Retrospective cross-sectional study of the evolution of the use of pharmacological opioids and heroin in a population group in the Barcelona area

Opioid dependence is causing an epidemic in the US, but unlike the 1970s it seems more related to prescription opioids than heroin.The objective of this study is to assess whether this new epidemic has already reached our environment and to see if there are changes in consumption and in the characteristics of consumers.Retrospective cross-sectional study. 1,140 patients were included between 2012 and 2019, 633 of whom were first visits to Drug Addiction Care and (CAS) Monitoring Centers, 502 corresponding to emergency room visits for problems related to overdose or withdrawal of heroin or opioids with prescription, and the remaining 5 are newborns of mothers addicted to heroin. Demographic data and characteristics of the substances of abuse were analyzed, comparing between partial periods.There was a global decrease in the first visits of patients to the CAS who reported heroin addiction (P=.001), while those addicted to pharmacy opioids have remained stable. There has been an irregular increase in total emergency visits, overdose consultations, and withdrawal consultations, both for heroin and prescription opioids (P=.062, P=.166 and P=.005, respectively). Opioid-related emergencies have been less frequent than for heroin. Non-Spanish European patients have increased compared to Spanish patients.There has been no worrying increase in heroin or prescription opioid abuse in our setting.