(105) Rising Trends of Opioid Prescription in Brazil, 2014-2019

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 436

Presenting Author(s)

Raissa Carolina Fonseca Candido, BPharm
– MSc. , Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

Co-Author(s)

Cristiane Aparecida A. Menezes de Pádua
– Professor, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
Ana Paula Melo
– Universidade Federal de São João Del Rei, Brazil

Background: Opioids are essential medicines and both overuse and inappropriate use - in quantities below of indicated - are focus of public politics for appropriate access to opioids. In recent years, many countries have discussed about overuse and abuse of opioids. However, few studies have evaluated changes in prescribed opioid utilization in Brazil.

Objectives: To analyze consumption trends and the sales profile of opioid drugs in Brazil in a 6-year period.

Methods: We analyzed data from a national database of medicines commercialized under special control in private pharmacies. We collected data on codeine and tramadol products (including associations with paracetamol or diclofenac), fentanyl, buprenorphine, methadone, morphine, pethidine, and oxycodone. Trends and consumption profiles were assessed using the number of presentations sold and analyzed for each 27 Brazilian federative unit (FU). We calculated the changes in the prescription rates per 1,000 persons in 2014 compared to 2019. We used the Mann-Kendall trend test for analyzing trends in the prescription’s rate of single opioids presentations in the time series (2014-2019).

Results: Opioid prescriptions increased from 11,115,705 prescriptions in 2014 to 18,597,620 prescriptions in 2019 (from 54.8 to 88.5 prescriptions per 1,000 persons) in Brazil, corresponding to a 67.3% increase within the 6-year period. Among the FU the largest increase was observed in Rondônia with 52,292 prescriptions in 2014 and 655,924 prescriptions in 2019 (from 29.9 to 369.1 prescriptions per 1,000 persons) and the smallest increase was in Goiás with 741,922 prescriptions in 2014 and 857,276 prescriptions in 2019 (from 113.7 to 122.1 prescriptions per 1,000 persons). Significant changes in the prescription rates per 100,000 persons was found for fentanyl (tau=-0.732; p=0.05), buprenorphine (tau=1; p=0.003), methadone (tau=1; p=0.003), morphine (tau=1; p=0.003) and non-combined tramadol (tau=0.866; p=0.02). Increase trends were observed for all drugs, except to the fentanyl.

Conclusions: Important increases in opioid prescription rates were observed across Brazil. Our results should create awareness for the adoption of strategies of monitoring and surveillance of opioid use nationwide, to prevent overuse, and support public politics for appropriate access.