Watch out for the rise in oxycodone in some areas. This is the meaning of the message from Francesco Salvo, head of the pharmacovigilance center at the Bordeaux University Hospital, who is worried about a 25% increase in prescriptions for this opioid between 2017 and 2021 in New Aquitaine. There are now 950 consumers there per 100,000 inhabitants, twice as many as the French average (460 per 100,000) in 2021, according to a photograph by the French Society of Pharmacology and Therapeutics (SFPT). The rate is even higher in Brittany, with 1,255 consumers per 100,000 inhabitants. There seems to be an east-west gradient.
In the United States, where it has been marketed since 1996 under the name of OxyContin by the American firm Purdue Pharma, this powerful analgesic is in principle, like morphine, reserved for intense pain resistant to other treatments, especially in cancers. But deviations in the prescriptions have been the cause of hundreds of thousands of deaths.
In France, the consumption of oxycodone certainly increased by 738% between 2006 and 2017, especially in non-cancer pain, according to the Inserm Neuro-Dol team and the French Observatory of Analgesic Medicines. But the number of patients treated with this strong opioid was 310,000 in 2021, or 0.46% of the population. “Oxycodone remains in the viewfinder, like other opioids, of course, but data from 2021 and 2022 show that the increase is limited, from 1% to 2% on average in the territory since 2017”confirms Maryse Lapeyre-Mestre, head of the evaluation and information center on drug dependence-addictovigilance in Toulouse.
An addictogenic profile
However, the SFPT alerted itself, in a press release on May 22progress in recent years, and above all recalled “that there is no argument to prefer the first prescription of oxycodone over morphine”.
Oxycodone has “a more significant and lasting dopaminergic action than morphine, which could be associated with a more addictogenic profile. In addition, it is likely to give drug interactions”also prevents SFPT.
“We must go further in the analysis of these data, by looking in New Aquitaine if there are fewer morphine prescriptions, whether or not it concerns cancer or if these are single prescriptions”tempers Nicolas Authier, addictologist psychiatrist at Clermont-Ferrand University Hospital.
More generally, opioid analgesics are closely monitored in France, due to the risk of abuse, dependence and death, as indicated a report from the National Agency for the Safety of Medicines and Health Products in 2019. The Haute Autorité de santé recently produced recommendations on these analgesics, which are useful to relieve certain pains (cancer, postoperative, traumatic). But “the first postoperative prescription should not exceed fourteen days, and no more than three to five days after a visit to the emergency room”.
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