title: Detection of signals of abuse and dependence applying disproportionality analysis.
abstract: BACKGROUND
  Prescription drug abuse and dependence is a widespread phenomenon in many countries. The use of disproportionality measures in drug abuse surveillance is rarely performed.
  
  
  OBJECTIVE
  The aim of this study is to determine the occurrence of signals of abuse and dependence for different psychoactive drugs in real-life settings.
  
  
  METHODS
  Disproportionality analysis was realised from a database specifically constructed for the monitoring of drug abuse and dependence. This database provides information on approximately 5000 patients and 8000 consumption modalities for more than 100 distinct psychoactive medications for 2010 and 2011. Proportional reporting ratio (PRR) was computed in two population groups: subjects under an opiate maintenance treatment (OMT) versus those not under OMT, and focused on four types of behaviours: abuse and dependence, illegal acquisition, diverted route of administration and concomitant alcohol use.
  
  
  RESULTS
  Among the 100 psychoactive drugs for which a signal could be detected, those presenting the highest signals were the following: flunitrazepam, clonazepam, methylphenidate, ketamine, morphine sulfate, codeine and buprenorphine.
  
  
  CONCLUSIONS
  The present study shows an innovative application of disproportionality measures for drug abuse monitoring based on two cross-national, annual studies. The disproportionality analysis provided the opportunity to reveal and compare the magnitude of signals between 100 psychoactive drugs. This approach helps to compare the magnitude of abuse and dependence behaviours for a large number of drugs, and allows prioritizing actions in a context where such events are usually underreported.
authors.affiliation: Laboratoire de Santé Publique EA 3279, Faculté de Médecine Centre d'Evaluation de la Pharmacodépendance-Addictovigilance (CEIP-A) de Marseille (PACA-Corse) Associé, Aix Marseille Université, 27 Boulevard Jean Moulin, 13005, Marseille, France.
authors.forename: V
authors.initials: V
authors.lastname: Pauly
authors.forename: M
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.forename: D
authors.initials: D
authors.lastname: Braunstein
authors.forename: M
authors.initials: M
authors.lastname: Rueter
authors.forename: X
authors.initials: X
authors.lastname: Thirion
authors.forename: E
authors.initials: E
authors.lastname: Jouanjus
authors.forename: J
authors.initials: J
authors.lastname: Micallef
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D016208:Databases, Factual; D004333:Drug Administration Routes; D004363:Drug Utilization; D058999:Drug-Seeking Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000523:psychology
chemical_list: D011619:Psychotropic Drugs