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      The Trends in Opioid Use in Castile and Leon, Spain: A Population-Based Registry Analysis of Dispensations in 2015 to 2018

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          Abstract

          Opioids are driving-impairing medicines (DIM). To assess the evolution and trends of opioid analgesics use between 2015 and 2018 in Castile and Leon (Spain), a population-based registry study was conceived. The length of opioid use and its concomitant use with other DIMs were studied. Analyses were done considering age and gender distributions. Adjusted consumption for licensed drivers is also presented. Of the 5 million dispensations recorded between 2015 and 2018, opioid analgesics were dispensed to 11.44% of the general population and 8.72% of vehicle drivers. Increases among daily users (2.6 times higher) and chronic users (1.5% higher) were noted, supporting the overall increase in opioid use (1.5%). The use of multiple drugs including other DIMs was a common finding (mean ± SD, 2.54 ± 0.01). Acute use (5.26%) and chronic use (3.20%) were also frequent. Formulations combining opioid analgesics with nonopioid analgesics were preferred. The use of opioids increased in Spain between 2015 and 2018. Concomitant use with other DIMS especially affects women and the elderly. Frequent use of opioid analgesics with other DIMs is a serious problem for drivers and increases the risk of accidents. Promoting safe driving should be a main objective of health authorities, to be achieved by developing and implementing educational activities for healthcare professionals and patients.

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          Most cited references21

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          The Burden of Opioid-Related Mortality in the United States

          Key Points Question What has been the burden of opioid-related deaths in the United States over a recent 15-year period? Findings In this serial cross-sectional study, we found that the percentage of all deaths attributable to opioids increased 292% (from 0.4% to 1.5%) between 2001 and 2016, resulting in approximately 1.68 million person-years of life lost in 2016 alone (5.2 per 1000 population). The burden was particularly high among adults aged 24 to 35 years; in 2016, 20% of deaths in this age group involved opioids. Meaning Premature death from opioids imposes an enormous and growing public health burden across the United States.
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            Prescription Opioid Misuse, Abuse, and Treatment in the United States: An Update

            Objective Prescription opioid abuse and dependence have escalated rapidly in the United States over the past 20 years, leading to high rates of overdose deaths and a dramatic increase in the number of people seeking treatment for opioid dependence. The authors review the scope of the abuse and overdose epidemic, prescription practices, and the assessment, treatment, and prevention of prescription opioid misuse and dependence. Method The authors provide an overview of the literature from 2006 to the present, with the twin goals of highlighting advances in prevention and treatment and identifying remaining gaps in the science. Results A number of policy and educational initiatives at the state and federal government level have been undertaken in the past 5 years to help providers and consumers, respectively, prescribe and use opioids more responsibly. Initial reports suggest that diversion and abuse levels have begun to plateau, likely as a result of these initiatives. While there is a large body of research suggesting that opioid substitution coupled with psychosocial interventions is the best treatment option for heroin dependence, there is limited research focusing specifically on the treatment of prescription opioid dependence. In particular, the treatment of chronic pain in individuals with prescription opioid use disorders is underexplored. Conclusions While policy and educational initiatives appear to be effective in decreasing prescription opioid abuse and misuse, research focusing on the development and evaluation of treatments specific to prescription opioid dependence and its common comorbidities (e.g., chronic pain, depression) is critically needed.
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              Risk Factors for Misuse of Prescribed Opioids: A Systematic Review and Meta-Analysis

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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                05 December 2019
                December 2019
                : 8
                : 12
                : 2148
                Affiliations
                [1 ]Pharmacological Big Data Laboratory, Pharmacology and Therapeutics, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain; egutierreza@ 123456saludcastillayleon.es (E.G.-A.); ija@ 123456oftalvision.es (I.A.); alvarez@ 123456med.uva.es (F.J.Á.)
                [2 ]Nephrology, Hospital Virgen de la Concha—Sanidad de Castilla y León, 49022 Zamora, Spain
                [3 ]Technical Direction of Pharmaceutical Assistance, Gerencia Regional de Salud de Castilla y León, 47007 Valladolid, Spain
                [4 ]Gerencia de Asistencia Sanitaria-Sanidad de Castilla y León, 34001 Palencia, Spain; pcriado@ 123456saludcastillayleon.es
                [5 ]CEIm, Hospital Clínico Universitario de Valladolid—Sanidad de Castilla y León, 47003 Valladolid, Spain
                Author notes
                [* ]Correspondence: fherrerag@ 123456saludcastillayleon.es ; Tel.: +34-983423077
                Author information
                https://orcid.org/0000-0002-3110-692X
                https://orcid.org/0000-0003-2612-934X
                https://orcid.org/0000-0002-7566-5678
                Article
                jcm-08-02148
                10.3390/jcm8122148
                6947376
                31817357
                5a018e1c-5719-4de6-be3d-d2d8311cb07e
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 November 2019
                : 03 December 2019
                Categories
                Article

                analgesics,opioids,drug use,driving under the influence,population surveillance

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