{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:58:40Z","timestamp":1785473920572,"version":"3.56.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T00:00:00Z","timestamp":1647475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007281","name":"National Drug and Alcohol Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Tapentadol is a centrally acting opioid analgesic prescribed for the treatment of moderate to severe pain. The study aimed to determine the characteristics of Australian toxicity deaths related to tapentadol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All cases in which tapentadol use was coded contributory to death (<jats:italic>n<\/jats:italic>\u00a0=\u00a0159) were retrieved from the National Coronial Information System (1 July 2000\u201331 December 2020).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 48.5 (18\u201381) and 56% were female. Documented histories of problems with chronic pain (66%), mental health (60.4%), substance use (44%) and injecting drug use (23.3%) were common. The majority of deaths were deemed unintentional (76.1%) and in 18.9% pre\u2010existing disease was co\u2010contributory. The median peripheral blood tapentadol concentration was 1.00\u2009mg\u2009L<jats:sup>\u22121<\/jats:sup> (0.02\u201347.00), and the median aortic concentration was 2.05\u2009mg\u2009L<jats:sup>\u22121<\/jats:sup> (0.10\u201330.00). In all cases, psychoactive drugs other than tapentadol were also detected, most commonly antidepressants (72.3%), opioids (66.7%), hypnosedatives (64.2%) and gabapentinoids (43.4%). Of cases where autopsies were conducted, 27.7% were diagnosed with cardiomegaly and 18.5% with severe coronary artery stenosis. Pulmonary oedema (68.1%), aspiration of vomitus (39.5%) and acute pneumonia (26.9%) were common.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>The typical tapentadol\u2010related toxicity death involved unintentional death in the presence of multiple drugs, although a notable minority were intentional self\u2010harm. Multiple morbidities were common. The identification and characteristics of these cases indicate that the adverse event profile of tapentadol needs to be considered in the setting of polypharmacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13462","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T06:09:56Z","timestamp":1647583796000},"page":"1071-1077","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characteristics of fatal tapentadol\u2010related toxicity in Australia"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-7055","authenticated-orcid":false,"given":"Shane","family":"Darke","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Duflou","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"Sydney Medical School The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5705-2026","authenticated-orcid":false,"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Lappin","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"School of Psychiatry UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/03602532.2016.1229788"},{"key":"e_1_2_8_3_1","volume-title":"Disposition of toxic drugs and Chemicals in man","author":"Baselt RC","year":"2020"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S190162"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2011.611494"},{"key":"e_1_2_8_6_1","volume-title":"Tapentadol use and harms in Australia: analysis of opioid sales data and sentinel survey data from people who inject drugs","author":"Chrzanowska A","year":"2020"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.05.010"},{"key":"e_1_2_8_8_1","first-page":"51","article-title":"Fatal tapentadol poisoning \u2013 case study and literature review","volume":"121","author":"Giero\u0144 J","year":"2020","journal-title":"Probl Forensic Sci"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S190154"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0654-0"},{"key":"e_1_2_8_11_1","volume-title":"Goodman & Gilman's the pharmaceutical basis of therapeutics","author":"Brunton LL","year":"2017"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1196"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2018-0027"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098618760939"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2010.08.009"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028015604631"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/0022-3859.132341"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1310\/hpj5104-320"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2020.0604"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107697"},{"key":"e_1_2_8_21_1","first-page":"22","article-title":"New drug: tapentadol (Nucynta\u00ae)","volume":"34","author":"Anderson D","year":"2010","journal-title":"Toxtalk"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2016.08.020"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAF.0b013e3182887804"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1556-4029.2012.02299.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.904695"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bks041"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bky027"},{"key":"e_1_2_8_28_1","unstructured":"WineckerRE BrowerJO.Tapentadol in post\u2010mortem casework. 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