Misuse, Abuse and Medication Errors' Adverse Events Associated with Opioids-A Systematic Review

Area of Science:

• Pharmacology
• Public Health
• Clinical Pharmacy

Background:

• Opioids are potent analgesics vital for pain management.
• Understanding non-therapeutic opioid use (abuse, misuse, errors) is critical for safety and efficacy.
• Adverse events stemming from these issues require systematic investigation.

Purpose of the Study:

• To systematically review and identify known adverse events associated with opioid abuse, misuse, and medication errors.
• To synthesize current knowledge on the scope and nature of harm from non-standard opioid use.

Main Methods:

• Systematic literature search across PubMed, Scopus, and EBSCO databases (inception to December 2023).
• Independent screening and data extraction by two reviewers, with third-reviewer arbitration.
• Risk of bias assessment using JBI critical appraisal tools.

Main Results:

• 34 studies were included from 934 initially screened articles.
• Included studies covered diverse populations (9 to 298,433 patients) across all demographics.
• Fentanyl, morphine, oxycodone, tramadol, and hydrocodone were commonly implicated in adverse events.

Conclusions:

• Opioids, especially fentanyl, morphine, and oxycodone, are frequently linked to preventable adverse drug reactions, abuse, and medication errors.
• Significant data heterogeneity presents challenges in drawing definitive conclusions.
• Robust preventative strategies and continued research are essential to mitigate opioid-related harm.