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Health harms of non-medical prescription opioid use: A systematic review
Journal article - Review   Open access   Peer reviewed

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

Dan Werb, Ayden I Scheim, Ayorinde Soipe, Samantha Aeby, Indhu Rammohan, Benedikt Fischer, Scott E Hadland and Brandon D L Marshall
Drug and alcohol review, v 41(4), pp 941-952
May 2022
PMID: 35437841
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9064965View
Accepted (AM)Open Access (License Unspecified) Open

Abstract

Analgesics, Opioid - adverse effects Humans Opioid-Related Disorders - epidemiology Opioid-Related Disorders - psychology Prescriptions
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. 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. 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%). 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. 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.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Substance Abuse
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