Alprazolam misuse: Analysis of French Addictovigilance Network data from 2011 to 2020

IF 2.2 4区医学 Q3 PHARMACOLOGY & PHARMACY

Therapie Pub Date : 2023-11-01 DOI:10.1016/j.therap.2023.02.002

Laurine Diaz , Céline Eiden , Emilie Jouanjus , Elisabeth Frauger , Nathalie Fouilhé , Samira Djezzar , Valérie Gibaja , Alexandra Boucher , Reynald Le Boisselier , Frédéric Libert , Anne-Sylvie Caous , Emilie Monzon , Marylène Guerlais , Amélie Daveluy , Bernard Fauconneau , Hélène Peyrière

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引用次数: 1

Abstract

Objectives

Alprazolam, a high-potency and short-acting anxiolytic benzodiazepine, is one of the most misused benzodiazepines in France. In the context of various reports on alprazolam misuse during the COVID-19 pandemic, the objective of this study was to assess alprazolam abuse potential by analyzing French addictovigilance and international data.

Methods

Data collected from 2011 to 2020 using the following epidemiological tools of the French Addictovigilance Network were analyzed: spontaneous reports (SRs), OPPIDUM (addiction care center data), OSIAP (falsified prescriptions), DRAMES (substance-related deaths), and chemical submission surveys. Moreover, the VigiBase™ database was analyzed to evaluate alprazolam abuse liability worldwide.

Results

During the study period, 675 SRs concerning alprazolam misuse were recorded (sex ratio: ̴1; median age: 39 years). The desired effects were intensification of the therapeutic anxiolytic effect, euphoric effect, and management of substance withdrawal. Alprazolam was the third and first benzodiazepine listed in OPPIDUM and OSIAP surveys. Analysis of the SR and OPPIDUM data showed a recent increase in the alprazolam-opioid combination. In DRAMES data, alprazolam was directly linked to 11 deaths (associated with opioids in 10/11). VigiBase™ data analysis highlighted that France was the third country with the most cases of alprazolam misuse. The disproportionality analysis showed that in France, alprazolam was associated with higher risk of misuse and dependence compared with other benzodiazepines: reporting odds ratio = 1.43, (95% CI: 1.04–1.95) and = 1.97 (95% CI:1.50–2.59), respectively.

Conclusions

This study highlighted an increase in various signals of alprazolam abuse in France, and an increased use of the alprazolam-opioid combination that was also linked to most of the recorded alprazolam-linked deaths. These signals have been reported also in the international literature, and should be thoroughly investigated.

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阿普唑仑滥用:2011年至2020年法国成瘾警戒网络数据分析。

目的:阿普唑仑是一种高效、短效抗焦虑的苯二氮卓类药物，是法国滥用最严重的苯二氮卓类药物之一。在关于COVID-19大流行期间滥用阿普唑仑的各种报告的背景下，本研究的目的是通过分析法国成瘾警惕性和国际数据来评估阿普唑仑滥用的可能性。方法:使用法国成瘾警戒网络2011年至2020年收集的以下流行病学工具进行数据分析:自发报告(SRs)、OPPIDUM(成瘾护理中心数据)、OSIAP(伪造处方)、DRAMES(物质相关死亡)和化学品提交调查。此外，还分析了VigiBase™数据库，以评估全球范围内的阿普唑仑滥用责任。结果:在研究期间，共记录到675例与阿普唑仑滥用有关的ssr报告(性别比:1;中位年龄:39岁)。期望的效果是增强治疗性抗焦虑效果、欣快效果和药物戒断的管理。阿普唑仑是OPPIDUM和OSIAP调查中列出的第三种和第一种苯二氮卓类药物。SR和OPPIDUM数据分析显示，近期阿普唑仑-阿片类药物联合用药增加。在DRAMES数据中，阿普唑仑与11例死亡直接相关(10/11与阿片类药物有关)。VigiBase™数据分析强调，法国是阿普唑仑滥用案例最多的第三个国家。歧化分析显示，在法国，与其他苯二氮卓类药物相比，阿普唑仑与更高的滥用和依赖风险相关:报告优势比分别为1.43 (95% CI: 1.04-1.95)和=1.97 (95% CI:1.50-2.59)。结论:这项研究强调了法国滥用阿普唑仑的各种信号的增加，以及阿普唑仑-阿片类药物组合使用的增加，这也与大多数记录的阿普唑仑相关死亡有关。这些信号在国际文献中也有报道，应该进行彻底的调查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapie 医学-药学

CiteScore

3.50

自引率

7.70%

发文量

132

审稿时长

57 days

期刊介绍： Thérapie is a peer-reviewed journal devoted to Clinical Pharmacology, Therapeutics, Pharmacokinetics, Pharmacovigilance, Addictovigilance, Social Pharmacology, Pharmacoepidemiology, Pharmacoeconomics and Evidence-Based-Medicine. Thérapie publishes in French or in English original articles, general reviews, letters to the editor reporting original findings, correspondence relating to articles or letters published in the Journal, short articles, editorials on up-to-date topics, Pharmacovigilance or Addictovigilance reports that follow the French "guidelines" concerning good practice in pharmacovigilance publications. The journal also publishes thematic issues on topical subject. The journal is indexed in the main international data bases and notably in: Biosis Previews/Biological Abstracts, Embase/Excerpta Medica, Medline/Index Medicus, Science Citation Index.