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En 2017, l’antalgique opioïde le plus consommé en France est le tramadol. Il est suivi de la codéine en association et de la poudre d’opium associée au paracétamol. Viennent ensuite la morphine, premier antalgique opioïde fort, l’oxycodone, à présent pratiquement autant consommé que la morphine, puis le fentanyl transdermique et transmuqueux à action rapide. Antidouleurs : les opioïdes liés à quatre décès par semaine en France, avertit l'Agence du médicament. Une meilleure information du patient lors d'une prescription d'antalgique paraît d'autre part indispensable aux yeux de l'ANSM, tout comme, lorsque cela est possible, la proposition d'alternatives pour diminuer les doses prescrites avec des pratiques telles que la psychothérapie, la kinésithérapie, l'hypnothérapie, l'acupuncture ou encore la sophrologie. Une nécessité alors que près de 20 millions de Français souffrent de douleurs chroniques rebelles aux traitements antalgiques conventionnels. La situation est sans commune mesure avec la catastrophe sanitaire qui sévit aux États-Unis et au Canada. Pourtant, la vigilance est de mise. D'après un rapport de l'Agence du médicament (ANSM) publié le 20 février, le nombre d'hospitalisations liées à la consommation d'opioïdes a presque triplé (+167%) en France entre 2000 et 2017, tandis que le nombre de décès a bondi de 146% entre 2000 et 2015, avec "au moins quatre décès par semaine", indique l'organisme. Si, pour Nathalie Richard, directrice adjointe des médicaments antalgiques et stupéfiants à l'ANSM interviewée par l'AFP, cette augmentation reflète en premier lieu une "amélioration de la prise en charge de la douleur" à partir du début des années 2000, elle n'en reste pas moins préoccupante. "On voit apparaître des catégories de patients à qui on a prescrit ces médicaments pour soigner des douleurs" et qui, devenus dépendants, se retrouvent hospitalisés pour une surdose ou un syndrome de sevrage, décrit-elle. Il s'agit en majorité de femmes, souvent âgées de plus de 60 ans. Celle qui a coordonné le rapport de l'ANSM estime que l'enjeu réside désormais dans une meilleure sécurisation de l'utilisation des antalgiques opioïdes, "sans restreindre leur accès aux patients qui en ont besoin". Depuis juillet 2017, tous les opioïdes faibles sont soumis à prescription médicale. La codéine était effectivement jusqu'alors en vente libre sous forme de sirops contre la toux et de comprimés faiblement dosés. Les opioïdes forts, eux, nécessitent une ordonnance sécurisée. Lire aussi. Une meilleure information des patients et des alternatives préconisées. Les opioïdes sont des médicaments qui présentent les mêmes propriétés que l'opium. Parmi les opioïdes faibles, il est possible de citer le tramadol, la codéine ou les médicaments contenant de la poudre d'opium, comme le Lamaline. Les opioïdes forts eux, ne sont autres que la morphine l'oxycodone ou le fentanyl. Entre 2006 et 2017, la prescription d’opioïdes forts a augmenté d’environ 150 %. La consommation globale des opioïdes faibles est de son côté restée relativement stable. Les femmes de plus de 60 ans les plus exposées à la dépendance.

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