Winfried Häuser1, Eric Buchser2, David P Finn3, Geerd Dom4, Egil Fors5, Tarja Heiskanen6, Lene Jarlbaek7, Roger D Knaggs8,9, Eva Kosek10, Nevenka Krcevski-Škvarč11, Kaire Pakkonen12, Serge Perrot13, Anne-Priscille Trouvin13, Bart Morlion14. 1. Department Psychosomatic Medicine and Psychotherapy, Technische Universität München, München, Germany. 2. Department of Anaesthesia and Pain Management Neuromodulation Centre, Morges, Switzerland. 3. Pharmacology and Therapeutic, School of Medicine, Centre for Pain Research, Galway Neuroscience Centre National University of Ireland Galway, Galway, Ireland. 4. Collaborative Antwerp Psychiatric Research Institute, Antwerp University, Antwerp, Belgium. 5. Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway. 6. Pain Clinic, Helsinki University Hospital, Helsinki, Finland. 7. REHPA - The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Nyborg, Denmark. 8. School of Pharmacy, University of Nottingham, Nottingham, UK. 9. Pain Centre Versus Arthritis, Clinical Sciences Building, City Hospital Nottingham, Nottingham, UK. 10. Department of Surgical Sciences, Pain Research, Uppsala University, Uppsala, Sweden. 11. Department of Anesthesiology, Intensive Care and Pain Treatmen, Faculty of Medicine of University Maribor, Maribor, Slovenia. 12. Anaesthesiology, Operative and Intensive Care Service, Pärnu Hospital, Pärnu, Estonia. 13. Pain Medicine Department, University Hospital Cochin, Université de Paris, Paris, France. 14. Center for Algology & Pain Management, University Hospitals Leuven, Leuven, Belgium.
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.
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.
Authors: Stefania Chiappini; Rachel Vickers-Smith; Amira Guirguis; John M Corkery; Giovanni Martinotti; Daniel R Harris; Fabrizio Schifano Journal: Pharmaceuticals (Basel) Date: 2022-05-27
Authors: Aníbal García-Sempere; Isabel Hurtado; Salvador Peiró; Francisco Sánchez-Sáez; Clara Liliana Rodríguez-Bernal; Magda Puig-Ferrer; Manuel Escolano; Gabriel Sanfélix-Gimeno Journal: Front Pharmacol Date: 2022-04-05 Impact factor: 5.988