Current status of opioid epidemic in the United Kingdom and strategies for treatment optimisation in chronic pain

Alenezi, Aziza; Yahyouche, Asma; Paudyal, Vibhu

doi:10.1007/s11096-020-01205-y

Cited by 38 publications

(36 citation statements)

References 19 publications

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“…41 Based on these findings, several recommendations can be made to further prevent opioid-related problems in Europe, including evidence-based guidelines for pain treatment, evidence-based improvements to establish an efficient addiction treatment system, and raising awareness about the dangers of combining opioids with other central depressants. 42,43 Our analysis also revealed some transient increases in opioid-related harms that reflect the complexity of Europe's contemporary drug market, heterogeneity in national regulations and highlight the importance of early detection and monitoring of opioid supply chains and availability. In the Czech Republic high buprenorphine treatment admission rates were observed in 2014, 2015 and 2017.…”

Section: Discussionmentioning

confidence: 74%

Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018

et al. 2021

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Section: Discussionmentioning

confidence: 74%

Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018

et al. 2021

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“…The extent of the increased opioid use, including misuse, remains less debated in the UK. Yet, UK based studies indicate an upward trend in the use of prescribed opioid in the National Health Services (NHS) parallel to that in the US [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Roles, barriers and behavioral determinants related to community pharmacists' involvement in optimizing opioid therapy for chronic pain: a qualitative study

2021

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Background Opioid are currently widely used to manage chronic non-malignant pain (CNMP), but there is a growing concern about harm resulting from opioid misuse and the need for medicine optimization, in which pharmacists could potentially play a key role. Objective This study explored pharmacists' roles, barriers and determinants related to their involvement in optimizing prescribed opioids for patients with chronic pain. Setting Community pharmacies in the United Kingdom. Method Semi-structured interviews based on the Theoretical Domains Framework were conducted between January and May 2020 with 20 community pharmacists recruited through professional networks. Data were analysed thematically. Main outcome measure: Pharmacists’ perceived roles, barriers and behavioural determinants in relation to opioid therapy optimization. Result Pharmacists demonstrated desire to contribute to opioid therapy optimization. However, they described that they were often challenged by the lack of relevant knowledge, skills and training, inadequate time and resources, systemic constraints (such as lack of access to medical records and information about diagnosis), and other barriers including relationships with doctors and patients. Conclusion The contribution of community pharmacists to optimize opioid therapy in CNMP is unclear and impeded by lack of appropriate training and systemic constraints. There is a need to develop innovative practice models by addressing the barriers identified in this study to enhance the contribution of community pharmacists in optimization of opioid therapy for chronic pain.

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“…Outside the US, there is also an increasing trend in the prevalence of opioid including fentanyl use and associated harm in Europe. 21 , 22 In 2017, 1300 new synthetic opioids (NSOs) were seized by law enforcement, 72% of which were fentanyl derivatives. 23 In 2018, fake Xanax and OxyContin tablets were found to contain fentanyls in Denmark and Sweden, 23 similar to the previously mentioned incidents that occurred in the US.…”

Section: Introductionmentioning

confidence: 99%

Causes, Nature and Toxicology of Fentanyl-Analogues Associated Fatalities: A Systematic Review of Case Reports and Case Series

Rauf¹,

Ali²,

Dehele³

et al. 2021

JPR

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Objective: Mortalities due to fentanyl derivatives are on the rise with novel fentanyl analogues and still emerging on the global illicit drug market. They are highly potent and very fatal in low doses, yet there has been a lack of systematic research surrounding this subject. This review aims to assess the causes, nature, and toxicology of fatalities associated with fentanyl analogues. Methods: Five databases: Scopus, Embase, Medline, PubMed and Google Scholar were searched from inception to October 2020 to identify case studies and case series reporting fentanyl analogue-related fatalities. Two independent reviewers screened and selected the articles followed by the data extraction from each article, which included demography, route of administration, causes and nature of death, and the fentanyl analogue implicated. All articles were then subject to quality assessment tools developed by the Joanna Briggs Institute (JBI). A narrative synthesis was undertaken. Results: The initial data search yielded 834 articles, only 14 of which met the inclusion criteria -this included nine case reports and five case series. Of the 1079 fentanyl-analogue related deaths reported, the majority of them occurred in the US (n=1044, 96.8%). The majority of fatalities were male (n=766, 71%), white (n=884, 87%) and in the age ranges 25-34 and 35-44 years (30.5% and 29.6%, respectively). The most common route of administration was intravenous (n=319, 66%) and the manner of death was almost exclusively accidental (99.7%). The predominant cause of death was fentanyl-analogue toxicity (n=292, 85.4%) and involved mixed drug toxicity (n=47, 13.7%). The mean post-mortem fentanyl analogue concentration was 31.6 ng/mL. Conclusion: Most fatalities were reported in the US involving young white males. Overdose through intravenous administration and by mixed drug toxicities with other opioids were the major causes of death. Deaths reported in peer-reviewed literature were relatively less than those reported by real-world data.

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Current status of opioid epidemic in the United Kingdom and strategies for treatment optimisation in chronic pain

Cited by 38 publications

References 19 publications

Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018

Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018

Roles, barriers and behavioral determinants related to community pharmacists' involvement in optimizing opioid therapy for chronic pain: a qualitative study

Causes, Nature and Toxicology of Fentanyl-Analogues Associated Fatalities: A Systematic Review of Case Reports and Case Series

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