Non-medical use of opioid analgesics in contemporary Brazil: Findings from the 2015 Brazilian National Household Survey on Substance Use

Krawczyk, Noa; Silva, Pedro Luis do Nascimento; Boni, Raquel Brandini De; Mota, Jurema Corrêa da; Vascncellos, Mauricio; Bertoni, Neilane; Coutinho, Carolina; Bastos, Francisco Inácio

doi:10.1080/17441692.2019.1629610

Cited by 12 publications

(10 citation statements)

References 20 publications

(22 reference statements)

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“…Another report interviewed 8,589 Brazilians citizens aged between 12 and 65 years old, and the prevalence of opioid use was only 1.4% ( Galduróz and Cebrid, 2003 ). Finally, the latest report on opioid use in Brazil observed an increased prevalence when compared to previous years, nearly 2.9% of the individuals surveyed stated that they had used opioids at least once in their lives ( Krawczyk et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Opioids in COVID-19: Two Sides of a Coin

et al. 2022

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Introduction: The treatment of most severe COVID-19 patients included the large-scale use of sedatives and analgesics–possibly in higher doses than usual–which was reported in the literature. The use of drugs that decrease mortality is necessary and opioids are important agents in procedures such as orotracheal intubation. However, these drugs seem to have been overestimated in the COVID-19 pandemic. We performed a review of the PubMed-Medline database to evaluate the use of opioids during this period. The following descriptors were used to enhance the search for papers: “Opioids”, “COVID-19,” “COVID-19 pandemic,” “SARS-CoV-2,” “Opioid use disorder,” “Opioid dependence” and the names of the drugs used. We also evaluated the distribution of COVID-19 patients in Brazil and the applicability of opioids in our country during the COVID-19 pandemic.Results: Several positive points were found in the use of opioids in the COVID-19 pandemic, for instance, they can be used for analgesia in orotracheal intubation, for chronic pain management, and as coadjutant in the management of acute intensification of pain. However, high doses of opioids might exacerbate the respiratory depression found in COVID-19 patients, their chronic use can trigger opioid tolerance and the higher doses used during the pandemic might result in greater adverse effects. Unfortunately, the pandemic also affected individuals with opioid use disorder, not only those individuals are at higher risk of mortality, hospitalization and need for ventilatory support, but measures taken to decrease the SARS-CoV-2 spread such as social isolation, might negatively affect the treatment for opioid use disorder. In Brazil, only morphine, remifentanil and fentanyl are available in the basic health care system for the treatment of COVID-19 patients. Out of the 5,273,598 opioid units used in this period all over the country, morphine, fentanyl, and remifentanil, accounted for, respectively, 559,270 (10.6%), 4,624,328 (87.6%), and 90,000 (1.8%) units. Many Brazilian regions with high number of confirmed cases of COVID-19 had few units of opioids available, as the Southeast region, with a 0.23 units of opioids per confirmed COVID-19 case, and the South region, with 0.05 units. In the COVID-19 pandemic scenario, positive points related to opioids were mainly the occurrence of analgesia, to facilitate intubation and their use as coadjutants in the management of acute intensification of pain, whereas the negative points were indiscriminate use, the presence of human immunosuppressor response and increased adverse effects due to higher doses of the drug.Conclusion: The importance of rational and individualized use of analgesic hypnotics and sedative anesthetics should be considered at all times, especially in situations of high demand such as the COVID-19 pandemic.

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Section: Resultsmentioning

confidence: 99%

Opioids in COVID-19: Two Sides of a Coin

et al. 2022

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“…Native individuals living in indigenous villages, persons deprived of liberty, and individuals with physical or mental disabilities that precluded answering the interview questions were not eligible. [16][17][18][19] Details regarding sampling, questionnaires, data collection, data entry, and handling of non-response are fully available elsewhere. 20…”

Section: Methodsmentioning

confidence: 99%

Underage drinking in Brazil: findings from a community household survey

Rakovski

Cardoso

Mota

et al. 2022

Braz. J. Psychiatry

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Objectives: Previous studies have estimated the 30-day prevalence of alcohol use to be approximately 21% among youth in Brazil, despite the legal drinking age of 18 years. The present study aimed to determine the prevalence of underage drinking and its associated factors among adolescents in Brazil. Methods: The 3rd National Survey on Drug Use by the Brazilian Population (III Levantamento Nacional sobre o Uso de Drogas pela Populac¸a ˜o Brasileira) is a nationwide, multi-stage, probabilitysample household survey. Herein, youth between the ages of 12-17 years were included. Lifetime and 12-month alcohol use prevalence were estimated. Factors associated with 12-month alcohol use were evaluated through multivariate analysis considering survey weights and design. Results: Overall, 628 youth were interviewed. Estimated lifetime and 12-month alcohol use were 34.3% (standard error [SE] = 1.9) and 22.2% (SE = 1.7), respectively. Factors associated with 12-month drinking were: other/no religion vs. Christianity; living in rural vs. urban areas; self-reported diagnosis of depression vs. no self-reported depression; lifetime tobacco use vs. no history of tobacco use; and any illicit drug use vs. no history of illicit drug use. Conclusion:Considering that alcohol use is a major risk factor for early death among Brazilian youth, our findings highlight the importance of preventative measures to reduce underage drinking.

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“…Individuals were interviewed face-to-face by trained interviewers after signing the informed consent/assent form. The study was approved by the institutional review board of the Escola Politécnica Joaquim Venâncio-Fiocruz (CAAE # 35283814.4.0000.5241) 4,[20][21][22][23][24] .…”

Section: Methodsmentioning

confidence: 99%

Would the Brazilian population support the alcohol policies recommended by the World Health Organization?

et al. 2022

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OBJECTIVE To evaluate the support of the Brazilian population to the alcohol-policies proposed by the World Health Organization to decrease alcohol harm (specifically: to decrease alcohol availability and advertising, and to increase pricing). In addition, we evaluated the factors associated with being against those policies. METHODS Data from 16,273 Brazilians, aged 12–65 years, interviewed in the 3rd Brazilian Household Survey on Substance Use (BHSU-3) were analyzed. The BHSU-3 is a nationwide, probability survey conducted in 2015. Individuals were asked if they would be against, neutral, or in favor of seven alcohol policies grouped as: 1) Strengthen restrictions on alcohol availability; 2) Enforce bans or restrictions on alcohol advertising, sponsorship, and promotion; and 3) Raise prices on alcohol through excise taxes and pricing. Generalized linear models were fitted to evaluate factors associated with being against each one of those policies and against all of policies. RESULTS Overall, 28% of the Brazilians supported all the above mentioned policies, whereas 16% were against them. The highest rate of approval refers to restricting advertising (53%), the lowest refers to increasing prices (40%). Factors associated with being against all policies were: being male (AOR = 1.1; 95%CI: 1.0–1.3), not having a religion (AOR = 1.4; 95%CI: 1.1–1.8), being catholic (AOR = 1.3; 95%CI: 1.1–1.5), and alcohol dependence (AOR = 1.6; 95%CI: 1.1–2.4). CONCLUSIONS The Brazilian government could count on the support of most of the population to restrict alcohol advertising. This information is essential to tackle the lobby of the alcohol industry and its clever marketing strategy.

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Non-medical use of opioid analgesics in contemporary Brazil: Findings from the 2015 Brazilian National Household Survey on Substance Use

Cited by 12 publications

References 20 publications

Opioids in COVID-19: Two Sides of a Coin

Opioids in COVID-19: Two Sides of a Coin

Underage drinking in Brazil: findings from a community household survey

Would the Brazilian population support the alcohol policies recommended by the World Health Organization?

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