Estudio transversal retrospectivo de la evolución del consumo de opioides farmacológicos y de heroína en un grupo poblacional del área de Barcelona / Retrospective cross-sectional study of the evolution of the use of pharmacological opioids and heroin in a population group in the Barcelona area

Antecedentes: La dependencia de opioides está causando una epidemia en Estados Unidos, pero, a diferencia de la de los años setenta, parece más relacionada con los opioides de prescripción que con la heroína.ObjetivosEl objetivo de este estudio es evaluar si esta nueva epidemia ha llegado ya a nuestro medio y ver si hay cambios en el consumo y en las características de los consumidores.Pacientes y métodosEstudio transversal retrospectivo. Se incluyeron 1.140 pacientes entre el periodo 2012 y 2019, 633 de los cuales fueron primeras visitas a Centros de Atención y Seguimiento a las drogadicciones (CAS), 502 corresponden a visitas en urgencias por problemas relacionados con sobredosis o abstinencia de heroína o de opioides con receta, y los 5 restantes son recién nacidos de madres adictas a la heroína. Se analizaron los datos demográficos y las características de las sustancias de abuso, comparándose entre períodos parciales.ResultadosSe produjo una disminución global de las primeras visitas de pacientes a los CAS que referían adicción a la heroína (p=0,001), mientras que los adictos a los opioides de farmacia se han mantenido estables. Ha habido un aumento irregular del total de urgencias, consultas por sobredosis y por abstinencia, tanto de heroína como de opioides con receta (p=0,062, p=0,166 y p=0,005, respectivamente). Las urgencias relacionadas con opioides han sido menos frecuentes que las relacionadas con heroína. Los pacientes europeos no españoles han aumentado respecto los españoles.ConclusiónNo se ha producido un aumento preocupante del abuso de heroína ni de opioides con receta en nuestro medio. (AU)

Background: Opioid dependence is causing an epidemic in the US, but unlike the 1970s it seems more related to prescription opioids than heroin.ObjectivesThe objective of this study is to assess whether this new epidemic has already reached our environment and to see if there are changes in consumption and in the characteristics of consumers.Patients and methodsRetrospective cross-sectional study. 1,140 patients were included between 2012 and 2019, 633 of whom were first visits to Drug Addiction Care and (CAS) Monitoring Centers, 502 corresponding to emergency room visits for problems related to overdose or withdrawal of heroin or opioids with prescription, and the remaining 5 are newborns of mothers addicted to heroin. Demographic data and characteristics of the substances of abuse were analyzed, comparing between partial periods.ResultsThere was a global decrease in the first visits of patients to the CAS who reported heroin addiction (P=.001), while those addicted to pharmacy opioids have remained stable. There has been an irregular increase in total emergency visits, overdose consultations, and withdrawal consultations, both for heroin and prescription opioids (P=.062, P=.166 and P=.005, respectively). Opioid-related emergencies have been less frequent than for heroin. Non-Spanish European patients have increased compared to Spanish patients.ConclusionThere has been no worrying increase in heroin or prescription opioid abuse in our setting. (AU)

[Retrospective cross-sectional study of the evolution of the use of pharmacological opioids and heroin in a population group in the Barcelona area]. / Estudio transversal retrospectivo de la evolución del consumo de opioides farmacológicos y de heroína en un grupo poblacional del área de Barcelona.

BACKGROUND: Opioid dependence is causing an epidemic in the US, but unlike the 1970s it seems more related to prescription opioids than heroin. OBJECTIVES: The objective of this study is to assess whether this new epidemic has already reached our environment and to see if there are changes in consumption and in the characteristics of consumers. PATIENTS AND METHODS: Retrospective cross-sectional study. 1,140 patients were included between 2012 and 2019, 633 of whom were first visits to Drug Addiction Care and (CAS) Monitoring Centers, 502 corresponding to emergency room visits for problems related to overdose or withdrawal of heroin or opioids with prescription, and the remaining 5 are newborns of mothers addicted to heroin. Demographic data and characteristics of the substances of abuse were analyzed, comparing between partial periods. RESULTS: There was a global decrease in the first visits of patients to the CAS who reported heroin addiction (P=.001), while those addicted to pharmacy opioids have remained stable. There has been an irregular increase in total emergency visits, overdose consultations, and withdrawal consultations, both for heroin and prescription opioids (P=.062, P=.166 and P=.005, respectively). Opioid-related emergencies have been less frequent than for heroin. Non-Spanish European patients have increased compared to Spanish patients. CONCLUSION: There has been no worrying increase in heroin or prescription opioid abuse in our setting.