Global disparities persist in opioid painkiller access
Date:
March 31, 2022
Source:
University College London
Summary:
Global opioid sales increased by an estimated 4% annually from
2015 to 2019, but massive disparities in access to essential pain
relief medications persist between countries, a new study finds.
FULL STORY ========================================================================== Global opioid sales increased by an estimated 4% annually from 2015
to 2019, but massive disparities in access to essential pain relief
medications persist between countries, finds a study led by UCL
researchers.
========================================================================== Opioid use in some countries in Africa and South America was less than
one tenth of 1% of the rates in wealthier countries in North America,
Europe and Australia, according to the findings published in The Lancet
Public Health.
Some countries are starting to catch up, as the overall picture is one
of gradual geographic convergence in opioid consumption.
North America has seen a decline in opioid use, likely the result of
efforts to reduce inappropriate prescribing to curb deadly opioid misuse,
so multiple European countries, led by Switzerland, Germany, and Spain,
have surpassed the United States in opioid sales.
Lead author Dr Wallis Lau (UCL School of Pharmacy) said: "We found that
while there is some improvement in a lot of countries, there are still concerningly low rates of opioid use in large parts of the world, even
in numerous middle- income countries.
"Opioids have been listed by the World Health Organization as an essential class of medicine for acute pain, cancer-related pain, and palliative
care since 1977, so it is troubling that in many parts of the world,
people are unable to access this medicine. There is an urgent need to
tackle the global gap in opioid access.
========================================================================== "Some countries have low opioid analgesic consumption despite a high
cancer prevalence, which could suggest inadequate access to opioid
analgesics as much- needed pain control." The researchers analysed
the global pharmaceutical sales data of 66 countries or regions from
the IQVIA-Multinational Integrated Data Analysis System database on
opioid analgesics (painkillers) between 2015 and 2019. This included medications such as morphine and codeine, and included both prescription
and over-the-counter medications.
They found that across the surveyed countries, opioid analgesic sales
increased from 27.52 milligram morphine equivalent per 1,000 inhabitants
per day in 2015, to 29.51 in 2019.
The highest rate was found in Canada, at 988 MME per 1,000/day, which
had gone down from 1,581 in 2015.
For comparison, the UK rate was at 639 MME per 1,000/day, a slight
decline from 2015.
==========================================================================
At the other end of the scale, a group of 12 West African countries
reported only 0.01 MME per 1,000/day, while a few other countries,
including three in South America, also reported rates below 1 MME per 1,000/day.
The researchers say the disparities go beyond factors such as wealth,
overall healthcare network quality, or cancer rates, as there are
differences in attitudes of doctors and patients towards the use of opioid
pain killers. Some relatively wealthy countries such as the United Arab Emirates and Saudi Arabia reported very low rates, at 0.79 and 1.24, respectively, while some countries like Kazakhstan reported low rates
of opioid consumption (5.4) despite high cancer prevalence or cancer
death rates.
Opioid consumption rates did increase across the study period in most
areas that reported low use, including Eastern Europe, Asia, and South
America, but not in Africa.
Joint senior author Professor Ian Wong (UCL School of Pharmacy and
University of Hong Kong) said: "These findings reinforce the need to
recognise palliative care and pain relief as a global public health
priority. In countries that already have good access to opioid analgesics,
it is important to avoid opioid misuse and overprescribing, without
leaving patients undertreated." First author, PhD student Chengsheng Ju
(UCL School of Pharmacy) said: "Our data calls for global policies to
improve the integration of palliative care and pain relief provision
into healthcare systems, as well as the promotion of end-of-life care
education and staff training."
========================================================================== Story Source: Materials provided by University_College_London. Note:
Content may be edited for style and length.
========================================================================== Journal Reference:
1. Chengsheng Ju, Li Wei, Kenneth K C Man, Zixuan Wang, Tian-Tian Ma,
Adrienne Y L Chan, Ruth Brauer, Celine S L Chui, Esther W Chan,
Yogini H Jani, Yingfen Hsia, Ian C K Wong, Wallis C Y Lau. Global,
regional, and national trends in opioid analgesic consumption
from 2015 to 2019: a longitudinal study. The Lancet Public Health,
2022; 7 (4): e335 DOI: 10.1016/S2468-2667(22)00013-5 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/03/220331101612.htm
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