Health harms of non‐medical prescription opioid use: A systematic review

Issues Non‐medical prescription opioid use (NMPOU) contributes substantially to the global burden of morbidity. However, no systematic assessment of the scientific literature on the associations between NMPOU and health outcomes has yet been undertaken. Approach We undertook a systematic review evaluating health outcomes related to NMPOU based on ICD‐10 clinical domains. We searched 13 electronic databases for original research articles until 1 July 2021. We employed an adaptation of the Oxford Centre for Evidence‐Based Medicine ‘Levels of Evidence’ scale to assess study quality. Key Findings Overall, 182 studies were included. The evidence base was largest on the association between NMPOU and mental and behavioural disorders; 71% (129) studies reported on these outcomes. Less evidence exists on the association of NMPOU with infectious disease outcomes (26; 14%), and on external causes of morbidity and mortality, with 13 (7%) studies assessing its association with intentional self‐harm and 1 study assessing its association with assault (