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Annual prevalence of\n                      <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content>\n                      use and shopping behaviour (\u22651\u00a0day of overlapping prescriptions from \u22652 prescribers, dispensed by \u22653 pharmacies) was estimated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 2004\u20132017, the annual prevalence of weak opioid use codeine, tramadol and opium rose by 150%, 123%, and 244%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Strong opioid use increased from 0.54% to 1.1% (+104%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), significantly for oxycodone (+1950%). Strong opioid use in chronic noncancer pain rose by 88% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05) and 1180% for oxycodone. Opioid shopping increased from 0.50% to 0.67% (+34%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), associated with higher mortality risk\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a02.8 [95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ): 1.2\u20136.4]. Opioid\u2010related hospitalizations increased from 15 to 40 per 1,000,000 population (+167%, 2000\u20132017), and opioid\u2010related deaths from 1.3 to 3.2 per 1,000,000 population (+146%, 2000\u20132015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study provided a first European approach to a nationwide estimation with complete access to several national registries. In 2004\u20132017 in France,\n                      <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content>\n                      use excluding dextropropoxyphene more than doubled. The increase in oxycodone and fentanyl use, and nontrivial increasing trend in opioid\u2010related morbidity\u2013mortality should prompt authorities to closely monitor\n                      <jats:styled-content style=\"fixed-case\">PO<\/jats:styled-content>\n                      consumption in order to prevent alarming increases in opioid\u2010related morbidity\u2013mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In 2004\u20132017, prescription opioid use in France at least doubled and oxycodone use increased particularly, associated with a nontrivial increase in opioid\u2010related morbidity\u2013mortality. Although giving no indication for an \u2018opioid epidemic,\u2019 these findings call for proper monitoring of opioid use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.1291","type":"journal-article","created":{"date-parts":[[2018,7,27]],"date-time":"2018-07-27T03:43:46Z","timestamp":1532663026000},"page":"124-134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":172,"title":["Prescription opioid analgesic use in France: Trends and impact on morbidity\u2013mortality"],"prefix":"10.1002","volume":"23","author":[{"given":"C.","family":"Chenaf","sequence":"first","affiliation":[{"name":"Universit\u00e9 Clermont Auvergne CHU Clermont\u2010Ferrand Inserm, Neuro\u2010Dol Service de Pharmacologie m\u00e9dicale Centres Addictovigilance et Pharmacovigilance Centre Evaluation et Traitement de la Douleur D\u00e9l\u00e9gation \u00e0 la Recherche Clinique et \u00e0 l'Innovation F\u201063001 Clermont\u2010Ferrand 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