Psychoactive prescription drug use and misuse in patients on opioid agonist treatment.

IF 3 3区医学 Q2 PHARMACOLOGY & PHARMACY

British journal of clinical pharmacology Pub Date : 2025-10-16 DOI:10.1002/bcp.70306

Thomas Soeiro, Clémence Lacroix, Élisabeth Jouve, Élisabeth Frauger, Maryse Lapeyre-Mestre, Joëlle Micallef

{"title":"Psychoactive prescription drug use and misuse in patients on opioid agonist treatment.","authors":"Thomas Soeiro, Clémence Lacroix, Élisabeth Jouve, Élisabeth Frauger, Maryse Lapeyre-Mestre, Joëlle Micallef","doi":"10.1002/bcp.70306","DOIUrl":null,"url":null,"abstract":"Aims: To identify the patterns and trends in prescription drug use and misuse in patients on opioid agonist treatment.Methods: We used data from the OPPIDUM programme, which collects data from patients attending substance abuse treatment facilities. Data collected include use of psychoactive prescription drugs in the past week. In this cross-sectional study, we included patients aged at least 18 years, on opioid agonist treatment and reporting psychoactive prescription drug use in the past week from 2014 to 2023. The outcome was psychoactive prescription drug misuse (i.e., abuse and/or dependence, illegal acquisition and diverted route of administration) in the past week. We conducted disproportionality analyses to identify prescription drugs associated with misuse. We calculated the prevalence of use and misuse for each prescription drug to estimate trends.Results: We included 9631 patients. Misuse was disproportionately reported for morphine (e.g., diverted route of administration: n = 580; reporting odds ratio: 224.4 [95% confidence interval: 178.8, 281.7]), methylphenidate (e.g., diverted route of administration: 149; 31.6 [24.1, 41.4]), oxycodone (e.g., diverted route of administration: 24; 20.2 [11.1, 36.8]), clonazepam (e.g., illegal acquisition: 48; 6.0 [4.0, 9.0]) and fentanyl (e.g., diverted route of administration: 6; 5.8 [2.3, 14.8]). Trends in misuse paralleled trends in use for most prescription drugs. The sharpest increase in misuse included abuse and/or dependence (+2366%, from 0.9 per 1000 patients in 2014 to 23.0 per 1000 patients in 2023) for pregabalin. Conversely, the sharpest decrease in misuse included illegal acquisition (-59%, from 82.1 per 1000 patients in 2014 to 33.9 per 1000 patients in 2023) for morphine.Conclusion: In this population, prescription drug misuse primarily included opioid analgesics and increasingly pregabalin. Given the risk of opioid overdose, access to take-home naloxone should be further improved.","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British journal of clinical pharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/bcp.70306","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}

引用次数: 0

Abstract

Aims: To identify the patterns and trends in prescription drug use and misuse in patients on opioid agonist treatment.

Methods: We used data from the OPPIDUM programme, which collects data from patients attending substance abuse treatment facilities. Data collected include use of psychoactive prescription drugs in the past week. In this cross-sectional study, we included patients aged at least 18 years, on opioid agonist treatment and reporting psychoactive prescription drug use in the past week from 2014 to 2023. The outcome was psychoactive prescription drug misuse (i.e., abuse and/or dependence, illegal acquisition and diverted route of administration) in the past week. We conducted disproportionality analyses to identify prescription drugs associated with misuse. We calculated the prevalence of use and misuse for each prescription drug to estimate trends.

Results: We included 9631 patients. Misuse was disproportionately reported for morphine (e.g., diverted route of administration: n = 580; reporting odds ratio: 224.4 [95% confidence interval: 178.8, 281.7]), methylphenidate (e.g., diverted route of administration: 149; 31.6 [24.1, 41.4]), oxycodone (e.g., diverted route of administration: 24; 20.2 [11.1, 36.8]), clonazepam (e.g., illegal acquisition: 48; 6.0 [4.0, 9.0]) and fentanyl (e.g., diverted route of administration: 6; 5.8 [2.3, 14.8]). Trends in misuse paralleled trends in use for most prescription drugs. The sharpest increase in misuse included abuse and/or dependence (+2366%, from 0.9 per 1000 patients in 2014 to 23.0 per 1000 patients in 2023) for pregabalin. Conversely, the sharpest decrease in misuse included illegal acquisition (-59%, from 82.1 per 1000 patients in 2014 to 33.9 per 1000 patients in 2023) for morphine.

Conclusion: In this population, prescription drug misuse primarily included opioid analgesics and increasingly pregabalin. Given the risk of opioid overdose, access to take-home naloxone should be further improved.

查看原文本刊更多论文

阿片类激动剂治疗患者的精神活性处方药使用和滥用。

目的：了解阿片类激动剂治疗患者处方药使用和滥用的模式和趋势。方法：我们使用来自OPPIDUM项目的数据，该项目收集来自药物滥用治疗机构的患者的数据。收集的数据包括过去一周内使用精神处方药的情况。在这项横断面研究中，我们纳入了年龄在18岁以上、接受阿片类激动剂治疗并报告在2014年至2023年过去一周内使用精神活性处方药的患者。结果为过去一周精神类处方药滥用（即滥用和/或依赖、非法获取和转移给药途径）。我们进行了歧化分析，以确定与滥用有关的处方药。我们计算了每种处方药的使用和误用的流行程度，以估计趋势。结果：我们纳入了9631例患者。吗啡（例如，转移给药途径：n = 580；报告优势比：224.4[95%可信区间：178.8,281.7]）、哌甲酯（例如，转移给药途径：149；31.6[24.1,41.4]）、羟考酮（例如，转移给药途径：24；20.2[11.1,36.8]）、氯硝西泮（例如，非法获取：48；6.0[4.0,9.0]）和芬太尼（例如，转移给药途径：6；5.8[2.3,14.8]）的滥用报告比例不成比例。滥用的趋势与大多数处方药的使用趋势相一致。增加最多的误用包括普瑞巴林的滥用和/或依赖（+2366%，从2014年的每1000名患者0.9例增加到2023年的每1000名患者23.0例）。相反，滥用吗啡的急剧下降包括非法获取吗啡（下降59%，从2014年的每1000名患者82.1人降至2023年的每1000名患者33.9人）。结论：在这一人群中，处方药滥用主要包括阿片类镇痛药和越来越多的普瑞巴林。鉴于阿片类药物过量的风险，应进一步改善纳洛酮的可携带性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

British journal of clinical pharmacology 医学-药学

CiteScore

6.30

自引率

8.80%

发文量

419

审稿时长

1 months

期刊介绍： Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.