage Study

Monitoring Opioids in Europe: The Need for Shared Definitions and Measuring Drivers of Opioid Use and Related Harms

Opioid and analgesic utilization in Ireland in 2000 and 2015: A repeated cross‐sectional study

Contact Info

Product

Resources

About