Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands.
Ther Drug Monit. 2021 Feb 1;43(1):42-51. doi: 10.1097/FTD.0000000000000789.
In the U.S., an opioid overdose crisis has emerged, attributable to over-prescription of opioid analgesics, driven by aggressive marketing by pharmaceutical companies, followed by surging heroin overdose deaths, and more recently, by the high mortality rates predominately because of illicitly manufactured fentanyl and analogs of fentanyl. In Europe, the use of prescription opioids for pain management has also increased in the last 2 decades, although it is debatable as to whether this could lead to a similar opioid overdose crisis. To address this issue, recent trends in opioid prescription rates, prevalence rates of fatal and nonfatal incidents, and addiction care treatment were used as proxies of opioid-related harm. The current overview, comparing opioid use and its negative consequences in Germany, France, the U.K., and the Netherlands, using the same indicators as in the U.S., demonstrates that there is no evidence of a current or emerging opioid crisis in these European countries. Scotland, however, is an alarming exception, with high rates of opioid-related harms. Considering that the use of prescription opioids has been declining rather than increasing in Europe, an opioid crisis is not anticipated there yet. Authorities should, however, remain vigilant.
在美国，阿片类药物过量危机已经出现，这归因于阿片类镇痛药的过度处方，这是制药公司积极营销的结果，随后是海洛因过量死亡人数的激增，最近，非法制造的芬太尼和芬太尼类似物导致的高死亡率是主要原因。在欧洲，过去 20 年来，用于疼痛管理的处方类阿片的使用也有所增加，尽管这是否会导致类似的阿片类药物过量危机仍存在争议。为了解决这个问题，最近的阿片类药物处方率趋势、致命和非致命事件的流行率以及成瘾治疗被用作与阿片类药物相关伤害的替代指标。本综述比较了德国、法国、英国和荷兰的阿片类药物使用情况及其负面后果，使用了与美国相同的指标，结果表明，这些欧洲国家目前没有或即将出现阿片类药物危机的证据。然而，苏格兰是一个令人震惊的例外，阿片类药物相关危害的发生率很高。考虑到欧洲的处方类阿片使用量一直在下降而不是增加，预计那里不会出现阿片类药物危机。然而，当局仍应保持警惕。
