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González Lago S, Pérez García MJ, Gomila I, Puiguriguer J, Barceló B. High-sensitivity troponin I elevation and hyperamylasemia in a pediatric case with tramadol and morphine overdose. An Pediatr (Barc) 2022; 97:359-360. [PMID: 36154995 DOI: 10.1016/j.anpede.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Silvia González Lago
- Servicio de Urgencias de Pediatría, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - María José Pérez García
- Servicio de Urgencias de Pediatría, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Isabel Gomila
- Servicio de Análisis Clínicos, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain; Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain
| | - Jordi Puiguriguer
- Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain; Servicio de Urgencias, Unidad de Toxicología Clínica, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Bernardino Barceló
- Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Spain; Servicio de Análisis Clínicos, Unidad de Toxicología Clínica, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Spain.
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González Lago S, Pérez García MJ, Gomila I, Puiguriguer J, Barceló B. Elevación de troponina I ultrasensible e hiperamilasemia en una intoxicación pediátrica con tramadol y morfina. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2022.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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3
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Roussin A, Soeiro T, Fouque C, Jouanjus E, Frauger E, Fouilhé N, Mallaret M, Micallef J, Lapeyre-Mestre M. Increase of high-risk tramadol use and harmful consequences in France from 2013-2018: evidence from the triangulation of addictovigilance data. Br J Clin Pharmacol 2022; 88:3789-3802. [PMID: 35318713 PMCID: PMC9545570 DOI: 10.1111/bcp.15323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 03/03/2022] [Accepted: 03/13/2022] [Indexed: 12/11/2022] Open
Abstract
Aims The aim of this paper is to assess recent developments in non‐medical tramadol use, tramadol use disorder, illegal procurement and deaths. Methods This study used repeated cross‐sectional analysis of data collected nationwide from 2013 to 2018. Analysis was conducted through multisource monitoring of the French Addictovigilance Network of: (1) validated reports of high‐risk tramadol use, (2) record systems collecting information from toxicology experts investigating analgesic‐related deaths (DTA) and deaths related to substance abuse (DRAMES), and pharmacists for forged prescriptions (OSIAP), and (3) survey of drug users, with investigation of patterns of use while visiting addiction‐specialised institutions (OPPIDUM). Results Despite a plateauing level of tramadol exposure in the French population, the proportion of tramadol reports increased 1.7‐fold (187 cases in 2018, 3.2% (95% confidence interval [CI]: 2.74–3.63%), versus 1.9% (95% CI: 1.49–2.42% in 2013). Trends were similar in OSIAP: 11.9% of forged prescriptions in 2018 (95% CI: 10.56–13.45%); 1.7‐fold increase; in OPPIDUM: 0.76% (95% CI: 0.55–1.02); 2.2‐fold increase; and DRAMES: 3.2% of drug abuse‐related deaths in 2018 (95% CI: 1.89–5.16) versus 1.7% in 2013 (95% CI: 0.65–3.84). Tramadol was the primary opioid in analgesic‐related deaths in DTA (45% in 2018). Two profiles of high‐risk tramadol users were identified: (1) patients treated for pain or with tramadol persistence when pain disappeared (mainly women; mean age 44 years), and (2) individuals with non‐medical use for psychoactive effects (mainly men; mean age 36 years). Conclusion The triangulation of the data obtained through addictovigilance monitoring evidenced a recent increase in high‐risk tramadol use. These findings have a practical impact on the limitation of the maximal duration of tramadol prescriptions.
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Affiliation(s)
- Anne Roussin
- Département de Pharmacologie Clinique et Médicale, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Centre Hospitalier Universitaire de Toulouse, France.,Pharmacologie en Population Cohortes et Biobanques, Centre d'Investigation Clinique 1436, Université de Toulouse, France
| | - Thomas Soeiro
- Département de Pharmacologie Clinique et Médicale, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Centre Hospitalier Universitaire de Toulouse, France
| | - Charlotte Fouque
- Département de Pharmacologie Clinique et Médicale, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Centre Hospitalier Universitaire de Toulouse, France
| | - Emilie Jouanjus
- Département de Pharmacologie Clinique et Médicale, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Centre Hospitalier Universitaire de Toulouse, France.,CERPOP, Université de Toulouse, INSERM, France
| | - Elisabeth Frauger
- Aix-Marseille Université, Assistance publique-Hôpitaux de Marseille, Inserm, Inst Neurosci System, UMR 1106, Service de pharmacologie clinique et Pharmacovigilance, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Marseille, France
| | - Nathalie Fouilhé
- Département de Pharmacologie Médicale, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Centre Hospitalier Universitaire Grenoble Alpes, France
| | - Michel Mallaret
- Département de Pharmacologie Médicale, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Centre Hospitalier Universitaire Grenoble Alpes, France
| | - Joëlle Micallef
- Aix-Marseille Université, Assistance publique-Hôpitaux de Marseille, Inserm, Inst Neurosci System, UMR 1106, Service de pharmacologie clinique et Pharmacovigilance, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Marseille, France
| | - Maryse Lapeyre-Mestre
- Département de Pharmacologie Clinique et Médicale, Centre d'évaluation et d'information sur la pharmacodépendance-Addictovigilance, Centre Hospitalier Universitaire de Toulouse, France.,Pharmacologie en Population Cohortes et Biobanques, Centre d'Investigation Clinique 1436, Université de Toulouse, France
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Perelló M, Rio-Aige K, Guayta-Escolies R, Gascón P, Rius P, Jambrina AM, Bagaria G, Armelles M, Pérez-Cano FJ, Rabanal M. Evaluation of Medicine Abuse Trends in Community Pharmacies: The Medicine Abuse Observatory (MAO) in a Region of Southern Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7818. [PMID: 34360110 PMCID: PMC8345500 DOI: 10.3390/ijerph18157818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 01/23/2023]
Abstract
The misuse of medicines is a global public health concern that needs to be taken into consideration and requires actions across all government sectors and society. The aim of this study is to identify trends of drug abuse in Catalonia, a region of Spain located in the South of Europe. For this purpose, a questionnaire-based detection tool was created and implemented in 60 community pharmacies. Out of 548 questionnaires (98.4%), 64.2% of participants were men and the highest age proportion was 25-35 years (31.4%). Potential drug abuse was the highest in urban pharmacies (84.9%). The main drug class involved were benzodiazepines (31.8%), codeine (19.3%), tramadol (7.5%), methylphenidate (5.8%), gabapentinoids (5.8%), cycloplegic drops (4.4%), z-drugs (2.6%), piracetam (2.2%), dextromethorphan (1.6%) and clomethiazole (1.1%). The majority of drugs were requested without prescription (58.6%) and through probably forged prescriptions (23.7%). Slightly less than half (49.8%) of the patients request frequently to the pharmacist, especially in rural and mountain pharmacies (73.3% and 88.5%, respectively). A small proportion (10.8%) were requested with intimidation. Pharmacists only supplied in 21.7% of the cases. This study has demonstrated the suitability of the new detection system, being a useful approach to replicate in other locations with similar needs.
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Affiliation(s)
- Maria Perelló
- Barcelona College of Pharmacists, 08009 Barcelona, Spain; (M.P.); (G.B.)
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain; (K.R.-A.); (A.M.J.); (M.R.)
| | - Karla Rio-Aige
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain; (K.R.-A.); (A.M.J.); (M.R.)
- Institute of Research in Nutrition and Food Safety (INSA), 08921 Santa Coloma de Gramenet, Spain
| | - Rafel Guayta-Escolies
- Blanquerna School of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain; (R.G.-E.); (P.G.)
| | - Pilar Gascón
- Blanquerna School of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain; (R.G.-E.); (P.G.)
| | - Pilar Rius
- Council of the Pharmacist’s Association of Catalonia, 08009 Barcelona, Spain;
| | - Anna M. Jambrina
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain; (K.R.-A.); (A.M.J.); (M.R.)
- Directorate-General for Healthcare Planning and Regulation, Ministry of Health, Government of Catalonia, 08028 Barcelona, Spain;
| | - Guillermo Bagaria
- Barcelona College of Pharmacists, 08009 Barcelona, Spain; (M.P.); (G.B.)
- Council of the Pharmacist’s Association of Catalonia, 08009 Barcelona, Spain;
| | - Mercè Armelles
- Directorate-General for Healthcare Planning and Regulation, Ministry of Health, Government of Catalonia, 08028 Barcelona, Spain;
| | - Francisco José Pérez-Cano
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain; (K.R.-A.); (A.M.J.); (M.R.)
- Institute of Research in Nutrition and Food Safety (INSA), 08921 Santa Coloma de Gramenet, Spain
| | - Manel Rabanal
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain; (K.R.-A.); (A.M.J.); (M.R.)
- Institute of Research in Nutrition and Food Safety (INSA), 08921 Santa Coloma de Gramenet, Spain
- Directorate-General for Healthcare Planning and Regulation, Ministry of Health, Government of Catalonia, 08028 Barcelona, Spain;
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Abstract
PURPOSE OF REVIEW Opioid use is prevalent in the United Kingdom and prior to the COVID-19 pandemic it had been recognized that the safety of opioids was an important issue to be monitored by the UK medicines regulatory agency. With the emergence of COVID-19, this requirement has been even greater. This review was undertaken to determine the impact of the pandemic on safety and surveillance of opioids in the United Kingdom. RECENT FINDINGS During the COVID-19 pandemic, the surveillance of opioids in the United Kingdom continued, although primary research was often conducted with data prior to the pandemic. Of those studies that were conducted while the pandemic was ongoing, access to opioids (or opioid substitution therapy) and the subsequent effect on patient safety was the main theme. SUMMARY In the United Kingdom, changes in accessibility to the healthcare system and how healthcare providers operated during the COVID-19 pandemic may have had unintended consequences on use and safety of opioids, due to the shift in focus to preventing COVID-19 from overwhelming the healthcare system. The findings from this review support the need to continue surveillance in the United Kingdom, including the impact of the COVID-19 pandemic on opioid utilization and safety.
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Affiliation(s)
- Vicki Osborne
- Drug Safety Research Unit, Southampton
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
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Cremers S, Wright DFB. Nonmedical use of prescription drugs. Br J Clin Pharmacol 2021; 87:1635-1636. [PMID: 33710669 DOI: 10.1111/bcp.14797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Serge Cremers
- Department of Pathology & Cell Biology, Division of Laboratory Medicine, and Department of Medicine, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
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Wood DM, Dargan PI. Regional, national and international datasets: How they improve our understanding of the acute harms associated with prescription medicine misuse. Br J Clin Pharmacol 2020; 87:1654-1659. [PMID: 33118204 DOI: 10.1111/bcp.14592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 12/13/2022] Open
Abstract
Prescription medicine misuse is a significant problem in many areas of the world. Understanding the acute and chronic harms related to misuse of prescription medicines allows healthcare professionals, drug addiction treatment services and legislative authorities to determine what interventions may be beneficial to reduce these harms and protect individuals and society. However, it is difficult to obtain systematic data on the harms associated with prescription medicine misuse because of how patient visits to clinics and hospitals are recorded and coded in regional or national databases. In this review, we discuss how regional, national and international sources of information can help develop a greater understanding of the prevalence and pattern of acute harms related to prescription medicine misuse using data from ambulance attendances, emergency department presentations and poisons information services.
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Affiliation(s)
- David M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.,Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Paul I Dargan
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.,Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK
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