Rising Trends of Prescription Opioid Sales in Contemporary Brazil, 2009–2015

Krawczyk, Noa; Greene, M. Claire; Zorzanelli, Rafaela; Bastos, Francisco Inácio

doi:10.2105/ajph.2018.304341

Cited by 33 publications

(37 citation statements)

References 10 publications

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“…This is concerning given the rapid growth in opioid analgesic use that has occurred in the U.S over the past decade (Saha et al, 2016) and the opioid analgesic and heroin/fentanyl overdose epidemics that have followed to become a leading cause of death (Rudd, 2016). Especially alarming is this high prevalence coupled with the recent findings that reveal a dramatic increase in sales of medically prescribed opioids in pharmacies all over Brazil in recent years (Krawczyk et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…0.5-3.2) and lifetime non-prescribed use of other opioid analgesics was estimated at 1.3% (95% C.I:0.2-2.4) (Secretaria Nacional Antidrogas (SENAD), 2005), but little attention was given to these figures. Yet, new data show that prescription opioid sales have risen dramatically across Brazil, nearly quintupling in the past six years (Krawczyk, Greene, Zorzanelli, & Bastos, 2018), leading to questions of how this rise may impact the availability of these substances and subsequent misuse. The present paper presents findings from the most recent national household survey, focusing of the non-medical use of opioid analgesics.…”

Section: Introductionmentioning

confidence: 99%

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

Krawczyk

Silva

Boni

et al. 2019

Global Public Health

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Prior studies on substance use in Brazil have not focused on opioid misuse, previously thought to be nearly non-existent. This paper presents new findings on heroin and non-medical use of opioid analgesics. Data come from the 2015 Brazilian Household Survey on Substance Use (BHSU-3), a nationally representative survey estimating epidemiological parameters related to substance use by residents across Brazil. BHSU-3 used stratified multi-stage probability sampling across multiple geographic domains of interest, resulting in 16,273 interviews with household residents. Lifetime heroin use among Brazilians was 0.3 (95% C.I:0.2-0.4). Lifetime, past-year, and past-month nonmedical use of opioid analgesics were respectively 2.9 (95%C.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Krawczyk

Silva

Boni

et al. 2019

Global Public Health

Self Cite

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show abstract

“…This result puts us relatively among countries with lower use of this drug worldwide (Seya et al, 2011), although a significant increase of 465% was seen in opioid sales in Brazil during the period from 2009 to 2015, mainly due to codeine and oxycodone formulations. However, even so, we are still far from a comfortable situation (Krawczyk et al, 2018).…”

Section: Barriers For the Appropriate Pain Managementmentioning

confidence: 98%

Access to pain management for cancer patients treated under the Brazilian private healthcare system

Santos¹

2019

JBES

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Objective: To reflect about current pain management in cancer patients treated under the Brazilian Private Healthcare System, considering legal boundaries, access to essential drugs and involved ethical issues. Panelists aimed to reach a consensus about recommendations to increase access to proper analgesia for patients with cancer secondary pain. Methods: Four Brazilian specialists, being a radiation oncologist (and bioethicist), an oncologist, a pain specialist and a CEO of a private healthcare plan, met after the 2019 American Society of Clinical Oncology (ASCO) meeting, held in Chicago, and discussed the aforementioned subjects. A consensus was reached and is described below. Results: Cancer pain is prevailing in our country, probably undertreated, and may be a prevalent cause of medical services overuse, which may increase healthcare costs. Thus, there may be an opportunity to improve patient's quality of life, with a positive budget impact for private healthcare plans, if this treatment becomes mandatorily reimbursed. There are several studies in the literature showing similar results, but this should be prospectively studied, preferable using real word evidence, at the Brazilian scenario. Cancer pain treatment protocols, designed by specialists, should be designed in agreement with all stakeholders. Conclusion: Panelists agreed that pain treatment, which must be considered a human right, is a clear priority in Brazil. All stakeholders should collaborate in designing protocols to improve patient's quality of life, consequently improving health insurance's budgets. If so, this would have clear consequences in access to innovative cancer treatments, as those discussed during the 2019 ASCO meeting. RESUMO Objetivo: Refletir sobre o manejo atual da dor em pacientes com câncer atendidos no sistema de saúde privado brasileiro, considerando limites legais, acesso a medicamentos essenciais e questões éticas envolvidas. Os participantes do painel procuraram chegar a um consenso sobre recomendações para aumentar o acesso à analgesia adequada para pacientes com dor secundária ao diagnóstico de câncer. Métodos: Quatro especialistas brasileiros reuniram-se após a reunião da Sociedade Americana de Oncologia Clínica (ASCO) de 2019, realizada em Chicago, e discutiram os mencionados assuntos. Um consenso foi alcançado e é descrito abaixo. Resultados: A dor oncológica prevalece em nosso país, provavelmente subtratada, e pode ser uma causa predominante de uso excessivo de serviços médicos, o que pode aumentar os custos com saúde. Assim, pode haver uma oportunidade de melhorar a qualidade de vida do paciente, com um impacto orçamentário positivo para planos de saúde privados, se esse tratamento for obrigatoriamente reembolsado. Existem vários estudos na literatura que mostram resultados semelhantes, mas isso deve ser estudado prospectivamente, preferencialmente usando evidências provenientes de dados de mundo real, no cenário brasileiro. Os protocolos de tratamento da dor do câncer, preparados por especialistas, devem ser elab...

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“…[1][2][3] For example, in Brazil, while the drug monitoring program has been successful at keeping opioid prescriptions low, 4 the sales of prescription opioids still increased by more than 450% between 2009 and 2015. 5 The opioid epidemic is especially significant in the United States, where opioid overdose deaths account for more than 60% of all drug overdose deaths. 6 In addition, 40% of the opioid overdose deaths are due to prescription opioids.…”

Section: Introductionmentioning

confidence: 99%

Analysis of psychiatrists’ prescription of opioid, benzodiazepine, and buprenorphine in Medicare Part D in the United States

Pan

Silver

Davis³

2020

Trends Psychiatry Psychother.

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Introduction: The opioid epidemic is a severe problem in the world, especially in the United States, where prescription opioid overdose accounts for a quarter of drug overdose deaths. Objective: To describe psychiatrists' prescription of opioid, benzodiazepine, and buprenorphine in the United States. Methods: We conducted a retrospective cross-sectional study of the 2016 Medicare Part D claims data and analyzed psychiatrists' prescriptions of: 1) opioids; 2) benzodiazepines, whose concurrent prescription with opioids can cause overdose death; 3) buprenorphine, a partial opioid agonist for treating opioid addiction; 4) and naltrexone microsphere, a once-monthly injectable opioid antagonist to prevent relapse to opioid dependence. Prescribers with 11 or more claims were included in the analysis.

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Rising Trends of Prescription Opioid Sales in Contemporary Brazil, 2009–2015

Cited by 33 publications

References 10 publications

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

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

Access to pain management for cancer patients treated under the Brazilian private healthcare system

Analysis of psychiatrists’ prescription of opioid, benzodiazepine, and buprenorphine in Medicare Part D in the United States

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