Women and pharmacology: Drugs and genderAddictovigilance in women, the hidden part of the iceberg?
Section snippets
Abbreviations
- ASOS
Antalgiques stupéfiants et ordonnances sécurisées
- DRAMES
Décès en relation avec l’abus de médicaments et de substances
- EMCDDA
European Monitoring Centre for Drugs and Drug Addiction
- GHB
gamma hydroxybutyrate
- ICSR
individual case safety report
- MDMA
midoamfetamine (3,4-MethyleneDioxy-N-MethylAmphetamine)
- NPS
new psychoactive substances
- N2O
nitrous oxide
- OPPIDUM
Observatoire des produits psychotropes illicites ou détournés de leur usage médicamenteux
- OSIAP
Ordonnances suspectes indicateur d’abus possible
- SMQ
Addictovigilance monitoring
The French Addictovigilance Network was set up in the 1990s, in order to benefit from a proactive vigilance system targeted at substances with potential for abuse and dependence (except tobacco and alcohol), and to participate in a proactive and coordinated manner in the activities of the WHO expert committee on drug dependence. This specific drug and substance safety monitoring is based on spontaneous reporting by healthcare professionals of any serious case of misuse, abuse and drug
Panorama of addictovigilance reporting according to sex for the period 2020–2022
In order to provide some evidence about differences and similarities between women and men regarding reporting of abuse and dependence to drugs, we have examined information recorded in the WHO international pharmacovigilance database. This database named Vigibase® is the largest database of its kind in the world, with over 30 million reports of suspected adverse effects of medicines, submitted, since 1968, by member countries of the WHO's Program for International Drug Monitoring. It is
Prescription drug diversion
After an initial period of pilot studies in some areas, from 2001 onwards, the collection of suspect prescriptions has been performed by the French addictovigilance network, through the systematic periodic survey OSIAP. This survey provides relevant information about drug diversion along time as well as the profile of individuals who request these drugs with a potential of abuse [12], [13]. The first analysis at the national level exhibited different profiles of prescription drug diverters:
Nitrous oxide
It has been widely accepted for years that the incidental recreational use nitrous oxide (N2O) (“laughing gas”) elicits virtually no harm [56]. Recently, the French Addictovigilance Network raised the issue of the increase in serious health complications in parallel with the significant increase in non-medical use of N2O in France. These unexpected outcomes included severe neurological damage that occurred during the massive and/or prolonged consumption [57], [58]. From a first report of the
Conclusion
This panorama plaids for the necessary consideration of women in addictovigilance reviews. Substance use disorders are considered to be more frequent in men, consequently men predominate in most of studies investigating substance use disorders, with sex most often considered as a confounding factor. Investigating factors associated with unfavorable outcomes of substance use must be stratified on sex, allowing to identify women specificities. However, because of gender differences (women can be
Funding sources
This research work did not receive any specific financial support.
Disclosure of interest
The author declares that she has no competing interest.
Acknowledgments
The author would like to acknowledge all the contributors (many of them women) of the French addictovigilance network, who made it possible to collect this valuable information.
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