But what is going on in France with oxycodone? In its latest opinion, the French Society of Pharmacology and Therapeutics (SFPT) points to “a worrying increase in the use of oxycodone in the management of pain”. And this sounds like an alert to the ears of addiction specialists, who are trying to understand this unexpected increase.
Indeed, oxycodone is not a trivial drug. It’s the morphine-like painkiller behind the opioid crisis that has plagued the United States since the 2000s. Across the Atlantic, the vast majority of people addicted to opioids have one thing in common: they first used oxycodone – marketed as OxyContin – on the advice of their doctor as part of prescriptions to relieve their pain.
It is in this context that the SFPT is concerned about a 25% increase in prescriptions between 2017 and 2021 in New Aquitaine. The figures are impressive: in 2021, the region had more than 900 users per 100,000 inhabitants, twice as many as the French average (460 per 100,000) in the same year. Brittany is breaking all records with a rate of 1,255 users per 100,000 inhabitants.
“You see an east-west gradient in prescriptions. In the Lyon region, oxycodone prescriptions are, for example, well below the national average with around 200 users per 100,000 inhabitants. But the closer we get to the Atlantic, the more the rates increase, “explains Professor Nicolas Authier, psychiatrist, specializing in pharmacology and addictology at the University Hospital of Clermont-Ferrand, head of the Pain Assessment and Treatment Center. .
In total in France, approximately 300,000 French people receive at least one prescription for oxycodone in the year. For comparison, this figure is 400,000 for morphine. Between 2012 and 2018, the country saw an increase in oxycodone prescriptions primarily for non-cancer chronic pain indications.
“However, the evidence for efficacy is weakest and risk highest in classic cases of chronic pain such as those related to knee or hip osteoarthritis, neuropathies or chronic low back pain. By dint of using the drug, he walks less and less well, the patient takes more and more and it is more and more difficult to stop it, ”continues Professor Authier. Since 2018, the message seems to have passed on this type of prescription and the figures have stabilized… except in the West.
But why would New Aquitaine or Brittany be so fond of oxycodone? Professor Authier mentions the path of “university or continuing medical training which differs in these regions and which leads to stronger local prescription habits”. The addictologist also evokes the hypothesis of a “greater efficiency of the sales forces of the pharmaceutical laboratory” in these territories, encouraging to increase prescriptions. For his part, Dr Jean-Michel Delile, president of the Addiction federation, points out that “the Aquitaine region is known to have seized the treatment of pain in a very active way. This surely partly explains these figures far above the average.
But we are very far from an American situation. “For 7 or 8 years, we have been receiving patients who lose control with oxycodone, underlines Jean-Michel Delile. Their profiles are very different from other patients. They often belong to the middle or upper classes, they are often very socially integrated women. If the number of cases has increased a little, there is no general alert at all. »
The consumption of oxycodone and morphine remains below the so-called “weak” opioids, in the forefront of which is tramadol. Much easier to access, its prescription has increased significantly in recent years to reach more than 7 million consumers in 2021.
