Differences in the consumption rates and regulatory barriers to the accessibility of strong opioid analgesics in Israel and St. Petersburg

Ponizovsky, Alexander M.; Пчелинцев, М. В.; Marom, Eli; Zvartau, Edwin

doi:10.1007/s00228-011-1099-z

Cited by 12 publications

(15 citation statements)

References 11 publications

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“…A longitudinal study in the United States found that baseline reporting of drinking to cope was associated with subsequent drinking problems (Holahan et al, 2001), and among persons being treated for substance use disorders, persistent pain has been associated with a lower likelihood of being abstinent of alcohol or drugs in the future (Caldeiro et al, 2008; Larson et al, 2007). Because opioids are not typically prescribed for chronic pain management in Russia (Ponizovsky et al, 2012), it is conceivable that persons with pain might be more likely to turn to a legal, culturally sanctioned substance like alcohol to treat pain and pain-related stress. Effective pain management services may prove useful to reduce unforeseen consequences like unhealthy alcohol use among HIV-infected persons.…”

Section: Discussionmentioning

confidence: 99%

“…Important differences in the management of pain exist between the United States/Western Europe and Russia. Restrictive policies toward the medical use of opioids in Russia results in opioids being less frequently prescribed for pain (Ponizovsky et al, 2012). Given that opioids are not generally prescribed for treatment of pain, it is possible that HIV-infected patients in Russia with pain might turn to other substances to relieve their pain.…”

Section: Introductionmentioning

confidence: 99%

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Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia

Tsui¹,

Cheng²,

Coleman³

et al. 2014

Drug and Alcohol Dependence

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Background Pain is highly prevalent among persons with HIV. Alcohol may be used to “self-medicate” pain. This study examined the association between pain and risky alcohol use over time in a cohort of HIV-infected Russian drinkers. Methods This secondary analysis utilized longitudinal data from a randomized trial of a behavioral intervention. Subjects included HIV-infected adults who reported past 6-month risky drinking and unprotected sex and were recruited from HIV and addiction treatment sites in St. Petersburg, Russia. The main independent variable was pain that at least moderately interfered with daily living. The primary outcome was past month risky drinking amounts based on NIAAA guidelines. General estimating equations (GEE) logistic regression models were used to calculate odds ratios and 95% confidence intervals for the association between pain and risky drinking over time (i.e., baseline, 6- and 12-months), adjusting for potential confounders. Results Baseline characteristics of participants (n=699) were mean age of 30 (SD±5) years, 41% female, and 22% < 9th grade education. Nearly one quarter (24%) had a CD4 cell count <200 cells/μ/l, and only 17% were on antiretroviral therapy. Nearly half (46%) reported at least moderate pain interference in the past month and 81% were drinking risky amounts. In adjusted longitudinal GEE models, pain was significantly associated with greater odds of reporting past month risky drinking (AOR=1.34, 95% CI: 1.05-1.71, p-value=0.02). Conclusions Among a cohort of HIV-infected Russian drinkers, pain that at least moderately interfered with daily living was associated with higher odds of reporting risky drinking amounts over time.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia

Tsui¹,

Cheng²,

Coleman³

et al. 2014

Drug and Alcohol Dependence

View full text Add to dashboard Cite

show abstract

“…The INCB is actively monitoring opioid consumption worldwide to improve and control national policies of opioid use . The aim is to provide adequate medical access to the formularies, both organizationally and legally, for those needing it while establishing effective ways to control opioid accessibility to prevent illegal trafficking …”

Section: Introductionmentioning

confidence: 99%

“…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 . 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) …”

Section: Introductionmentioning

confidence: 99%

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

Ponizovsky¹,

Marom

Weizman

et al. 2018

Pharmacoepidemiology and Drug

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The increase in opioid consumption persisted throughout the years 2009 to 2016. This has been associated with substantial changes in the patterns of prescribing opioids, characterized by increases in oxycodone and fentanyl prescriptions and decreases in morphine, methadone, and pethidine prescriptions. A national program aiming to ensure safe use of opioids in the treatment of chronic pain is warranted.

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

Bosetti

Santucci

Radrezza

et al. 2018

European Journal of Pain

103

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Background Over the last decades, consumption of opioids for the treatment of pain increased steadily in the United States, Australia, and a few European countries. To date, no study has analysed time trends in opioid consumption across Europe. Methods We analysed data provided by International Narcotics Control Boards on the consumption of fentanyl, oxycodone, morphine, hydromorphone and pethidine in 40 European countries over the last decade. Trends in total opioid consumption from 1990 to 2016 in 22 selected European countries, the European Union (EU) as a whole, and, for comparison purpose, the United States, were analysed using the joinpoint regression analysis. Results In 2014–2016, opioid use was >10,000 defined daily doses for statistical purposes (s‐DDD) per 1,000,000 inhabitants die in Western/Northern countries, whereas it was <1000 s‐DDD in Southern/Eastern ones. In most European countries, opioid consumption increased to a great extent between 2004–2006 and 2014–2016; it rose from 6,477 to 8,967 s‐DDD (+38.4%) in the EU, and from 14,598 to 16,491 s‐DDD (+13%) in the United States. The increase in opioid use was steady since the early to mid‐1990s in most European countries and it slowed down after the mid‐ to late 2000s. In Denmark, Finland, France, Ireland, Switzerland, Poland and the EU, opioid use levelled off or declined over most recent years. Conclusions Consumption of opioid analgesics sharply increased in most of European countries since the early to mid‐1990s. This notwithstanding, in the mid‐2010s there was still a more than 10‐fold difference between the highest consumption in Western/Northern countries and the lowest one in Southern/Eastern countries. Significance This study provides an updated and comprehensive analysis of time trends and geographic variations in opioid consumption use across European countries over the last three decades.

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Differences in the consumption rates and regulatory barriers to the accessibility of strong opioid analgesics in Israel and St. Petersburg

Cited by 12 publications

References 11 publications

Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia

Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia

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

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

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