Article Dans Une Revue British Journal of Clinical Pharmacology Année : 2022

Medical prescription forms of opioid cough suppressants falsified by the patients before and after they switched from over‐the‐counter to prescription‐only in France

Résumé

Aims The French Ministry of Health scheduled opioid cough suppressants as prescription‐only drugs on 12 July 2017. The present study assessed the impact of this regulation on the diversion modalities of the concerned drugs and the related drug pholcodine by analysing the national OSIAP (Ordonnances Suspectes Indicateur d'Abus Possible) database. Methods Medical prescriptions with at least 1 mention of codeine, dextromethorphan, ethylmorphine, noscapine or pholcodine for cough suppression recorded in 2013–2019 were extracted from OSIAP. Annual mentioning rates were estimated by dividing numbers of mentions over those of prescriptions recorded the year considered. A descriptive analysis compared the characteristics of prescriptions before and after 12 July 2017. Results Overall, 832 mentions of the requested drugs were retrieved on 827 prescription forms. Codeine was the most frequent ( n = 809, 8.7%) with 6 additional mentions of codeine/ethylmorphine combination, followed by dextromethorphan ( n = 11, 0.1%) and pholcodine ( n = 6, 0.1%). There was no mention of noscapine. Annual mentioning rates varied between 0 and 0.3% for all drugs except codeine. Codeine mentioning rates ranged between 0.3% ( n = 2) and 0.7% ( n = 9) before 12 July 2017 and increased to 10.1% ( n = 61) thereafter in 2017, 16.1% ( n = 314) in 2018, and 19.8% ( n = 414) in 2019. The profile of subjects evolved accordingly with an increased male/female ratio (10.0 vs . 1.5 before) and decreased age (23 vs . 40 y before, P < .001). Discussion The sharp increase of recourse to falsified prescription forms indicates that codeine diversion continues despite restricted access, whereas the other drugs studied do not seem to have been impacted.

Dates et versions

hal-04245743 , version 1 (17-10-2023)

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Citer

Emilie Jouanjus, Valérie Gibaja, Florence Fabre, Maryse Lapeyre-Mestre. Medical prescription forms of opioid cough suppressants falsified by the patients before and after they switched from over‐the‐counter to prescription‐only in France. British Journal of Clinical Pharmacology, 2022, 88 (4), pp.1713-1721. ⟨10.1111/bcp.15052⟩. ⟨hal-04245743⟩
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