{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:32:44Z","timestamp":1793665964465,"version":"4.5.1"},"reference-count":53,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"unspecified","delay-in-days":171,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur. Psychiatr."],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0924933821022197_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Given the ongoing opioid crisis in the United States (US), we investigated the opioid situation in Europe. The aims of the study are to provide an overview of trends in prescription opioid (PO) use and opioid-related adversities between 2010 and 2018 for different opioids in 19 European countries and to present a comparison with similar data from the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0924933821022197_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multisource database study with national data from 19 European countries evaluating trends between 2010 and 2018 in (a) PO consumption, (b) high-risk (HR) opioid users, (c) opioid-related hospital admissions, (d) opioid-related overdose deaths, (e) opioid use disorder treatment entries, and (f) patients in opioid substitution therapy (OST). Within and between-country comparisons and comparisons with data from the US were made.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0924933821022197_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was considerable variation between European countries. Most countries showed increased PO consumption with the largest increase and the highest consumption in the United Kingdom (UK) compared to the rest of Europe and the US in 2018 (UK: 58,088 defined daily doses for statistical purposes\/1000 population\/day). In 2018, Scotland had the highest rates (per 100,000 population) of HR opioid users (16\u00b72), opioid-related hospital admissions (118), opioid-related deaths (22\u00b77), opioid use disorder treatment admissions (190), and OST patients (555) of all included European countries. These rates were similar or even higher than those in the US in 2018. Other countries with high rates of opioid-related adversities were Northern Ireland (synthetic and \u201cother\u201d opioids), Ireland (heroin and methadone), and England (all opioids). All other countries had no or little increase in opioid-related adversities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0924933821022197_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Apart from the British Isles and especially Scotland, there is no indication of an opioid crisis comparable to that in the US in the 19 European countries that were part of this study. More research is needed to identify drivers and develop interventions to stop the emerging opioid crisis in the UK and Ireland.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/j.eurpsy.2021.2219","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T04:11:44Z","timestamp":1624248704000},"source":"Crossref","is-referenced-by-count":129,"title":["Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018"],"prefix":"10.1192","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9243-5559","authenticated-orcid":false,"given":"Mimi","family":"Pierce","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8847-4387","authenticated-orcid":false,"given":"Jan","family":"van Amsterdam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7858-7153","authenticated-orcid":false,"given":"Gerard A.","family":"Kalkman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnt","family":"Schellekens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"van den Brink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"S0924933821022197_r23","volume-title":"Narcotic drugs 2017 \u2013 estimated world requirements for 2018","year":"2018"},{"key":"S0924933821022197_r49","unstructured":"49. European Monitoring Centre for Drugs and Drug Addiction. Take home naloxone [Internet]; 2020 [cited 2020 Jun 2], https:\/\/www.emcdda.europa.eu\/publications\/topic-overviews\/take-home-naloxone_en#"},{"key":"S0924933821022197_r17","volume-title":"Statistical bulletin 2018 \u2013 methods and definitions for problem drug use","year":"2018"},{"key":"S0924933821022197_r29","unstructured":"29. Scotland NHS (NHS). Methadone patient analysis 2011\/12\u20132018\/19. Information Services Division; 2019."},{"key":"S0924933821022197_r5","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm675152e1"},{"key":"S0924933821022197_r42","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-03026-4"},{"key":"S0924933821022197_r10","volume-title":"European drug report 2019: trends and developments","year":"2019"},{"key":"S0924933821022197_r16","volume-title":"Rapid communication: Drug-related deaths and mortality in Europe: Technical report: Drug-related hospital emergency presentations in Europe: update from the Euro-DEN Plus expert network","year":"2020"},{"key":"S0924933821022197_r21","unstructured":"21. European Monitoring Centre for Drugs and Drug Addiction. Reitox network of national focal points [Internet]; 2020 [cited 2020 Jun 3], https:\/\/www.emcdda.europa.eu\/about\/partners\/reitox_en"},{"key":"S0924933821022197_r46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jflm.2012.04.023"},{"key":"S0924933821022197_r31","volume-title":"Treatment demand indicator (TDI) standard protocol 3.0","year":"2012"},{"key":"S0924933821022197_r20","volume-title":"Narcotic drugs 2019 \u2013 estimated world requirements for 2020","year":"2020"},{"key":"S0924933821022197_r32","first-page":"3","article-title":"Chronology of direct-to-consumer advertising regulation in the United States","volume":"23","author":"Mogull","year":"2008","journal-title":"AMWA J"},{"key":"S0924933821022197_r38","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102877"},{"key":"S0924933821022197_r39","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30209-3"},{"key":"S0924933821022197_r44","first-page":"215","article-title":"Problem opioid use in the Czech Republic from a historical perspective: times are changing but opioid pharmaceuticals remain","volume":"18","author":"Malinovska","year":"2018","journal-title":"Adiktologie"},{"key":"S0924933821022197_r40","article-title":"Drivers of the opioid crisis in Scotland. A comparison across Great Britain","author":"van Amsterdam","journal-title":"Eur Addict Res"},{"key":"S0924933821022197_r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2015.04.003"},{"key":"S0924933821022197_r30","unstructured":"30. Information Services Division (ISD). Prevalence of problem drug use in Scotland 2015\/16 estimates; 2019."},{"key":"S0924933821022197_r27","volume-title":"Country drug reports 2019","year":"2019"},{"key":"S0924933821022197_r41","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-020-01205-y"},{"key":"S0924933821022197_r50","volume-title":"Drug-related deaths in Sweden","author":"Leifman","year":"2016"},{"key":"S0924933821022197_r25","volume-title":"Narcotic drugs 2013 \u2013 estimated world requirements 2014","year":"2014"},{"key":"S0924933821022197_r2","first-page":"1487","article-title":"Vital signs: overdoses of prescription opioid pain relievers \u2013 United States, 1999\u20132008","volume":"60","author":"Paulozzi","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0924933821022197_r4","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"S0924933821022197_r6","unstructured":"6. United Nations. World drug report [Internet]. United Nations Publication; 2019 [cited 2020 Apr 25], https:\/\/wdr.unodc.org\/wdr2019\/prelaunch\/WDR19_Booklet_3_DEPRESSANTS.pdf"},{"key":"S0924933821022197_r8","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000789"},{"key":"S0924933821022197_r33","unstructured":"33. Cozens, C . Europe rejects drug advertising. The Guardian. 2002 Oct 23. ISSN 0261-3077."},{"key":"S0924933821022197_r26","volume-title":"Narcotic drugs 2011 \u2013 estimated world requirements 2012","year":"2012"},{"key":"S0924933821022197_r37","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30373-X"},{"key":"S0924933821022197_r3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.2174\/187447370801150611184218","article-title":"The misuse of prescription opioids: a threat for Europe?","volume":"8","author":"van","year":"2015","journal-title":"Curr Drug Abuse Rev"},{"key":"S0924933821022197_r1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6911a4"},{"key":"S0924933821022197_r11","unstructured":"11. Barnsdale, L , Gounari, X , Graham, L. The national drug-related deaths database (Scotland) report; 2018."},{"key":"#cr-split#-S0924933821022197_r19.1","unstructured":"19. WHO Collaborating Centre for Drug Statistics Methodology. ATC\/DDD index 2020 [Internet]"},{"key":"#cr-split#-S0924933821022197_r19.2","unstructured":"2020 [cited 2020 May 10], https:\/\/www.whocc.no\/atc_ddd_index\/"},{"key":"S0924933821022197_r34","unstructured":"34. European Drug Report 2017. Drug use prevalence and trends: synthetic opioids: increasingly seen in high-risk opioid use. [Internet]. European Monitoring Centre for Drugs and Drug Addiction; 2017 [cited 2021 April 20], https:\/\/www.emcdda.europa.eu\/publications\/edr\/trends-developments\/2017\/html\/prevalence-trends\/synthetic-opioids_en"},{"key":"S0924933821022197_r45","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-018-0268-0"},{"key":"S0924933821022197_r47","volume-title":"Drug-related deaths and mortality in Europe","year":"2019"},{"key":"S0924933821022197_r48","volume-title":"Technical report: Drug-related hospital emergency presentations in Europe: update from the Euro-DEN Plus expert network","year":"2020"},{"key":"S0924933821022197_r12","volume-title":"European drug report: trends and developments","year":"2019"},{"key":"S0924933821022197_r51","volume-title":"European drug report: trends and developments","year":"2017"},{"key":"S0924933821022197_r18","unstructured":"18. European Monitoring Centre for Drugs and Drug Addiction. Guidelines for the prevalence of problem drug use (PDU) key indicator at national level [Internet]; 2004 [cited 2020 Jun 6], https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/321\/Guidelines_Prevalence_Revision_280704_b-1_124620.pdf"},{"key":"S0924933821022197_r7","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30128-8"},{"key":"S0924933821022197_r22","unstructured":"22. Correlation Network. Correlation network focal points [Internet]; 2020 [cited 2020 Jun 3], https:\/\/www.correlation-net.org\/focal-points\/"},{"key":"S0924933821022197_r9","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1337"},{"key":"S0924933821022197_r52","doi-asserted-by":"publisher","DOI":"10.1159\/000506630"},{"key":"S0924933821022197_r28","unstructured":"28. Public Health England (PHE). Substance misuse treatment for adults: statistics 2018 to 2019. Statistics on alcohol and drug misuse treatment for adults from PHE\u2019s National Drug Treatment Monitoring System (NDTMS) [Internet]. National Statistics; 2019 [cited 2020 Apr 13], https:\/\/www.gov.uk\/government\/publications\/substance-misuse-treatment-for-adults-statistics-2018-to-2019\/adult-substance-misuse-treatment-statistics-2018-to-2019-report"},{"key":"S0924933821022197_r24","volume-title":"Narcotic drugs 2015 \u2013 estimated world requirements 2016","year":"2016"},{"key":"S0924933821022197_r43","volume-title":"Drug situation in the Czech Republic in 2018","author":"Mrav\u010d\u00edk","year":"2020"},{"key":"S0924933821022197_r15","volume-title":"Rapid communication: drug-related deaths and mortality in Europe: update from the EMCDDA expert network","year":"2019"},{"key":"S0924933821022197_r14","volume-title":"European drug report 2018: trends and developments","year":"2018"},{"key":"S0924933821022197_r35","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.802"},{"key":"S0924933821022197_r36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60232-2"}],"container-title":["European Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0924933821022197","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T08:24:03Z","timestamp":1627374243000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0924933821022197\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021]]}},"alternative-id":["S0924933821022197"],"URL":"https:\/\/doi.org\/10.1192\/j.eurpsy.2021.2219","relation":{},"ISSN":["0924-9338","1778-3585"],"issn-type":[{"value":"0924-9338","type":"print"},{"value":"1778-3585","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]},"article-number":"e47"}}