Wastewater-based evaluation of the efficacy of oxycodone regulations in Australia.

Autor: Verhagen R; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia., Gerber C; Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, Australia., Thai PK; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia., Connor J; National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.; Discipline of Psychiatry, The University of Queensland, Herston, Australia., Loveday B; Healthcare Protection and Regulation Branch, Queensland Public Health and Scientific Services, Queensland Health, Australia., Bade R; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia., O'Brien J; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia., Jaunay EL; Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, Australia., Simpson BS; Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, Australia., Chan G; National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia., Hall W; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia.; National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia., Thomas KV; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia., Mueller JF; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia., Tscharke BJ; Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Australia.
Jazyk: angličtina
Zdroj: Addiction (Abingdon, England) [Addiction] 2024 Sep 11. Date of Electronic Publication: 2024 Sep 11.
DOI: 10.1111/add.16653
Abstrakt: Background and Aims: Between 2018 and 2020, Australia implemented major policy changes to improve the quality and safety of opioid prescribing, with a specific focus on oxycodone. This study used wastewater-based epidemiology to assess the efficacy of Australia's regulatory reforms by measuring change in consumption of oxycodone via exploratory analysis.
Design, Setting, Participants, Measurements: Wastewater analysis data on oxycodone consumption was from the National Wastewater Drug Monitoring Program. The program captures data from more than 50 wastewater treatment plant catchments across Australia, equivalent to more than 50% of the national population. Geographic trend analyses were conducted for both major cities and regional areas within all states and territories of Australia over a 6-year period between 2017 and 2023.
Findings: Oxycodone consumption showed a statistically significant increase nationally from 78 mg/day/1000 people (95% confidence interval [CI] = 71, 84) in 2017 to 120 mg/day/1000 people in August 2019 (95% CI = 110, 120), an increase of 52% (95% CI = 42, 62, P < 0.0001). From August 2019 to December 2020, there was a statistically significant decrease from 120 to 65 mg/day/1000 people (95% CI = 60, 71), a decrease of 45% (95% CI = 40, 51), followed by a modest 2.4% increase to the end of the study period in April 2023 (95% CI [2.0,2.7]).
Conclusions: A 45% reduction in oxycodone consumption in Australia from 2019 to 2020 coincided with national policy changes that aimed to reduce consumption of prescription opioids. The overall declining trend in consumption was suggestive of the effectiveness of national interventions in reducing pharmaceutical opioid use. Wastewater-based epidemiology provides an effective approach for assessing the effectiveness of controlled substances policy changes.
(© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
Databáze: MEDLINE
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