{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:54:52Z","timestamp":1791230092683,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T00:00:00Z","timestamp":1669075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The current opioid epidemic in the United States began 20\u2009years ago and has become the leading cause of accidental deaths in the country. This crisis prompted us to explore trends in opioid abuse and dependence worldwide. We sought to identify other countries at high\u2010risk of opioid use disorders, using the World Health Organization's (WHO) pharmacovigilance database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a disproportionality analysis using VigiBase, the WHO Global Individual Case Safety Report (ICSR) database. Five opioids used worldwide were included: oxycodone, fentanyl, morphine, tramadol, and codeine. We extracted all ICSRs associated with the drugs of interest, considered as suspect medication and recorded up until 5 June 2021, using the narrow Standardised MedDRA Query (SMQ) for drug abuse and dependence. Countries with at least one ICSR for each of the five opioids were retained. The relationship between the use of a drug (i.e. an opioid) and the occurrence of an adverse drug reaction (i.e. drug abuse and dependence) for each country was assessed by calculating the information component (IC) and its 99.9% CI [IC\n                      <jats:sub>0005<\/jats:sub>\n                      ; IC\n                      <jats:sub>9995<\/jats:sub>\n                      ], using a quasi\u2010Bayesian confidence propagation neural network (BCPNN). A hierarchical cluster analysis (Ward's method) of the IC\n                      <jats:sub>0005<\/jats:sub>\n                      value for each of the five opioids was performed to identify subgroups of countries with similar reported risks of opioid abuse and dependence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 21 countries, the optimal number of clusters was calculated to be four, each with a Jaccard index &gt;0.5 (0.95, 0.78, 0.65 and 0.75, respectively). Six countries with the highest signals of drug abuse and dependence were identified in cluster 1, with significant CIs for the five opioids of interest (IC\n                      <jats:sub>0005<\/jats:sub>\n                      \u2009&gt;\u20090), ranging from 0.9 to 5.8 for the lower endpoint.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There appear to be four distinct clusters of countries with similar opioid abuse and dependence profiles. The group with the highest reported risk for the opioids oxycodone, fentanyl, morphine, tramadol and codeine includes Australia, Canada, France, Germans, the United Kingdom and the United States.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.16081","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T12:06:04Z","timestamp":1667563564000},"page":"771-775","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":81,"title":["The opioid epidemic: A worldwide exploratory study using the WHO pharmacovigilance database"],"prefix":"10.1111","volume":"118","author":[{"given":"Marion","family":"Robert","sequence":"first","affiliation":[{"name":"Addictovigilance Department Grenoble Alpes University Hospital  Grenoble France"},{"name":"Pharmacovigilance Department Grenoble Alpes University Hospital  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3510-2475","authenticated-orcid":false,"given":"Emilie","family":"Jouanjus","sequence":"additional","affiliation":[{"name":"Addictovigilance Department Toulouse University Hospital  Toulouse France"},{"name":"INSERM Unit 1027 Toulouse III University  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Khouri","sequence":"additional","affiliation":[{"name":"Pharmacovigilance Department Grenoble Alpes University Hospital  Grenoble France"},{"name":"INSERM Unit 1300, HP2 Laboratory Grenoble Alpes University  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Fouilh\u00e9 Sam\u2010La\u00ef","sequence":"additional","affiliation":[{"name":"Addictovigilance Department Grenoble Alpes University Hospital  Grenoble France"},{"name":"Pharmacovigilance Department Grenoble Alpes University Hospital  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2931-2940","authenticated-orcid":false,"given":"Bruno","family":"Revol","sequence":"additional","affiliation":[{"name":"Addictovigilance Department Grenoble Alpes University Hospital  Grenoble France"},{"name":"Pharmacovigilance Department Grenoble Alpes University Hospital  Grenoble France"},{"name":"INSERM Unit 1300, HP2 Laboratory Grenoble Alpes University  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,22]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Institute on Drug Abuse.Overdose death rates [Internet].2021[cited 2021 Aug 1]. Available from:https:\/\/www.drugabuse.gov\/drug-topics\/trends-statistics\/overdose-death-rates"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.38.6.02"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031914-122957"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12346"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2017.10.016"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00161-6"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1011512"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/ES191"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12617"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5599"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2021.2219"},{"key":"e_1_2_8_13_1","unstructured":"Organisation for Economic Co\u2010operation and Development OECD.Adressing problematic opioid use in OECD countries [Internet].2019. Available from:https:\/\/www.oecd.org\/health\/addressing-problematic-opioid-use-in-oecd-countries-a18286f0-en.htm"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30128-8"},{"key":"e_1_2_8_15_1","unstructured":"UNITED NATIONS Vienna 2021 INTERNATIONAL NARCOTICS CONTROL BOARD.Report of the International Narcotics Control Board for 2020 [Internet].2021[cited 2021 Jul 15]. Available from:https:\/\/www.incb.org\/incb\/en\/publications\/annual-reports\/annual-report-2020.html"},{"key":"e_1_2_8_16_1","unstructured":"United Nations Office on Drugs and Crime.World Drug Report 2021 [Internet].2021[cited 2021 Jul 15]. United Nations: Office on Drugs and Crime. Available from:https:\/\/www.unodc.org\/unodc\/en\/data-and-analysis\/wdr2021.html"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.668"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/03610910903168603"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmva.2007.07.002"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0221153"},{"key":"e_1_2_8_21_1","unstructured":"ANSM.Etat des lieux de la consommation des antalgiques opio\u00efdes et leurs usages probl\u00e9matiques [Internet].2019Feb. Available from:ansm.sante.fr\/uploads\/2020\/10\/19\/20201019-rapport-antalgiques-opioides-fev-2019-3-pdf-2019-03-06.pdf"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1291"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.5459"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/20494637211013052"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16081","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.16081","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T16:18:27Z","timestamp":1692289107000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.16081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,22]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1111\/add.16081"],"URL":"https:\/\/doi.org\/10.1111\/add.16081","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,22]]},"assertion":[{"value":"2022-04-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}