Lucas O Maia1, Dimitri Daldegan-Bueno2, Benedikt Fischer3,4,5,6. 1. Centre for Applied Research in Mental Health and Addiction, SFU Faculty of Health Sciences, Simon Fraser University, 515 W. Hastings Street, V6B 5K3, Vancouver, BC, Canada. 2. Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, 1023, Grafton, Auckland, New Zealand. 3. Centre for Applied Research in Mental Health and Addiction, SFU Faculty of Health Sciences, Simon Fraser University, 515 W. Hastings Street, V6B 5K3, Vancouver, BC, Canada. bfischer@sfu.ca. 4. Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, 1023, Grafton, Auckland, New Zealand. bfischer@sfu.ca. 5. Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, ON, Canada. bfischer@sfu.ca. 6. Department of Psychiatry, Federal University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, 05403-903, São Paulo, Brazil. bfischer@sfu.ca.
Abstract
BACKGROUND: Global opioid consumption increased multifold post-2000, disproportionately in high-income countries, with severe mortality/morbidity consequences. Latin America features comparatively low opioid availability; Brazil, the region's most populous country, makes an interesting case study concerning opioid use/harms. In this comprehensive overview, we aimed to identify and summarize medical and non-medical data and indicators of opioid availability and use, regulation/control, and harm outcomes in Brazil since 2000. METHODS: We searched multiple scientific databases to identify relevant publications and conducted additional 'grey' literature searches to identify other pertinent information. RESULTS: Despite some essential indicators, opioid-related data are limited for Brazil. Data indicate that population-level availability of prescription opioids represents only a small fraction of use in comparison to high-income countries. However, within Latin America, Brazil ranks mid-level for opioid consumption, indicating relatively moderate consumption compared to neighboring jurisdictions. Brazil has implemented restrictive regulations to opioid prescribing and is considered 'highly restricted' for opioid access. Codeine remains the major opioid analgesic utilized, but stronger opioids such as oxycodone are becoming more common. Professional knowledge regarding medical opioid use and effects appears limited. National surveys indicate increases in non-medical use of prescription opioids, albeit lower than observed in North America, while illicit opioids (e.g., heroin) are highly uncommon. CONCLUSIONS: Overall population-level opioid availability and corresponding levels of opioid-related harms in Brazil remain substantially lower than rates reported for North America. However, the available surveillance and analytical data on opioid use, policy/practice, and harms in Brazil are limited and insufficient. Since existing and acute (e.g., pain-related) needs for improved opioid utilization and practice appear to be substantiated, improved indicators for and understanding of opioid use, practice, and harms in Brazil are required.
BACKGROUND: Global opioid consumption increased multifold post-2000, disproportionately in high-income countries, with severe mortality/morbidity consequences. Latin America features comparatively low opioid availability; Brazil, the region's most populous country, makes an interesting case study concerning opioid use/harms. In this comprehensive overview, we aimed to identify and summarize medical and non-medical data and indicators of opioid availability and use, regulation/control, and harm outcomes in Brazil since 2000. METHODS: We searched multiple scientific databases to identify relevant publications and conducted additional 'grey' literature searches to identify other pertinent information. RESULTS: Despite some essential indicators, opioid-related data are limited for Brazil. Data indicate that population-level availability of prescription opioids represents only a small fraction of use in comparison to high-income countries. However, within Latin America, Brazil ranks mid-level for opioid consumption, indicating relatively moderate consumption compared to neighboring jurisdictions. Brazil has implemented restrictive regulations to opioid prescribing and is considered 'highly restricted' for opioid access. Codeine remains the major opioid analgesic utilized, but stronger opioids such as oxycodone are becoming more common. Professional knowledge regarding medical opioid use and effects appears limited. National surveys indicate increases in non-medical use of prescription opioids, albeit lower than observed in North America, while illicit opioids (e.g., heroin) are highly uncommon. CONCLUSIONS: Overall population-level opioid availability and corresponding levels of opioid-related harms in Brazil remain substantially lower than rates reported for North America. However, the available surveillance and analytical data on opioid use, policy/practice, and harms in Brazil are limited and insufficient. Since existing and acute (e.g., pain-related) needs for improved opioid utilization and practice appear to be substantiated, improved indicators for and understanding of opioid use, practice, and harms in Brazil are required.
Entities:
Keywords:
Brazil; Harms; Latin America; Non‐medical use; Opioids; Pain; Policy; Public health; Regulation
Authors: Noa Krawczyk; Pedro Luis do Nascimento Silva; Raquel B De Boni; Jurema Mota; Mauricio Vascncellos; Neilane Bertoni; Carolina Coutinho; Francisco I Bastos Journal: Glob Public Health Date: 2019-06-13
Authors: Gery P Guy; Kun Zhang; Michele K Bohm; Jan Losby; Brian Lewis; Randall Young; Louise B Murphy; Deborah Dowell Journal: MMWR Morb Mortal Wkly Rep Date: 2017-07-07 Impact factor: 17.586
Authors: João Batista Santos Garcia; Maria Patricia Gomez Lopez; Guilherme Antonio Moreira Barros; Héctor G Molina Muñiz; Marisol Ahumada Olea Ahumada Olea; Patricia Bonilla; Elizabeth Díaz Pérez de Valtolina; Daniel Neves Forte; María Del Rocío Guillén Nuñez; Bethania Martinez Del Villar; Nicolas Sarria; José Manuel Barrientos Peñaloza; Durval Campos Kraychete; Eduardo Grossmann; André Filipe Junqueira Dos Santos; Debora Brigitte Martineau Arteaga; Manoel Jacobsen Teixeira Journal: Pain Rep Date: 2019-05-21
Authors: L Sathish Kumar; Sidheswar Routray; A V Prabu; S Rajasoundaran; V Pandimurugan; Amrit Mukherjee; Mohammed S Al-Numay Journal: Cluster Comput Date: 2022-08-23 Impact factor: 2.303