Protocol for a scoping review on misuse of psychoactive medicines and its consequences

Abstract

IntroductionMisuse of psychoactive medicines, especially prescription opioids, but also benzodiazepines, hypnotics and sedatives, has become a significant public health issue in some countries, especially in the USA, where it has been extensively documented, as well as in Canada and Australia. However, in the European Union (EU) published literature on the topic is scarce and heterogeneous regarding definitions, sources of data, tools and methods of analysis.The aim of this scoping review is to map the key concepts on psychoactive medicines’ misuse and examine the existing body of evidence on this topic in the EU. Data on the possible consequences of medicines’ misuse—adverse drug reactions, poisonings, hospitalisations and deaths—will also be analysed.Methods and analysisThe scoping review will follow the framework of Arksey and O’Malley, further developed by Levacet aland the Joanna Briggs Institute. The search strategy, developed by the authors, includes querying three electronic databases—PubMed, Web of Science and Scopus—using keywords and the Medical Subject Headings, for evidence published in English, French, Spanish or Portuguese between 2011 and 2020. Additionally, articles from PubMed alerts and other sources will also be considered. The results of the scoping review will describe the currently available evidence regarding misuse of medicines at EU level.Ethics and disseminationSince the scoping review methodology focuses on published data, this study does not require ethical approval. We will publish our findings in a peer-reviewed journal and plan to disseminate our work in conferences and scientific meetings.Registration detailsThis scoping review protocol is registered in the Open Science Framework (OSF; seehttps://osf.io/fzr9u) and has also been shared as a preprint in this free and open-source project management repository. It is available athttps://doi.org/10.31219/osf.io/y3s4q.

Prescription drugs with potential for misuse: protocol for a multi-indicator analysis of supply, detection and the associated health burden in Ireland between 2010 and 2020

“…Furthermore, evidence from North America may not translate to EU countries due to differences across healthcare systems, regulatory frameworks and prescribing practices. 23 Identifying relevant and accessible means of surveillance in EU countries, allowing for the detection of drug trends, is an essential first step in this process. This is the first study to use multiple early warning systems, drug supply and epidemiological indicators to examine trends in the use and harms associated with PDPM in Ireland.…”

“…However, there is a paucity of evidence in relation to the misuse of prescription medicines, particularly psychoactive substances, in the EU. Furthermore, evidence from North America may not translate to EU countries due to differences across healthcare systems, regulatory frameworks and prescribing practices 23. Identifying relevant and accessible means of surveillance in EU countries, allowing for the detection of drug trends, is an essential first step in this process.…”

Use and misuse of psychoactive medicines: a descriptive cross-sectional study in a densely populated region of Portugal

“…However, despite their clinical benefits, PMed constitute a unique group of medicinal products given their high risk of misuse. The concept of medicines’ misuse varies in the literature (Barrett et al, 2008 ), namely as non-medical use (consumption of a medication not prescribed, or in a manner not intended by the prescriber [Araújo et al, 2022 , 2023 ; Novak et al, 2016 ; Smith et al, 2017 ), abuse (intentional excessive use accompanied by harmful physical or psychological effects [European Medicines Agency, 2017 ]) and doctor shopping (intentional use of a dose higher than prescribed by seeking multiple clinicians to obtain several prescriptions [Biernikiewicz et al, 2019 ]). Chronic use of medicines intended for short-term treatments was also considered in our definition of misuse.…”

“…In Europe, literature on PMed misuse is more limited (Araújo et al, 2022 , 2023 ; Bramness & Person, 2014 ; Casati et al, 2012 ; van Amsterdam & van den Brink, 2015 ) and differences between national guidelines, prescribing practices, health systems’ organisation and availability of PMed hamper its evaluation (Araújo et al, 2023 ). Data available in Portugal essentially refer to consumption, pointing to high levels of antidepressant and especially BZD use (Conselho Nacional de Saúde 2019 ; Coordenação Nacional da Estratégia do Medicamento e dos Produtos de Saúde, 2017 ; INFARMED, 2017 , 2020 ; OECD, 2020 , 2023 ; Faria Vaz et al, 2017a ).…”