Misuse of psychoactive medicines and its consequences in the European Union - a scoping review

BackgroundMedicines acting on the central nervous system can be inappropriately used. The aim of this study was to clarify the key concepts on misuse of prescription medicines, mapping the existing body of evidence on this topic in the European Union and identifying the main medicines misused, risk factors, and morbidity/mortality consequences of this behavior.MethodsThree databases - PubMed, Scopus, and Web of Science - were searched. Retrieved articles were added to other studies previously identified from additional sources (e.g., PubMed alerts). Following the PRISMA-ScR flow diagram, the final list was screened for article selection.ResultsA total of 1,637 abstracts were reviewed, resulting in the inclusion of 136 articles. Most studies reported misuse of prescription opioids (66%), benzodiazepines/z-drugs, gabapentinoids, and antidepressants. Risk factors included history of substance use/addiction, mental health or alcohol disorders, female sex, older age, low income/deprivation, and psychoactive substance concomitant use. The main consequences addressed were adverse drug reactions, poisonings, emergency visits, and deaths.ConclusionsThe medicines with highest potential misuse were opioids, benzodiazepines/z-drugs, and gabapentinoids. The considerable variety of data among EU countries suggests the need to invest in systematic centralized research to identify and understand prescription drug misuse at country-level across the EU.