Slow-release oral morphine sulfate abuse: results of the postmarketing surveillance systems for psychoactive prescription drug abuse in France.

Background: Few data are available concerning the diversion and abuse of morphine sulfate. In France, morphine sulfate abuse is currently investigated by the health authorities. The aim of our study was to provide data on morphine sulfate abuse in France, collected during the period 1996-2011.

Methods: The French monitoring system for psychoactive medication abuse collected data from several sources: spontaneous reporting of cases of abuse or dependence (NotS; 'Notifications Spontanées'), specific periodic surveys from specialized care centers (OPPIDUM; 'Observation des Produits Psychotropes Illicites ou Détournés de leur Utilisation Médicamenteuse'), and community pharmacists (OSIAP; 'Ordonnances Suspectes Indicateur d'Abus Possible').

Results: A total of 649 cases (75% men, median age: 34 years) were spontaneously reported: 578 cases of abuse and 71 cases of use as opiate maintenance treatment. The medication formulation was Skenan(®) (614 cases), and Moscontin(®) (35 cases). All surveys (NotS, OPPIDUM, and OSIAP) showed an overrepresentation of Skenan(®) (87.9-94.6% of cases) that was intravenously injected in 60.4-61.2% of the cases. Data analysis showed that patients abusing morphine sulfate have a long history of drug abuse and a history of polydrug use.

Conclusion: All the data presented in this study highlight the level of morphine sulfate abuse, specify the modalities of use (intravenous route), and show the risks associated with abuse (infectious diseases). This study outlines the usefulness of our epidemiological tools, and provides evidence supporting intensive surveillance.