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Detection of signals of abuse and dependence applying disproportionality analysis

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Introduction

Prescription drug abuse and dependence is a widespread phenomenon in many countries. The use of disproportionality measures in drug abuse surveillance is rarely performed.

Purpose

The aim of this study is to determine the occurrence of signals of abuse and dependence for different psychoactive drugs in real-life settings.

Methods

Disproportionality analysis was realised from a database specifically constructed for the monitoring of drug abuse and dependence. This database provides information on approximately 5000 patients and 8000 consumption modalities for more than 100 distinct psychoactive medications for 2010 and 2011. Proportional reporting ratio (PRR) was computed in two population groups: subjects under an opiate maintenance treatment (OMT) versus those not under OMT, and focused on four types of behaviours: abuse and dependence, illegal acquisition, diverted route of administration and concomitant alcohol use.

Results

Among the 100 psychoactive drugs for which a signal could be detected, those presenting the highest signals were the following: flunitrazepam, clonazepam, methylphenidate, ketamine, morphine sulfate, codeine and buprenorphine.

Conclusions

The present study shows an innovative application of disproportionality measures for drug abuse monitoring based on two cross-national, annual studies. The disproportionality analysis provided the opportunity to reveal and compare the magnitude of signals between 100 psychoactive drugs. This approach helps to compare the magnitude of abuse and dependence behaviours for a large number of drugs, and allows prioritizing actions in a context where such events are usually underreported.

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Contributions of authors statement

V. Pauly, J. Micallef and M. Lapeyre-Mestre have elaborated the design of the work, interpretation of the data, have drafted the work and written the manuscript. V Pauly has performed the statistical analyses. D. Braunstein, M. Rueter, E. Jouanjus and X. Thirion have revisited critically the design of the study and made important intellectual modifications; they have made important contributions to the interpretation of the data and ensured the accuracy of any part of the work. All the authors have contributed to the writing of the manuscript and all have finally approved the version to be published.

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Authors and Affiliations

  1. Laboratoire de Santé Publique EA 3279, Faculté de Médecine Centre d’Evaluation de la Pharmacodépendance-Addictovigilance (CEIP-A) de Marseille (PACA-Corse) Associé, Aix Marseille Université, 27 Boulevard Jean Moulin, 13005, Marseille, France

    V. Pauly & X. Thirion

  2. Centre d’Evaluation et d’Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, CHU, UMR INSERM 1027, Equipe de Pharmacoépidémiologie, Université de Toulouse, 37 Allées Jules Guesde, 31000, Toulouse, France

    M. Lapeyre-Mestre, M. Rueter & E. Jouanjus

  3. Institut des Neurosciences, CEIP (PACA-Corse) Service de Pharmacologie Clinique et Pharmacovigilance. AP-HM, UMR 7289 CNRS, Aix Marseille Université, 264 Rue St Pierre, 13005, Marseille, France

    V. Pauly, D. Braunstein & J. Micallef

  4. Hôpital Timone, Service de Pharmacologie Clinique & Pharmacovigilance, 264 Rue St Pierre, 13005, Marseille, France

    J. Micallef

Authors
  1. V. Pauly
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  2. M. Lapeyre-Mestre
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  3. D. Braunstein
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  4. M. Rueter
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  5. X. Thirion
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  6. E. Jouanjus
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  7. J. Micallef
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Corresponding author

Correspondence to J. Micallef.

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Pauly, V., Lapeyre-Mestre, M., Braunstein, D. et al. Detection of signals of abuse and dependence applying disproportionality analysis. Eur J Clin Pharmacol 71, 229–236 (2015). https://doi.org/10.1007/s00228-014-1783-x

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  • DOI: https://doi.org/10.1007/s00228-014-1783-x

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