Is the EU Facing the Next Opioid Epidemic?
By Dr.Fourkan Ali
A new study suggests some countries in the European
Union are showing concerning levels of abuse of dangerous, addictive
prescription painkillers, creating some trepidation that they will follow
the United States, which has in
recent years faced a deadly
epidemic.
The study published Wednesday in BMC Psychiatry shows levels haven't
reached the same abuse rates as the U.S., but are still higher than researchers
expected.
"For now we don't know whether we are seeing a
steady trend or if we are picking up the start of a tidal wave," says
Scott Novak, the study's lead researcher and a senior research scientists at
RTI International.
This is occurring even though "doctor
shopping," or going to multiple doctors for the same prescription, is more
difficult in countries that have universal health care systems. Doctors tend to
be assigned on a regional basis, with greater coordination of care, and
patients often have to wait days or weeks to get an appointment. In the U.S.,
where doctor shopping is cited as a main way for people to get access to
prescription medications, the system is more fragmented.
To assemble the data for the study, researchers
surveyed 22,077 participants in 2014 across five European countries,
including Denmark, Germany, Great Britain, Spain andSweden. They asked
about the abuse of prescription painkillers – which include oxycodone and
hydrocodone and are referred to as opioids – as well as sedatives like
tranquilizers, and stimulants like Adderall, which is often prescribed for
learning disabilities. Those surveyed ranged in age from 12 to 49.
Spain had the highest use of opioids for non-medical
purposes, and Great Britain had the second-highest. Germany had the lowest
estimates not only for opioids, but for sedatives and stimulants, too.
Widely collected data from the U.S. in recent years
has revealed the extent of the opioid problem here: Deaths from overdoses have
surpassed car accidents as the No. 1 cause of injury death. Often, those who
become addicted to prescription painkillers turn to heroin, which has similar
effects on the brain and is a cheaper alternative.
But the European Union does not have such a systematic
approach to collecting public health data on addiction, and also lacks funding
to do so. For the study, researchers had to actively recruit participants,
which places some limitations on the results. They also didn't look at the
outcomes of drug abuse, including motor vehicle
accidents or emergency department visits, though it is known that
the U.S. has higher incidences of both.
Under drug abuse fall several categories: obtaining a
drug from someone that isn't a doctor, or taking a drug in a way that is
different from what was instructed, including at higher doses or through
snorting. It also includes obtaining a drug illegally or pretending to have
symptoms that will result in them getting the drug prescribed.
Opioid abuse is occurring even though doctors tend to
be more cautious in Europe about prescribing painkillers, Novak says. "A
European treatment model won't reach for an opiate until it's the last
chance," he says.
This is probably among one of the reasons that
researchers found most people obtained drugs from family or friends, and
sometimes from internet pharmacies.
Sources of nonmedial prescription drug use among
past-year users, 2014. COURTESY RTI INTERNATIONAL
Still, people were eight times more likely to abuse
prescription painkillers if they had received a prescription for one before.
While countries in Europe do not have prescription drug monitoring systems,
they do keep medical records in computer databases, lowering the need for them.
Some states in the U.S. do have these systems. "The cracks patients can
fall through [in the U.S.] at any point are greater than in the EU," Novak
says. "Even though they don't have a prescription drug monitoring program
they have other system-wide characteristics that serve that same
function."
Other findings from the report showed people were more
likely to abuse prescription drugs if they had a sexually transmitted disease,
HIV, a mental illness, or were arrested at a young age. People who were
unemployed or had left the workforce were also more likely to abuse
prescription drugs.
Contrary to trends seen in the U.S., in which
prescription drug abuse is highest among whites, Europe saw higher rates of
abuse of drug classes among other races. Race in Europe is measured differently
than in the U.S., so researchers limited their descriptions to white and
non-white, relying on how people self-reported their race. Non-whites made up a
disproportionately smaller share of those surveyed, at 7 percent, but were
found to have a higher incidence of prescription drug use across all
categories.
RELATED CONTENT
Why the rise of death rates among Caucasians is way
more complex than the pundits would have you believe.
Novak points out that non-whites in these countries
are often immigrants who experience racial segregation and lower socioeconomic
status. "They face a lot of pressure and with that can come the need to
relieve with prescription medication," he says.
European countries differ in how they tackle
prescription drug abuse Across Scandinavia, Novak says, are treatment centers
and needle exchange programs.
"The problems are almost equally divided across
countries but some are working to address it and over time we'll see if the
institutional approaches work long term over several generations," he
says.
Source:Web Site
0 comments:
Post a Comment