SWITCH TO STRONG OPIOIDS IN CHRONIC OPIOID USERS: ANALYSIS OF THE FRENCH NATIONAL HEALTH INSURANCE DATABASE. THE FRANTALGIC STUDY

Background and aims
In the midst of the "opioid" epidemic in America, question is raised about the risk of such an epidemic in Europe. The aim of the FRANTALGIC study is to identify the characteristics of chronic opioid users (COU) in particular the distinction between non-cancer and cancer pain, and treatments' trajectories.
Methods
Retrospective cohort study from the generalist sample of beneficiaries (EGB) of the French national healthcare insurance. The EGB is a representative sample of the French adult population. Subjects initiating weak or strong opioid from 2012 to 2015 and being issued at least 6 consecutive months of treatment were selected and followed for 2years or until death. These preliminary results describe the first switch of treatment in the cohort.
Results
A cohort of 2,081 patients (0.5% of the EGB) COU was found of which 14.8% with cancer. Mean age and women distribution were respectively in the non-cancer (NCG) group 61.4years and 60.3% and 66.6years and 50.5% in the cancer group (CG). At inclusion 93.8% of the CG and 96.9% of the NCG patients received a weak opioid.
If 82.6% and 59% of the NCG and CG patients kept weak opioids, an intensification from weak to strong opioids is observed for 14.3% and 34.9%, respectively.
Conclusions
In patients under chronic opioid therapy, more than 14% have an intensification of treatment in non-cancer pain after already 6 months of weak opioid treatment. The upcoming survival analysis and patients' characterization will provide new insights about treatment trajectories.