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 eval...
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| Veröffentlicht in: | Drug and alcohol review 2022-05, Vol.41 (4), p.941-952 |
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| creator | Werb, Dan Scheim, Ayden I. Soipe, Ayorinde Aeby, Samantha Rammohan, Indhu Fischer, Benedikt Hadland, Scott E. Marshall, Brandon D. L. |
| description | 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 ( |
| doi_str_mv | 10.1111/dar.13441 |
| format | Article |
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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 (<1%).
Implications
A large body of evidence has identified associations between NMPOU and opioid use disorder as well as on fatal and non‐fatal overdose. We found equivocal evidence on the association between NMPOU and the acquisition of HIV, hepatitis C and other infectious diseases. We identified weak evidence regarding the potential association between NMPOU and intentional self‐harm, suicidal ideation and assault.
Discussion and Conclusions
Findings may inform the prevention of harms associated with NMPOU, although higher‐quality research is needed to characterise the association between NMPOU and the full spectrum of physical and mental health disorders.</description><identifier>ISSN: 0959-5236</identifier><identifier>EISSN: 1465-3362</identifier><identifier>DOI: 10.1111/dar.13441</identifier><identifier>PMID: 35437841</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Analgesics, Opioid - adverse effects ; Assaults ; Behavior disorders ; Evidence-based medicine ; health outcome ; Health status ; Hepatitis C ; HIV ; Human immunodeficiency virus ; Humans ; Infectious diseases ; Mental disorders ; Mental health ; Morbidity ; Narcotics ; non‐medical ; opioid overdose ; Opioid-Related Disorders - epidemiology ; Opioid-Related Disorders - psychology ; Opioids ; prescription drug ; Prescriptions ; Substance use disorder ; Suicidal ideation ; Suicide ; Systematic review</subject><ispartof>Drug and alcohol review, 2022-05, Vol.41 (4), p.941-952</ispartof><rights>2022 Australasian Professional Society on Alcohol and other Drugs.</rights><rights>2022 Australasian Professional Society on Alcohol and other Drugs (APSAD)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4431-fd50784c31ad1afecabd28eb22c26c772e264cb5c65382c654bf417dec4b32173</citedby><cites>FETCH-LOGICAL-c4431-fd50784c31ad1afecabd28eb22c26c772e264cb5c65382c654bf417dec4b32173</cites><orcidid>0000-0003-0614-9386 ; 0000-0002-2186-4030</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdar.13441$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdar.13441$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,30976,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35437841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Werb, Dan</creatorcontrib><creatorcontrib>Scheim, Ayden I.</creatorcontrib><creatorcontrib>Soipe, Ayorinde</creatorcontrib><creatorcontrib>Aeby, Samantha</creatorcontrib><creatorcontrib>Rammohan, Indhu</creatorcontrib><creatorcontrib>Fischer, Benedikt</creatorcontrib><creatorcontrib>Hadland, Scott E.</creatorcontrib><creatorcontrib>Marshall, Brandon D. L.</creatorcontrib><title>Health harms of non‐medical prescription opioid use: A systematic review</title><title>Drug and alcohol review</title><addtitle>Drug Alcohol Rev</addtitle><description>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 (<1%).
Implications
A large body of evidence has identified associations between NMPOU and opioid use disorder as well as on fatal and non‐fatal overdose. We found equivocal evidence on the association between NMPOU and the acquisition of HIV, hepatitis C and other infectious diseases. We identified weak evidence regarding the potential association between NMPOU and intentional self‐harm, suicidal ideation and assault.
Discussion and Conclusions
Findings may inform the prevention of harms associated with NMPOU, although higher‐quality research is needed to characterise the association between NMPOU and the full spectrum of physical and mental health disorders.</description><subject>Analgesics, Opioid - adverse effects</subject><subject>Assaults</subject><subject>Behavior disorders</subject><subject>Evidence-based medicine</subject><subject>health outcome</subject><subject>Health status</subject><subject>Hepatitis C</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Morbidity</subject><subject>Narcotics</subject><subject>non‐medical</subject><subject>opioid overdose</subject><subject>Opioid-Related Disorders - epidemiology</subject><subject>Opioid-Related Disorders - psychology</subject><subject>Opioids</subject><subject>prescription drug</subject><subject>Prescriptions</subject><subject>Substance use disorder</subject><subject>Suicidal ideation</subject><subject>Suicide</subject><subject>Systematic review</subject><issn>0959-5236</issn><issn>1465-3362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kLtOwzAUhi0EoqUw8ALIEhNDWl-TlAGpKpeCkJAQzJbjONRVGgc7bdWNR-AZeRIMKRUMnMFn8Kfv_PoBOMaoj8MMcun6mDKGd0AXs5hHlMZkF3TRkA8jTmjcAQfezxBChHOyDzqUM5qkDHfB3UTLspnCqXRzD20BK1t9vL3PdW6ULGHttFfO1I2xFbS1sSaHC6_P4Qj6tW_0XDZGQaeXRq8OwV4hS6-PNrsHnq-vnsaT6P7h5nY8uo8UYxRHRc5RuK0oljmWhVYyy0mqM0IUiVWSEE1ipjKuYk5TEl6WFQwnuVYsowQntAcuWm-9yEJOpavGyVLUzsylWwsrjfj7U5mpeLFLMUQxGwZrD5xuBM6-LrRvxMwuXBUyCxLzFFGMGArUWUspZ713uthewEh81S5C7eK79sCe_I60JX96DsCgBVam1Ov_TeJy9NgqPwFufY4b</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Werb, Dan</creator><creator>Scheim, Ayden I.</creator><creator>Soipe, Ayorinde</creator><creator>Aeby, Samantha</creator><creator>Rammohan, Indhu</creator><creator>Fischer, Benedikt</creator><creator>Hadland, Scott E.</creator><creator>Marshall, Brandon D. L.</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0614-9386</orcidid><orcidid>https://orcid.org/0000-0002-2186-4030</orcidid></search><sort><creationdate>202205</creationdate><title>Health harms of non‐medical prescription opioid use: A systematic review</title><author>Werb, Dan ; Scheim, Ayden I. ; Soipe, Ayorinde ; Aeby, Samantha ; Rammohan, Indhu ; Fischer, Benedikt ; Hadland, Scott E. ; Marshall, Brandon D. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4431-fd50784c31ad1afecabd28eb22c26c772e264cb5c65382c654bf417dec4b32173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Analgesics, Opioid - adverse effects</topic><topic>Assaults</topic><topic>Behavior disorders</topic><topic>Evidence-based medicine</topic><topic>health outcome</topic><topic>Health status</topic><topic>Hepatitis C</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Morbidity</topic><topic>Narcotics</topic><topic>non‐medical</topic><topic>opioid overdose</topic><topic>Opioid-Related Disorders - epidemiology</topic><topic>Opioid-Related Disorders - psychology</topic><topic>Opioids</topic><topic>prescription drug</topic><topic>Prescriptions</topic><topic>Substance use disorder</topic><topic>Suicidal ideation</topic><topic>Suicide</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Werb, Dan</creatorcontrib><creatorcontrib>Scheim, Ayden I.</creatorcontrib><creatorcontrib>Soipe, Ayorinde</creatorcontrib><creatorcontrib>Aeby, Samantha</creatorcontrib><creatorcontrib>Rammohan, Indhu</creatorcontrib><creatorcontrib>Fischer, Benedikt</creatorcontrib><creatorcontrib>Hadland, Scott E.</creatorcontrib><creatorcontrib>Marshall, Brandon D. L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Drug and alcohol review</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Werb, Dan</au><au>Scheim, Ayden I.</au><au>Soipe, Ayorinde</au><au>Aeby, Samantha</au><au>Rammohan, Indhu</au><au>Fischer, Benedikt</au><au>Hadland, Scott E.</au><au>Marshall, Brandon D. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Health harms of non‐medical prescription opioid use: A systematic review</atitle><jtitle>Drug and alcohol review</jtitle><addtitle>Drug Alcohol Rev</addtitle><date>2022-05</date><risdate>2022</risdate><volume>41</volume><issue>4</issue><spage>941</spage><epage>952</epage><pages>941-952</pages><issn>0959-5236</issn><eissn>1465-3362</eissn><abstract>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 (<1%).
Implications
A large body of evidence has identified associations between NMPOU and opioid use disorder as well as on fatal and non‐fatal overdose. We found equivocal evidence on the association between NMPOU and the acquisition of HIV, hepatitis C and other infectious diseases. We identified weak evidence regarding the potential association between NMPOU and intentional self‐harm, suicidal ideation and assault.
Discussion and Conclusions
Findings may inform the prevention of harms associated with NMPOU, although higher‐quality research is needed to characterise the association between NMPOU and the full spectrum of physical and mental health disorders.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>35437841</pmid><doi>10.1111/dar.13441</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-0614-9386</orcidid><orcidid>https://orcid.org/0000-0002-2186-4030</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Analgesics, Opioid - adverse effects Assaults Behavior disorders Evidence-based medicine health outcome Health status Hepatitis C HIV Human immunodeficiency virus Humans Infectious diseases Mental disorders Mental health Morbidity Narcotics non‐medical opioid overdose Opioid-Related Disorders - epidemiology Opioid-Related Disorders - psychology Opioids prescription drug Prescriptions Substance use disorder Suicidal ideation Suicide Systematic review |
| title | Health harms of non‐medical prescription opioid use: A systematic review |
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