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Definitions related to the use of pharmaceutical opioids: Extramedical use, diversion, non-adherence and aberrant medication-related behaviours.
MedLine Citation:
PMID:  21545553     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aims. This paper (i) reviews the language used to describe and manage those patient practices that fall outside standard medical models of opioid treatment (for pain and opioid dependence), and (ii) proposes a consistent terminology that can be applied across multiple healthcare settings. Method. Peer-reviewed and grey literature documenting empirical studies of (non-)adherence with opioid treatment, proposed definitions or other potentially important aspects of terminology were included in this review. Results. There are international inconsistencies in the terminology used to describe the unintended consequences of opioid treatment, and the terms used often lack specificity. The terms 'hazardous use', 'extramedical use', 'opioid dependence', 'diversion', 'non-adherence' and 'aberrant behaviours' are defined. We advocate for consistent application of these terms in the context of opioid treatment, and propose that care is taken to describe individual practices and intentions. Conclusions. The increasing global attention on the use and diversion of pharmaceutical opioids warrants a discussion of current terms and definitions. Exaggerated concerns regarding 'addiction potential' may result in restrictions in the supply of opioids and the under-treatment of legitimate medical conditions. Researchers, clinicians, policy-makers and patients need to ensure greater care is given to terminology, including detailed descriptions of patient practices, the context in which they occur and severity of associated harm.[Larance B, Degenhardt L, Lintzeris N, Winstock A, Mattick R. Definitions related to the use of pharmaceutical opioids: Extramedical use, diversion, non-adherence and aberrant medication-related behaviours. Drug Alcohol Rev 2011;30:236-245].
Authors:
Briony Larance; Louisa Degenhardt; Nick Lintzeris; Adam Winstock; Richard Mattick
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Drug and alcohol review     Volume:  30     ISSN:  1465-3362     ISO Abbreviation:  Drug Alcohol Rev     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9015440     Medline TA:  Drug Alcohol Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  236-45     Citation Subset:  IM    
Copyright Information:
© 2011 Australasian Professional Society on Alcohol and other Drugs.
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia Burnet Institute, Melbourne, Australia Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia The Langton Centre, South East Sydney and Illawarra Area Health Service, Sydney, Australia Faculty of Medicine, University of Sydney, Sydney, Australia Addictions, Kings College London, London, UK.
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