ASOS, a national monitoring study to assess narcotic prescriptions and indications in France since 2001

Analgesics are among the most widely used drugs worldwide. The French Addictovigilance Network (FAN) established the antalgiques stupéfiants et ordonnances sécurisées (ASOS [narcotic analgesics and secure prescriptions]) survey in order to assess the dissemination of tamper-resistant prescription forms for narcotic analgesic within the medical community, as well as the nature and evolution of the prescriptions. After outlining the missions of the FAN, this article will describe the population treated with narcotic analgesics in France, their therapeutic indications and how the data have evolved since 2007.

A cross-sectional, national, multicentre survey study was conducted that included surveys taken every year from 2007 to 2023 in a national sample of 1500 randomly selected dispensing pharmacies.

The mean age of patients, mostly women (around 60%), remained stable over the study period (63.2years in 2007, 67.6years in 2023). Most prescriptions involved morphine, oxycodone and fentanyl. Morphine and fentanyl were the reference molecules for prescribing opioid analgesics, but the sharp increase in oxycodone prescriptions between 2007 and 2015 impacted their usage. Cancer and rheumatologic pains were the main indications, with an increase in neurological indications in recent years. A focus on fentanyl and oxycodone highlights misuse patterns that are difficult to identify in other surveys.

This study demonstrates how narcotic opioids are prescribed in France, thanks to the active participation of health professionals, and confirms the striking increase in the prescription of oxycodone and the misuse of fentanyl.