Trends in the consumption of opioids for the treatment of severe pain in Europe, 1990–2016

Background: Over the last decades, consumption of opioids for the treatment of pain increased steadily in the United States, Australia, and a few European countries. To date, no study has analysed time trends in opioid consumption across Europe. Methods: We analysed data provided by International Narcotics Control Boards on the consumption of fentanyl, oxycodone, morphine, hydromorphone and pethidine in 40 European countries over the last decade. Trends in total opioid consumption from 1990 to 2016 in 22 selected European countries, the European Union (EU) as a whole, and, for comparison purpose, the United States, were analysed using the joinpoint regression analysis. Results: In 2014\u20132016, opioid use was >10,000 defined daily doses for statistical purposes (s-DDD) per 1,000,000 inhabitants die in Western/Northern countries, whereas it was <1000 s-DDD in Southern/Eastern ones. In most European countries, opioid consumption increased to a great extent between 2004\u20132006 and 2014\u20132016; it rose from 6,477 to 8,967 s-DDD (+38.4%) in the EU, and from 14,598 to 16,491 s-DDD (+13%) in the United States. The increase in opioid use was steady since the early to mid-1990s in most European countries and it slowed down after the mid- to late 2000s. In Denmark, Finland, France, Ireland, Switzerland, Poland and the EU, opioid use levelled off or declined over most recent years. Conclusions: Consumption of opioid analgesics sharply increased in most of European countries since the early to mid-1990s. This notwithstanding, in the mid-2010s there was still a more than 10-fold difference between the highest consumption in Western/Northern countries and the lowest one in Southern/Eastern countries. Significance: This study provides an updated and comprehensive analysis of time trends and geographic variations in opioid consumption use across European countries over the last three decades

Prevention of COVID-19 transmission from deceased subject: A critical point of view

On December 31, 2019, China reported to the WHO cases of pneumonia in Wuhan caused by a novel coronavirus (2019-nCoV). This escalated into an unprecedented outbreak of infections, leading the WHO to characterise it as a pandemic on March 11, 2020. The COVID-19 pandemic is rapidly evolving, and since October 9, 2021, almost 200000000 people have been infected with more than 4000000 deaths globally [1]. To reduce transmission and mortality, efforts have been made to develop vaccines against COVID-19. Since December 2020, new vaccines have been authorized to help control the spread of the virus [2]. Despite the vaccination campaign progressing successfully, our battle is not yet won, and avoiding exposure to this virus is crucial to preventing COVID-19. Person-to-person transmission occurs primarily via direct contact or through droplets spread by the infected individual coughing or sneezing [3-5]. Although the infection rate from dead bodies is unclear [4], managing them is of great importance in reducing viral transmission, especially because mortuary staff and pathologists will be exposed to potentially infective materials from cadavers, transmitted through airways, body bags, autopsy tables, and autopsy room walls [4,6]. For this reason, many societies, institutes, and governments have given general infection and prevention advice. This viewpoint aims to summarize how different countries manage the COVID-19 dead and perform autopsies and whether common prevention recommendations can be identified. The PubMed database was searched until October 9, 2021. We used keywords for: deceased covid 19, management of death covid 19, autopsy covid 19 ((deceased covid 19) AND management of death covid 19) AND autopsy covid 19). The selected articles’ references were also screened. Only documents in English were included, while reviews were excluded