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Sadutto D, Picó Y. Validation of LC-MS/MS method for opioid monitoring in Valencia City wastewater: Assessment of synthetic wastewater as potential aid. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174382. [PMID: 38955278 DOI: 10.1016/j.scitotenv.2024.174382] [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: 12/19/2023] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024]
Abstract
In this study, a comprehensive and sensitive method for the simultaneous detection of 17 opioids (OPs) and their human metabolites in wastewater using high-performance liquid chromatography coupled to tandem mass spectrometry was validated. The chromatographic separations of opioids were carried out on a Kinetex® Biphenyl column (1.7 μm, 100 Å, 50 × 2.1 mm). A synthetic wastewater approach was used for recovery studies to mimic a contaminant-free matrix. Two solid-phase extraction (SPE) sorbents (hydrophilic-lipophilic balance and mixed mode with the previous phase and a weak cationic exchange) were studied to optimize sample treatment and obtain higher recoveries. The mixed mode was chosen because the recoveries of 17 target analytes at three spiked concentrations (25, 50, and 100 ng mL-1) were > 80 % for 75 % of the analytes in a simulated wastewater. The intra- and inter-day relative standard deviations (RSDs) were between ±1 % and ±20 %. The method limits of quantification ranged from 5 to 25 ng L-1, the only exceptions being heroin (275 ng L-1) and morphine-3β-glucuronide (250 ng L-1). Suppression/enhancement is comparable between the synthetic and the influent wastewater. The analytical method was applied to the OPs analysis in twenty-one influent samples collected from the treatment plants treating the wastewater of Valencia City (Spain). Twelve OPs were detected with total daily concentrations ranging from 1 ng L-1 to 2135 ng L-1. The widespread presence of these compounds in water suggests potential widespread exposure, highlighting the need for increased environmental awareness. Furthermore, the estimated daily intake results raise concerns about opioid use as a potential future health and social issue.
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Affiliation(s)
- Daniele Sadutto
- Centre for the Control and Evaluation of Medicines, Chemical Medicines Unit, Istituto Superiore di Sanita', Viale Regina Elena 299, 00161 Rome, Italy.
| | - Yolanda Picó
- Environmental and Food Safety Research Group of the University of Valencia (SAMA-UV), Research Center on Desertification (CIDE), CSIC-UV-GV, Moncada-Naquera Road km 4.5, 46113 Moncada, Valencia, Spain
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Pulido J, Pastor-Moreno G, Guerras JM, Belza MJ, Cáceres A, Cea-Soriano L, Sordo L. New Patients in Treatment for Opioid Addiction in Spain. Subst Abuse 2023; 17:11782218231182552. [PMID: 37426878 PMCID: PMC10326463 DOI: 10.1177/11782218231182552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023]
Abstract
Introduction Patients seeking first time treatment for opioid consumption reflect the characteristics of the consumer population. This group has not been studied in Spain in decades. The objective of this study was to characterize the opioid user population seeking first time treatment (incidents) and compare them group with those with prior treatment (prevalents). Methods Cross-sectional study (N = 3325) with patients with opioid addiction seeking care at public addiction centers in the Community of Madrid from 2017 through 2019. Differentiation and comparisons were carried out using bivariate analysis, adjusted by sociodemographic characteristics related and those related to substance use consumption in incident and prevalent patients. Results About 12.2% were incidents. Compared to prevalents, there were more foreigners (34.1% vs 19.1% P < .001), but with a better social network. Regarding opioid use, incidents were less likely to use injection (10.7% compared to 16.8% P = .008), but had greater daily frequency (75.8% vs 52.2%, P < .001). The age of initial consumption was greater (27 years vs 21.3 years, (P < .001)). About 15.5% of incidents sought care for non-heroin opioids, compared to 4.8% of prevalents (P < .001). Women sought care at twice the rate of men (29.3% vs 12.3%; P > .001). Discussion New patients presented a profile with many stable characteristics, but which highlighted an increase in the use of other opioids, as occurs in the international context. Surveillance of the new patient characteristics can serve as an early indicator of consumption changes in. Thus, periodic monitoring is important.
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Affiliation(s)
- Jose Pulido
- Public Health and Maternal Health
Department, Faculty of Medicine, Complutense University of Madrid, Madrid,
Spain
- CIBER of Epidemiology and Public Health
(CIBERESP), Madrid, Spain
| | - Guadalupe Pastor-Moreno
- CIBER of Epidemiology and Public Health
(CIBERESP), Madrid, Spain
- Andalusian School of Public Health
(EASP), Granada, Spain
- Biohealth Research Institute of
Granada, Ibs. Granada, Granada, Spain
| | - Juan Miguel Guerras
- CIBER of Epidemiology and Public Health
(CIBERESP), Madrid, Spain
- National School of Health, Carlos III
Institute, Madrid, Spain
| | - María José Belza
- CIBER of Epidemiology and Public Health
(CIBERESP), Madrid, Spain
- National School of Health, Carlos III
Institute, Madrid, Spain
| | - Ana Cáceres
- Institute of Addiction, City Council of
Madrid, Madrid, Spain
| | - Lucía Cea-Soriano
- Public Health and Maternal Health
Department, Faculty of Medicine, Complutense University of Madrid, Madrid,
Spain
| | - Luis Sordo
- Public Health and Maternal Health
Department, Faculty of Medicine, Complutense University of Madrid, Madrid,
Spain
- CIBER of Epidemiology and Public Health
(CIBERESP), Madrid, Spain
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3
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Salazar A, Moreno-Pulido S, Prego-Meleiro P, Henares-Montiel J, Pulido J, Donat M, Sotres-Fernandez G, Sordo L. Correlation Between Opioid Drug Prescription and Opioid-Related Mortality in Spain as a Surveillance Tool: Ecological Study. JMIR Public Health Surveill 2023; 9:e43776. [PMID: 37379061 PMCID: PMC10365608 DOI: 10.2196/43776] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 05/08/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Opioid drug prescription (ODP) and opioid-related mortality (ORM) have increased in Spain. However, their relationship is complex, as ORM is registered without considering the type of opioid (legal or illegal). OBJECTIVE This ecological study aimed to examine the correlation between ODP and ORM in Spain and discuss their usefulness as a surveillance tool. METHODS This was an ecological descriptive study using retrospective annual data (2000-2019) from the Spanish general population. Data were collected from people of all ages. Information on ODP was obtained from the Spanish Medicines Agency in daily doses per 1000 inhabitants per day (DHD) for total ODP, total ODP excluding those with better safety protocols (codeine and tramadol), and each opioid drug separately. Rates of ORM (per 1,000,000 inhabitants) were calculated based on deaths registered (International Classification of Diseases, 10th Revision codes) as opioid poisoning by the National Statistics Institute, derived from the drug data recorded by medical examiners in death certificates. Opioid-related deaths were considered to be those that indicated opioid consumption (accidental, infringed, or self-inflicted) as the main cause of death: death due to accidental poisoning (X40-X44), intentional self-inflicted poisoning (X60-X64), drug-induced aggression (X85), and poisoning of undetermined intention (Y10-Y14). A descriptive analysis was carried out, and correlations between the annual rates of ORM and DHD of the prescribed opioid drugs globally, excluding medications of the least potential risk of overdose and lowest treatment tier, were analyzed using Pearson linear correlation coefficient. Their temporal evolution was analyzed using cross-correlations with 24 lags and the cross-correlation function. The analyses were carried out using Stata and StatGraphics Centurion 19. RESULTS The rate of ORM (2000-2019) ranged between 14 and 23 deaths per 1,000,000 inhabitants, with a minimum in 2006 and an increasing trend starting in 2010. The ODP ranged between 1.51 to 19.94 DHD. The rates of ORM were directly correlated with the DHD of total ODP (r=0.597; P=.006), total ODP without codeine and tramadol (r=0.934; P<.001), and every prescribed opioid except buprenorphine (P=.47). In the time analysis, correlations between DHD and ORM were observed in the same year, although not statistically significant (all P≥.05). CONCLUSIONS There is a correlation between greater availability of prescribed opioid drugs and an increase in opioid-related deaths. The correlation between ODP and ORM may be a useful tool in monitoring legal opiates and possible disturbances in the illegal market. The role of tramadol (an easily prescribed opioid) is important in this correlation, as is that of fentanyl (the strongest opioid). Measures stronger than recommendations need to be taken to reduce off-label prescribing. This study shows that not only is opioid use directly related to the prescribing of opioid drugs above what is desirable but also an increase in deaths.
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Affiliation(s)
- Alejandro Salazar
- Observatory of Pain, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cádiz, Spain
- Department of Statistics and Operational Research, University of Cádiz, Puerto Real, Spain
| | | | - Pablo Prego-Meleiro
- Department of Public Health and Maternal-Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Department of Analytical Chemistry, Physical Chemistry and Chemical Engineering, Faculty of Pharmacy, University of Alcalá, Alcalá de Henares, Spain
| | - Jesús Henares-Montiel
- Center for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - José Pulido
- Department of Public Health and Maternal-Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Marta Donat
- National School of Health, Salud Carlos III Health Institute, Madrid, Spain
| | - Gabriel Sotres-Fernandez
- Oncology Department, Hospital Quirón Salud, Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Luis Sordo
- Department of Public Health and Maternal-Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid, Spain
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4
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Quast T, Andel R, Gregory S, Storch EA. Years of life lost associated with COVID-19 deaths in the USA during the first 2 years of the pandemic. J Public Health (Oxf) 2022; 44:e353-e358. [PMID: 35640260 PMCID: PMC9213874 DOI: 10.1093/pubmed/fdac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Prior estimates of the years of life lost (YLLs) in the USA associated with coronavirus disease 2019 (COVID-19) were 1.2 million through 11 July 2020 and 3.9 million through 31 January 2021 (which roughly coincides with the first full year of the pandemic). The aim of this study is to update YLL estimates through the first 2 years of the pandemic. Methods We employed data regarding COVID-19 deaths through 5 February 2022 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs. Results We estimated roughly 9.7 million YLLs due to COVID-19 deaths. The number of YLLs per 10 000 capita was 297.5, with the highest rate in Mississippi (482.7) and the lowest in Vermont (61.4). There was substantial interstate variation in the timing of YLLs and differences in YLLs by gender. YLLs per death increased from 9.2 in the first year of the pandemic to 10.8 through the first 2 years. Conclusions Our findings improve our understanding of how the mortality effects of COVID-19 have evolved. This insight can be valuable to public health officials as the disease moves to an endemic phase.
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Affiliation(s)
- Troy Quast
- Address correspondence to Troy Quast, E-mail:
| | - Ross Andel
- University of South Florida, College of Behavioral and Community Sciences, School of Aging Studies, Tampa, FL 33620, USA
- Charles University and Motol University Hospital, Department of Neurology, Prague, Czechia
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czechia
| | - Sean Gregory
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
| | - Eric A Storch
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
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5
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García-Sempere A, Hurtado I, Peiró S, Sánchez-Sáez F, Rodríguez-Bernal CL, Puig-Ferrer M, Escolano M, Sanfélix-Gimeno G. Impact of Three Safety Interventions Targeting Off-Label Use of Immediate-Release Fentanyl on Prescription Trends: Interrupted Time Series Analysis. Front Pharmacol 2022; 13:815719. [PMID: 35450053 PMCID: PMC9016332 DOI: 10.3389/fphar.2022.815719] [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: 11/15/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The Spanish health authorities are concerned by the off-label use of immediate-release formulations of fentanyl (IRF) in noncancer pain and cancer pain in patients with no chronic pain therapy. Aim: To evaluate the impact of different interventions to improve appropriateness of IRF prescription on off-label prescription. Patients and methods: We used interrupted time series (ITS) to estimate immediate and trend changes of IRF prescription for noncancer pain (NCP) and breakthrough cancer pain (BCP) in patients with and without chronic cancer pain therapy associated with two medication reviews (I1 and I2) and the issue of a safety warning letter (I3) with data from a Spanish region with 5 million inhabitants, from 2015 to 2018. Results: The use of IRF for NCP in the region Valencia was reduced from about 1,800 prescriptions per week to around 1,400. The first medication review was followed by an immediate level change of -192.66 prescriptions per week (p < 0.001) and a downward trend change of -6.75 prescriptions/week (p < 0.001), resulting in a post-intervention trend of -1.99 (p < 0.001). I2 was associated with a trend change of -23.07 (p < 0.001) prescriptions/week. After I3, the trend changed markedly to 27.23 additional prescriptions/week, for a final post-intervention trend of 2.17 (p < 0.001). Controlled-ITS provided comparable results. For potentially inappropriate BCP use, the second medication review was followed by a downward, immediate level change of -10.10 prescriptions/week (p = 0.011) and a trend change of 2.31 additional prescriptions/week (p < 0.001) and the issue of the safety warning (I3) was followed by a downward trend change of -2.09 prescriptions/week (p = 0.007). Conclusion: Despite IRF prescription for NCP decreased, the interventions showed modest and temporary effect on off-label prescription. Our results call for a review of the design and implementation of safety interventions addressing inappropriate opioid use.
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Affiliation(s)
- Aníbal García-Sempere
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Valencia, Spain.,Spanish Network for Chronic Health Services Research, REDISSEC, Valencia, Spain
| | - Isabel Hurtado
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Valencia, Spain.,Spanish Network for Chronic Health Services Research, REDISSEC, Valencia, Spain
| | - Salvador Peiró
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Valencia, Spain.,Spanish Network for Chronic Health Services Research, REDISSEC, Valencia, Spain
| | - Francisco Sánchez-Sáez
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Valencia, Spain.,Spanish Network for Chronic Health Services Research, REDISSEC, Valencia, Spain
| | - Clara Liliana Rodríguez-Bernal
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Valencia, Spain.,Spanish Network for Chronic Health Services Research, REDISSEC, Valencia, Spain
| | - Magda Puig-Ferrer
- General Directorate for Pharmacy, Valencia Health System, Valencia, Spain
| | - Manuel Escolano
- General Directorate for Pharmacy, Valencia Health System, Valencia, Spain
| | - Gabriel Sanfélix-Gimeno
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Valencia, Spain.,Spanish Network for Chronic Health Services Research, REDISSEC, Valencia, Spain
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6
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Pulido J, Sanchez-Niubo A, Llorens N, Hoyos J, Barrio G, Belza MJ, Cea-Soriano L, Angulo-Brunet A, Sordo L. Estimating the Prevalence of Recreational Opioid Use in Spain Using a Multiplier Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084815. [PMID: 35457681 PMCID: PMC9027743 DOI: 10.3390/ijerph19084815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 01/27/2023]
Abstract
Acknowledgement of the prevalence of recreational opioid use (PROU) is key to the planning and evaluation of care services. However, in Spain, the prevalence of PROU in recent years is unknown. The objective of this study was to estimate the PROU between 2005 and 2019 in the general populations of six Spanish cities. A benchmark-multiplier methodology was used to estimate the PROU population size. The benchmark used was overdose deaths from recreational opioid use in Spain’s six most populated cities. The multiplier was the overdose death rate in a cohort of heroin users. Linear regression was used to estimate the trend of the PROU estimate over the set period of years. In 2005, the PROU was 4.78 (95%CI 3.16–7.91) per 1000 people. The estimated trend decreased, with the two lowest values being 2.35 per 1000 in 2015 and 2.29 in 2018. In 2019 the PROU was 2.60 per 1000 (95%CI 1.72–4.31), 45% lower than in 2005. While the decline in the PROU continues, its deceleration over the last four years calls for increased vigilance, especially in light of the opioid crisis in North America that has occurred over the last few years.
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Affiliation(s)
- José Pulido
- Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.P.); (J.H.); (L.C.-S.); (L.S.)
- CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (G.B.); (M.J.B.)
| | - Albert Sanchez-Niubo
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
- CIBER en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence:
| | - Noelia Llorens
- Delegación del Gobierno Para el Plan Nacional Sobre Drogas, Ministerio de Sanidad, Gobierno de España, 28008 Madrid, Spain;
| | - Juan Hoyos
- Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.P.); (J.H.); (L.C.-S.); (L.S.)
- CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (G.B.); (M.J.B.)
| | - Gregorio Barrio
- CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (G.B.); (M.J.B.)
- Escuela Nacional de Salud, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maria Jose Belza
- CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (G.B.); (M.J.B.)
- Escuela Nacional de Salud, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Lucía Cea-Soriano
- Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.P.); (J.H.); (L.C.-S.); (L.S.)
| | - Ariadna Angulo-Brunet
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 08018 Barcelona, Spain;
| | - Luis Sordo
- Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.P.); (J.H.); (L.C.-S.); (L.S.)
- CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (G.B.); (M.J.B.)
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7
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Häuser W, Buchser E, Finn DP, Dom G, Fors E, Heiskanen T, Jarlbaek L, Knaggs RD, Kosek E, Krcevski-Škvarč N, Pakkonen K, Perrot S, Trouvin AP, Morlion B. Is Europe also facing an opioid crisis?-A survey of European Pain Federation chapters. Eur J Pain 2021; 25:1760-1769. [PMID: 33960569 DOI: 10.1002/ejp.1786] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/17/2021] [Accepted: 04/18/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is considerable public interest in whether Europe is facing an opioid crisis comparable to the one in the United States and the contribution of opioid prescriptions for pain to a potential opioid crisis. METHODS A task force of the European Pain Federation (EFIC) conducted a survey with its national chapter representatives on trends of opioid prescriptions and of drug-related emergency departments and substance use disorder treatment admissions and of deaths as proxies of opioid-related harms over the last 20 years. RESULTS Data from 25 European countries were received. In most European countries opioid prescriptions increased from 2004 to 2016. The levels of opioid consumption and their increase differed between countries. Some Eastern European countries still have a low opioid consumption. Opioids are mainly prescribed for acute pain and chronic noncancer pain in some Western and Northern European countries. There was a parallel increase in opioid prescriptions and some proxies of opioid-related harms in France, Finland and the Netherlands, but not in Germany, Spain and Norway. In United Kingdom, opioid overdose deaths, but not opioid prescriptions increased between 2016 and 2018. There are no robust data available on whether prescribed opioids for pain patients contributed to opioid-related harms. CONCLUSIONS There are marked differences between European countries in trends of opioid prescribing and of proxies for opioid-related harms. Europe as a whole is not facing an opioid crisis. Discussions on the potential harms of opioids should not obstruct their prescription for cancer pain and palliative care. SIGNIFICANCE Europe as a whole is not facing an opioid crisis. Some Eastern European countries have limited access to opioid medicines. Discussions on the potential harms of opioid medicines for noncancer pain should not obstruct opioid therapy for cancer therapy and palliative care.
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Affiliation(s)
- Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy, Technische Universität München, München, Germany
| | - Eric Buchser
- Department of Anaesthesia and Pain Management Neuromodulation Centre, Morges, Switzerland
| | - David P Finn
- Pharmacology and Therapeutic, School of Medicine, Centre for Pain Research, Galway Neuroscience Centre National University of Ireland Galway, Galway, Ireland
| | - Geerd Dom
- Collaborative Antwerp Psychiatric Research Institute, Antwerp University, Antwerp, Belgium
| | - Egil Fors
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tarja Heiskanen
- Pain Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Lene Jarlbaek
- REHPA - The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Nyborg, Denmark
| | - Roger D Knaggs
- School of Pharmacy, University of Nottingham, Nottingham, UK.,Pain Centre Versus Arthritis, Clinical Sciences Building, City Hospital Nottingham, Nottingham, UK
| | - Eva Kosek
- Department of Surgical Sciences, Pain Research, Uppsala University, Uppsala, Sweden
| | - Nevenka Krcevski-Škvarč
- Department of Anesthesiology, Intensive Care and Pain Treatmen, Faculty of Medicine of University Maribor, Maribor, Slovenia
| | - Kaire Pakkonen
- Anaesthesiology, Operative and Intensive Care Service, Pärnu Hospital, Pärnu, Estonia
| | - Serge Perrot
- Pain Medicine Department, University Hospital Cochin, Université de Paris, Paris, France
| | - Anne-Priscille Trouvin
- Pain Medicine Department, University Hospital Cochin, Université de Paris, Paris, France
| | - Bart Morlion
- Center for Algology & Pain Management, University Hospitals Leuven, Leuven, Belgium
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8
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Quast T, Andel R, Gregory S, Storch EA. Years of life lost associated with COVID-19 deaths in the USA during the first year of the pandemic. J Public Health (Oxf) 2021; 44:e20-e25. [PMID: 33839789 PMCID: PMC8083296 DOI: 10.1093/pubmed/fdab123] [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: 03/05/2021] [Revised: 03/18/2021] [Accepted: 03/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background Years of Life Lost (YLLs) measure the shortfall in life expectancy due to a medical condition and have been used in multiple contexts. Previously it was estimated that there were 1.2 million YLLs associated with coronavirus disease 2019 (COVID-19) deaths in the USA through 11 July 2020. The aim of this study is to update YLL estimates for the first full year of the pandemic. Methods We employed data regarding COVID-19 deaths in the USA through 31 January 2021 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs. Results We estimated roughly 3.9 million YLLs due to COVID-19 deaths, which correspond to roughly 9.2 YLLs per death. We observed a large range across states in YLLs per 10 000 capita, with New York City at 298 and Vermont at 12. Nationally, the YLLs per 10 000 capita were greater for males than females (136.3 versus 102.3), but there was significant variation in the differences across states. Conclusions Our estimates provide further insight into the mortality effects of COVID-19. The observed differences across states and genders demonstrate the need for disaggregated analyses of the pandemic’s effects.
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Affiliation(s)
- Troy Quast
- University of South Florida, College of Public Health, Tampa, FL 33612, USA
| | - Ross Andel
- University of South Florida, College of Behavioral and Community Sciences, Tampa, FL 33620, USA.,Department of Neurology, Charles University and Motol University Hospital, Prague, 150 06, Czechia.,International Clinical Research Center, St. Anne's University Hospital, Brno, 656 91, Czechia
| | - Sean Gregory
- Baylor College of Medicine, Houston, TX 77030, USA
| | - Eric A Storch
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
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9
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Quast T, Andel R, Gregory S, Storch EA. Years of life lost associated with COVID-19 deaths in the United States. J Public Health (Oxf) 2020; 42:717-722. [PMID: 32894287 PMCID: PMC7499646 DOI: 10.1093/pubmed/fdaa159] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The mortality effects of COVID-19 are a critical aspect of the disease's impact. Years of life lost (YLLs) can provide greater insight than the number of deaths by conveying the shortfall in life expectancy and thus the age profile of the decedents. METHODS We employed data regarding COVID-19 deaths in the USA by jurisdiction, gender and age group for the period 1 February 2020 through 11 July 2020. We used actuarial life expectancy tables by gender and age to estimate YLLs. RESULTS We estimated roughly 1.2 million YLLs due to COVID-19 deaths. The YLLs for the top six jurisdictions exceeded those for the remaining 43. On a per-capita basis, female YLLs were generally higher than male YLLs throughout the country. CONCLUSIONS Our estimates offer new insight into the effects of COVID-19. Our findings of heterogenous rates of YLLs by geography and gender highlight variation in the magnitude of the pandemic's effects that may inform effective policy responses.
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Affiliation(s)
- Troy Quast
- University of South Florida, College of Public Health, Tampa, FL 33612, USA
| | - Ross Andel
- University of South Florida, College of Behavioral and Community Sciences, Tampa, FL 33620, USA
- Department of Neurology, Charles University and Motol University Hospital, Prague, 150 06, Czechia
- International Clinical Research Center, St. Anne’s University Hospital, Brno, 656 91, Czechia
| | - Sean Gregory
- Department of Politics and International Affairs, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
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10
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De Sola H, Dueñas M, Salazar A, Ortega-Jiménez P, Failde I. Prevalence of Therapeutic use of Opioids in Chronic non-Cancer Pain Patients and Associated Factors: A Systematic Review and Meta-Analysis. Front Pharmacol 2020; 11:564412. [PMID: 33364942 PMCID: PMC7750787 DOI: 10.3389/fphar.2020.564412] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/16/2020] [Indexed: 02/01/2023] Open
Abstract
Objectives: To determine the prevalence and factors associated with the use of opioids among patients with chronic non-cancer pain (CNCP). Methods: A systematic review and meta-analysis. Comprehensive literature searches in Medline-PubMed, Embase and SCOPUS databases. Original studies published between 2009 and 2019 with a cross-sectional design were included. The quality of the studies was assessed with Critical Appraisal Checklist for Studies Reporting Prevalence Data from the Joanna Briggs Institute. Protocol registered in the International Prospective Register of Systematic Reviews with reference number: CRD42019137990. Results: Out of the 1,310 potential studies found, 25 studies fulfilled the inclusion criteria. Most of the studies were of high quality. High levels of heterogeneity were found in the studies included. In the general population, the prevalence of long-term opioid use was 2.3% (95% CI: 1.5–3.6%), the prevalence of short-term opioid use was 8.1% (95% CI: 5.6–11.6%), and among people with chronic low back pain it was 5.8% (95% CI: 0.5–45.5%). The prevalence of opioid use among patients from the health records or medical surveys was 41% (95% CI: 23.3–61.3%). Finally, in patients with musculoskeletal pain, the prevalence was 20.5% (95% CI: 12.9–30.9%) and in patients with fibromyalgia, 24.5% (95% CI: 22.9–26.2%). A higher prevalence of opioid use was observed among men, younger people, patients receiving prescriptions of different types of drugs, smokers and patients without insurance or with noncommercial insurance. In addition, non-white and Asian patients were less likely to receive opioids than non-Hispanic white patients. Conclusions: The prevalence of opioid use among patients with CNCP was higher in subjects with short or occasional use compared to those with long-term use. Men, younger people, more chronic pain conditions, and patients without insurance or with noncommercial insurance were most related to opioid use. However, non-white and Asian patients, and those treated by a physician trained in complementary medicine were less likely to use opioids.
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Affiliation(s)
- Helena De Sola
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Preventive Medicine and Public Health Area, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - María Dueñas
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain.,Department of Statistics and Operational Research, University of Cádiz, Cádiz, Spain
| | - Alejandro Salazar
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain.,Department of Statistics and Operational Research, University of Cádiz, Cádiz, Spain
| | - Patricia Ortega-Jiménez
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Department of Statistics and Operational Research, University of Cádiz, Cádiz, Spain
| | - Inmaculada Failde
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Preventive Medicine and Public Health Area, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
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11
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De Sola H, Maquibar A, Failde I, Salazar A, Goicolea I. Living with opioids: A qualitative study with patients with chronic low back pain. Health Expect 2020; 23:1118-1128. [PMID: 32558064 PMCID: PMC7696128 DOI: 10.1111/hex.13089] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Opioids are one of the most prescribed treatments for chronic pain (CP). However, their long-term use (>3 months) has been surrounded by controversy, due to loss of beneficial effects. OBJECTIVE To explore the experiences of people with chronic non-malignant low back pain in Spain undergoing long-term treatment with opioids. DESIGN Qualitative study. SETTING AND PARTICIPANTS We conducted 15 semi-structured interviews at the Pain Clinic with persons taking opioid treatment. METHODS The interviews were analysed by qualitative content analysis as described by Graneheim and Lundman, and developed categories and themes discussed in light of a biomedicalization framework. MAIN RESULTS We developed one overarching theme-Living with opioids: dependence and autonomy while seeking relief-and three categories: The long pathway to opioids due to the invisibility of pain; Opioids: from blind date to a long-term relationship; and What opioids cannot fix. DISCUSSION The long and difficult road to find effective treatments was a fundamental part of coping with pain, involving long-term relationships with the health system. This study reflects the benefits, and drawbacks of opioids, along with struggles to maintain autonomy and make decisions while undergoing long-term treatment with opioids. The paper also highlights the consequences of pain in the economy, family and social life of patients. CONCLUSIONS Patients' experiences should be considered to a greater extent by health-care professionals when giving information about opioids and setting treatment goals. Greater consideration of the social determinants of health that affect CP experiences might lead to more effective solutions to CP.
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Affiliation(s)
- Helena De Sola
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.,Preventive Medicine and Public Health Area, Cádiz, Spain
| | - Amaia Maquibar
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
| | - Inmaculada Failde
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.,Preventive Medicine and Public Health Area, Cádiz, Spain
| | - Alejandro Salazar
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.,Department of Statistics and Operational Research, University of Cádiz, Cádiz, Spain
| | - Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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