Mitchell, C. orcid.org/0000-0002-4790-0095, Dolan, N. and Dürsteler, K.M. (2020) Management of dependent use of illicit opioids. BMJ, 2020 (368). m710. ISSN 1759-2151
Abstract
Use of illicit opioids, most commonly heroin, has a wide ranging impact on individuals and society. It may lead to dependence, which is best conceptualised using a “chronic disease” model: effective treatments are available, but illness is often characterised by relapses, remissions, and risk of premature death.
Across Europe, four trends are noteworthy: a decline in the use of intravenous heroin, a rise in the use of high potency synthetic opioids (for example, fentanyl), a rise in opioid related deaths, and an increase in the number of long term opioid users aged over 40. The widely reported “epidemic” of opioid associated deaths in the US and Canada is also of global concern and has been attributed to under-regulated medical prescribing of high potency synthetic opioids and a growth in internet supply chains. Concurrent use of other substances, for example, alcohol, cocaine, benzodiazepines, neuropathic agents, and novel drugs such as “spice,” increases the risk of adverse outcomes of opioid use in all settings.
In this review we describe an evidence based collaborative approach to caring for people who are dependent on illicit opioids (heroin or synthetic opioids that have been obtained illegally, against custom, and used harmfully) and who seek help for their dependence.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The Authors. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-NonCommercial 4.0 International (http://creativecommons.org/licenses/by-nc/4.0/). |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) |
Funding Information: | Funder Grant number National Institute for Health Research N/A |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 16 Mar 2020 11:17 |
Last Modified: | 18 Mar 2020 11:43 |
Status: | Published |
Publisher: | BMJ Publishing Group |
Refereed: | Yes |
Identification Number: | 10.1136/bmj.m710 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:158448 |