Consumption of three strong opioids (morphine, oxycodone and fentanyl) in seven European countries during seven years (2003–2009)

Abstract

The aim was to analyse the consumption of selected strong opioid analgesics during a seven-year period of 2003-2009 in order to compare Slovak consumption with that in six other European countries and to determine our position. Methods: Drug consumption data from the State Institute for Drug Control in Slovak Republic were used. As to the data from other countries, annual health statistics published on websites were used in comparison. Results: Obviously the consumption of one of studied opioid drugs with transdermal aplication route, particularly fentanyl, tended to increase in all countries during the observed period. Oxycodone tends to yield a rapid increase in consumption as well. As opposed to the latter drugs, the consumption of morphine was decreasing throughout the observed period. The consumption of these drugs in Slovakia remains low (except for that of fentanyl). Conclusion: Our analysis confi rmed a clear shift from oral to transdermal therapy as well as usage of newer drugs. Drug consumption data are a relatively new source of information for health research. Our analysis showed increasing trends in fentanyl (patch opioid) consumption in all compared countries as well as an increasing consumption of oxycodone and decreasing consumption of morphine (Fig. 3, Ref. 17).

Trends in the consumption of opioids for the treatment of severe pain in Europe, 1990–2016

“…With reference to single opioid analgesics, fentanyl is the most frequent used opioid in most of Europe and increased consumption of this analgesic has largely contributed to the rises in total opioid consumption, particularly since the early 2000s. Its easy administration and patients’ compliance, along with strong marketing of transdermal use, can explain such an increase (Chinellato et al., ; Garcia del Pozo et al., ; Hamunen et al., ; Hudec et al., ).…”

“…Disparities in the availability of opioid analgesics exist not only between high and low‐income regions of the world, but also within high‐income regions, such as Europe (Berterame et al., ; Hastie et al., ; International Narcotics Control Board ). Although several studies have reported patterns in opioid use in specific European countries (Chenaf et al., ; Chinellato, Skaper, Giusti, & Debetto, ; De Conno, Ripamonti, & Brunelli, ; Garcia del Pozo, Carvajal, Viloria, Velasco, & Garcia del Pozo, ; Hamunen, Paakkari, & Kalso, ; Hudec, Tisonova, Foltan, & Kristova, ; Just, Mucke, & Bleckwenn, ; Krnic et al., ; Neutel, Skurtveit, Berg, & Sakshaug, ; Zin, Chen, & Knaggs, ), no study has focused on the trend of opioid consumption over time and the comparison of opioid consumption across all European countries.…”

Changes in consumption of opioid analgesics in Israel 2009 to 2016: An update focusing on oxycodone and fentanyl formulations

“…Changing patterns of opioid prescription in severe pain management, characterized by increased use of fentanyl and oxycodone and decreasing use of morphine, has been reported in several other countries . This phenomenon has occurred in the absence of any data demonstrating superior therapeutic indices for the newer fentanyl and oxycodone formulations over morphine, with the exception of transmucosal fentanyl in breakthrough pain and Targin for postoperative pain therapy .…”

“…3 Changing patterns of opioid prescription in severe pain management, characterized by increased use of fentanyl and oxycodone and decreasing use of morphine, has been reported in several other countries. [9][10][11][12][13][14] This phenomenon has occurred in the absence of any data demonstrating superior therapeutic indices for the newer fentanyl and oxycodone formulations over morphine, with the exception of transmucosal fentanyl in breakthrough pain 25 and Targin for postoperative pain therapy. 26 It is important to note that in the USA, the volume of prescribing immediate-release opioids far exceeds that of extendedrelease opioids, 27,28 whereas in our study, we observed an opposite pattern of prescribing more extended-release opioids than immedi-…”

“…8 Pharmacoepidemiological studies show that the overall consumption of opioid analgesics for severe pain management has increased significantly worldwide over the last 30 years, although there are still substantial differences between the developed and the developing countries. [9][10][11][12][13][14][15] For example, a recent comprehensive survey of medical opioid availability and accessibility in Middle East countries (Egypt, Yemen, Israel, Qatar, Saudi Arabia, Algeria, Iran, Morocco, Syria, Afghanistan, Iraq, Lebanon, Libya, the OPT, and Tunisia) found that with the exception of Israel, opioid availability was low because of deficiencies in opioid formularies and restricted access resulting from widespread over-regulation across the region. 9 A similar situation has been observed in the Russian Federation as well, where because of pervasive over-regulation, accessibility to opioid analgesics is low (compared to Israel).…”