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Title: Harms associated with extramedical use of prescription opioid analgesics in Australia: A scoping review.
Austin Authors: Lalic, Samanta;Jokanovic, Natali;Ilomäki, Jenni;Gisev, Natasa;Lloyd, Belinda;Lubman, Dan I;Bell, J Simon
Affiliation: School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
Turning Point, Eastern Health, Melbourne, Australia
Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Box Hill, Australia
Pharmacy Department, Alfred Health, Melbourne, Australia
School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
Pharmacy Department, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 2019 2018-07-03
Publication information: Research in social & administrative pharmacy : RSAP 2019; 15(8): 925-935
Abstract: Evidence is accumulating globally on harms from extramedical prescription opioid analgesic (POA) use. The aim of this scoping review was to explore harms and documented risk factors associated with extramedical POA use in Australia. 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. 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. 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.
DOI: 10.1016/j.sapharm.2018.07.001
ORCID: 0000-0002-7055-3626
Journal: Research in social & administrative pharmacy : RSAP
PubMed URL: 30076092
Type: Journal Article
Subjects: Australia
Drug overdose
Extramedical use
Opioid analgesics
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