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Dawudi Y, Azoyan L, Broucker TDE, Gendre T, Miloudi A, Echaniz-Laguna A, Mazoyer J, Zanin A, Kubis N, Dubessy AL, Gorza L, Ben Nasr H, Caré W, d'Izarny-Gargas T, Formoso A, Vilcu AM, Bonnan M. Marked increase in severe neurological disorders after nitrous oxide abuse: a retrospective study in the Greater Paris area. J Neurol 2024; 271:3340-3346. [PMID: 38478030 PMCID: PMC11136741 DOI: 10.1007/s00415-024-12264-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Recreational nitrous oxide (N2O) use has become more widespread worldwide, leading to an increase in myelopathies and peripheral neuropathies. The aim of this study was to describe clinical and socioeconomical characteristics of severe N2O-induced (NI) neurological disorders (NI-NDs), to determine its incidence in the Greater Paris area and to compare it with that of similar inflammatory neurological disorders. METHODS We performed a retrospective multicentric cohort study of all adult patients with severe NI-NDs in the neurology and general internal medicine departments of the Greater Paris area from 2018 to 2021. The incidence was compared with that of non-NI-myelitis and Guillain-Barré syndrome (GBS) using a sample of 91,000 hospitalized patients sourced from health insurance data. RESULTS Among 181 patients, 25% had myelopathy, 37% had peripheral neuropathy and 38% had mixed disease. Most were aged between 20 and 25 years, lived in socially disadvantaged urban areas, and exhibited high rates of unemployment (37%). The incidence of NI-NDs increased during 2020 and reached a peak mid-2021. The 2021 incidence in 20-25-year-olds was 6.15 [4.72; 8.24] per 100,000 persons for NI-myelopathy and 7.48 [5.59; 9.37] for NI-peripheral neuropathy. This was significantly higher than for non-NI-myelitis (0.35 [0.02; 2.00]) and GBS (2.47 [0.64; 4.30]). The incidence of NI-NDs was two to three times higher in the most socially disadvantaged areas. CONCLUSION The recent increase in recreational N2O use has led to a rise in the incidence of severe NI-NDs, particularly in young adults with low socioeconomic status for whom NI-NDs strongly outweigh similar neurological disorders.
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Affiliation(s)
- Yachar Dawudi
- Neurology Department, Centre Hospitalier de Saint-Denis, 2 Rue du Dr Delafontaine, 93200, Saint-Denis, France.
- Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136, Sorbonne Université INSERM, Paris, France.
| | - Loris Azoyan
- Neurology Department, Centre Hospitalier de Saint-Denis, 2 Rue du Dr Delafontaine, 93200, Saint-Denis, France
- Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136, Sorbonne Université INSERM, Paris, France
| | - Thomas D E Broucker
- Neurology Department, Centre Hospitalier de Saint-Denis, 2 Rue du Dr Delafontaine, 93200, Saint-Denis, France
| | - Thierry Gendre
- Neurology Department, Hôpital Henri-Mondor, 1 Rue Gustave Eiffel, 94000, Créteil, France
| | - Amal Miloudi
- Neurology Department, Centre Hospitalier Intercommunal Robert Ballanger, Bd Robert Ballanger, 93600, Aulnay-Sous-Bois, France
| | - Andoni Echaniz-Laguna
- Neurology Department, Hôpital Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Julie Mazoyer
- Neurology Department, Hôpital Avicenne, 125 Route de Stalingrad, 93009, Bobigny, France
| | - Adrien Zanin
- Clinical Physiology Department, Hôpital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France
| | - Nathalie Kubis
- Clinical Physiology Department, Hôpital Lariboisière, 2 Rue Ambroise Paré, 75010, Paris, France
| | - Anne-Laure Dubessy
- Neurology Department, Hôpital Saint-Antoine, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France
| | - Lucas Gorza
- Neurology Department, Hôpital Foch, 40 Rue Worth, 92150, Suresnes, France
| | - Haifa Ben Nasr
- Neurology Department, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, 91100, Corbeil-Essonnes, France
| | - Weniko Caré
- Department of Internal Medicine, Bégin Military Teaching Hospital, Saint-Mandé, France
- Paris Poison Control Center, Toxicology Federation (FeTox), Hôpital Fernand Widal, AP-HP, Paris, France
| | | | - Aude Formoso
- Neurology Department, Hôpital de La Pitié Salpêtrière, 47-83 Bd de L'Hôpital, 75013, Paris, France
| | - Ana-Maria Vilcu
- Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136, Sorbonne Université INSERM, Paris, France
| | - Mickael Bonnan
- Neurology Department, Centre Hospitalier de Saint-Denis, 2 Rue du Dr Delafontaine, 93200, Saint-Denis, France
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Frauger E, Fouilhé N, Lacroix C, Daveluy A, Le Boisselier R, Bertin C, Revol B, Carton L, Chevalier C, Eiden C, Gibaja V, Aquizerate A, Chaouachi L, Bouquet E, Roussin A, Mallaret M, Micallef J. [Increase of overdose and deaths related to methadone during COVID-19 epidemic in 2020]. Therapie 2024; 79:297-306. [PMID: 37391322 PMCID: PMC10266982 DOI: 10.1016/j.therap.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/02/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023]
Abstract
INTRODUCTION Due to the risk of overdoses increase especially with methadone, a reinforced monitoring has been set up by the French Addictovigilance Network following the first lockdown related to coronavirus disease 2019 (COVID-19). In this context, we managed a specific study to analyze overdoses related to methadone in 2020 compared to 2019. MATERIAL AND METHODS We analyzed methadone-related overdoses which occurred in 2019 and 2020 from two sources: DRAMES program (deaths with toxicological analysis) and the French pharmacovigilance database (BNPV) (overdoses that did not lead to death). RESULTS Data from DRAMES program in 2020 show methadone as the first drug involved in deaths as well as an increase in deaths: in number (n=230 versus n=178), in proportion (41% versus 35%) and number of deaths per 1000 exposed subjects (3.4 versus 2.8). According to BNPV, the number of overdose increased in 2020 compared to 2019 (98 versus 79; i.e., 1.2-fold increase) particularly during several target periods: first lockdown, end of lockdown/summer period and second lockdown. In 2020, a higher number of cases were observed in April (n=15) and May (n=15). Overdoses and deaths occurred in subjects enrolled in treatment programs or not (naïve subjects/occasional users who obtained methadone from street market or family/friends). Overdoses resulted from different factors: overconsumption, multiple drug use with depressants drugs or cocaine, injection, consumption for sedative, recreational purposes or voluntary drug poisoning. DISCUSSION/CONCLUSION All these data show an increase of morbidity and mortality related to methadone during COVID-19 epidemic. This trend has been observed in other countries.
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Affiliation(s)
- Elisabeth Frauger
- Centre d'addictovigilance, service de pharmacologie clinique, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, institut de neurosciences des systèmes, Inserm UMR1106, 13005 Marseille, France.
| | - Nathalie Fouilhé
- Centre d'addictovigilance, CHU de Grenoble-Alpes, 38043 Grenoble, France
| | - Clémence Lacroix
- Centre d'addictovigilance, service de pharmacologie clinique, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, institut de neurosciences des systèmes, Inserm UMR1106, 13005 Marseille, France
| | - Amélie Daveluy
- Centre d'addictovigilance, département de pharmacologie, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France
| | - Reynald Le Boisselier
- Centre d'addictovigilance, service de pharmacologie, CHU de Caen, 14033 Caen, France
| | - Célian Bertin
- Centre d'addictovigilance, service de pharmacologie médicale, CHU de Clermont-Ferrand, université Clermont Auvergne, 63003 Clermont-Ferrand, France
| | - Bruno Revol
- Centre d'addictovigilance, CHU de Grenoble-Alpes, 38043 Grenoble, France
| | - Louise Carton
- Centre d'addictovigilance, service de pharmacologie, faculté de médecine-pôle recherche, 59037 Lille, France
| | - Cécile Chevalier
- Centre d'addictovigilance, service hospitalo-universitaire de pharmacotoxicologie, hospices civils de Lyon, 69424 Lyon cedex, France
| | - Céline Eiden
- Centre d'addictovigilance, département de pharmacologie médicale et toxicologie, hôpital Lapeyronie, CHU de Montpellier, 34295 Montpellier, France
| | - Valérie Gibaja
- Centre d'addictovigilance, CHRU de Nancy, hôpital Brabois, 54511 Vandoeuvre-les-Nancy, France
| | - Aurélie Aquizerate
- Centre d'addictovigilance, service de pharmacologie clinique, institut de biologie, CHU de Nantes, 44093 Nantes, France
| | - Leila Chaouachi
- Centre d'addictovigilance, hôpital Fernand-Widal, 75475 Paris, France
| | - Emilie Bouquet
- Centre d'addictovigilance, service de pharmacologie clinique et vigilances, CHU de Poitiers, 86021 Poitiers, France
| | - Anne Roussin
- Centre d'addictovigilance, faculté de médecine, 31000 Toulouse, France
| | - Michel Mallaret
- Centre d'addictovigilance, CHU de Grenoble-Alpes, 38043 Grenoble, France
| | - Joëlle Micallef
- Centre d'addictovigilance, service de pharmacologie clinique, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, institut de neurosciences des systèmes, Inserm UMR1106, 13005 Marseille, France
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Gimenez L, Bonis D, Morel M, Palmaro A, Dassieu L, Dupouy J. Barriers and facilitators to the involvement of general practitioners in the prescription of buprenorphine. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 156:209182. [PMID: 37858793 DOI: 10.1016/j.josat.2023.209182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/26/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION France has one of the highest opioid agonist treatment (OAT) coverage rates in the world. French general practitioners (GPs) are providing the majority of prescriptions. However, a fall in the number of GPs initiating buprenorphine has been observed over the last decade. METHODS The objective of this study was to explore the obstacles and facilitators to the involvement of GPs in the prescription of buprenorphine. A qualitative study comprising 14 individual interviews and a focus group bringing together 5 GPs was conducted among GPs based in France between June 2021 and March 2022. We performed data analysis using a grounded theory methodology. RESULTS The interviews showed a great diversity in the level of involvement of GPs, depending on their experience, their representations of patients with OUD, their mode of exercise, and their personal preferences. The negative representations of the patients associated with the feeling of physical and ethical endangerment, the feeling of powerlessness, the fear of a disruption of the practice and the feeling of incompetence appeared at the forefront of the difficulties stated. Conversely, the strengthening of initial training and the facilitation of access to self-training tools and multidisciplinarity, the consideration of opioid use disorder (OUD) as a chronic illness with the application of a patient-centered motivational approach, as well as the defining and respecting one's own limits when prescribing buprenorphine seem to be the keys to a balanced and fulfilling practice. CONCLUSION Raising awareness of the frequency of OUD appeared to be an additional lever to enhance the interest of the GPs concerned. Additional studies focusing on the evolution of professional practices would be necessary to extend these findings.
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Affiliation(s)
- Laëtitia Gimenez
- Département Universitaire de Médecine Générale, Université de Toulouse, Faculté de Médecine, 133 route de Narbonne, 31063 Toulouse, France; MSPU La Providence, 1 avenue Louis Blériot, 31500 Toulouse, France; CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Délia Bonis
- Département Universitaire de Médecine Générale, Université de Toulouse, Faculté de Médecine, 133 route de Narbonne, 31063 Toulouse, France
| | - Mathilde Morel
- Département Universitaire de Médecine Générale, Université de Toulouse, Faculté de Médecine, 133 route de Narbonne, 31063 Toulouse, France
| | - Aurore Palmaro
- Département Universitaire de Médecine Générale, Université de Toulouse, Faculté de Médecine, 133 route de Narbonne, 31063 Toulouse, France
| | - Lise Dassieu
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 850 rue Saint Denis, Montréal, QC H2X0A9, Canada
| | - Julie Dupouy
- Département Universitaire de Médecine Générale, Université de Toulouse, Faculté de Médecine, 133 route de Narbonne, 31063 Toulouse, France; CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France; MSPU de Pins Justaret, 1 chemin de la gare, 31860 Pins Justaret, France.
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Carton L, Bastien A, Chérot N, Caron C, Deheul S, Cottencin O, Gautier S, Moreau-Crépeaux S, Dondaine T, Bordet R. An overview of the use of psychoactive substances among students at the University of Lille during the COVID-19 health crisis: Results of the PETRA study. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:101-111. [PMID: 37837439 PMCID: PMC10578082 DOI: 10.1080/19585969.2023.2268063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES Students represent a population at risk for substance abuse. That risk may have been exacerbated by the COVID-19 pandemic. We aimed to describe substance abuse among students and to compare consumption according to the university field. METHODS A self-administered questionnaire was sent by email to all students at the University of Lille, France, between March and July 2021. This anonymous questionnaire included questions about sociodemographic characteristics, university courses and the use of psychoactive substances (frequency, reasons, routes of administration) since the first university year. RESULTS Among the 4431 students who responded (response rate 6.1%), eighty percent declared having used alcohol since the first university year, 34% cannabis, 15.4% benzodiazepines, 14.7% opioid drugs, 7.5% cocaine, 6.8% nitrous oxide and 6.5% MDMA. More than 20% of the users of cannabis, benzodiazepines, amphetamines and cocaine reported having already felt dependent. Recreational use was described by more than 10% of benzodiazepine or opioid drug users. Nitrous oxide use was significantly more frequent in the health and sport field (p < 0.001). Tobacco, benzodiazepine, cannabis and MDMA uses were significantly more frequent in the humanities and social sciences/art, language and literature fields (p < 0.001). CONCLUSION Prevention measures focusing on alcohol, cannabis, illicit psychostimulants, nitrous oxide and prescription drugs are required in the student population.
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Affiliation(s)
- Louise Carton
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Axel Bastien
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Nathalie Chérot
- Department of Occupational Health, Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMP ECS - IMPact de l‘Environnement Chimique sur la Santé humaine, Lille, France
| | - Clément Caron
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Sylvie Deheul
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Olivier Cottencin
- Department of Psychiatry and Addiction Medicine, Univ Lille, CHU Lille, INSERM U-1172, Plasticity & SubjectivitY (P SY) team, Lille Neuroscience & Cognition Centre (LiNC), Lille, France
| | - Sophie Gautier
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | | | - Thibaut Dondaine
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Régis Bordet
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
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Diaz L, Eiden C, Jouanjus E, Frauger E, Fouilhé N, Djezzar S, Gibaja V, Boucher A, Le Boisselier R, Libert F, Caous AS, Monzon E, Guerlais M, Daveluy A, Fauconneau B, Peyrière H. Alprazolam misuse: Analysis of French Addictovigilance Network data from 2011 to 2020. Therapie 2023; 78:647-657. [PMID: 36918317 DOI: 10.1016/j.therap.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/17/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
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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Affiliation(s)
- Laurine Diaz
- Addictovigilance Centre, Lapeyronie Hospital, CHU de Montpellier, Univ Montpellier, 34000 Montpellier, France
| | - Céline Eiden
- Addictovigilance Centre, Lapeyronie Hospital, CHU de Montpellier, Univ Montpellier, 34000 Montpellier, France
| | - Emilie Jouanjus
- Addictovigilance Centre, Medecine Faculty, CHU, 31000 Toulouse, France
| | | | | | - Samira Djezzar
- Addictovigilance Centre, Fernand Widal Hospital, 75000 Paris, France
| | | | | | | | - Frédéric Libert
- Addictovigilance Centre-CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | | | - Emilie Monzon
- Agence Nationale de Sécurité des Médicaments et Produits de Santé (ANSM), 93210 Saint Denis La Plaine, France
| | | | - Amélie Daveluy
- Addictovigilance Centre-CHU Bordeaux, 33000 Bordeaux, France
| | | | - Hélène Peyrière
- Addictovigilance Centre, Lapeyronie Hospital, CHU de Montpellier, Univ Montpellier, 34000 Montpellier, France; Pathogenesis and Control of Chronic Infections, Univ Montpellier, INSERM, EFS, CHU Montpellier, 34000 Montpellier, France.
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Perino J, Demourgues M, Ramaroson H, Bezin J, Micallef J, Miremont-Salamé G, Frauger E, Gilleron V, Ong N, Daveluy A. Increase in hospitalisation-associated methadone intoxication in France following first COVID-19 lockdown. Public Health 2023; 223:1-6. [PMID: 37572562 DOI: 10.1016/j.puhe.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/20/2023] [Accepted: 07/04/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES At the beginning of the COVID-19 pandemic, the French Addictovigilance Network drew attention to the need to facilitate access to methadone while ensuring its safe use, in order to avoid the occurrence of overdoses and deaths. The objectives of the study were to assess the impact of the lockdowns on the incidence of methadone-use-related hospitalisations (MUHs) and describe the characteristics of patients and hospitalisations. STUDY DESIGN An interrupted time series using the unobserved components model was performed to predict the monthly incidence of MUHs in 2020 on the basis of previous years' data and compared with MUHs observed. Data were presented with prediction intervals (PI95%). METHODS This retrospective study was conducted on patients hospitalised in France for methadone between 2014 and 2020, using the French national database hospital discharge database. Patients' characteristics and hospitalisations were described over four periods: before lockdown, first lockdown, after first lockdown, and second lockdown. RESULTS Compared to the predictions, a higher incidence of MUH was found during the first lockdown, especially in March 2020 (66 cases vs. 51.3; PI95%: 34-65), and there was a large increase during the month following the end of the first lockdown (79 cases vs. 61; PI95%: 46-75). Coconsumptions (alcohol, cannabis, cocaine) were more frequent during the first lockdown, whereas patients aged over 30 years were more concerned thereafter. The second lockdown did not present any particularity. CONCLUSIONS The first lockdown had a significant impact on the incidence of MUHs. These results confirm the data from the reinforced national monitoring during first lockdown published in 2020, where methadone was the primary substance involved in overdoses and deaths.
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Affiliation(s)
- J Perino
- Service de Pharmacologie Médicale, CHU de Bordeauxx, Centre de Pharmacovigilance de Bordeaux, F-33000 Bordeaux, France; University Bordeaux, INSERM, BPH, U1219, CHU de Bordeaux, F-33000 Bordeaux, France
| | - M Demourgues
- Service de Pharmacologie Médicale, CHU de Bordeauxx, Centre de Pharmacovigilance de Bordeaux, F-33000 Bordeaux, France
| | - H Ramaroson
- Service d'Information Médicale, Unité de Coordination et d'Analyse de l'Information Médicale-département d'Information Médicale (UCAIM-DIM), CHU de Bordeaux, F-33000 Bordeaux, France
| | - J Bezin
- University Bordeaux, INSERM, BPH, U1219, CHU de Bordeaux, F-33000 Bordeaux, France
| | - J Micallef
- Centre d'Addictovigilance, Aix Marseille University, AP-HM, INSERM, Institute Neuroscience System, Service de Pharmacologie Clinique et Pharmacovigilance, Marseille, France
| | - G Miremont-Salamé
- Service de Pharmacologie Médicale, CHU de Bordeauxx, Centre de Pharmacovigilance de Bordeaux, F-33000 Bordeaux, France; University Bordeaux, INSERM, BPH, U1219, CHU de Bordeaux, F-33000 Bordeaux, France; Service de Pharmacologie Médicale, Centre d'Addictovigilance, CHU de Bordeaux, F-33000 Bordeaux, France
| | - E Frauger
- Centre d'Addictovigilance, Aix Marseille University, AP-HM, INSERM, Institute Neuroscience System, Service de Pharmacologie Clinique et Pharmacovigilance, Marseille, France
| | - V Gilleron
- Service d'Information Médicale, Unité de Coordination et d'Analyse de l'Information Médicale-département d'Information Médicale (UCAIM-DIM), CHU de Bordeaux, F-33000 Bordeaux, France
| | - N Ong
- Service d'Information Médicale, Unité de Coordination et d'Analyse de l'Information Médicale-département d'Information Médicale (UCAIM-DIM), CHU de Bordeaux, F-33000 Bordeaux, France
| | - A Daveluy
- Service de Pharmacologie Médicale, CHU de Bordeauxx, Centre de Pharmacovigilance de Bordeaux, F-33000 Bordeaux, France; University Bordeaux, INSERM, BPH, U1219, CHU de Bordeaux, F-33000 Bordeaux, France; Service de Pharmacologie Médicale, Centre d'Addictovigilance, CHU de Bordeaux, F-33000 Bordeaux, France.
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Jonville-Bera AP, Gautier S, Micallef J, Massy N, Atzenhoffer M, Drici MD, Grandvuillemin A. [Monitoring the safety of drugs and COVID-19 vaccines by the French Pharmacovigilance Centers during the pandemic: a win-win bet with Health Authorities!]. Therapie 2023; 78:477-488. [PMID: 36890032 PMCID: PMC9943552 DOI: 10.1016/j.therap.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/21/2023] [Indexed: 02/23/2023]
Abstract
The pandemic subsequent to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus resulted, for the French institutional pharmacovigilance, in a "health crisis" in 2 phases: the coronavirus disease 2019 - "COVID-19" phase during which the missions of the Regional Pharmacovigilance Centres (RPVC) were to detect a possible impact of drugs on this disease, as whether existed a possible aggravating role of certain drugs, or the safety profile of drugs used for the management of COVID-19 could evolve. The second phase followed the availability of COVID-19 vaccines, during which the RPVCs' missions were to detect as early as possible any new serious adverse effect, source of a potential signal that would modify the benefit/risk ratio of a vaccine and require the implementation of health safety measures. During these two periods, signal detection remained the core business of the RPVCs. The RPVCs had to organize themselves to handle an historical surge of declarations and requests for advice, whereas the RPVCs in charge of monitoring vaccines had to deal with an extraordinary dense activity over a long period of time, in order to produce in real time and on a weekly basis, a summary of all the declarations and an analysis of safety signals. The national organization put in place made it possible to meet the challenge of real-time pharmacovigilance monitoring of 4 vaccines with conditional marketing authorizations. Short-circuit efficient exchanges with the French Regional Pharmacovigilance Centres Network was paramount for the French National Agency for medicines and health products (Agence nationale de sécurité du médicament et des produits de santé) to develop an optimal collaborative partnership. The RPVC network has shown agility and flexibility, has been able to adapt swiftly and demonstrated its effectiveness in the early detection of safety signals. This crisis confirmed the superiority of manual/human signal detection as the most effective and powerful tool to date, to rapidly detect a new adverse drug reaction and enable to elaborate rapid measures of risk reduction. In order to maintain the performance of French RPVCs in signal detection and to monitor all drugs as they should and as expected by our fellow citizens, a new funding model correcting the inadequacy of RPVCs' expertise resources in relation to the volume of reports should be considered.
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Affiliation(s)
- Annie Pierre Jonville-Bera
- Service de pharmacosurveillance, centre régional de pharmacovigilance Centre Val de Loire, CHRU de Tours, 37000 Tours, France.
| | - Sophie Gautier
- Service de pharmacologie, centre régional de pharmacovigilance Nord Pas de Calais, CHRU de Lille, 59000 Lille, France
| | - Joëlle Micallef
- Inserm, service de pharmacologie, université d'Aix-Marseille, UMR 1106, APHM, centre régional de pharmacovigilance, institut de neuroscience des systèmes, 13005 Marseille, France
| | - Nathalie Massy
- Service de pharmacologie médicale, centre régional de pharmacovigilance de Rouen, CHRU de Rouen, 76000 Rouen, France
| | - Marina Atzenhoffer
- Centre régional de pharmacovigilance, hospices civils de Lyon, 69000 Lyon, France
| | - Milou-Daniel Drici
- Service de pharmacologie, centre régional de pharmacovigilance de Nice, CHRU de Nice, 06000 Nice, France
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Mannaioni G, Lugoboni F. Precautions in the management of opioid agonist therapy: from target population characteristics to new formulations and post-marketing monitoring - a focus on the Italian system. Drugs Context 2023; 12:2023-2-6. [PMID: 37664791 PMCID: PMC10470859 DOI: 10.7573/dic.2023-2-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/29/2023] [Indexed: 09/05/2023] Open
Abstract
Opioid use disorder (OUD) is a serious medical condition with vast social, health and economic impact. Individuals with OUD are prescribed opioid agonist therapies, such as methadone, levomethadone, buprenorphine or naloxone/buprenorphine, to reduce the risks associated with illegal substance abuse, eventually leading to opioid use abstinence. The OUD population has peculiar frailties, mainly related to the psychiatric sphere, which may jeopardize their therapeutic course. Amongst the possible phenomena that may contribute to treatment failure, opioid agonist therapy misuse and diversion are of utmost importance, leading to serious repercussions for patients as well as for national health systems. To minimize the consequences related to these practices, it is necessary to implement cross-cutting precautions, from the formulation of abuse-deterrent drugs to the implementation of a national monitoring system that oversees the health situation and signals when action is needed. Based on these premises, this article focuses on data and insights concerning the Italian territory.
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Affiliation(s)
- Guido Mannaioni
- Sezione di Farmacologia e Tossicologia dell’Università degli Studi di Firenze, Florence,
Italy
- Struttura Organizzativa Dipartimentale di Tossicologia Medica e Centro Antiveleni, Azienda Ospedaliera Universitaria Careggi, Florence,
Italy
| | - Fabio Lugoboni
- Unità di Medicina delle Dipendenze, Dipartimento di Medicina Interna, Azienda Ospedaliera Universitaria Integrata di Verona, Policlinico “G.B. Rossi”, Verona,
Italy
- International Society of Substance Use Professionals, Italian Chapter
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9
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Rance J, Bryant J, Caruana T, Brener L. Practising care in a pandemic: Accounting for everyday life during COVID-19 among people who inject drugs. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:791-809. [PMID: 36738164 DOI: 10.1111/1467-9566.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 01/04/2023] [Indexed: 05/04/2023]
Abstract
From the outset of the COVID-19 pandemic, fears have been raised worldwide regarding the unique challenges facing socially marginalised people such as those who inject drugs. This article draws on in-depth interviews conducted during the first year of the pandemic with people who inject drugs living in urban and regional Australia. Perhaps the most surprising finding to emerge was the number of participants who reported minimal disruption to their everyday lives, even improved wellbeing in some instances. Attempting to make sense of this unanticipated finding, our analysis draws on the concept of 'care', not as a moral disposition or normative code but as something emergent, contingent and realised in practice. Working with Foucault's ethics and recent feminist insights on the politics of care from the field of Science and Technology Studies, we explore how care was enacted in the everyday lives of our participants. We examine how participants' daily routines became objects of care and changed practice in response to the pandemic; how their ongoing engagement with harm reduction services afforded not only clinical support but vital forms of social and affective connection; and how for some, care was realised through an ethos and practice of constrained sociality and solitude.
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Affiliation(s)
- Jake Rance
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Theresa Caruana
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Loren Brener
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
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10
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Istvan M, Bresdin V, Mainguy M, Laigo P, Grall-Bronnec M, Eudeline V, Guillet JE, Guillo M, Babonnaud L, Jolliet P, Schreck B, Victorri-Vigneau C. First results of the French OCTOPUS survey among festival attendees: a latent class analysis. Harm Reduct J 2023; 20:43. [PMID: 36991395 PMCID: PMC10057684 DOI: 10.1186/s12954-023-00770-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Illicit substance use has constantly evolved over the years, particularly in the party scene. Monitoring these changes is essential to adapt harm reduction strategies. The OCTOPUS survey was implemented to enhance knowledge on drug use at music festivals. The objective of the work presented here was to describe drug use and to characterize profiles of substance use in music festival attendees. METHODS OCTOPUS was a cross-sectional survey carried out during 13 various music festivals (dub, eclectic and electronic music) in the Loire-Atlantique department (France) from July 2017 to July 2018. Participants were festival attendees. Data were collected by trained research staff using a face-to-face structured interview. We analysed the use of illicit drugs in the last 12 months to describe the prevalence of use and to characterize the profile of substance use using a latent class analysis. RESULTS In total, 383 festival attendees were included. Of 314 (82%) participants who reported drug use, the most reported drugs were cannabis, ecstasy/MDMA and cocaine. We identified two profiles of drug use: (i) a "no/low polysubstance use" profile mainly characterized by the use of "classic" stimulants (ecstasy/MDMA, cocaine) and (ii) "moderate/extensive polysubstance use", with high probabilities of "classic" stimulants use and especially other drugs reported: speed, ketamine, new psychoactive substances (NPSs). CONCLUSION We observed frequent polysubstance use in festival attendees. Harm reduction should be targeted at the increased risk of toxicity linked to polysubstance use, and the reduction in harm caused by particular drugs (ketamine, NPS, speed) could be further strengthened.
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Affiliation(s)
- Marion Istvan
- Nantes Université, CHU Nantes, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France.
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France.
| | - Vincent Bresdin
- Nantes Université, CHU Nantes, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
| | - Marie Mainguy
- Nantes Université, CHU Nantes, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
| | - Pauline Laigo
- Nantes Université, CHU Nantes, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000, Nantes, France
| | - Vincent Eudeline
- OPPELIA, Association de Prévention et de Soin en Addictologie, Nantes et St Nazaire, France
| | - Jean-Emmanuel Guillet
- OPPELIA, Association de Prévention et de Soin en Addictologie, Nantes et St Nazaire, France
| | - Manon Guillo
- Techno + Nantes, Association de Santé Communautaire en Milieu Techno, Nantes, France
| | - Laurent Babonnaud
- AIDES Nantes, association de soutien et accompagnement des personnes, Actions de prévention et de réduction des risques du VIH/SIDA et des hépatites, Nantes, France
| | - Pascale Jolliet
- Nantes Université, CHU Nantes, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
| | - Benoit Schreck
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000, Nantes, France
| | - Caroline Victorri-Vigneau
- Nantes Université, CHU Nantes, Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
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11
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Blayac L, Ponte C, Lavaud M, Micallef J, Lapeyre-Mestre M. Increase of cannabis and cocaine use by pregnant women in France from 2005 to 2018: Insights of the annual cross sectional OPPIDUM survey. Therapie 2023; 78:201-211. [PMID: 36283856 DOI: 10.1016/j.therap.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/21/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT Substance use disorders during pregnancy are associated with antenatal, neonatal and long-term adverse drug reactions in children. The aim of this study was to describe, using data from OPPIDUM survey, the evolution of illicit substance use or diverted prescription drug use among pregnant women visiting French addiction care centres from 2005 to 2018. MATERIAL AND METHOD The current study focused on women of childbearing age (15-44years old) identified as pregnant, and included in the OPPIDUM survey from 2005 to 2018. OPPIDUM is a French nationwide survey repeated each year since 1995, which anonymously collects information on drug abuse and dependence observed in patients recruited in addiction care centres. Patterns of illicit substance use, psychoactive medications, and opioid maintenance treatment (OMT) were described over time (by period of 2 years) and changes between 2005-2006 and 2017-2018 were investigated. RESULTS From 2005 to 2018, 784 pregnant women were included in the OPPIDUM survey (median age 28, interquartile range (IQR): 25-33). The proportion of women using exclusively cannabis (1.2% vs. 17.1%, P=0.0004) and cocaine (including crack) use (4.7% vs. 14.3%, P=0.0384) significantly increased over the period. Considering the first substance reported as leading to dependence, heroin significantly decreased (78.8% vs. 50.0%, P=0.0002) whereas cannabis significantly increased (5.9% vs. 25.7%, P=0.0005). CONCLUSION This study highlighted an important change of patterns of drug use by French pregnant women over a 14-year-period. Health professionals must be aware of these changes to adapt prevention and care among women of childbearing age and pregnant women.
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Affiliation(s)
- Léna Blayac
- Service de pharmacologie médicale et clinique, centre d'addictovigilance (CEIP-A), CHU de Toulouse - UFR santé, université de Toulouse, 31000 Toulouse, France.
| | - Camille Ponte
- Service de pharmacologie médicale et clinique, centre d'addictovigilance (CEIP-A), CHU de Toulouse - UFR santé, université de Toulouse, 31000 Toulouse, France
| | - Monique Lavaud
- École de sages-femmes, université de Toulouse, 31059 Toulouse, France
| | - Joëlle Micallef
- UMR 1106, Inserm, service de pharmacologie clinique, centre d'addictovigilance, AP-HM, Aix-Marseille université, 13005 Marseille, France
| | - Maryse Lapeyre-Mestre
- Service de pharmacologie médicale et clinique, centre d'addictovigilance (CEIP-A), CHU de Toulouse - UFR santé, université de Toulouse, 31000 Toulouse, France
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12
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郑 俊, 孟 适, 刘 王, 常 祥, 时 杰. [Appropriate Use and Abuse of Sedative-Hypnotic Drugs]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:231-239. [PMID: 36949678 PMCID: PMC10409172 DOI: 10.12182/20230260302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Indexed: 03/24/2023]
Abstract
The incidence of insomnia has been increasing in recent years. In addition, due to the impact of the COVID-19 pandemic, more and more people are experiencing a variety of insomniac problems, including having difficulty in sleep initation, waking up too early, and short sleep duration. Chronic insomnia may seriously affect patients' life and work, increase their risks of developing physical and mental illnesses, and cause crushing social and economic burdens. Sedative-hypnotics, including benzodiazepine agonists, melatonin receptor agonists, orexin receptor antagonists, and antidepressants with hypnotic effects, are widely used to treat most patients suffering from insomnia. However, there is the phenomenon of the non-medical use and abuse of sedative-hypnotic drugs, especially benzodiazepine receptor agonists. The abuse of sedative-hypnotic drugs may lead to mental and physical dependence, cognitive impairment, depression and anxiety, as well as an increased risks of falls and death. Therefore, drug regulatory authorities in China and other countries have issued relevant policies to reinforce regulation. Herein, we reviewed the prevalent use and safety of sedative-hypnotic drugs and proposed suggestions concerning their appropriate use. Both the efficacy and safety of sedative-hypnotic drugs should be carefully considered so that patients suffering from insomnia receive thorough and prompt treatment and the problem of potential abuse of sedative-hypnotic drugs is assessed in an objective and scientific manner. We also hope to provide references for the standardized clinical use of insomnia drugs.
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Affiliation(s)
- 俊玮 郑
- 北京大学中国药物依赖性研究所 (北京 100191)National Institute on Drug Dependence, Peking University, Beijing 100191, China
- 北京大学基础医学院 (北京 100191)School of Basic Medical Sciences, Peking University, Beijing 100191, China
| | - 适秋 孟
- 北京大学中国药物依赖性研究所 (北京 100191)National Institute on Drug Dependence, Peking University, Beijing 100191, China
| | - 王玥 刘
- 北京大学中国药物依赖性研究所 (北京 100191)National Institute on Drug Dependence, Peking University, Beijing 100191, China
- 北京大学基础医学院 (北京 100191)School of Basic Medical Sciences, Peking University, Beijing 100191, China
| | - 祥文 常
- 北京大学中国药物依赖性研究所 (北京 100191)National Institute on Drug Dependence, Peking University, Beijing 100191, China
| | - 杰 时
- 北京大学中国药物依赖性研究所 (北京 100191)National Institute on Drug Dependence, Peking University, Beijing 100191, China
- 北京大学基础医学院 (北京 100191)School of Basic Medical Sciences, Peking University, Beijing 100191, China
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Lapeyre-Mestre M. Addictovigilance in women, the hidden part of the iceberg? Therapie 2023; 78:157-164. [PMID: 36280399 DOI: 10.1016/j.therap.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 11/07/2022]
Abstract
Epidemiology of substance use disorders and their complications is driven by a male predominance, and women, even if they are more and more prevalent, are never specifically represented in studies in the field. Apart from the time of pregnancy, which in itself requires specific prevention, treatment and follow-up, the importance of the sex of women in the complications of substance abuse is neglected. To illustrate, we described some characteristics of women identified in the addictovigilance information system in France and Europe, related to drug use disorders (both for illicit substances and medications). Even if the exposure to some psychoactive substances remains more prevalent in men, women, and particularly young women, seem to be more vulnerable to the adverse effects of these substances, as observed for opioid analgesics, benzodiazepines, cannabis and even nitrous oxide. It is now imperative that the female sex/gender be taken into consideration in addictovigilance expertise and in drug safety in general, even for substances for which use is predominantly male. In addition, the adequate management of the women requires the development of specific prevention and care strategies.
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Affiliation(s)
- Maryse Lapeyre-Mestre
- Service de pharmacologie médicale et clinique, centre d'addictovigilance (CEIP-A), CHU de Toulouse-UFR santé, université de Toulouse, 31000 Toulouse, France.
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Kadi M, Bourion-Bédès S, Bisch M, Baumann C. A Structural Validation of the Brief COPE Scale among Outpatients with Alcohol and Opioid Use Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2695. [PMID: 36768059 PMCID: PMC9916298 DOI: 10.3390/ijerph20032695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Recovery from substance use disorder requires access to effective coping resources. The most widely self-reported questionnaire used to assess coping responses is the Brief COPE; however, different factorial structures were found in a variety of samples. This study aimed to examine across outpatients with substance use disorders the factor structure of the short dispositional French version of the Brief Coping Orientation to Problem Experienced (COPE) inventory. The French version of the Brief COPE was administered in a sample of 318 outpatients with alcohol or opioid substance use disorder. A clustering analysis on latent variables (CLV) followed by a confirmatory factorial analysis (CFA) was conducted to examine the factor structure of the scale. The internal consistency of the Brief COPE and its subscales were also studied. The analysis revealed a nine-factor structure with a revised 24-item version consisting of functional strategies (four items), problem-solving (four items), denial (two items), substance use (two items), social support seeking (four items), behavioral disengagement (two items), religion (two items), blame (two items), and humor (two items) that demonstrated a good fit to the data. This model explained 53% of the total variance with an overall McDonald's omega (ω) of 0.96 for the revised scale. The present work offers a robust and valid nine-factor structure for assessing coping strategies in French outpatients with opioid or alcohol substance use disorder. This structure tends to simplify its use and interpretation of results for both clinicians and researchers.
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Affiliation(s)
- Melissa Kadi
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
| | - Stéphanie Bourion-Bédès
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
- Versailles Hospital, University Department of Child and Adolescent Psychiatry, 78157 Versailles-Le-Chesnay, France
| | - Michael Bisch
- Health Care Centre of Accompaniment and Prevention in Addictology (CSAPA), 54520 Laxou, France
| | - Cédric Baumann
- UR4360 APEMAC, Health Adjustment, Measurement and Assessment, Interdisciplinary Approaches, School of Public Health, Faculty of Medicine, University of Lorraine, 54000 Nancy, France
- Methodology, Data Management and Statistics Unit, University Hospital of Nancy, 54000 Nancy, France
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Guerlais M, Aquizerate A, Lionnet A, Daveluy A, Duval M, Gérardin M, Istvan M, Laforgue EJ, Victorri-Vigneau C. Nitrous oxide: a unique official French addictovigilance national survey. Front Public Health 2023; 11:1167746. [PMID: 37206871 PMCID: PMC10189051 DOI: 10.3389/fpubh.2023.1167746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/31/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Nitrous oxide has become over the last few years a public health problem in many countries. France has a dedicated health monitoring system dedicated to the surveillance of the abuse, dependence and consequences associated with the use of psychoactive substances coordinated by the French National Agency for the Safety of Medicines and Health Products.We present the French national survey of nitrous oxide. Materials and methods We analyzed all the cases with nitrous oxide from 2012 to 2021: number of notifications, characteristics of the subjects and consumption, consequences reported and their evolutions over time. In addition, we have made a special focus on the four main complications reported. Results A total of 525 cases were received with an exponential increase since 2019. We observed changes in the characteristics of the notifications with an increase in the proportion of women [42.7% in 2021 vs. 30.8% in 2020 (p = 0.02)]; an increase in the quantities consumed (use of cylinders); a negative evolution of the contexts of use with a search for self-therapeutic effects and use in violent contexts; an increasing trend of the severity of cases [78.1% in 2021 vs. 70.0% in 2020 (p = 0.07)].The main effects were substance use disorders and/or associated criteria (82.5%), neurological disorders (75.4%), psychiatric symptoms (15.4%) and cardiovascular events (8.6%). In terms of evolution, we observed a significant increase in cases with a use disorder and an increase in neurological complications. Moreover, new serious effects, notably cardiovascular events were reported. Discussion The combination of high availability, varied effects from euphoria to relief of discomfort in a stressful global pandemic context and the development of dependence could explain the rapid growth of consumption and the seriousness of the cases.It must now be taken into account that (i) Substance use disorders are associated with nitrous oxide consumption; (ii) clinicians must consider "nitrous oxide" in young subjects presenting different types of manifestations; and (iii) stopping consumption is imperative and is the first treatment. In this context, an addictological assessment must also be carried out.
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Affiliation(s)
- Marylène Guerlais
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique – Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance, Nantes, France
| | - Aurélie Aquizerate
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique – Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance, Nantes, France
| | - Arthur Lionnet
- Nantes Université, CHU Nantes, Service de Neurologie, Nantes, France
- Inserm, U1235, Nantes, France
| | - Amélie Daveluy
- Centre d’Addictovigilance, Département de Pharmacologie Médicale, INSERM, BPH, U1219, CHU de Bordeaux, Bordeaux, France
| | - Mélanie Duval
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique – Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance, Nantes, France
- Nantes Université, CHU Nantes, INSERM, methodS in Patient-centered outcomes and HEalth ResEarch, Nantes, France
| | - Marie Gérardin
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique – Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance, Nantes, France
| | - Marion Istvan
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique – Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance, Nantes, France
- Nantes Université, CHU Nantes, INSERM, methodS in Patient-centered outcomes and HEalth ResEarch, Nantes, France
| | - Edouard-Jules Laforgue
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique – Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance, Nantes, France
- Nantes Université, CHU Nantes, INSERM, methodS in Patient-centered outcomes and HEalth ResEarch, Nantes, France
| | - Caroline Victorri-Vigneau
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique – Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance, Nantes, France
- Nantes Université, CHU Nantes, INSERM, methodS in Patient-centered outcomes and HEalth ResEarch, Nantes, France
- *Correspondence: Caroline Victorri-Vigneau,
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Saleh EA, Haddadin RN, Saleh B, Elayeh E. Changes in drug demand when a pandemic coincides with other outbreaks in a war zone country: a cross-sectional pilot study. J Pharm Policy Pract 2022; 15:89. [PMID: 36419090 PMCID: PMC9682693 DOI: 10.1186/s40545-022-00487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Yemen's health system has severely deteriorated due to the ongoing civil war accompanied by the COVID-19 pandemic which coincided with other outbreaks of endemic infections. Many health institutions closed due to insufficient equipment and supplies. Consequently, pharmacists became the available healthcare provider on the frontlines. This study aimed to evaluate the pattern of demand for prescription and nonprescription drugs during the pandemic based on the pharmacist's perspective in Yemen, a conflict zone country. METHODS An online survey was developed, validated, and distributed among pharmacists. The questionnaire was composed of two sections: (1) demographic characteristics of the participants and (2) changes in the demand for different drug categories. Chi-square test and Fisher's exact test were used to find statistical associations. RESULTS Responses (330) were received from pharmacists working in 12 out of 22 governorates in Yemen. During the pandemic, there was an increase in the demand for prescription drugs such as antibiotics, antimalarials, and sedatives (95%, 90%, and 71%, respectively) and an increase in the demand for nonprescription drugs such as vitamins (93%) and paracetamol (> 90%). Some of these drugs could have serious side effects if taken without medical advice, and others could result in severe effects if taken concomitantly. In addition, there was an increase in the demand for prescription drugs without a prescription, which was reported by 50% of the participants. No statistical difference was seen between the frontline districts and major cities in terms of requesting these drugs without a prescription. On the other hand, most participants (75.2%) did not attend any training or workshop during the last 6 months of conducting this survey. CONCLUSION COVID-19 has increased the demand for many prescription and nonprescription drugs, where the irrational use of these drugs may lead to devastating health effects. In war zone areas hit by a pandemic, policymakers and public health organizations should focus on training and educating pharmacists as important health care and medicine providers for the public.
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Affiliation(s)
- Ebtesam A. Saleh
- grid.411125.20000 0001 2181 7851Department of Pharmacology & Toxicology, School of Pharmacy, University of Aden, Aden, Yemen
| | - Randa N. Haddadin
- grid.9670.80000 0001 2174 4509Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Bassam Saleh
- Medical and Health Unit, International Organization of Migration (IOM), Aden, Yemen
| | - Eman Elayeh
- grid.9670.80000 0001 2174 4509Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
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Évaluation du mésusage de l’alprazolam : données du réseau français d’addictovigilance. Therapie 2022. [DOI: 10.1016/j.therap.2022.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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18
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Chiappini S, Schifano F, Martinotti G. Editorial: Prescribing psychotropics: Misuse, abuse, dependence, withdrawal and addiction, Volume II. Front Psychiatry 2022; 13:1053896. [PMID: 37255962 PMCID: PMC10226078 DOI: 10.3389/fpsyt.2022.1053896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 06/01/2023] Open
Affiliation(s)
- Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D'Annunzio” University, Chieti, Italy
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Giovanni Martinotti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D'Annunzio” University, Chieti, Italy
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Chong WWY, Acar ZI, West ML, Wong F. A Scoping Review on the Medical and Recreational Use of Cannabis During the COVID-19 Pandemic. Cannabis Cannabinoid Res 2022; 7:591-602. [PMID: 34981958 PMCID: PMC9587770 DOI: 10.1089/can.2021.0054] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background/Introduction: The shelter-in-place orders and social distancing regulations on account of the COVID-19 pandemic have impacted lifestyles, including the use of cannabis. The purpose of this scoping review is to summarize both the gray and academic literature on the use of cannabis during the pandemic. Materials and Methods: A total of 11 databases, including 2 medical databases, 7 social science databases, and 2 gray literature databases were searched resulting in 316 titles and abstracts of which 76 met inclusion criteria. Results: Nine themes emerged: (a) prevalence and trends of cannabis use during COVID[1]19; (b) demographics; (c) profile of mode of consumption; (d) context of using cannabis (i.e., solitary use vs. in groups); (e) factors contributing to use; (f) factors inhibiting use; (g) adverse clinical and psychiatric outcomes of cannabis use during the pandemic; (h) similarities between EVALI (E-Cigarette or Vaping Product Use-Associated Lung Injury) and COVID-19 symptoms; (i) implications for policy and practice. Studies published until February 2, 2021 were included in this review. Discussion: Findings have highlighted that feelings of boredom, depression, and anxiety during the pandemic have contributed to an increase in the use of cannabis. Furthermore, accessibility to cannabis was noted to affect use during the pandemic. Adverse psychiatric and clinical outcomes were associated with the increased use of cannabis. Conclusion: Practitioners and policymakers are called to employ harm reduction strategies to respond to increasing cannabis use. There is a need for population-based studies and further examination of factors contributing to the increased use of cannabis during the pandemic and associated negative consequences.
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Affiliation(s)
- Wendy Wing-Yee Chong
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Zeynep Ilgaz Acar
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Meghan Lee West
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Francis Wong
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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20
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Carton L, Icick R, Weibel S, Dematteis M, Kammerer E, Batisse A, Rolland B. What is the potential for abuse of lisdexamfetamine in adults? A preclinical and clinical literature review and expert opinion. Expert Rev Clin Pharmacol 2022; 15:921-925. [PMID: 35959655 DOI: 10.1080/17512433.2022.2112950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : Lisdexamfetamine dimesylate (LDX) is a prodrug approved for attention deficit/hyperactivity disorder and for moderate-to-severe binge eating disorder in adults in some countries. AREA COVERED : We aimed to specify the abuse potential of LDX in adults, using a review of pharmacokinetic/pharmacodynamic (PK/PD), animal, clinical, and pharmaco-epidemiological studies, through a PubMed search since inception until May 2021 using the following keywords: "lisdexamfetamine AND ("misuse" OR "abuse" OR "diversion" OR "addiction"). EXPERT OPINION : Most of the studies highlighted a longer Tmax than dexamphetamine leading to a delayed onset of effects and a decreased Cmax. These PK parameters were often associated with a diminished feeling of euphoria, in comparison to immediate-release dexamphetamine. The potential for abuse was also limited by the prodrug property of LDX, thus reducing the risk of misuse. Nevertheless, all the data were not convergent, as some authors reported similar Cmax for LDX and dexamphetamine and reinforcing properties with a dose-dependent effect. Epidemiological studies found that abuse rates of LDX were substantially lower than those of immediate-release dexamphetamine. Overall, although LDX abuse seems possible, we did not find evidence concerning current safety signal. However, more long-term pharmaco-epidemiological studies are still needed to confirm this finding.
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Affiliation(s)
- Louise Carton
- Degenerative and Vascular Cognitive Disorders, Pharmacology Department, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, UMR-S1172, Lille, France
| | - Romain Icick
- Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, APHP.Nord, Assistance Publique - Hôpitaux de Paris (AP-HP), France Université de Paris, Inserm UMR-S1144, Paris F-75006, France
| | - Sébastien Weibel
- Pôle de Psychiatrie, Santé Mentale et Addictologie, Hôpitaux Universitaires de Strasbourg; Inserm U1114, Strasbourg France
| | - Maurice Dematteis
- CSAPA, CHU Grenoble Alpes , Univ. Grenoble Alpes, Service Universitaire de Pharmaco-Addictologie, 38043 Grenoble, France
| | | | - Anne Batisse
- Centre d'Addictovigilance, Hôpital Fernand-Widal, Paris, France
| | - Benjamin Rolland
- Service universitaire d'Addictologie de Lyon (SUAL), HCL, CH Le Vinatier, Bron, France
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21
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Hospitalisations après consommation de substances psychoactives pendant la pandémie de COVID-19. Therapie 2022; 78:334-338. [PMID: 35908997 PMCID: PMC9329723 DOI: 10.1016/j.therap.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/21/2022]
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22
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Enrico C, Caldiroli A, Di Brita C, Colmegna F, Nava R, Colzani LC, Sibilla M, Prodi T, Buoli M, Clerici M. Profile of patients attending psychiatric emergency care during the coronavirus 2019 (COVID 19) pandemic: a comparative cross-sectional study between lockdown and post-lockdown periods in Lombardy, Italy. Int J Psychiatry Clin Pract 2022; 26:132-138. [PMID: 34151680 DOI: 10.1080/13651501.2021.1939385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the long-term impact of early COVID-19 lockdown phase on emergency psychiatric consultations in two psychiatric emergency departments located in Italy. METHODS We conducted a cross-sectional study comparing the number and characteristics of emergency psychiatric consultations during post-lockdown with respect to the lockdown period. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis, information on multiple psychiatric consultations and hospitalisation were collected. RESULTS A rise of almost 60% in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed. Emergency psychiatric consultations in the post-lockdown period were associated with lower rates of cannabis (aOR = 0.42, p = 0.011) and cocaine use (aOR = 0.39, p = 0.011). Despite a lower occurrence of two or more psychiatric consultations was observed during post-lockdown phase (aOR = 0.44, p = 0.008), subjects who had anxiety disorders (aOR = 3.91, p = 0.000) and substance intoxication or withdrawal (aOR = 6.89, p = 0.000) were more likely to present to emergency psychiatric consultations during post-lockdown period compared to the lockdown one. CONCLUSIONS Substance intoxication or withdrawal and anxiety disorders increased after the COVID-19 lockdown. The findings of this study suggest to address more economic and professional sources to the mental health areas potentially more affected by the different phases of a pandemic.KEYPOINTSCOVID-19 pandemic and lockdown measures increased mental health unmet needs.According to our findings, a rise in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed.Patients with substance intoxication or withdrawal syndrome and anxiety disorders were significantly more likely to present to emergency psychiatric consultations during post-lockdown.Lockdown was associated with higher rates of both cannabis and cocaine use disorders as well as of multiple psychiatric consultations.Alternative strategies to improve mental health such as e-health technologies should be promoted.
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Affiliation(s)
- Capuzzi Enrico
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Carmen Di Brita
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Roberto Nava
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Lia Chiara Colzani
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Matteo Sibilla
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Tiziano Prodi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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Nino-Orrego MJ, Baracaldo-Santamaría D, Patricia Ortiz C, Zuluaga HP, Cruz-Becerra SA, Soler F, Pérez-Acosta AM, Delgado DR, Calderon-Ospina CA. Prescription for COVID-19 by non-medical professionals during the pandemic in Colombia: a cross-sectional study. Ther Adv Drug Saf 2022; 13:20420986221101964. [PMID: 35646306 PMCID: PMC9136451 DOI: 10.1177/20420986221101964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/03/2022] [Indexed: 01/08/2023] Open
Abstract
Background: The COVID-19 pandemic has led to an increase in the behavior of
self-medication (SM). Given the massive release of misleading information
during the pandemic, some pharmacies recommend drugs such as ivermectin,
azithromycin, and hydroxychloroquine that are not useful for preventing or
treating COVID-19 and could expose patients to unnecessary adverse drug
reactions (ADRs), drug-drug interactions (DDIs), disease masking, and
antibiotic resistance. Rationale: SM with drugs advertised for COVID-19 can have consequences, and people
should be aware of approved uses, potential contraindications, and ADRs.
Thus, the aim of this study was to know the drug therapies including natural
products and homeopathic drugs offered by Colombian pharmaceutical
establishments for the prevention and treatment of COVID-19, as well as the
information provided on the safe use of the product. Methods: An observational, cross-sectional mystery shopping study was carried out to
determine the pharmaceutical alternatives for the management of COVID-19
offered by pharmaceutical establishments (drugstores, pharmacies,
homeopathic pharmacies, and nutritional supplements stores) in Colombia, and
information related to the safe use of the product. The study included 482
pharmaceutical establishments from 16 Colombian departments. Data collection
was done through telephone calls to each of the establishments following an
interview protocol pretending to be a patient who presents symptoms related
to COVID-19. Results: About 57.3% (276) of the establishments recommended a product for the
treatment of COVID-19 infection, 66.6% (321) asked whether the caller had
COVID-19 symptoms and what they are, and 44.2% (213) suggested taking a
COVID-19 test. Of 59 drugs suggested by pharmacies, the most recommended
were azithromycin, ivermectin, acetaminophen, ibuprofen, and ASA (aspirin).
From the establishments that recommended a product, dosage was indicated in
85.5% (236) of the pharmaceutical establishments and 14.5% (40) of the
establishments reported the most common adverse effects of this substance.
About 9.4% (26) of the establishments reported possible interactions of the
recommended drugs and substances with food, beverages, or
supplements.Conclusion: Pharmaceutical establishments in
Colombia seem to have significantly contributed to self-medication for
COVID-19 in Colombia during the pandemic. This behavior is inappropriate,
since the mild forms of the disease do not have a specific treatment. Plain Language Summary Self-medication induced by pharmaceutical establishments in Colombia
during the COVID-19 pandemic Background: The COVID-19 pandemic has led to an increase in the
behavior of self-medication (SM). Given the massive release of misleading
information during the pandemic, some pharmacies recommend drugs such as
ivermectin, azithromycin, hydroxychloroquine among others, which are not
useful for preventing or treating COVID-19 and could expose patients to
unnecessary side effects and interactions with other medications. People
should be aware of the approved and non-approved uses, and potential side
effects of these drugs. Rationale: The aim of this study was to
know the drugs, including natural products and homeopathic drugs, offered by
Colombian pharmaceutical establishments for the prevention and treatment of
COVID-19, as well as the information provided on the safe use of the
product. Methods: The study was done using the mystery shopping
method, collecting data through telephone calls to each of the
establishments by a trained individual pretending to be a patient with
COVID-19 symptoms. The study included 482 pharmaceutical establishments from
16 Colombian departments. Results: Of 59 drugs suggested by
pharmacies, the most recommended were azithromycin, ivermectin,
acetaminophen, ibuprofen, and aspirin. The recommended dose was indicated in
85.5% (236) of the pharmaceutical establishments, and 14.5% (40) of them
reported the most common adverse effects of the recommended product. About
9.4% (26) of the establishments reported possible interactions of the
recommended drugs and substances with food, beverages, or supplements.
Conclusion: The majority of the pharmaceutical
establishments included in the study promoted inadequate self-medication for
COVID-19 in Colombia during the pandemic.
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Affiliation(s)
- Maria Jose Nino-Orrego
- Center for Research in Genetics and Genomics (CIGGUR), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Daniela Baracaldo-Santamaría
- Pharmacology Unit, Department of Biomedical Sciences, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Claudia Patricia Ortiz
- Corporación Universitaria Minuto de Dios-UNIMINUTO, Programa de Administración en Salud Ocupacional, Grupo de Investigación en Seguridad y Salud en el Trabajo, Neiva, Colombia
| | | | | | - Franklin Soler
- Observatory of Self-Medication Behavior, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Andrés M. Pérez-Acosta
- Observatory of Self-Medication Behavior, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Daniel Ricardo Delgado
- Grupo de Investigación en Dinámicas Sociales, Universidad Cooperativa de Colombia, Campus Neiva, Neiva, Colombia
| | - Carlos-Alberto Calderon-Ospina
- Center for Research in Genetics and Genomics (CIGGUR), School of Medicine and Health Sciences, Universidad del Rosario, 111221 Bogotá, Colombia. Pharmacology Unit, Department of Biomedical Sciences, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
- Observatory of Self-Medication Behavior, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Mezaache S, Donadille C, Martin V, Le Brun Gadelius M, Appel L, Spire B, Briand Madrid L, Bastien M, Roux P. Changes in cannabis use and associated correlates during France's first COVID-19 lockdown in daily cannabis users: results from a large community-based online survey. Harm Reduct J 2022; 19:26. [PMID: 35292040 PMCID: PMC8922077 DOI: 10.1186/s12954-022-00611-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/04/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Lockdown measures during the first wave of the COVID-19 pandemic in France led to serious public health concerns over people who use illicit drugs, especially in terms of mental health. We assessed changes in cannabis use during the first lockdown in France among daily cannabis users and associated correlates. METHODS CANNAVID is a French, national, cross-sectional web-based survey, conducted from 17 April to 11 May 2020. Daily cannabis users aged ≥ 18 years and living in France were invited to participate through advertisements. Respondents completed an ad hoc questionnaire on a dedicated online platform. We analyzed changes in cannabis use during the first lockdown (i.e., stopped, decreased, unchanged, or increased) and performed a multinomial logistic regression analysis to evaluate correlates of these changes. RESULTS Of the 4019 participants, 74.0% were men. Median age was 27 years (interquartile range: 22-37). With regard to cannabis use, 293 (7.3%) persons stopped, 1153 (28.7%) decreased, 1146 (28.5%) did not change, and 1427 (35.5%) increased their use during the lockdown. A multinomial logistic regression model revealed several sociodemographic, behavioral and health-related factors associated with changes in cannabis use. Compared with participants with an unchanged level of cannabis use during the lockdown, those who increased and those who stopped cannabis use were more likely to have increased tobacco and alcohol use and to have experienced depression and sleep disorders intensification. Those who stopped cannabis use were also more likely to have increased benzodiazepine use and to have experienced pain increase during lockdown. CONCLUSIONS France's first COVID-19-related lockdown had a differential impact on daily cannabis users' consumption patterns. Most study respondents reported changes to their cannabis consumption pattern. Those who reported a stable cannabis use were more likely to report fewer negative changes. Specific interventions are needed for this population, as well as research to assess the long-term impacts of these changes.
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Affiliation(s)
- Salim Mezaache
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Cécile Donadille
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | | | | | | | - Bruno Spire
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Laelia Briand Madrid
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Martin Bastien
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Perrine Roux
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France. .,Faculté de médecine, INSERM U1252 SESSTIM, 27 bd Jean Moulin, Marseille, France.
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Roux P, Donadille C, Girard G, Spire B, Protière C, Velter A. Impact of COVID-19 Pandemic on Men Who Have Sex With Men That Practice Chemsex in France: Results From the National ERAS Web Survey. Am J Mens Health 2022; 16:15579883211073225. [PMID: 35156425 PMCID: PMC8848067 DOI: 10.1177/15579883211073225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Chemsex-the use of drugs in a sexual context-has been associated with more at-risk sexual practices and substance-related complications in men who have sex with men (MSM). To date, no study has focused on the impact of France's first coronavirus disease 2019 (COVID-19)-related lockdown on the mental health and drug/alcohol use of MSM who practice chemsex. We implemented a web-based survey of 9,488 MSM living in France in June 2020 (after the country's first COVID-19 lockdown). Specifically, we first compared the subpopulation of MSM who self-reported practicing chemsex during their most recent sexual intercourse (defined as "chemsexers") with other MSM, using five outcomes: increased 1/tobacco use, 2/alcohol use, and 3/other psychoactive drug use. 4/using psychotropic medication during the lockdown, and finally 5/psychological distress. We then analyzed the outcomes' associations with the main explanatory variable "chemsexer," after adjusting for all relevant variables. Among 7,195 MSM who had sexual intercourse with a man during the previous 6 months, 359 participants (5%) were identified as "chemsexers." Multivariable analyses showed that during the first lockdown period, chemsexers were significantly more likely than non-chemsexers to have increased their use of tobacco, alcohol, and other psychoactive substances. Chemsexers were also more likely to have used psychotropic medication and to have experienced psychological distress during the previous month. Given the ongoing COVID-19 pandemic in France and worldwide, this finding highlights the need to develop psychosocial interventions and harm reduction services for MSM chemsexers, potentially via mobile health.
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Affiliation(s)
- Perrine Roux
- Aix-Marseille University, INSERM, IRD, U1252 SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
| | - Cécile Donadille
- Aix-Marseille University, INSERM, IRD, U1252 SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
| | - Gabriel Girard
- Aix-Marseille University, INSERM, IRD, U1252 SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
| | - Bruno Spire
- Aix-Marseille University, INSERM, IRD, U1252 SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
| | - Christel Protière
- Aix-Marseille University, INSERM, IRD, U1252 SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
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Esposito M, Salerno M, Scoto E, Di Nunno N, Sessa F. The Impact of the COVID-19 Pandemic on the Practice of Forensic Medicine: An Overview. Healthcare (Basel) 2022; 10:healthcare10020319. [PMID: 35206933 PMCID: PMC8871677 DOI: 10.3390/healthcare10020319] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/12/2022] Open
Abstract
During the COVID-19 pandemic, forensic sciences, on the one hand, contributed to gaining knowledge about different aspects of the pandemic, while on the other hand, forensic professionals were called on to quickly adapt their activities to respond adequately to the changes imposed by the pandemic. This review aims to clarify the state of the art in forensic medicine at the time of COVID-19, discussing the following: the influence of external factors on forensic activities, the impact of autopsy practice on COVID-19 and vice-versa, the persistence of SARS-CoV-2 RNA in post-mortem samples, forensic personnel activities during the SARS-CoV-2 pandemic, the global vaccination program and forensic sciences, forensic undergraduate education during and after the imposed COVID-19 lockdown, and the medico-legal implications in medical malpractice claims during the COVID-19 pandemic. The COVID-19 pandemic has greatly influenced different aspects of human life, and, accordingly, the practical activities of forensic sciences that are defined as multidisciplinary, involving different expertise. Indeed, the activities are very different, including crime scene investigation (CSI), external examination, autopsy, and genetic and toxicological examinations of tissues and/or biological fluids. At the same time, forensic professionals may have direct contact with subjects in life, such as in the case of abuse victims (in some cases involving children), collecting biological samples from suspects, or visiting subjects in the case of physical examinations. In this scenario, forensic professionals are called on to implement methods to prevent the SARS-CoV-2 infection risk, wearing adequate PPE, and working in environments with a reduced risk of infection. Consequently, in the pandemic era, the costs involved for forensic sciences were substantially increased.
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Affiliation(s)
- Massimiliano Esposito
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (E.S.)
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (E.S.)
| | - Edmondo Scoto
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (E.S.)
| | - Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy;
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
- Correspondence: ; Tel.: +39-881-736926
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Trajkovski T, Marić N. Use of anxiolytics and hypnotic drugs during COVID-19 pandemic: The literature review. MEDICINSKI PODMLADAK 2022. [DOI: 10.5937/mp73-35916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Anxiolytics and hypnotics are widely used drugs. First-line psychiatric indications for benzodiazepines (BZD) are alcohol/sedative-hypnotic withdrawal and catatonia, while panic disorder, general anxiety disorder, social anxiety disorder and insomnia are indications after failing of first/second-line treatments, and its use is recommended only for a short time. The spread of the SARS-CoV-2 virus influenced regular daily living, psychological, social, and economic stability. The COVID-19 pandemic has a multifactorial effect on people's mental health and has directly and indirectly influenced changing trends in the prescription, use and misuse of anxiolytics and hypnotics during the pandemic. This article will show use of anxiolytics and hypnotics in inpatients with SARS-CoV-2 infection with or without delirium, will present recommendation for BZD utilization in the infected individuals and will review interactions between BZD and antiviral drugs. Moreover, it will summarize available data on the frequency and reasons for use and abuse of BZD in the general population during the pandemic.
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Langlumé L, Eiden C, Roy S, Taruffi F, Gambier J, Donnadieu-Rigole H, Peyrière H. Management of Pregabalin Use Disorder: A Case Series. J Psychoactive Drugs 2021; 54:386-391. [PMID: 34930090 DOI: 10.1080/02791072.2021.2013579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pregabalin is indicated for the treatment of partial epilepsy, generalized anxiety disorder, and neuropathic pain. The first reports on pregabalin use disorder have been published in Europe in 2010 and notified to the French Addictovigilance Network (FAN) in 2011. The management of pregabalin use disorder is challenging due to the risks associated with the abrupt withdrawal and lack of guidelines. In this retrospective observational study, the management of pregabalin use disorder was analyzed in eight cases reported to the addictovigilance center of Montpellier, France, between 2019 and 2020. Most of these patients had a history of illicit psychoactive substance use. During the withdrawal period, patients experienced mainly psychiatric problems, nervous system symptoms, general disorders, and gastrointestinal symptoms. Multiple strategies were proposed for these patients to manage pregabalin withdrawal, such as hospitalization and pregabalin gradual dose reduction with or without adjuvant medications. Two patients relapsed and the others were lost to follow up. Although other reports of pregabalin use disorder have been published, recommendations or guidelines for its management are not yet available. The current case series and the previous reports suggest that the use of adjunctive therapy may be useful to limit the risk of convulsions and anxiety.
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Affiliation(s)
- Lisa Langlumé
- Département de Pharmacologie Médicale Et Toxicologie, Centre d'Addictovigilance, Chu Montpellier, Univ Montpellier, Montpellier, France
| | - Céline Eiden
- Département de Pharmacologie Médicale Et Toxicologie, Centre d'Addictovigilance, Chu Montpellier, Univ Montpellier, Montpellier, France
| | - Sophie Roy
- Département de Pharmacologie Médicale Et Toxicologie, Centre d'Addictovigilance, Chu Montpellier, Univ Montpellier, Montpellier, France
| | - Floriane Taruffi
- Département d'Addictologie, CHU Montpellier, Univ Montpellier, Montpellier, France
| | | | | | - Hélène Peyrière
- Département de Pharmacologie Médicale Et Toxicologie, Centre d'Addictovigilance, Chu Montpellier, Univ Montpellier, Montpellier, France
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29
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[Acute and chronic toxicities associated with the use and misuse of nitrous oxide: An update]. Rev Med Interne 2021; 43:170-177. [PMID: 34903366 DOI: 10.1016/j.revmed.2021.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/07/2021] [Accepted: 10/09/2021] [Indexed: 11/22/2022]
Abstract
Nitrous oxide (N2O) is used since the eighteenth century as an anesthetic and analgesic but also for recreational use. If the labelled uses of N2O and their modalities are nowadays perfectly framed, the misuse of N2O takes very alarming proportions among teenagers and young adults. This misuse is the cause of acute (hypoxia, barotrauma, burns, neuropsychiatric disorders) and chronic complications if repeated (myeloneuropathy, anemia, thrombosis, inhalant use disorder). The main mechanism of the latter is mainly related to a functional deficit in vitamin B12 induced by N2O. The management of acute complications is symptomatic. The management of chronic complications is based on vitamin B12 supplementation. The best biomarker of chronic N2O exposure is the elevation of the plasmatic level of methylmalonic acid. In all cases of recreational misuses, addiction treatment is necessary to prevent complications or their worsening by providing information in order to stop consumption.
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30
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Roberts A, Rogers J, Mason R, Siriwardena AN, Hogue T, Whitley GA, Law GR. Alcohol and other substance use during the COVID-19 pandemic: A systematic review. Drug Alcohol Depend 2021; 229:109150. [PMID: 34749198 PMCID: PMC8559994 DOI: 10.1016/j.drugalcdep.2021.109150] [Citation(s) in RCA: 161] [Impact Index Per Article: 53.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although evidence suggests substance and alcohol use may change during the Covid-19 pandemic there has been no full review of the evidence around this. METHODS A systematic review of all available evidence was carried out to document and interpret the frequency and severity of alcohol and other substance use during the Covid-19 pandemic and their relationship to demographic and mental health variables that may suggest further clinical implications. Peer reviewed articles in MEDLINE, Embase, PsycINFO, CINAHL complete and Sociological Abstracts were searched from December 2019 until November 2020. RESULTS The search and screening identified 45 articles from 513 deduplicated records. The evidence suggests a mixed picture for alcohol use. Overall, there was a trend towards increased alcohol consumption. The proportion of people consuming alcohol during the pandemic ranged from 21.7% to 72.9% in general population samples. Unlike alcohol use, there was a clear trend towards increased use of other substances use during the COVID-19 pandemic. The proportion of people consuming other substances during the pandemic ranged from 3.6% to 17.5% in the general population. Mental health factors were the most common correlates or triggers for increased use of both alcohol and other substances. CONCLUSION There is an increased need for treatment for alcohol and other substance use related problems during the pandemic. Increased targeting and evidence-based interventions will also be important in the period which follows this pandemic, to improve the quality of life for individuals and families, but also to prevent additional costs to society and health systems.
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Affiliation(s)
- Amanda Roberts
- School of Psychology, College of Social Science, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, UK.
| | - Jim Rogers
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, UK
| | - Rachael Mason
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, UK
| | - Aloysius Niroshan Siriwardena
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, UK
| | - Todd Hogue
- School of Psychology, College of Social Science, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, UK
| | - Gregory Adam Whitley
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, UK
| | - Graham R Law
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS, UK
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Goncalves R, Labadie M, Chouraqui S, Peyré A, Castaing N, Daveluy A, Molimard M. Involuntary MDMB-4en-PINACA intoxications following cannabis consumption: clinical and analytical findings. Clin Toxicol (Phila) 2021; 60:458-463. [PMID: 34850659 DOI: 10.1080/15563650.2021.1994144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS MDMB-4en-PINACA is a synthetic cannabinoid receptor agonist (SCRA) that has recently emerged. Data regarding clinical presentations in the event of intoxication is scarce. This study presents MDMB-4en-PINACA identification in cannabis consumers with clinical and analytical descriptions. METHODS Between November 2020 and March 2021, all patients with unexpected or unusually severe effects and Poisoning Severity Score (PSS) greater than or equal to 2 after cannabis consumption were included. Blood and/or urine samples were collected for toxicological analysis. When available, drug material samples were also collected for analysis. RESULTS Between November 2020 and March 2021, 13 patients were included. All cases typically presented with altered mental status (n = 13), and nearly all had returned to a normal or quasi-normal state after around 11 h of observation. Neurological symptoms included headaches (n = 3), hallucinations (3), mydriasis (3), amnesia (2) and seizures (5). Psychiatric symptoms were paranoia (6) and anxiety (2). Digestive symptoms were nausea (2) and vomiting (6). No deaths were recorded. All patients were positive for the SCRA MDMB-4en-PINACA in urine, blood and/or drug material sample. Results from toxicology testing paired with case history showed the potential for MDMB-4en-PINACA to cause or contribute to different clinical disorders. Conclusions: This study highlights the risk of intoxication by SCRAs when taking low-THC cannabis products. Forensic scientists, public health and public safety officials, law enforcement personnel and clinicians should be aware of the impact that these emergent SCRAs may have in their work, especially MDMB-4en-PINACA.
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Affiliation(s)
- Ruben Goncalves
- CHU de Bordeaux, Laboratoire de Pharmacologie et Toxicologie, Bordeaux Cedex, France.,Univ. Bordeaux, INSERM U1219, BPH, Bordeaux Cedex, France
| | - Magali Labadie
- CHU de Bordeaux, Centre-Antipoison et Toxicovigilance de Nouvelle Aquitaine, Bordeaux Cedex, France
| | - Simon Chouraqui
- CHU de Bordeaux, Urgences adultes, Place Amélie Raba Léon, Bordeaux Cedex, France
| | - Alexandre Peyré
- CHU de Bordeaux, Centre d'addictovigilance, Place Amélie Raba Léon, Bordeaux Cedex, France
| | - Nadège Castaing
- CHU de Bordeaux, Laboratoire de Pharmacologie et Toxicologie, Bordeaux Cedex, France
| | - Amélie Daveluy
- Univ. Bordeaux, INSERM U1219, BPH, Bordeaux Cedex, France.,CHU de Bordeaux, Centre d'addictovigilance, Place Amélie Raba Léon, Bordeaux Cedex, France
| | - Mathieu Molimard
- CHU de Bordeaux, Laboratoire de Pharmacologie et Toxicologie, Bordeaux Cedex, France.,Univ. Bordeaux, INSERM U1219, BPH, Bordeaux Cedex, France
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32
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Dumonceau RG, Soeiro T, Lacroix C, Giocanti A, Frauger É, Mezaache S, Micallef J. Antidepressants abuse in subjects with opioid use disorders: A 10-year study in the French OPPIDUM program. Fundam Clin Pharmacol 2021; 36:436-442. [PMID: 34837277 DOI: 10.1111/fcp.12738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/22/2023]
Abstract
Accumulating evidence shows that some antidepressants are abused for their psychostimulant effects, but the extent of antidepressants abuse is unknown in subjects with opioid use disorders (OUD). The objective of this work is to assess the prevalence of antidepressant abuse and its correlates in subjects with OUD. Subjects ≥18 year-old in an opiate maintenance treatment (OMT) program who reported using an antidepressant were selected from the OPPIDUM program from 2011 to 2020. The outcome was antidepressant abuse. Antidepressant abusers were identified as subjects reporting at least one of the following behaviors: "drug abuse," "concomitant use of alcohol," "illegal obtaining," and "dose higher than recommended in the Summary of Product Characteristics." Among the 83 040 observations of subjects ≥18 year-old in an OMT program included in the OPPIDUM program from 2011 to 2020, 2708 (3.3%) subjects reported using an antidepressant in monotherapy. Among them, there were 385 (14.2%) abusers. The proportion of abusers was the highest for amitriptyline (n = 31, 25.0%). In multivariate analysis, antidepressant abuse was positively associated with amitriptyline (OR 2.07, 95% CI [1.16, 3.73]; p = 0.015), unemployment (OR 1.52, 95% CI [1.16, 2.01]; p = 0.003), the use of intravenous route of administration (OR 1.77, 95% CI [1.12, 2.80]; p = 0.014), and the use of benzodiazepines (OR 1.53, 95% CI [1.21, 1.94]; p < 0.001). Clinicians should be aware of the risk of antidepressant abuse when prescribing in subjects with OUD, accounting for their heterogeneous pharmacological properties that may account for their abuse potential.
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Affiliation(s)
- Robinson Gravier Dumonceau
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Thomas Soeiro
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France.,Aix-Marseille Université, Inserm, UMR 1106, Marseille, France
| | - Clémence Lacroix
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France.,Aix-Marseille Université, Inserm, UMR 1106, Marseille, France
| | - Adeline Giocanti
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Élisabeth Frauger
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Salim Mezaache
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Joëlle Micallef
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France.,Aix-Marseille Université, Inserm, UMR 1106, Marseille, France
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33
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Comparison of ARIMA, ES, GRNN and ARIMA–GRNN hybrid models to forecast the second wave of COVID-19 in India and the United States. Epidemiol Infect 2021. [PMCID: PMC8632421 DOI: 10.1017/s0950268821002375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As acute infectious pneumonia, the coronavirus disease-2019 (COVID-19) has created unique challenges for each nation and region. Both India and the United States (US) have experienced a second outbreak, resulting in a severe disease burden. The study aimed to develop optimal models to predict the daily new cases, in order to help to develop public health strategies. The autoregressive integrated moving average (ARIMA) models, generalised regression neural network (GRNN) models, ARIMA–GRNN hybrid model and exponential smoothing (ES) model were used to fit the daily new cases. The performances were evaluated by minimum mean absolute per cent error (MAPE). The predictive value with ARIMA (3, 1, 3) (1, 1, 1)14 model was closest to the actual value in India, while the ARIMA–GRNN presented a better performance in the US. According to the models, the number of daily new COVID-19 cases in India continued to decrease after 27 May 2021. In conclusion, the ARIMA model presented to be the best-fit model in forecasting daily COVID-19 new cases in India, and the ARIMA–GRNN hybrid model had the best prediction performance in the US. The appropriate model should be selected for different regions in predicting daily new cases. The results can shed light on understanding the trends of the outbreak and giving ideas of the epidemiological stage of these regions.
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Istvan M, Laforgue EJ, Guerlais M, Jolliet P, Victorri-Vigneau C. ZORRO: When the mask falls off-Comment. Br J Clin Pharmacol 2021; 88:2450-2451. [PMID: 34610152 DOI: 10.1111/bcp.15086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/18/2021] [Accepted: 09/04/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Marion Istvan
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.,UMR INSERM 1246, SPHERE "methodS in Patient-centered outcomes and HEalth ResEarch", University of Nantes, University of Tours, Nantes, France
| | - Edouard-Jules Laforgue
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.,UMR INSERM 1246, SPHERE "methodS in Patient-centered outcomes and HEalth ResEarch", University of Nantes, University of Tours, Nantes, France
| | - Marylène Guerlais
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, Nantes, France
| | - Pascale Jolliet
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.,UMR INSERM 1246, SPHERE "methodS in Patient-centered outcomes and HEalth ResEarch", University of Nantes, University of Tours, Nantes, France
| | - Caroline Victorri-Vigneau
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.,UMR INSERM 1246, SPHERE "methodS in Patient-centered outcomes and HEalth ResEarch", University of Nantes, University of Tours, Nantes, France
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35
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Dufayet L, Care W, Laborde-Casterot H, Deheul S, Langrand J, Vodovar D. Augmentation de l’usage récréatif de la prégabaline chez les adolescents en contexte de précarité. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2021. [DOI: 10.1016/j.toxac.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Vollhardt R, Mazoyer J, Bernardaud L, Haddad A, Jaubert P, Coman I, Manceau P, Mongin M, Degos B. Neurological consequences of recreational nitrous oxide abuse during SARS-CoV-2 pandemic. J Neurol 2021; 269:1921-1926. [PMID: 34417869 PMCID: PMC8379581 DOI: 10.1007/s00415-021-10748-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/01/2021] [Accepted: 08/06/2021] [Indexed: 02/03/2023]
Abstract
Introduction Recreational use of nitrous oxide (N2O) is a growing practice in France and all around the world and is often associated with neurological complications. We report detailed clinical and paraclinical presentations of 12 patients with combined degeneration of the spinal cord and peripheral neuropathies in relation to N2O consumption, possibly favored by lockdowns due to SARS-CoV-2 pandemic. Results With variable levels of consumption, the 12 patients presented spinal cord and/or peripheral nerve damage, with mostly motor and ataxic symptoms, motor axonal nerve damage, and medullary T2-weighted hyperintensities on MRI. There was a clear improvement in symptoms after vitamin B12 substitution, although some sequelae remained, particularly sensory. Discussion We report detailed clinical, electrophysiological, radiological, and biological consequences of N2O abuse in 12 patients. Our data support the clinical and paraclinical observations reported in the literature. The mechanisms of neurological N2O toxicity are still debated. There is currently no precise recommendation on the therapeutic management. The clinical evolution after vitamin B12 substitution seems sufficient but could depend on early management. Effective messages targeting at risk population, but also the health professionals involved, seem crucial as does a better legal framework for this growing practice.
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Affiliation(s)
- Raphael Vollhardt
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Julie Mazoyer
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Lucy Bernardaud
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Andrei Haddad
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Pauline Jaubert
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Irène Coman
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Philippe Manceau
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Marie Mongin
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Bertrand Degos
- Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris - Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France.
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS, UMR7241/INSERM U1050, Université PSL, 75005, Paris, France.
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Ripoll J, Contreras-Martos S, Esteva M, Soler A, Serrano-Ripoll MJ. Mental Health and Psychological Wellbeing during the COVID-19 Lockdown: A Longitudinal Study in the Balearic Islands (Spain). J Clin Med 2021; 10:jcm10143191. [PMID: 34300356 PMCID: PMC8304509 DOI: 10.3390/jcm10143191] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 12/18/2022] Open
Abstract
Confining the entire population to a lockdown after the outbreak of SARS-CoV-2 was an unprecedented measure designed to protect the health of those living in Spain. The objective of the present study is to assess the evolution of mental health and psychological wellbeing during lockdown. To do this, we carried out a longitudinal study, via an online survey over the eight weeks of lockdown (weekly assessments). Sociodemographic variables were recorded, along with data related to COVID-19, psychological wellbeing (anxiety, depression, psychotropic drugs, consultations made to improve mood or anxiety), life satisfaction, and self-perceived health. A total of 681 individuals participated in the study, 76.8% were women; the mean age was 43 years old (SD = 12.7). Initially, high scores were reported for anxiety, depression, and the number of consultations to improve mood, but these decreased significantly over the study period. The reverse seems to be true for life satisfaction, perceived good health, and intake of psychotropic drugs. We also identified groups whose psychological wellbeing was more susceptible to the effects of lockdown. Women, those worried about their jobs after the pandemic, and those afraid of being infected were the most affected individuals. More generally, after the initial negative effect on psychological wellbeing, various indicators improved over the lockdown period.
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Affiliation(s)
- Joana Ripoll
- Primary Care Research Unit of Mallorca, Balearic Health Service, 07002 Palma, Balearic Islands, Spain; (S.C.-M.); (M.E.); (A.S.); (M.J.S.-R.)
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Balearic Islands, Spain
- Correspondence:
| | - Sara Contreras-Martos
- Primary Care Research Unit of Mallorca, Balearic Health Service, 07002 Palma, Balearic Islands, Spain; (S.C.-M.); (M.E.); (A.S.); (M.J.S.-R.)
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Balearic Islands, Spain
- Primary Care Research Support Unit Costa Ponent, University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Magdalena Esteva
- Primary Care Research Unit of Mallorca, Balearic Health Service, 07002 Palma, Balearic Islands, Spain; (S.C.-M.); (M.E.); (A.S.); (M.J.S.-R.)
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Balearic Islands, Spain
| | - Aina Soler
- Primary Care Research Unit of Mallorca, Balearic Health Service, 07002 Palma, Balearic Islands, Spain; (S.C.-M.); (M.E.); (A.S.); (M.J.S.-R.)
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Balearic Islands, Spain
- Department of Medicine, University of the Balearic Islands (UIB), 07122 Palma, Balearic Islands, Spain
| | - Maria Jesús Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Health Service, 07002 Palma, Balearic Islands, Spain; (S.C.-M.); (M.E.); (A.S.); (M.J.S.-R.)
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Balearic Islands, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07122 Palma, Balearic Islands, Spain
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Maidment I, Young E, MacPhee M, Booth A, Zaman H, Breen J, Hilton A, Kelly T, Wong G. Rapid realist review of the role of community pharmacy in the public health response to COVID-19. BMJ Open 2021; 11:e050043. [PMID: 34135054 PMCID: PMC8210681 DOI: 10.1136/bmjopen-2021-050043] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/13/2021] [Accepted: 04/29/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Community pharmacists and their teams have remained accessible to the public providing essential services despite immense pressures during the COVID-19 pandemic. They have successfully expanded the influenza vaccination programme and are now supporting the delivery of the COVID-19 vaccination roll-out. AIM This rapid realist review aims to understand how community pharmacy can most effectively deliver essential and advanced services, with a focus on vaccination, during the pandemic and in the future. METHOD An embryonic programme theory was generated using four diverse and complementary documents along with the expertise of the project team. Academic databases, preprint services and grey literature were searched and screened for documents meeting our inclusion criteria. The data were extracted from 103 documents to develop and refine a programme theory using a realist logic of analysis. Our analysis generated 13 context-mechanism-outcome configurations explaining when, why and how community pharmacy can support public health vaccination campaigns, maintain essential services during pandemics and capitalise on opportunities for expanded, sustainable public health service roles. The views of stakeholders including pharmacy users, pharmacists, pharmacy teams and other healthcare professionals were sought throughout to refine the 13 explanatory configurations. RESULTS The 13 context-mechanism-outcome configurations are organised according to decision makers, community pharmacy teams and community pharmacy users as key actors. Review findings include: supporting a clear role for community pharmacies in public health; clarifying pharmacists' legal and professional liabilities; involving pharmacy teams in service specification design; providing suitable guidance, adequate compensation and resources; and leveraging accessible, convenient locations of community pharmacy. DISCUSSION Community pharmacy has been able to offer key services during the pandemic. Decision makers must endorse, articulate and support a clear public health role for community pharmacy. We provide key recommendations for decision makers to optimise such a role during these unprecedented times and in the future.
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Affiliation(s)
- Ian Maidment
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Emma Young
- The University of Sheffield, Sheffield, UK
| | - Maura MacPhee
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Juanita Breen
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Andrea Hilton
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Tony Kelly
- NHS Birmingham and Solihull Clinical Commissioning Group, Birmingham, UK
| | - Geoff Wong
- Primary Care Health Sciences, University of Oxford, Oxford, UK
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Sarangi A, McMahon T, Gude J. Benzodiazepine Misuse: An Epidemic Within a Pandemic. Cureus 2021; 13:e15816. [PMID: 34306882 PMCID: PMC8294026 DOI: 10.7759/cureus.15816] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) had deleterious effects on patients with mental health problems and several studies have shown a spike in the rates of depression, insomnia, and post-traumatic stress disorder. Anxiety and insomnia rates have also increased among both the general public and health care professionals. Benzodiazepines are some of the most commonly used drugs in the treatment of anxiety and insomnia. However, benzodiazepines are also misused, abused alone, or abused in combination with other drugs. Lockdowns and social distancing have also had negative consequences on patients with mental health problems. We assessed the extent of benzodiazepine use during the pandemic and interpreted its effects in the future. We conducted a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and eight articles reviewed specifically reported worrying fluctuations in benzodiazepine use during the pandemic. We observed varied trends in the usage of benzodiazepines in various parts of the world. Some studies showed an increase in the consumption of benzodiazepine while others demonstrated a decrease in the prescription refills of benzodiazepine, which may be a result of gaps in mental health care. At this time, we can conclude that the current trend with benzodiazepine use is fluctuating and mental health professionals must continue to exercise caution before prescribing benzodiazepines. Future research is also warranted to be aware of the changing patterns and to avoid misuse and/or abuse at an epidemic level.
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Affiliation(s)
- Ashish Sarangi
- Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Terry McMahon
- Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
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Ambrosioni J, Blanco JL, Reyes-Urueña JM, Davies MA, Sued O, Marcos MA, Martínez E, Bertagnolio S, Alcamí J, Miro JM. Overview of SARS-CoV-2 infection in adults living with HIV. Lancet HIV 2021; 8:e294-e305. [PMID: 33915101 PMCID: PMC8075775 DOI: 10.1016/s2352-3018(21)00070-9] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 12/23/2022]
Abstract
Around 2·5 million deaths and more than 110 million COVID-19 cases have been reported globally. Although it initially appeared that HIV infection was not a risk factor for COVID-19 or more severe disease, more recent large studies suggest that people living with HIV (particularly with low CD4 cell counts or untreated HIV infection) might have a more severe clinical course than those who are HIV-negative. Moreover, the COVID-19 pandemic has disrupted HIV prevention and treatment services worldwide, creating huge challenges to the continuity of essential activities. We have reviewed the most relevant features of COVID-19 in people living with HIV and highlighted topics where further research is required.
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Affiliation(s)
- Juan Ambrosioni
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - José Luis Blanco
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Juliana M Reyes-Urueña
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Mary-Ann Davies
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Omar Sued
- Fundación Huésped, Buenos Aires, Argentina
| | - Maria Angeles Marcos
- Microbiology Service, Hospital Clinic-ISGlobal, University of Barcelona, Barcelona, Spain
| | - Esteban Martínez
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Silvia Bertagnolio
- Department of Global HIV, Hepatitis, and STI Programmes, World Health Organization, Geneva, Switzerland; Department of Infection and Population Health, University College London, London, UK
| | - Jose Alcamí
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain; AIDS Immunopathogenesis Unit, Instituto de Salud Carlos III, Madrid, Spain
| | - Jose M Miro
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
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Nguyen T, Buxton JA. Pathways between COVID-19 public health responses and increasing overdose risks: A rapid review and conceptual framework. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 93:103236. [PMID: 33838990 PMCID: PMC8545050 DOI: 10.1016/j.drugpo.2021.103236] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022]
Abstract
Background Emerging evidence indicates that illicit drug overdoses are increasing throughout the COVID-19 pandemic. There is a paucity of evidence on the causative pathways for this trend, but expert opinions, commentaries, and some reviews offer theoretical underpinnings. Methods In this rapid review, we collate the available published evidence, expert opinions, commentaries, and reviews on the unintended pathways between COVID-19 public health responses and increasing illicit drug overdoses. Using tenets of thematic analyses and grounded theory, we also offer a visual conceptual framework for these unintended pathways. Results Our framework focuses on five particular public health responses, namely social isolation/physical distancing/quarantine; staff/resource reallocations and reductions; closures of businesses and other places of employment; border closures and transportation restrictions; and the early release of people from prisons. As argued in the literature reviewed here, these public health responses have unintentionally created increased overdose risks by producing high risk use scenarios; increased risks of relapsing; disrupted addictions services and treatment; an increasingly toxic supply of drugs; and the risk of using with lowered tolerance. Conclusions Health care systems should respond to these pathways to mitigate the unintended consequences. Furthermore, the COVID-19 pandemic may represent an opportunity to enact proactive, progressive, and innovative solutions to an overdose crisis that will surely outlast the current pandemic.
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Affiliation(s)
- Tribesty Nguyen
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
| | - Jane A Buxton
- British Columbia Centre for Disease Control, 655W 12th Ave, Vancouver, BC V5Z 4R4, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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Gras M, Gras-Champel V, Moragny J, Delaunay P, Laugier D, Masmoudi K, Liabeuf S. Impact of the COVID-19 outbreak on the reporting of adverse drug reactions associated with self-medication. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 79:522-529. [PMID: 33631179 PMCID: PMC7899020 DOI: 10.1016/j.pharma.2021.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 11/21/2022]
Abstract
Objectives The primary objective of the present study was to describe the characteristics of adverse drug reactions (ADRs) linked to self-medication that were notified to the French Pharmacovigilance Database (FPVD) during the COVID-19 outbreak in 2020 first wave. The secondary objective was to compare the characteristics of these ADRs in 2020 with those notified during the same calendar period a year previously. Material and methods We analyzed ADRs recorded in the FPVD between March 15th and May 31st, 2020 vs. the same dates in 2019. Only ADRs linked to self-medication were analyzed. Descriptive statistics were used to obtain an overview of the types and characteristics of these ADRs. Results Of 3114 ADRs notified to the FPVD during the COVID-19 period in 2020, 114 (3.7%) were linked to self-medication. The equivalent proportion in 2019 was 1.6% (113 out of 7097). Half of the ADRs notified in 2020 were “serious”. The median age of affected patients was 30.5, and 22% of the ADRs concerned children. Of the 114 ADRs linked to self-medication, 107 (66%) were for prescription-only drugs. The three mostly frequently suspected ATC classes were analgesics, psycholeptics, and antibacterials for systemic use. The most frequent ADRs were general disorders, gastrointestinal disorders, and nervous system disorders. The main difference between the non-COVID-19 period and the COVID-19 period was the higher proportion of medication errors during the latter. Conclusion The present study is the first to have reported on ADRs linked to self-medication and notified during a COVID-19 outbreak. Further studies of self-medication patterns and their consequences in a pandemic context are mandatory and effective information on medication use (including self-medication and its dangers) during a pandemic is essential.
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Affiliation(s)
- M Gras
- Department of Clinical Pharmacology, Amiens University Hospital, Amiens, France
| | - V Gras-Champel
- Department of Clinical Pharmacology, Amiens University Hospital, Amiens, France; MP3CV Laboratory, EA7517, Jules-Verne University of Picardie, Amiens, France
| | - J Moragny
- Department of Clinical Pharmacology, Amiens University Hospital, Amiens, France
| | - P Delaunay
- Department of Clincal Pharmacology and Vigilances, Poitiers University Hospital, Poitiers, France
| | - D Laugier
- Regional Pharmacovigilance Centre Marseille - Provence - Corse, Sainte-Marguerite Hospital, AP-HM, Marseille, France
| | - K Masmoudi
- Department of Clinical Pharmacology, Amiens University Hospital, Amiens, France
| | - S Liabeuf
- Department of Clinical Pharmacology, Amiens University Hospital, Amiens, France; MP3CV Laboratory, EA7517, Jules-Verne University of Picardie, Amiens, France.
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Chappuy M, Peyrat M, Lejeune O, Duvernay N, David B, Joubert P, Lack P. Drug consumption during prolonged lockdown due to Covid-19 as observed in French addiction center. Therapie 2021; 76:379-382. [PMID: 33516544 PMCID: PMC7817436 DOI: 10.1016/j.therap.2021.01.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/02/2020] [Accepted: 01/18/2021] [Indexed: 12/05/2022]
Affiliation(s)
- Mathieu Chappuy
- CSAPA (Center for Supportive Care and Prevention in Addictology) Bâtiment C-1(er), Croix Rousse university hospital, Hospices Civils de Lyon, 69004 Lyon, France; CSAPA (Center for Supportive Care and Prevention in Addictology), Édouard Herriot university hospital, Hospices Civils de Lyon, 69004 Lyon, France; SUAL (Academic Department of addiction medicine), Le Vinatier hospital, 69678 Bron, France.
| | - Marie Peyrat
- CSAPA (Center for Supportive Care and Prevention in Addictology) Bâtiment C-1(er), Croix Rousse university hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Olivier Lejeune
- CSAPA (Center for Supportive Care and Prevention in Addictology) Bâtiment C-1(er), Croix Rousse university hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Nathalie Duvernay
- CSAPA (Center for Supportive Care and Prevention in Addictology) Bâtiment C-1(er), Croix Rousse university hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Brigitte David
- CSAPA (Center for Supportive Care and Prevention in Addictology) Bâtiment C-1(er), Croix Rousse university hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Philippe Joubert
- CSAPA (Center for Supportive Care and Prevention in Addictology) Bâtiment C-1(er), Croix Rousse university hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Philippe Lack
- CSAPA (Center for Supportive Care and Prevention in Addictology) Bâtiment C-1(er), Croix Rousse university hospital, Hospices Civils de Lyon, 69004 Lyon, France
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Soeiro T, Lacroix C, Pradel V, Lapeyre-Mestre M, Micallef J. Early Detection of Prescription Drug Abuse Using Doctor Shopping Monitoring From Claims Databases: Illustration From the Experience of the French Addictovigilance Network. Front Psychiatry 2021; 12:640120. [PMID: 34079478 PMCID: PMC8165176 DOI: 10.3389/fpsyt.2021.640120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/29/2021] [Indexed: 12/30/2022] Open
Abstract
Opioid analgesics and maintenance treatments, benzodiazepines and z-drugs, and other sedatives and stimulants are increasingly being abused to induce psychoactive effects or alter the effects of other drugs, eventually leading to dependence. Awareness of prescription drug abuse has been increasing in the last two decades, and organizations such as the International Narcotics Control Board has predicted that, worldwide, prescription drug abuse may exceed the use of illicit drugs. Assessment of prescription drug abuse tackles an issue that is hidden by nature, which therefore requires a specific monitoring. The current best practice is to use multiple detection systems to assess prescription drug abuse by various populations in a timely, sensitive, and specific manner. In the early 2000's, we designed a method to detect and quantify doctor shopping for prescription drugs from the French National Health Data System, which is one of the world's largest claims database, and a first-class data source for pharmacoepidemiological studies. Doctor shopping is a well-known behavior that involves overlapping prescriptions from multiple prescribers for the same drug, to obtain higher doses than those prescribed by each prescriber on an individual basis. In addition, doctor shopping may play an important role in supplying the black market. The paper aims to review how doctor shopping monitoring can improve the early detection of prescription drug abuse within a multidimensional monitoring. The paper provides an in-depth overview of two decades of development and validation of the method as a complementary component of the multidimensional monitoring conducted by the French Addictovigilance Network. The process accounted for the relevant determinants of prescription drug abuse, such as pharmacological data (e.g., formulations and doses), chronological and geographical data (e.g., impact of measures and comparison between regions), and epidemiological and outcome data (e.g., profiles of patients and trajectories of care) for several pharmacological classes (e.g., opioids, benzodiazepines, antidepressants, and methylphenidate).
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Affiliation(s)
- Thomas Soeiro
- Aix-Marseille Université, Inserm, UMR 1106, Hôpitaux Universitaires de Marseille, Service de Pharmacologie Clinique, Centre d'évaluation et d'information sur la Pharmacodépendance - Addictovigilance, Marseille, France
| | - Clémence Lacroix
- Aix-Marseille Université, Inserm, UMR 1106, Hôpitaux Universitaires de Marseille, Service de Pharmacologie Clinique, Centre d'évaluation et d'information sur la Pharmacodépendance - Addictovigilance, Marseille, France
| | - Vincent Pradel
- Aix-Marseille Université, Inserm, UMR 1106, Hôpitaux Universitaires de Marseille, Service de Pharmacologie Clinique, Centre d'évaluation et d'information sur la Pharmacodépendance - Addictovigilance, Marseille, France
| | - Maryse Lapeyre-Mestre
- Université Paul Sabatier, Inserm, CIC 1436, Centre Hospitalier Universitaire de Toulouse, Service de Pharmacologie Clinique, Centre d'évaluation et d'information sur la Pharmacodépendance - Addictovigilance, Toulouse, France
| | - Joëlle Micallef
- Aix-Marseille Université, Inserm, UMR 1106, Hôpitaux Universitaires de Marseille, Service de Pharmacologie Clinique, Centre d'évaluation et d'information sur la Pharmacodépendance - Addictovigilance, Marseille, France
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Abstract
The current COVID-19 pandemic is an exceptional health situation including for drug use. As there was no known effective drug for COVID-19 at the beginning of the pandemic, different candidates were proposed. In this short article, we present the French public pharmacovigilance activities during this health crisis. Although COVID-19 is a confounding factor per se, owing to its potential for multi-organ damage including the heart and kidney, the quality of the transmitted data in adverse drug reaction reports, the timeliness of feedback from clinicians, and the real-time pharmacological and medical analysis by the French network of the regional pharmacovigilance centers made it possible to swiftly identify relevant safety signals. The French National Agency of Medicine was thus able to validate the data and convey their findings very early. This decentralized organization based on medical and pharmacological evaluation of case reports has proven to be efficient and responsive in this unique and challenging healthcare emergency.
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Effect of COVID-19 on Mental Health Rehabilitation Centers. ACTA ACUST UNITED AC 2020; 8:97-100. [PMID: 33106766 PMCID: PMC7577361 DOI: 10.1007/s40737-020-00203-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/03/2020] [Indexed: 01/13/2023]
Abstract
The SARS‐CoV‐2 outbreak is an unprecedented event in modern history worldwide. To facilitate speedy and smooth recovery during this time period, an added responsibility is placed upon rehabilitation center counselors, staff and management. In this paper we expose the role that psychiatric rehabilitation plays during the COVID-19 crisis. Since COVID-19 pandemic has remarkably raised mental health concerns, one of the high risks and possibly neglected groups includes individuals undergoing mental health rehabilitation, the impact on which can be significant as compared to the rest of the population. In order to ensure that individuals on the road to recovery are not alone and forgotten during the times of coronavirus crisis they should be provided with adequate resources, such as online meetings and group therapy sessions, assessment, treatment and support by telephone and video consultation and getting the medications they need to recover. This article highlights how the coronavirus pandemic, that has hit hard the health care and all categories of patients affected by mental disorders, is likely to be particularly dramatic for mental health rehabilitation centers. Indeed, the COVID-19 crisis has severely tested the health systems worldwide, reducing sometimes the quality and quantity of care offered to psychiatric patients both hospitalized and not in rehabilitation centers. The main goal of this paper is to raise awareness of the importance, often underestimated, of mental health rehabilitation centers, on which one should invest for the both future of psychological and psychiatric rehabilitation and the current crisis as well.
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Lapeyre-Mestre M. Novel forms of injectable buprenorphine and French model of opioid use disorder treatment. Therapie 2020; 75:393-395. [PMID: 33039103 PMCID: PMC7521403 DOI: 10.1016/j.therap.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/20/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Maryse Lapeyre-Mestre
- Service de pharmacologie médicale et clinique, centre d'evaluation et d'information sur la pharmacodépendance-addictovigilance, faculté de médecine, CHU de Toulouse, allées Jules-Guesde, 31000 Toulouse, France.
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Di Trana A, Carlier J, Berretta P, Zaami S, Ricci G. Consequences of COVID-19 Lockdown on the Misuse and Marketing of Addictive Substances and New Psychoactive Substances. Front Psychiatry 2020; 11:584462. [PMID: 33192730 PMCID: PMC7644618 DOI: 10.3389/fpsyt.2020.584462] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- Annagiulia Di Trana
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Jeremy Carlier
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy.,Unit of Forensic Toxicology, Section of Legal Medicine, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Paolo Berretta
- National Centre on Addiction and Doping, National Institute of Health, Rome, Italy
| | - Simona Zaami
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Giovanna Ricci
- Medico Legal Section, School of Law, University of Camerino, Macerata, Italy
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