Monitoring Opioids in Europe: The Need for Shared Definitions and Measuring Drivers of Opioid Use and Related Harms

The past 20 years, the USA is facing a serious opioid crisis initiated by an increase in prescription opioid use. Europe has also seen an increase in prescription opioid use, but the extent of related harm is still largely unknown. Given the impact of the US opioid epidemic, it is important to closely monitor signs of emerging opioid-related problems to guarantee early warnings and timely actions. Shared and meaningful definitions for opioid use and related harms, and relevant information about specific drivers for opioid use and related problems are needed for an adequate policy response. In this commentary, we discuss these definitions, the need to know more about the specific drivers for increased opioid use, its related harm, and proposals for strategies to move forward. Policy recommendations include making a distinction between licit and illicit opioids when monitoring and reporting on opioid-related harm, and using oral morphine equivalents to quantify prescription opioid use in a clinically relevant and comparable manner. A major topic of further research is exploring unique and universal drivers of prescription opioid (mis)use across Europe, in particular the role of opioid diversion.

Automated summary

Over the past 20 years, both the USA and Europe have faced an increase in prescription opioid use, leading to a serious crisis. While the extent of harm in Europe is largely unknown, it is important to monitor emerging opioid-related problems closely to take timely actions. This commentary highlights the need for shared definitions of opioid use and harms, understanding the specific drivers for increased use and related problems, and proposing strategies for further action. Policy recommendations include distinguishing between licit and illicit opioids in monitoring and reporting, as well as using oral morphine equivalents to quantify prescription opioid use. Further research is needed to explore the unique and universal drivers of prescription opioid use, particularly the role of opioid diversion.